Second Opinion

My name's Xand van Tulleken. I'm a doctor, and every day,

I make decisions based on years of training and medical experience.

But when it comes to health stories, in the news or on the telly,

I'm frequently at a loss.

Every day, we're bombarded with sensational headlines.

Now, some of them are so bizarre, they're a complete delight...

..but sometimes, they're downright irresponsibly terrifying.

I'm going to have a look at last year's health headlines,

and find out the truth. Coming up tonight -

could paracetamol be turning us into a nation of psychopaths?

Could you be going to the loo all wrong?

An Israeli study showed that it halves your pooping time.

And could Noel Edmonds really have stumbled across

a magic box that can tackle cancer?

Well, the answer might surprise you. This is Second Opinion.

APPLAUSE

Welcome to Second Opinion, the show that's knowledgeable enough

to pull the nonsense out of the headlines,

and professional and discreet enough not to ask how it got in there.

I read medical news all the time - I'm fascinated by it, I love it.

Whether it's a headline that claims juicing makes you live forever,

or this one weird tip to cut belly fat, I'll make that juice,

I'll click that link,

and the only thing I'm forgetting when I read this stuff

is that I spent seven years training not to believe any of it!

So, here's what I want to do tonight - we're going to go through

the headlines, and see if we can make sense of them.

We've got experiments, we've got correspondents,

we've spoken to medical experts.

What I want to do is take the year's medical news gently

in the palm of a warm, gloved hand, and ask it to cough.

Here are my top five headlines from last year.

At five, from November...

Wrong!

Everybody has an equal likelihood of death,

and that likelihood of death is, for the optimists among you,

100%.

Sorry to break it to everyone(!)

The study, from the University of California, San Diego,

in association with Facebook,

found that in any given year,

someone who uses Facebook is about 12% less likely to die

than someone who doesn't, but are they really alive,

or have they just not updated their status yet?

At number four, from September...

On the face of it, this does seem absurd.

Let me remind you what kidney stones are.

They're waste products that have crystallised out of your urine,

a little bit like limescale in your kettle.

They turn into little rocks in your kidneys,

and if you can shake them loose before they get too big,

that will save you lots of pain and possibly some emergency surgery.

Professor David Wartinger, a urological surgeon from Michigan,

heard from an unusual number of his patients that riding

a particular roller-coaster was a good way of helping kidney stones

to pass out, so what did he do?

Of course - he 3D printed a model of a kidney with kidney stones in it,

put it in a backpack at kidney height, and

rode around Disney World's Big Thunder Mountain railroad repeatedly.

What he found was that sitting at the back of the roller-coaster

resulted in successful passing of a kidney stone

in the model 64% of the time.

The front was not so good, at 17% success rate.

Let's be clear - despite what the headline would have you believe,

this is not a cure for kidney stones.

If you have a family history of kidney stones,

and you like riding roller-coasters, maybe you should give it a go,

but it's more important to stay hydrated.

In at three, from September...

Now, this was an article back in September about cat scratch disease.

You can get it from a bite or a scratch from

a cat infected with Bartonella henselae bacteria.

In humans, this can cause fever, pustules,

and in extreme cases, it can cause death. It sounds awful.

So, should we not be cuddling these death-dealing felines any more?

Well, the answer is - it's fine.

Of course it's fine!

Anyone who's ever met or seen a person who's handled a cat

knows it's fine.

To help prevention efforts, scientists in America

conducted a survey of disease patterns over an eight-year period.

It's extremely uncommon.

Most cases resolve spontaneously, and it's very treatable.

Only one case in the UK last year, and they survived just fine.

So how should you read this story?

If you get ill after handling a cat,

or after not handling a cat,

go and see your doctor!

At number two, from April...

Yes, it's a classic "thing causes cancer" story,

but maybe it is time to eat less meat and eat more rice.

Or maybe it's time to go fully veggie.

God, this is awful! I need a sit down and a nice cup of tea.

What?!

Look, unfortunately, the problem with things that cause cancer

is that they are almost unavoidable.

I know it's frightening, but one in two of us will get it.

It's built into who we are as humans.

Lots of the things that give us pleasure, or improve our health,

like sunlight, can also give us cancer,

so I, for one, won't judge you if you take the attitude that it's all going to end at some point anyway,

and we may as well just go out and enjoy ourselves.

Ah! APPLAUSE

And at number one, from May...

An American study looked into paracetamol, also known as

acetaminophen, and its effect on different kinds of pain.

Now, there are three kinds of pain - physical pain, emotional pain,

and pain that you feel on behalf of other people -

and if you don't believe me, watch this.

