Illness QI XL


Illness

Stephen Fry investigates Illness with Jo Brand, Ben Goldacre, Andy Hamilton and Alan Davies.


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Transcript


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APPLAUSE AND CHEERING

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Good evening, good evening, good evening, good evening.

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And welcome to QI, in my breeziest and most patronising bedside manner,

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for a show that's all about illness, infection and injury.

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Joining me in Casualty are the slightly indisposed Andy Hamilton.

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-APPLAUSE

-Thank you. Thank you.

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The disturbingly insidious Ben Goldacre.

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APPLAUSE

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The seriously infectious Jo Brand.

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APPLAUSE

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-And the terminally ill-informed Alan Davies.

-Thank you.

-APPLAUSE

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And, to tell you the truth, their buzzers don't sound so hot.

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-Andy goes...

-COUGHING

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-Ben goes...

-SNEEZING

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-Jo goes...

-SIREN WAILS

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-And Alan goes...

-THE FUNERAL MARCH

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And...don't forget, of course, that you have your Nobody Knows jokers.

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-FANFARE 'Nobody knows!'

-Yes.

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In this series, the answer may well be "Nobody knows".

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If you guess which question that is, you can get extra points.

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Before we start, I have to ask you all to fill in this questionnaire.

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It's on the Epworth Sleepiness Scale. It's about how likely you are to fall asleep

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under certain circumstances and whether you have a healthy sleep cycle.

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You're all concentrating very hard! Well, you were...

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-Jo has fallen asleep.

-Filling in questionnaires!

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-Yes, that's the one that makes you fall asleep.

-Finished!

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Have you really? Well done. I'm very impressed.

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I've always filled in questionnaires quickly. I think if you finish first, you get marks somehow.

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-You better put your name on them.

-Oh, who hasn't put their name on their work?!

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-I'm feeling more than usual like a schoolmaster.

-Jo...Brand.

-LAUGHTER

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-I feel that men fall asleep more somehow. Do you cat nap during the day?

-Only during sex.

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-Fair enough.

-When you're watching sex or doing sex?

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Either. I don't really mind.

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It is one of the afflictions of getting old, I fear, falling asleep.

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While you sleep, we'll be playing QI.

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The first question is why would you swallow a pill made of a poisonous metalloid?

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-SIREN WAILS

-Yes?

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Would it be because you got really pissed one night and you woke up

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and realised you were next to Michael Winner in bed?

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Well, oddly enough,

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until you got to that last point, one use of that poisonous metalloid was as a morning after pill.

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But its other use was for the other end.

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It's a metalloid called antimony and it's a poison.

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It was popular in the Middle Ages as a pill. Very good for constipation.

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You'd make a pill of antimony and it would pass through the body.

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You would then rummage through your leavings and wash it and use it again.

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-GROANS

-"Rummage through your leavings."

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LAUGHTER

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-I wasn't quite sure how to put it.

-I'm certainly going to use that again, though!

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These got handed on from father to son, through generations. They used the same one.

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Your father's leavings and his father's leavings before.

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-"This pill was good enough for your great-grandfather..."

-The earliest repeat prescription.

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-Very good!

-For hundreds of years.

-APPLAUSE

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Absolutely. The other use of it was an antimony cup.

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You'd pour wine into it overnight, when you'd had a large evening, and in the morning

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you'd take the wine from the cup and it made you vomit instantly. So it was used as an emetic.

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-So it's a naturally occurring... thing?

-An element.

-And an irritant, presumably?

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There's a mnemonic for remembering laxatives - bulkers, lubricants, irritants, softeners and explosives.

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Explosives work like...cholera.

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You stick them up your bum. That's a technical term.

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A suppository, as we comedians say.

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-So that's for a really serious case of being stuffed up.

-Yeah.

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-Proper phosphate enema. Rocket fuel.

-Wow.

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-On a skateboard.

-In Ancient Egypt,

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there was a doctor whose special function was to administer enemas to the pharaoh - the neru phuyt,

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which literally translates as "shepherd of the anus".

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-An official job. Rather pleasing.

-With the crook?

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Oh!

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It's not a natural thing. Animals don't pump warm water up their arses. It doesn't happen in nature.

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-How did it come about?

-They are very popular with quacks.

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There's something quite attractive about how transgressive it is to squirt something up your bum

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-that makes pretend doctors feel like real doctors. John Harvey Kellogg...

-The Road To Wellville, yes.

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Yeah, yeah. He had this big kind of quack clinic that he ran

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where the moment that you arrived you had to make a visit to a man called the Rear Admiral...

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who would bend you over and fill you with fresh yoghurt. And then you'd poo that out.

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Then you'd crack on with your detox.

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-And deal with your thrush.

-What time's this show going out?

-LAUGHTER

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-Will people be eating?

-Well, it is almost the most kind of...basic fact about us all,

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that we poo. And also that we are, as we age supposedly, we get more obsessed by it.

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It's all you've got left, really, isn't it? There are stories of nurses who get sent stools

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-by grateful patients. You must have heard those stories.

-Not necessarily grateful.

