Letter from London

Under a front page headline ‘The Hidden Epidemic’, the Independent1 gives 170 000 as the number of teenagers and young adults attending hospital after deliberately hurting themselves (including overdoses). These figures were produced by the National Institute for Clinical Excellence (NICE), but the true picture may be much worse because many self-harmers do not seek treatment. In a number of cases self-harm leads to suicide. Self-harmers are pushed to the bottom of the queue in Accident and Emergency departments and made to feel that it is their own fault; they receive no psychological assessment or follow up. Contrary to popular belief, men are also affected, but to a lesser extent, though they may progress more rapidly to suicide than women. At the moment there is no explanation for the rise in self-harm, though depression and low self-esteem appear to be the predisposing factors.2 However, there is no explanation for the increase in these factors. Young Asian women are at particular risk for self-harm and suicide, due to alienation from their parents, often over the question of arranged marriages.3 Unfortunately, there appear to be no data from other countries, particularly in western Europe, where one might expect a similar situation.Two days earlier the same newspaper4 headlined the possibility of immunizing children against addiction to smoking (i.e. nicotine), heroin and cocaine. The proposal is to immunize, by injection, children at birth (why so early?) in a way that neutralizes the ‘high’ from these drugs, making it pointless to use them. It seems that the procedure may be available within 2 years, but this seems unduly optimistic, particularly as there appear to have been no clinical trials.
     In an unprecedented ‘letter’ to the British Medical Journal,5 Michael Baum, Emeritus Professor of Surgery at University College, London, criticizes the Prince of Wales for promoting Complementary and Alternative Medicine (CAM). He recalls that in 1984 when the Prince was appointed President of the British Medical Association he spoke in favour of ‘alternative medicine’. Shortly after this he was given a 4-page supplement in the London Evening Standard. Baum was asked to respond and was allowed a quarter of a page. Baum writes, ‘It is in the nature of your world to be surrounded by sycophants (including members of the medical establishment hungry for their mention in the Queen’s birthday honours list) who constantly reinforce what they assume are your prejudices. Sir, they patronise you.’ Baum quotes articles in the Observer and Daily Express, which reported the Prince’s promotion of coffee enemas and carrot juice as treatments for cancer. He finishes with the challenge to the proponents of CAM to subject their remedies to scientific testing; if they fail to do this ‘they are bigots who will be forever condemned to practise on the fringe’.

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