BLEEP BLEEP BLEEP

and my new band is called Syskill.

AUDIENCE GROANS

You felt that pain, right?

You enjoyed it, but you felt it.

In the study, the scientists found that if you read a short story

about someone in pain or in distress, you were less empathetic

- you felt their pain less - if you had taken paracetamol.

The authors say...

But if this is true, I don't think this is a side effect.

It's the banner headline!

It's a painkiller! It does exactly what it says on the tin!

They say it like it's a bad thing,

but I think it could be incredibly useful.

Life is full of stresses.

My dog has to be put down, my marriage is on the rocks,

and I've got to fire all these people.

I used to care about other people's feelings,

but then I discovered paracetamol.

Now I'm wrapped in a lovely warm blanket of human indifference.

Thanks, paracetamol.

Off you go.

Go on, out you go. Go on, you're done. You're fired.

Benji, here, boy. Come on.

Come on. DOG BARKS

Back in June, Noel Edmonds got into a bit of a spat

after he tweeted that he had found an unusual way to tackle cancer.

"A simple box that slows ageing, reduces pain,

"lifts depression and stress, and tackles cancer.

"Yep, tackles cancer!"

With radio stations for pets and cosmic ordering among

Noel's interests, you can perhaps understand why people

weren't ready to believe these remarkable claims.

But Noel does really seem to believe in the product,

and he appeared on This Morning to defend it.

I believe doctors and scientists who say...

So far, so good.

..that disruption of our immune system by negative energy...

Oh, there we go.

..makes you prone to diseases, of which cancer is one.

That is a scientific medical fact, and I agree with those doctors.

The other belief I have is that pulsed electromagnetism

can help with tackling cancer.

OK, one thing - cancer isn't caused by negative energy

any more than his contestants can use positive energy

to guess how much money is in box number four.

It is important to note that the company distanced themselves

from Noel's claims, releasing a statement saying this:

That's three ways of not agreeing with Noel Edmonds - not bad.

And indeed, on their website,

they don't say that the EMPpad will tackle cancer,

but I am a bit confused by some of the things they do say.

So, it's time to call in an expert.

Here he is - computational physicist

and electromagnetic safety expert Dr Richard Findlay.

Now, I asked him to have a look at

the claims made on the EMPpad website, so let's start with this.

Sounds good. Richard, has health got a frequency?

Health hasn't got a frequency.

OK, fair enough. How about this one?

Does it, Richard?

It doesn't. The earth's magnetic field is static,

and the fields they're generating are time varying,

so they're very, very different quantities.

OK, but the website is full of scientific references.

Surely some of those are pretty good, aren't they?

All over the place, really.

OK, keep it civil, Richard!

So, heal or no heal?

We asked EMPpad for a box for Richard to test,

but they didn't send us one.

We asked for peer-reviewed clinical studies about the product,

but they didn't send us any.

They did send us this statement.

EMPpad disagreed with Richard on a number of points, saying...

But here's what really annoys me about this story -

pseudo-science poisons the well for real science

that could help people, and that's a huge problem, because in fact,

electromagnetic field therapy IS currently being investigated

as a means of treating cancer.

There's a company in America called Novocure,

who have developed a device that appears to keep tumours at bay

using electromagnetic fields.

This is Marsha Miller.

Her brain tumour was surgically removed,

but it was expected to grow back, and the Optune device seems, so far,

to be preventing this happening.

It's really important not to dismiss new research like this,

so am I saying Noel Edmonds was right?

Look, I'm not even saying Noel Edmonds is real.

The one thing I'd need to part with my cash is a well-designed,

well-conducted clinical trial, in humans, published in a reputable

journal, that demonstrates a statistically significant benefit,

and that trial does not exist, so for me, it's no deal.

Now, if you've been keeping up with Australian tax news...

LAUGHTER

..you'll be well aware of the next story.

Back in August, The Sun revealed that the Australian Tax Office

has installed squat toilets in one of its buildings in Canberra.

The large number of South-East Asian employees are used to

a squat toilet, one of these,

rather than a Western-style toilet,

as you can see

from this helpful sticker.

So, this is just your typical hysterical story about

the dangers of immigrants, with a nice new scatological twist, right?

So how should you read this story?

What if we approach this from a medical point of view?

In the UK, 80% of people will suffer piles in their lifetime.

25% will suffer regularly.

As a nation, we spend £48 million a year on prescription laxatives,

and that doesn't include over-the-counter purchases.

But in Asia and Africa, by contrast, where squat toilets are more common,

in seems instance of piles and colorectal disease is lower.