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LAUGHTER

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It's an expression of love!

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I've no idea why, but that habit has followed me into my comedy career.

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A chap recently tried to kill somebody. He packed his anus with explosives.

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It was a Middle East prince. His plan was to shake the guy by the hand and then trigger it.

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Unfortunately, the body is very good at absorbing explosions. That's why people jump onto hand grenades.

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So all that happened was... he shook this prince by the hand and the bomb went off

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and he just bounced up in the air slightly and crumpled to his knees.

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And the prince, like any royal, just went, "Very good."

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Oh, dear, oh, dear. Well, that's antimony.

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Antimony pills were quite literally passed down through the family. Now placebos.

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Placebos are often administered in the shape of sugar pills.

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My question is: how do they work?

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-Oh, oh!

-Very good!

-'Nobody knows!'

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Now you might want to question this, Ben.

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APPLAUSE

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-Well, they do work.

-They do.

-But nobody quite knows why yet.

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Not only do they work, they work even when you tell someone it's a placebo.

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-You've studied this more than most.

-Mm, it's amazing.

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I think the magic ingredient of the sugar pills is belief and expectation.

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-We know that four sugar pills a day are a more effective treatment than two sugar pills a day.

-Yes.

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And a salt water injection is more effective than taking a sugar pill,

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not because it does anything physically to your body, but because an injection feels more dramatic.

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Is it to do with you just feel you're being taken care of? Some part of your body yields

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-to the authority of an injection even more than to a pill.

-Yeah.

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-Pacemakers start working before they've been switched on.

-Yes!

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I've heard this. Or knee surgery. They've cut people's knees open, then sewn them up,

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and they've said they feel better. But they've not done anything.

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That's why it's important to do proper trials, otherwise you'd think it was worth cutting people open

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and messing around with their heart. And actually it wasn't.

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The almost priest-like nature of the doctor, the faith in them,

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goes some way, I suppose, to explaining homoeopathy. That's as inert as a sugar pill.

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I know someone who was told to take arnica for her Caesarean scar.

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She went and spoke to an obstetrician and said, "Is there any truth in that?"

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He said, "The thing is with homoeopathic medicine, there haven't been proper clinical trials,

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"but arnica is one that has been tested. It has been found to have absolutely no effect whatsoever."

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Homoeopathy's a really good teaching tool for evidence-based medicine.

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The homoeopaths' trials, in general, are so crudely rigged

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that they make extremely good teaching examples.

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They're not double-blind, randomised trials in the approved manner?

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Each individual trial has been done poorly or you get cherry picking.

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So if you run 100 trials of something, it's inevitable that maybe five give positive results.

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If you only cite positive trials, it looks as if your treatment works.

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The pharmaceutical industry are even bigger buggers for that, really, than the quacks

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because it matters more. There are still no laws to stop people hiding trial data. Not meaningful laws.

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This is the problem with people like me who are lazy...

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-Lazy?!

-No, I mean when we read in a newspaper, "Studies show..."

-He's writing a novel under the desk!

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I mean lazy in this sense. If I read, "Studies show..."

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I kind of go, "Gosh! That study shows..." but it takes Ben to go, "What's the study?

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"How many people were used?" That's basically the problem.

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-But to be fair, this show's probably more guilty of that than anyone!

-Oh...

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And it's a very easy thing to fix. I think every news story or feature or TV show or anything

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that makes a reference to a piece of primary research should give a link to that piece of research

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-so people can go and see what the evidence was.

-Indeed.

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Anyway, the placebo effect is incredibly powerful. On the other hand, drugs are powerful, too.

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-If you inject someone with cyanide and say it's a sugar pill, they will die.

-Yes.

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As Andy rightly said, nobody really knows how placebos work, but work they jolly well do.

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-What kind of condition that astronauts suffer from is measured by the Garn Scale?

-Garn?

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-That's what Steptoe used to say!

-Yes!

-"Garn!"

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Eliza Doolittle says, "Garn!" doesn't she? Yeah, it's named after Senator Garn,

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-a senator who became an astronaut and he suffered from what most astronauts suffer.

-Depression?

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No, seasickness. Or travel sickness. It's really, really bad up there, apparently.

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-There's a lot of vomming, which is not nice in weightlessness!

-Drifting around the cabin...

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-In fact...

-AUDIENCE GROANS

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They can't do that - they've got a helmet on. It would have to be...

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Yeah.

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47% of all the medication used by the Shuttle astronauts was seasickness tablets.

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The sickest was Jake Garn in '85. After him, they used the Garn Scale.

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-A score of one Garn means you are completely incapacitated.

-It's the right word.

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-It sounds like someone chucking up.

-Do you know what causes seasickness, for example?

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-Is it going up and down on the sea?

-Yes...

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-That's the condition in which it happens.

-Oh, you mean physically causes it.

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I've felt unwell on a ship just from the throbbing of the engines. The boat wasn't moving.

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There's some sensation of constant movement that starts to make things come up.

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-It's a disconnect between the visual information and balance information.

-That's right.

