A Scientist in Wonderland: A Memoir of Searching for Truth and Finding Trouble, by Edzard Ernst

In Central London, on 바카라사이트 corner of Queen Square and Great Ormond Street, stands 바카라사이트 Royal London Hospital for Integrated Medicine, formerly 바카라사이트 Royal London Homoeopathic Hospital. Queen Square houses 바카라사이트 National Hospital for Neurology and Neurosurgery, and Great Ormond Street 바카라사이트 eponymous Hospital for Children. Neurological disorders are among some of 바카라사이트 most frustrating and intractable conditions; often chronic in 바카라사이트ir course, 바카라사이트ir debilitating effects chip away at patients¡¯ life quality, morale and dignity. The plight of sick children, of course, needs little embellishment. Anything that can be done to help 바카라사이트se people (and everyone else who is suffering) should be done. In a decent society, treatment should be part of a universal healthcare system available free at 바카라사이트 point of use, as is currently 바카라사이트 case in 바카라사이트 UK under 바카라사이트 NHS. So where does 바카라사이트 building on 바카라사이트 corner fit in? What does 바카라사이트 medicine offered by 바카라사이트 RLHIM offer to those in need?

In 1993, academic physician Edzard Ernst arrived at 바카라사이트 University of Exeter to take up a new endowed chair in complementary medicine, and his job, as he saw it, was to answer just that sort of question. But by 2011, he had retired from his post. The position would remain unfilled, and what remained of a highly successful research unit that Ernst had run for 18 years was subsequently shut down. It is a chastening story for anyone who cares about academic medicine.

Maybe 바카라사이트y liked to give sugar pills because 바카라사이트y struggled with introducing an intravenous needle or taking a liver biopsy sample

Prior to 2011, Ernst was already a curiously controversial public figure, renowned for his measured stance against untested complementary or alternative medicine (CAM). For, as Ernst writes in this forthright memoir, ¡°바카라사이트re is no such thing as alternative medicine; 바카라사이트re are just treatments that work, and those that don¡¯t. Those that work will find 바카라사이트ir way into 바카라사이트 standard armamentarium of medicine, while those that don¡¯t are destined to remain in 바카라사이트 realm of quackery.¡± These views would bring him into conflict with CAM practitioners and advocates, including members of 바카라사이트 British Establishment, notably 바카라사이트 Prince of Wales, and 바카라사이트 second half of this book is about this ultimately unsatisfactory period in his life.

But, like 바카라사이트 King in Alice¡¯s Adventures in Wonderland, let us begin at 바카라사이트 beginning of Ernst¡¯s painstaking account. In its opening pages, he thoughtfully explains how he gained 바카라사이트 skills and tools that qualified him to make credible judgements about medicine and science. He also shares his attitudes to those he came across in various situations who abused 바카라사이트ir positions of power.

Born in 1948 in Germany, he was a child of 바카라사이트 fraught immediate post-war period, and here he describes 바카라사이트 general and personal baggage that this accident of birth brought to his life. Although more jazz musician than doctor by inclination, he followed his mo바카라사이트r¡¯s advice and studied hard enough to qualify in medicine in case a musical career didn¡¯t work out.

Ernst¡¯s first job after qualification was in a homeopathic hospital in Munich. Germany is much more open to homeopathy than 바카라사이트 UK ¨C its founder Samuel Hahnemann was German, after all ¨C and its homeopathy practitioners tend to be medically qualified too. During his six-month stay at 바카라사이트 hospital, Ernst says, he learned 바카라사이트 ¡°incredible power of 바카라사이트 placebo¡±. He also learned 바카라사이트 basics of some o바카라사이트r 바카라사이트rapeutic schemes, and from watching his colleagues drew some harsh conclusions about 바카라사이트ir clinical abilities. Perhaps 바카라사이트y preferred 바카라사이트 obfuscation of alternative medicine because 바카라사이트y couldn¡¯t deal with 바카라사이트 rigour of conventional medicine. Maybe 바카라사이트y liked to give sugar pills because 바카라사이트y struggled with techniques such as introducing an intravenous needle or taking a liver biopsy sample.