So, are squat toilets actually better for us?

In America, they've invented a clever way of turning your

traditional Western toilet into a squat toilet, but they've had

to work pretty hard to make it an attractive proposition.

When you sit on a porcelain throne,

this muscle puts a kink in the hose

and stops the Ben & Jerry's from sliding out smoothly.

But what happens when you go from a sit to a squat?

Voila! This muscle relaxes,

and that kink goes away

faster than Pegasus laying sweet sherbet dookie.

Truly, a footstool fit for a constipated king.

APPLAUSE

After this advert, sales in America went up by 250%,

but interestingly, in the UK, there was not the same sales spike.

It seems like we Brits just don't like to think

about how we go to the loo.

But I'm convinced Britain CAN find a way to take squatting

into our hearts, so we sent Second Opinion's in-house GP,

Dr Ahmed Kazmi, to try and sell it

to the unsuspecting shoppers of South London.

Today, I'm going to be posing as an undercover salesperson

in this showroom, where we've installed a squat toilet.

Right, let's sell some squat toilets.

-Hello, sir, are you OK?

-Yeah, I'm OK, how you doing?

-Very well.

Are you looking for anything in particular?

-Erm, a whole new bathroom, to be honest.

-Oh, OK.

-So, erm...

I'll just show you something a little bit novel.

It's the most popular toilet model worldwide.

It's definitely compact.

It's the traditional squat toilet.

Have you ever used one?

So there's loads of health benefits, actually.

It reduces the risk of haemorrhoids, piles, diverticulitis.

Because of the hip flection,

it pulls the anal rectal junction

into a much more favourable position for opening the bowels,

so you need to apply less strain, which is why it helps with

-diverticulitis and with haemorrhoids.

-Yeah.

It's good for your joints, too.

A Japanese study showed that, because of the hip flection,

it pulls the anal rectal canal into the correct position,

-so you don't have to strain to pass the motion.

-Right.

An Israeli study showed that it halves your pooping time,

so everyone could benefit from that.

It makes it less than one minute that you'd spend on the toilet.

Have you ever tried one? Like, on holiday, or...?

-Yeah, I hate them. You tend to get splashes on your feet.

-Yeah?

Oh, yeah, I know what you mean. That's a technique thing, though.

Do you know, actually, the majority of the world poops like this?

-Is it something you'd ever consider?

-I don't think so.

Do you want to have a quick go, just see how it feels?

-I think I'm all right with that.

-Oh, just try, go on.

You're not going to sell it to me, I'm afraid.

-It's only £150.

-OK.

-Is it something you might consider?

-No.

Xand, I really tried my hardest,

but I'm afraid I wasn't able to sell any squat toilets.

My diagnosis is that England is not ready yet,

but I'm taking one home myself.

APPLAUSE

Dr Ahmed there, with no sales,

thus guaranteeing himself a place on the next series of The Apprentice.

It seems Brits just aren't ready for squat toilets,

so are we damaging our health?

Well, I went along to see

consultant gastroenterologist Dr Lisa Das to find out.

-Hello.

-Hello. Is it Lisa?

-It is.

-Xand.

-Nice to meet you.

Very nice to meet you.

Lisa, you're a world-class gastroenterologist.

You've worked in the US and the UK.

You've won prizes. You've passed all the exams.

I have a burning question -

are we going to the loo wrong?

I think we are, so it's a massive problem.

About 60% of my practice is about disorder defecation,

people not going to the bathroom properly.

So why do you think we're getting this all wrong?

I would probably say a large part is because we don't pay attention

to our bodies, and that normal urge, that call to stool,

when your body's telling you you need to open the bowels,

we tend to inhibit that, and that's because we're busy,

we're going to a meeting,

we're sorting out the children in the morning.

OK, Lisa, scenario -

you and I, we're on a date, we're in a restaurant.

I get the urge.

I get up and excuse myself, walk around the table,

our eyes meet, and you whisper three pieces of advice

about how to go to the loo. What are those pieces of advice?

-So diet, fibre, water and exercise.

-Fibre, water, exercise.

It's a bit late for that, it's the middle of the date,

but let's say I had the salad and I've had a glass of water.

-I'm on the move.

-You're doing the right thing.

You've attended to that call to stool, which is when you feel

like you need to go, you have to take advantage of that.

That's the great thing about being on a date with

a gastroenterologist -

they don't mind when you answer the call to stool.

So, I make my way through the restaurant, I get to the loo,

I open the door, I sit down, I'm straining.

Dial back that straining,

because too much straining can cause problems with haemorrhoids,

-so 80% strain.