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-I'm about half a Garn at the moment.

-Just looking at that?

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-Watch the horizon!

-Why don't birds get it when they bob about on it?

-How do you know they don't?

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That's true. Or maybe they've just evolved not to.

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The bad things to do are going below deck for long, reading a book or staring at one point.

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You should stay in the fresh air, drink plenty of water, avoid fatty and spicy foods...

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They say that for everything!

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You can't move for advice now. You turn on 5Live and someone's always telling you,

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"We've got an expert in because it's sunny today. What should we do?"

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"Well, watch out for sun burn so apply a cream or wear a hat." Are we seriously saying this?!

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-What are we doing?

-Or avoid fatty and spicy foods.

-"Don't jump out of the window from the 10th floor."

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-That must be from The Perfect Storm.

-It looks like a film.

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That's an exceptionally good photo from another boat!

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That's such a good point!

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"How did you hold that so still?"

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Anyway, that's the Garn Scale. Almost half of all astronauts suffer from space sickness it seems.

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What is intelligent falling? ..Jo Brand.

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Is it when you see Michael Winner coming towards you

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and you deliberately trip so that you can squash him?

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LAUGHTER

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That would be intelligent falling. APPLAUSE

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-A very good example.

-You've really got it in for the Winster.

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-I have.

-Is it because he's not returning your calls, Jo? Is that what it is?

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He won't take me out to dinner!

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Is intelligent falling what Ronaldo does in the penalty area?

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No, it's a way to demonstrate what scientists mean by theory.

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As you'll know, they have in America this idea that it's equivalent to teach Intelligent Design

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as it is to teach the theory of evolution because they say,

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"The theory of evolution is only a theory, so why can't we suggest our theory?"

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-Which misunderstands what scientists mean by a theory.

-You've lost me.

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-You've heard of the theory of evolution?

-Yes.

-And you've heard of Intelligent Design?

-No.

-Ah.

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In America, religious people who decided that evolution is contrary to what the Bible says,

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they want children to believe that all creation was made by an intelligent being, ie God.

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-That the universe was designed by something.

-And the name for it is Intelligent Design.

-I see, right.

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"It's the THEORY of evolution, so why can't we have a theory taught in the same way?"

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Theory has a rather specific meaning in science. It's not like "guess"!

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It's not even like "hypothesis". This is what the OED says:

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"a statement of what are held to be general laws, principles or causes of something known or observed."

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That's not a guess. The theory of evolution, as any biologist says,

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is true. I mean, it is supported by facts.

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-So what's intelligent falling?

-It's saying, "Newton had a theory of gravity, overturned by Einstein's.

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-"So why can't we suggest our theory?" Which is intelligent falling.

-Isn't the point partly

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that different theories are supported by different amounts of evidence? David Icke has a theory

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that the Royal Family are all 7-foot green lizards in 6-foot human skin suits, with not a lot of evidence.

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-Does he?

-Whereas evolution is supported by a lot of evidence.

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-If you want to question a theory, you should do so by challenging its evidence...

-Exactly.

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-..rather than...

-Intelligent Design believers, what do they think they put in their cars?

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It's a hard position to be a fundamentalist.

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On the one hand you have to forgive people, on the other, take their eye out.

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-It's difficult to know which one to do.

-If Michael Winner's around... LAUGHTER

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-I'd manage to make a decision.

-I've got this fantasy of Michael Winner sitting down saying,

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"Oh, it's Friday. What shall I do? I know, I'll watch QI. Jo Brand's on. She's my favourite."

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-The disappointment when he sees you...

-No, he won't be disappointed.

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Perhaps he won't.

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So there we are. Evolution and gravity may be THEORIES, but they work perfectly well in practice.

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Describe the symptoms of either drapetomania or dysesthesia aethiopica.

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-Who the hell is that?!

-LAUGHTER

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I don't know, but that's what the girl is thinking as well.

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They're all thinking, "I would."

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It's nothing to do, I have to say, with Gregory House.

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We're in the 1850s. Just before the Civil War is the clue.

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Drapetomania was a diagnosis of a quite inexplicable outbreak

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-of a sort of mental failing among the slave population.

-Were they singing?

-No.

-Cheerful songs?

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No, a doctor called Samuel Cartwright coined the phrase to explain the mental disorder

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-displayed by slaves who wanted to run away!

-Right.

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-Surely not!

-I know! He said,

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"It was as much a disease of the mind as any other species of mental alienation and more curable."

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-He thought it was caused by slaves getting too much authority and freedom.

-My husband's got this.

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LAUGHTER

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He's always having a crack at running away.

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-Shackles.

-Shackles are the answer, that's right.

-Massive bungee rope.

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Yeah! He claimed the slaves should have the desire to run away beaten out of them.

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-That's always the answer with slaves.

-What was the first one?

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-Drapetomania? And the second one?

-The second one I'll tell you about.

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Dysesthesia aethiopica. It's an aversion to doing slave labour.

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What a peculiar thing! Other symptoms include rascality and not taking care of property.

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The prescription was to put the patient to some kind of hard work in the sunshine.