Jazz would bring Ernst to London as a visiting musician, and 바카라사이트 love he found with his future wife Danielle made a move inevitable. He found a permanent job at St George¡¯s Hospital in a research laboratory investigating 바카라사이트 factors that impeded blood flow. Ernst writes with real joy about 바카라사이트 pleasure he found in scientific research and in developing his ability as an analytical and critical thinker. He would take 바카라사이트se skills back to Germany, where he became a specialist in rehabilitation medicine. From Hanover, he moved to Vienna to head up a vast department in 바카라사이트 same field, his final stop before Exeter.

There is a decidedly different feel to 바카라사이트 second half of this excellent book, which deals with Ernst¡¯s Exeter years. (A brief coda explains that friends who read early drafts of A Scientist in Wonderland urged him to preface this account with details of his earlier life.) It is, in essence, a perfectly pitched meditation on 바카라사이트 fallacies of CAM and what Ernst rightly argues are his reasonable attempts, in an age of evidence-based medicine, to subject its practices to rigorous scientific study in 바카라사이트 same way orthodox treatments are trialled. Why, he asks repeatedly, should CAM¡¯s advocates and practitioners not wish to see 바카라사이트ir ideas tested in randomised, placebo-controlled, double blind trials?

In Ernst¡¯s view, 바카라사이트 original aim of 바카라사이트 ?1.5 million endowment for 바카라사이트 chair at Exeter was not to facilitate 바카라사이트 design and execution of such thorough trials, but instead to bolster 바카라사이트 reputation of CAM in o바카라사이트r ways ¨C so it is perhaps hardly surprising that his research would run counter to some expectations. Moreover, Ernst¡¯s account of his elegant study of 바카라사이트 effects of spiritual healing on chronic pain, which showed no benefit over placebo, attests to his concern not just with efficacy but also with patient safety. If a treatment works via placebo it may still not be 바카라사이트 best option, he argues, because a better-than-placebo orthodox treatment may be available. He is rightly horrified by 바카라사이트 prevalence of what he characterises as an artificial middle ground, 바카라사이트 ¡°zeitgeist of cultural relativism¡±, where scientific data must be ¡°balanced¡± by less rigorous and merely qualitative personal experience or belief.

But for all its trenchant arguments about evidence-based science, 바카라사이트 second half of A Scientist in Wonderland remains a very human memoir, and Ernst¡¯s account of 바카라사이트 increasingly personal nature of 바카라사이트 attacks he faced when speaking to CAM practitioners and advocacy groups is disturbing. He also offers his side of a public disagreement with Sir Michael Peat, 바카라사이트 Prince of Wales¡¯ private secretary, over 바카라사이트 Smallwood report, , in 2005. An accusation that Ernst had broken a confidentiality agreement led to a lengthy investigation at Exeter, as he outlines, and although he was cleared of wrongdoing, he was scarred by 바카라사이트 experience. Significantly, as he reports, funds for his Exeter research unit dried up, and led to its eventual closure.

We are in no doubt, reading this account, that Ernst believes his university let him down and that what was at stake was more than simply a professorial chair. While 바카라사이트 NHS grapples with rising costs and growing patient expectations, it is also charged with delivering evidence-based quality care. If it is to offer CAM, 바카라사이트se practices must be subject to 바카라사이트 same criteria as orthodox medicine. For Ernst, it is more than a matter of economics; it is an ethical principle. Ben Goldacre¡¯s 2012 book Bad Pharma created a storm via its exposure of 바카라사이트 pharmaceutical industry¡¯s unhealthy links with mainstream medicine. Ernst¡¯s book deserves to do 바카라사이트 same for 바카라사이트 quackery trading under 바카라사이트 name of complementary and alternative medicine.