-80% effort. Take it down a little bit, relax.

Just calm down, it's all right, we've got time,

we're in this for the long haul.

Third piece of advice - you shout it across the restaurant,

into the toilet, what is it?

Get in the right position and raise your legs.

-Get your knees up?

-Indeed.

This date's going better than I expected.

Could I get your phone number?

APPLAUSE

So, there we go, or rather, there we COULD go,

if we ate well and got into the right position.

This is a much bigger problem than most of us are prepared to admit.

Look, I know you're going to ignore me about drinking more water

and eating your greens

- you've been ignoring doctors about that stuff for years -

but if you are having problems, try getting your knees up,

and don't ignore the call to stool.

APPLAUSE

Now, smoking - one of the biggest health issues we face.

A study in March claimed if you're trying to give up,

going cold turkey could be the best option, though, to be honest,

it is a lot easier these days than it used to be,

when cigarette brands could make adverts like this.

According to this repeated nationwide survey...

Speaking as a doctor, I'd probably rather you smoked an actual camel.

If you are trying to quit smoking, this year,

you might find it a little bit easier

without even knowing it, thanks to recent government legislation.

New laws are coming into force from May, meaning that all tobacco

packaging that we now see on the shelves will have to be plain.

This means that, as well as standard sizes, fonts,

and large health warnings, the government has chosen

the world's ugliest shade of green for the new cigarette packets.

It's officially known as...

It's not a coincidence that The Beatles never wrote a song

called We All Live In A Pantone 448C Opaque Couche Submarine.

These aren't the most beautiful things you've ever seen,

but maybe people will still love them.

Previously, this has only been researched with focus groups

where people picked out that colour as the least appealing one.

So, we at Second Opinion teamed up with Bristol University to do

some original research into people's subconscious colour preferences.

Can a colour by itself really make any difference

to people's smoking habits?

We sent Second Opinion's smokin' correspondent...

Oh, sorry - we sent Second Opinion's SMOKING correspondent,

Dr Emily Grossman, to find out.

I'm here at Bristol University. We've got some volunteers,

and we're ready to put this to the test.

Good afternoon. Thanks for coming to help us with this demonstration.

We are the tobacco and alcohol research group,

and we are interested in lifestyle behaviours, and in particular,

why people smoke and drink, and so this afternoon,

you're going to be doing a short test on these computers that

you have in front of you, and we can talk about the results afterwards.

In this test, we have to work as quickly as possible to sort words

like "fresh," "clean," and "damaging,"

into positive and negative categories,

and then do the same with blue and green cigarette packages.

So what exactly is this weird test that you've had us do today?

It's called the implicit association test,

and it's designed to capture people's unconscious attitudes.

One of the problems we have in psychology is that,

when we want to understand what people think, what they tell us

isn't always an accurate reflection of what they really think.

So, by getting people to automatically pair colours

with positive and negative words,

we can measure how quickly people associate the colours with

positive words compared to negative words,

and that gives us a sense of the unconscious strength with which

they associate a colour with a positive or a negative image.

So what do our results actually tell you?

It's interesting that all of you showed

a preference towards the blue colour,

and that's the colour that's been used on

a number of different cigarette packs over the years, because

it conveys a sense of lightness and happiness and healthiness.

So, hang on - you're saying that we basically don't like

the colour green. I've got loads of green clothes.

Am I wearing stuff that people don't like?

That's a different question, really, but it's possible that

different colours have different associations depending on how

you use the product associated with those colours, so anything that

you're putting into your mouth, for example, if it has a slightly

rotten colour associated with it, might be more unappealing.

So, we found out today that our volunteers felt more negative

about green cigarette packaging, and that these colour preferences

might also apply to other things that we put in our mouths.

APPLAUSE

Prof Munafo's team will now expand this into a proper study,

so watch this space,

and maybe they can look into getting kids to eat their greens.

Healthcare innovations now, and it seems I'm soon to be

out of a job, if this headline from July is anything to go by.

This is Pillo, a healthcare robot

currently being developed in America

that's always on,

and watches everything you and your family do,

turning your house into a friendly, electronic North Korea.

It dispenses medication by plopping it out its bottom,

and it makes darn sure you take it.

Wait, John, it's Tuesday. Here's your blood pressure medication.

You're right. Thank you, Pillo.

And if you want, he'll notify your care takers in case of an emergency,

like when he forgot his heart medication.

Hey, Dad. I just got a message from Pillo.

Everything OK?

"Dad, Pillo says you've been having capitalist thoughts!"