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You do get a lot of these weird diagnoses even now.

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In Russia and China, they had political mania - convincing friends of the need for political change.

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In China, political mania has got symptoms like carrying banners, shouting slogans,

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-and expressing views on important domestic and international political matters.

-Yes, you're right.

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The Russians, famously, through the '60s and '70s had the psychology turned backwards.

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-Paranoia was defined as a yearning for justice.

-"Truth and justice are commonly found

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-"in the personality of the paranoid delusional."

-That's the phrase they used.

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There is a book, well known to anybody who studies mental health, called the DSM.

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-The Diagnostic and Statistical Manual. It has various editions.

-A lot of it is cock.

-Indeed.

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But very important cock because, for example, if you sue your employer because you have a medical condition

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it is the DSM which defines whatever supposed mental disorder you have. I think there's four editions.

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-It's coming up for five.

-In 2013. And people submit to it their idea of a condition.

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And some of them are accepted and some aren't. We have some for you

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which are under consideration or might have been suggested.

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-What are they? Sluggish Cognitive Tempo Disorder.

-Can't dance.

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-LAUGHTER

-That's just people who can't...

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Guilty feet have got no rhythm.

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Is that being a student?

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Basically. Your Daily Mail journalist would write off, as they do, any mental condition

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as a shabby excuse for a character flaw, but when you read the descriptions

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of the symptoms of sluggish cognitive tempo disorder, the word that you come up with is "laziness".

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-It's basically laziness. Relational disorder?

-Unpleasantness.

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-Yeah, an inability to get on with people.

-Ryan Giggs.

-Sorry?

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LAUGHTER

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-Ryan Giggs has got that.

-Ryan Giggs is not getting on with people.

-He gets on with SOME people.

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But they're usually married to other people.

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Anyway, negativistic personality disorder?

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-Not being very nice.

-It's being negativistic about something - whining, basically.

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-Jeremy Paxman.

-LAUGHTER

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Whining and complaining. Intermittent explosive disorder?

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-Farting.

-That's flatulence.

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Well, it would... This is the DSM - basically, adult tantrums, people who lose their temper.

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The point is that one can laugh at these, but there are some things that are obviously real

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that produce terrible mental conditions and that is well-known,

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then somewhere along the line, there are things to do with concentration disorders

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and compulsion disorders which seem so limited that you think, "Is that worth putting in a book?

0:23:040:23:10

"Do you need special treatment for that?" Where do you draw the line? Doctor, do tell us.

0:23:100:23:15

Some people want to be pathologised and have a label

0:23:150:23:19

and sometimes it's about flogging a treatment.

0:23:190:23:22

I mean, female sexual dysfunction, for example, started being pushed

0:23:220:23:27

at the time that various companies were trying to get licences for things like Viagra

0:23:270:23:32

for the 50% of the population unlucky enough not to have a penis.

0:23:320:23:37

-Steady!

-Along with that... LAUGHTER

0:23:370:23:40

Jo's got loads of penises, but they're all in a drawer at home.

0:23:400:23:44

LAUGHTER

0:23:440:23:46

But FSD was about medicalising it and saying that, um, you know,

0:23:460:23:52

desire is a matter of clitoral blood flow imaging and nitric oxide molecules in your body...

0:23:520:23:59

I think that's the most disgusting thing I've ever heard!

0:23:590:24:03

-Rather than relationships...

-Clitoral blood flow imaging?!

0:24:030:24:07

-Dot com.

-Dot com!

0:24:070:24:10

That is a dirty book!

0:24:100:24:12

No, that's true. I'm pretty sure that if I had been born later,

0:24:130:24:18

I would have been diagnosed with having attention deficit disorder and been given one of those drugs.

0:24:180:24:25

As it was, I was called a "tosser" and expelled from lots of schools.

0:24:250:24:29

Part of me thinks I WAS a tosser. I couldn't concentrate, I was extremely aggravating,

0:24:290:24:34

I was expelled from schools and I was a damn nuisance,

0:24:340:24:38

but probably something in my brain was different to others

0:24:380:24:42

and some people will always see that as a moral character thing which is under your control

0:24:420:24:48

and refuse to accept there is a medical condition for it.

0:24:480:24:51

It's not only moral. It's social and cultural as well.

0:24:510:24:55

-Yeah.

-Because 50 years ago, people who were gay were given electric shocks or whatever they were

0:24:550:25:02

to "cure" them of their illness,

0:25:020:25:04

-so as history moves on, you medicalise different sorts of behaviour, don't you?

-Yeah.

0:25:040:25:10

There you are. Some psychologists seem to have disorder-naming compulsion disorder,

0:25:100:25:15

which is not exactly fatal, but who was the last British monarch deliberately killed?

0:25:150:25:21

Was it one of the ones that got beheaded?

0:25:210:25:24

No.

0:25:240:25:25

You avoided saying Charles I whom most people would think...

0:25:250:25:29

Only cos I couldn't bloody remember what...

0:25:290:25:32

It happened in Norfolk. Where would that likely be if it was a monarch?

0:25:330:25:38

-Sandringham.

-Yes.

-It's the Queen's dad.

0:25:380:25:41

No, the Queen's grandfather. This is King George V, the grandfather of our current monarch.

0:25:410:25:47

There he is, looking spookily like his cousin Nicholas... Tsar Alexander.

0:25:470:25:52

It's an attested story by the man who did it.

0:25:520:25:55

In 1936, he was at Sandringham, feeling unwell.

0:25:550:25:59

On January 15th, he retired to his bedroom.

0:25:590:26:02

By the 20th, he was comatose and clearly dying, but still clinging to life.

0:26:020:26:07

This presented his doctor, Lord Dawson, a bit of a problem.

0:26:070:26:11

In Dawson's opinion, the world at large would be better served

0:26:110:26:15

by hearing of the King's death in the morning papers,

0:26:150:26:18

rather than by him lingering on a bit and it being in what he sniffily called "the evening journals".

0:26:180:26:24

So he decided to force the issue.

0:26:240:26:27

He wrote a very famous bulletin on the back of a menu card which was telephoned to the BBC.

0:26:270:26:33

"The life of the King is moving peacefully to its close."

0:26:330:26:37

He went up to the bedroom and this, according to his diary, is what he did.

0:26:370:26:42

"I therefore decided to determine the end

0:26:420:26:44

"and injected morphia, three-quarters of a grain,

0:26:440:26:48

"and shortly afterwards cocaine, one grain..."

0:26:480:26:52

Lucky old King!

0:26:520:26:54

"..into the distended jugular vein.

0:26:540:26:57

"I did it myself because it was obvious that Sister B, the King's nurse,

0:26:570:27:02

"was disturbed by the procedure."

0:27:020:27:04

"So I injected Sister B as well(!)"

0:27:040:27:07

Essentially, isn't that what a speedball is? He's basically gone the same way as John Belushi.

0:27:080:27:14

He gave him a speedball of morphia and cocaine which is pretty....

0:27:140:27:18

-He told the family?

-He wrote it in his diary and this was revealed in 1986.

0:27:180:27:23

-Treason?

-Well, it was quite extraordinary.

0:27:230:27:26

Being a Lord, he was in the House of Lords, and he voted against euthanasia in the euthanasia debate.

0:27:260:27:33

He said, "I'm not opposed to euthanasia per se..." Having just killed the King, not surprising!

0:27:330:27:39

"I just felt it should be left to the discretion of doctors, not anybody else." There we are.

0:27:390:27:45

-Or "a" doctor.

-Or myself, basically.

0:27:450:27:49

Now for a bizarre illness. What would you call a man who eats literally everything?

0:27:490:27:54

Winner.

0:27:540:27:55

LAUGHTER

0:27:550:27:57

KLAXON SOUNDS

0:27:570:27:59

Gotcha!

0:28:000:28:02

Oh, no!

0:28:020:28:04

APPLAUSE

0:28:040:28:05

Everything? Like pens and paper clips?

0:28:050:28:09

-Light bulbs?

-Yeah, polyphagism. It's also known as "pica",

0:28:090:28:13

an excessive appetite, often for non-nutritious substances - coal, clay, chalk, nuts, bolts, soil.

0:28:130:28:20

It's an exaggerated version of what can happen in pregnancy. Did you get any weird appetite things?

0:28:200:28:26

Yeah, I ate a bit less.

0:28:260:28:28

Some animals suffer from it. In horses, it's called "depraved appetite".

0:28:280:28:33

But the most extreme example we can come across is a man called Tarrare, a Frenchman in the 18th century.

0:28:330:28:40

He was abandoned by his family as a child because they couldn't afford the food he ate.

0:28:400:28:45

After working as a street entertainer swallowing stones and live animals, he became a soldier.

0:28:450:28:51

They tested his appetite and he ate a meal intended for 15 people in a single sitting.

0:28:510:28:56

He tore apart and ate without chewing live cats, snakes, lizards and puppies,

0:28:560:29:04

so they thought he'd be a useful spy.

0:29:040:29:06

They gave him things to swallow. They were at war with Prussia. But he was caught first time.

0:29:060:29:12

He'd be a good spy? He'd rather draw attention to himself...

0:29:120:29:16

-Well, no...

-Eating everything all the time!

0:29:160:29:19

They thought he could swallow a box with military secrets, so when he was searched, he would have nothing.

0:29:190:29:26

He was then put on a diet in a military hospital.

0:29:260:29:30

He would scavenge for offal in gutters and outside butcher's shops.

0:29:300:29:34

-Scavenge for offal in gutters?

-Yes, and outside butcher's shops.

0:29:340:29:39

-Someone had gone, "I don't like the look of that liver," and chucked it?

-Yeah.

0:29:390:29:44

He attempted to drink the blood of other patients and eat the corpses in the hospital morgue.

0:29:440:29:49

You know who's like that, don't you?

0:29:490:29:52

I don't even need to say it any more, do I?

0:29:520:29:56

Anyway, he was eventually ejected from the hospital under suspicion of having eaten a toddler.