And, if the idea of an in-home robot Big Brother tracking your

every move wasn't troubling enough, it also has thoughts on your dinner.

Since Pillo's always connected,

he can answer all of your health-related questions.

Pillo, how many calories are in a celery stick?

Six calories, Clara. Celery is excellent for your health.

Great, I'll have a bunch, then.

Aww!

Ugh!

Look, if there's one thing science fiction has taught us,

it's that we should definitely entrust artificial intelligence

with keeping us alive, and this will never, ever backfire.

Pillo's going to be on the market from summer. Good luck, everyone.

Right, what should we tackle next? I fancy something really easy.

How about the junior doctors strike?

Now, this was the biggest health story of last year,

and for very good reason - doctors pretty much never go on strike.

The last junior doctors strike in the UK was back in 1975,

but last year, they walked out five times from January to April.

Now, for doctors to go on strike, there has to be something

pretty wrong, so let's tackle what happened,

and I'm using "tackle" in the Noel Edmonds sense of

"not solve at all".

I'll start with what we think we all know - that doctors are lovely,

and the Health Secretary, Jeremy Hunt, is not.

But I would say that - I'm a doctor - so let's try to be fair here.

Why did Jeremy Hunt want to change the junior doctors' contract

in the first place?

Around 6,000 people lose their lives every year because we don't have

a proper seven-day service in hospitals.

6,000 deaths!

Is that really true? Well, this study says it is.

And lots of others say it isn't.

It's a heavily disputed figure, but for the sake of argument,

let's buy it. Let's buy that number

- 6,000 extra people dying, but slow down -

are those 6,000 deaths caused by a lack of junior doctors?

Well, like most complicated things, this is probably best explained

in terms of cheese.

Imagine the junior doctors as a wedge of cheese.

There are more of them around during the week,

and they taper off a bit at weekends.

Now, there's already a shortage of doctor cheese.

There are gaps in the rota, so now, our cheese...

is getting smaller, and looking pretty Swiss.

And what Jeremy Hunt wants to do

is stretch this cheese over the weekend, but here's the problem -

he isn't making any more cheese!

He's just trying to smoosh the cheese across a seven-day week,

and clearly, when you smoosh cheese over a seven-day week,

this isn't going to improve the cheese.

You can't just smoosh it over the week, Jeremy.

It gets sweaty, and it gets over-stressed.

This is no longer top quality cheese. It is sub-standard.

What Jeremy should do is make more cheese - train more doctors,

or hire more doctors from other countries.

APPLAUSE

But even if he did that, this is only junior doctors.

You need the whole cheese board.

You want the brie, the camembert, the cheddar, the stilton,

the radiographers, the lab techs, the MRI operators,

crackers, grapes, quince jelly, a little glass of port.

Jeremy Hunt isn't saying anything about the other contracts,

or getting more of them in at weekends,

so as far as we know, he won't save any of those 6,000 lives.

Ironically, like an exhausted, stressed-out junior doctor,

Jeremy Hunt was misdiagnosing the problem,

and giving the wrong treatment.

APPLAUSE

But still, he won, he broke the strike,

so why am I still talking about this story when it's all over?

Because record numbers of doctors are now leaving the profession

after training, and late last year, the GMC revealed that the number of

requests from doctors seeking certificates to work abroad

had increased by 30 times.

Now, I've worked as a junior doctor, and it IS a hard job,

but it's really rewarding.

There's a reason why getting into medical school is competitive -

it's fascinating, and it's fun, and some days,

you get to feel like a hero who can save lives.

That's what you want from a doctor -

someone with warm hands and a soft voice,

who'll hear your problems, examine you properly,

have time to make a considered diagnosis,

and then come back and check on you and make sure the treatment worked.

But if there aren't enough doctors,

if you're juggling too many patients,

being constantly paged to another ward,

if all the support staff are thin on the ground

and everyone's stressed and stretched and miserable,

it becomes much less fascinating and much more like playing Whack-A-Mole.

And before you go,

"Oh, boo-hoo, poor doctors, having to play Whack-A-Mole,

"I love Whack-A-Mole," bear in mind, in this scenario, you're the mole.

So, yes, the strikes are over,

but the underlying issues are still there,

and if you leave an underlying condition untreated,

it will come back to bite you. Just ask a doctor,

if you can still find one.

So that's our show!

I hope it's been as entertaining and informative for you watching

as it was for us making it, and of course,

if you didn't enjoy it, you can just numb the pain with some paracetamol.

Either way, I hope the next time

you see or read something about your health, you'll think,

"Do I believe this, or do I need a second opinion?"