0:29:560:30:02

-A toddler?

-A toddler, a little baby, yeah, a child, an infant which is against the law in France.

0:30:020:30:09

-Yeah, it is.

-Yes.

-They're picky, the French, aren't they?

0:30:090:30:13

They drew the line somewhere.

0:30:130:30:15

He had a belly so loose, he could wrap the loose folds of skin around his waist.

0:30:150:30:21

He sweated constantly and stank to such a degree that he could not be endured within 20 paces.

0:30:210:30:26

-His eyes would become bloodshot and a visible vapour...

-I'm becoming increasingly attracted towards him.

0:30:260:30:33

A visible vapour would rise from his body when he ate.

0:30:330:30:37

-Sounds bloody marvellous!

-Someone's got to make a film about him!

0:30:370:30:41

He didn't gain weight or vomit and he seemed perfectly sane.

0:30:410:30:46

-He didn't gain weight?

-No.

-On the "eat everything" diet, he didn't gain weight?

0:30:460:30:50

With a whole cat and a dog inside, they'll have eaten everything else.

0:30:500:30:55

-Like the old lady who swallowed the fly.

-They had a diet pill like that.

0:30:550:30:59

People would eat tapeworm egg, wait till they got to their ideal weight,

0:30:590:31:04

then take the helminthicide to kill the tapeworm, they'd poo out the worm and get on nicely slim.

0:31:040:31:09

I wish they still made that(!)

0:31:090:31:12

His autopsy revealed an enlarged liver and an enormous stomach covered in ulcers and oozing pus.

0:31:120:31:18

So that's nice(!)

0:31:180:31:20

Time to hand your test results in.

0:31:200:31:23

Let's talk about your sleepiness here. We've got Ben here first.

0:31:230:31:28

I'll tell you what the questions are. You fill in how likely you are to doze off

0:31:280:31:32

in the following situations, according to the following scale.

0:31:320:31:37

The situations are sitting and reading, watching TV,

0:31:370:31:40

sitting inactive in a public place, e.g, theatre or meeting,

0:31:400:31:44

travelling as a passenger in a car for an hour, lying down to rest in the afternoon,

0:31:440:31:49

sitting and talking to someone, sitting quietly after a lunch without alcohol,

0:31:490:31:54

in the car while stopped in traffic.

0:31:540:31:57

Ben here scored 6 and you'll be pleased to know that 7 to 8 is average.

0:31:570:32:01

0 to 6 indicates you get sufficient sleep. I don't know that my taxes are going properly

0:32:010:32:07

if a doctor gets sufficient sleep. I pay you to be utterly overworked and underslept.

0:32:070:32:12

-I thought this was a confidential medical...

-Oh, sorry. Damn!

0:32:120:32:17

This is Jo "Marlon Brando".

0:32:180:32:21

LAUGHTER

0:32:210:32:23

-You answered zero to everything. You sleep enough. You never fall asleep.

-I never fall asleep anywhere, no.

0:32:230:32:30

That's fantastic. Andy...

0:32:300:32:32

Sitting and reading - 1, watching TV - 3. Your total, which you haven't done... Thanks.

0:32:320:32:37

I got too tired.

0:32:370:32:40

Your total is 14.

0:32:400:32:42

-Yes.

-Alan has answered "3" to almost everything, except sitting and talking to someone.

0:32:420:32:48

-I don't sleep there.

-And you score 19.

0:32:480:32:52

If I sit and read a book, I fall asleep immediately.

0:32:520:32:55

Anyway, you get sufficient sleep, Ben.

0:32:550:32:58

The rest of you, I'm sorry to say... 7 to 8 is average.

0:32:580:33:02

Anything above 9 indicates you should seek the advice of a sleep specialist without delay.

0:33:020:33:08

-YAWNING:

-I'll get on to it straight away.

0:33:080:33:11

There you are. Drop your trousers. It's time for a dose of general ignorance. Fingers on beepers.

0:33:110:33:17

Why shouldn't you sleep with a dog?

0:33:170:33:20

-COUGHING

-Yes?

0:33:200:33:23

He won't respect you in the morning, will he?

0:33:230:33:25

-LAUGHTER

-It's against the law, isn't it?

0:33:250:33:29

Not in a sexual sense. I mean "share a bed with". I'm afraid it's terribly unhealthy.

0:33:290:33:34

Quite a lot of plague, amazingly, good old bubonic plague,

0:33:340:33:38

-especially in the southern USA.

-Not in this country surely?

0:33:380:33:43

-At the moment, we seem to be OK.

-Because dogs are wearing those anti-plague hats.

0:33:430:33:48

LAUGHTER

0:33:480:33:50

Can I just say a propos of nothing, what hideous pillow cases!

0:33:500:33:55

-They are, aren't they?

-Is it from the '70s, that picture?

0:33:550:33:59

I bet they're that kind of brushed nylon where you catch your fingernails on it.

0:33:590:34:04

The diseases you get off animals are often worse than the diseases you get off people

0:34:040:34:09

because the diseases that live in humans can't kill you off instantly and universally,

0:34:090:34:15

otherwise the disease would die out.

0:34:150:34:17

They need you to carry on sneezing on the bus and scratching your arse and preparing food

0:34:170:34:23

and the things you do to transmit stuff,

0:34:230:34:25

but something that lives on a dog doesn't care if it kills off a dead-end host like a human.

0:34:250:34:31

-It's not bred to... It's not part of its normal life cycle.

-Yeah.

0:34:310:34:35

Letting dogs and cats share your bed can cause all manner of problems.

0:34:350:34:40

Now I'm having a panic attack. What do you recommend?

0:34:400:34:43

A paper bag. KLAXON SOUNDS

0:34:430:34:46

Ah, yes, the good old paper bag.

0:34:470:34:50

-Is that not recommended any more?

-No, it isn't.

0:34:500:34:54

-Nor indeed the other stand-by - take a deep breath.

-"Pull yourself together."

0:34:540:34:59

-"Pull yourself together" is probably OK.

-Yes.

0:34:590:35:02

-"Doctor, I think I'm a pair of curtains."

-Slap her, she's hysterical!

0:35:020:35:07

-She had, I think...

-She had good reason to be hysterical.

-Jack was not behaving normally, was he?

0:35:070:35:13

He was being odd. There's a new treatment called capnometry assisted respiratory training

0:35:130:35:19

or CART. It encourages people to take shallow, not deep breaths.

0:35:190:35:23

-You want to avoid blowing off too much carbon dioxide.

-Yeah.

0:35:230:35:26

Because you're hyperventilating, you're getting rid of too much CO2.

0:35:260:35:31

The idea was that if you do it in the bag, you're breathing back in the CO2,

0:35:310:35:36

but this is now not considered a good idea. "It's dangerous and should be retired" is the opinion.

0:35:360:35:42

-It's quite hard to find a paper bag.

-I'm still going to try it on Winner.

0:35:420:35:47

And avoid if you can fatty and spicy foods.

0:35:470:35:51

So now I'm feeling extremely angry! What should I do?

0:35:510:35:55

Calm down, dear!

0:35:560:35:59

LAUGHTER AND APPLAUSE

0:35:590:36:01

That's very good. You're quite right.

0:36:010:36:04

-What's the best thing to do when you're angry?

-Have a cigarette?

0:36:070:36:11

-I'm not sure that's medically recommended.

-Lie down in a dark room? Think about something nice?

0:36:110:36:16

-Puppies?

-Those are all good suggestions.

0:36:160:36:20

The suggestion I'm glad you didn't make is "let it out".

0:36:200:36:23

There was this idea that if you got very angry, you should punch a punchbag and shout.

0:36:230:36:29

They've done some experiments and those that let out their anger became over time more aggressive.

0:36:290:36:36

The hypothesis is that blowing off steam may reduce psychological stress in the short term,

0:36:360:36:42

but it acts as a reward mechanism, reinforcing aggressive behaviour.

0:36:420:36:46

You feel good when you let it out again, so maybe it's better to bottle it up.

0:36:460:36:51

Be British, in other words. Stiff upper lip.

0:36:510:36:54

-Don't make a scene or a fuss.

-Don't make a bloody fuss!

0:36:540:36:58

And above all... avoid fatty and spicy foods.

0:36:580:37:02

Yes, also according to psychologists at the University of California Santa Barbara,

0:37:020:37:07

it's best to make decisions when you're angry which is not what you might think.

0:37:070:37:12

It seems that anger will actually... Again it's a hypothesis.

0:37:120:37:16

..that anger is designed to motivate people to take action.

0:37:160:37:22

-It helps people take the right action.

-Buying shoes.

0:37:220:37:25

-Buying shoes when you're angry.

-Make sure you're livid when you go in the shop.

-"I want my shoes!"

0:37:250:37:32

"Which pair would you like?" "THOSE! I'm pleased with these."

0:37:320:37:36

Letting your anger out just makes matters worse.

0:37:360:37:39

If you want to wash the bacteria off your hands, what temperature should the water be?

0:37:390:37:45

I would say it would need to be above 30, 40...

0:37:450:37:49

To kill the bacteria, the water would have to be far too hot to touch.

0:37:490:37:54

It would have to be about 80 degrees centigrade.

0:37:540:37:57

It's nothing to do with the temperature. It's the vigorousness of the scrubbing action.

0:37:570:38:03

For proper infection control, we should all be naked below the elbow.

0:38:030:38:08

-Short sleeves is the answer?

-Yeah.

-Which you do see in some doctors nowadays.

0:38:080:38:13

-Is that now the norm?

-I think so.

-That's interesting.

-I like those taps they have, the elbow taps.

0:38:130:38:19

I'll get some of those for home.

0:38:190:38:22

But do, above all, avoid fatty and spicy foods.

0:38:240:38:27

How many portions of fruit and veg should you eat each day?

0:38:270:38:32

Oh, now, in Japan they say nine.

0:38:320:38:35

Yes, it's different all over the world, it seems.

0:38:350:38:38

The five is being chosen in Britain because that's the most they could persuade the British to eat.

0:38:380:38:46

-We are the most reluctant to eat...

-"There's no way they'll eat any of it."

-Anything green is repulsive.

0:38:460:38:53

Denmark says six, France ten.

0:38:530:38:55

-In Canada, it's between five and ten.

-Somebody just went, "Eugh!"

-The idea!

0:38:550:39:00

In Scotland, it's one.

0:39:000:39:03

A month.

0:39:040:39:06

Supposedly, it's seven for women and...

0:39:060:39:09

Haribos count in Scotland!

0:39:090:39:12

Wine gums, things like that.

0:39:130:39:15

-SCOTTISH ACCENT:

-Have some vegetables - Starmix!

0:39:150:39:18

"I'll have a bag of Dolly Mixtures!"

0:39:180:39:22

I really wish my fridge looked like that.

0:39:220:39:25

-Does anyone's fridge ever look like that?

-Certainly not mine, no.

0:39:250:39:30

I can't see a single pork pie in there.

0:39:300:39:33

-No.

-I have a lot of veg in my fridge.

-Do you like pork pies?

-I love them.

-I love pork pies.

0:39:330:39:39

I like pork pies, but you start a pork pie and you think, "I really like this,"

0:39:390:39:44

but two-thirds of the way through, I start to go off it and I don't know why. Is that to do with me?

0:39:440:39:50

Send it to me, the rest of it.

0:39:500:39:53

-You've got pork pie avoidance syndrome.

-Yes, you have.

0:39:530:39:58

It's rather staggering there are any British people left alive in the world. It's just amazing.

0:39:580:40:05

We all eat fatty, spicy food and certainly don't get our five a day.

0:40:050:40:10

Lastly, here's something every teenage boy should know.

0:40:100:40:14

What is it that burns when you set fire to your farts?

0:40:140:40:17

-You want someone to say "methane", don't you?

-I'll say it. Methane.

0:40:190:40:23

-KLAXON

-Thank you, Andy.

-I thought it was methane.

-Everybody does.

0:40:230:40:27

No, most human beings do not produce methane in their extrusions.

0:40:270:40:32

It seems that we produce about three pints of wind a day.

0:40:320:40:37

-Pints?

-Yes, it's measured in pints.

0:40:370:40:40

Released in 10 to 15 individual episodes.

0:40:400:40:44

You can get a box set as well.

0:40:450:40:47

LAUGHTER

0:40:470:40:50

Best...

0:40:510:40:53

Or you can have a feature-length episode.

0:40:530:40:57

Pyro-flatulence, igniting these episodes, can lead to serious burns, so don't try it at home, everybody.

0:40:590:41:05

Methane in the body results from microbes called methanogens,

0:41:050:41:09

but only a third of humans have methanogens in their gut flora. It seems to be genetically determined.

0:41:090:41:16

A 2009 study by Arizona State University showed that methane producers are more efficient

0:41:160:41:22

at converting their undigested food into fat reserves, which bluntly put, means fat people fart more.

0:41:220:41:28

-The major components of flatus...

-LAUGHTER

0:41:280:41:32

The major components are all odourless.

0:41:320:41:35

The aroma is caused by skatole, indole and hydrogen sulphide.

0:41:350:41:39

During the Great Plague of London, doctors recommended patients store their farts in a jar,

0:41:390:41:45

then when they were feeling unwell, smell them. Apparently, this would help.

0:41:450:41:49

Anyway, it's usually hydrogen that's lit.

0:41:490:41:52

As I always say, better out than in.

0:41:520:41:55

-Definitely.

-A bit like Simon Cowell in a lifeboat.

0:41:550:41:58

LAUGHTER AND APPLAUSE

0:41:580:42:01

And now the complications set in as we look at the final scores.

0:42:010:42:06

It's very exciting because in first place

0:42:060:42:09

with a very positive and a very thrillingly impressive eight points, it's Andy Hamilton!

0:42:090:42:15

-APPLAUSE

-That's not happened before.

0:42:150:42:19

And in...

0:42:190:42:21

In second place with five points, it's Dr Ben Goldacre!

0:42:210:42:25

APPLAUSE

0:42:250:42:27

But by no means the sickest patient on the ward with only minus seven is Alan Davies!

0:42:290:42:35

Oh, no! APPLAUSE

0:42:350:42:37

I'm afraid it's get the mortuary trolley ready at minus 24 - Jo Brand!

0:42:380:42:45

APPLAUSE

0:42:450:42:47

That's all from us tonight, so it's good night from Ben, Andy, Jo, Alan and me.

0:42:500:42:56

I leave you with this heart-warming tale from America.

0:42:560:42:59

In 1981, the Mayor of Springfield, Illinois suffered a heart attack during a council meeting.

0:42:590:43:05

The council voted to wish him a speedy recovery by a margin of 19 votes to 18. Good night.

0:43:050:43:11

Subtitles by Subtext for Red Bee Media Ltd 2011

0:43:290:43:33

Email [email protected]

0:43:330:43:36

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