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Narrative medicine


The pro and cons of alternative medicine
Harold Lambert Physician
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Earlier, you know, you had to have an antibiotic for everything and in the latter years before I retired you had some patients, mostly sort of middle class as they say, who said, 'Do we really need to give this?', which would have been unthinkable 20 years before, really unthinkable and you could have the discussion about the pros and cons.

Alternative medicine? Not a great deal because people, on the whole, didn't tell me about where they'd been, but I did have one really very touching episode where a chap came in and he, it was... I don't actually remember what the problem was, but he told me about... on several occasions people told me they had been using alternative medicines, and I was quite interested in this and asked them about it. And the thing that really shocked me was the amount of money they were spending. And it wasn't, you know, people had this image of people prancing through the fields picking lovely herbs which will do you good, which they might and they might not, but they don't say these chaps have to earn a living, and they charge money for the herbs and for the consultation. And one chap said to me: well, I've tried this and I tried this but I... I ran out of money so I thought I'd come and see you, which I thought was wonderful. And, they, people underestimate... it's the press, they have this sort of image of the evil doctors trying to kill you off, and these herbal chaps helping you with natural... I mean, of course, I'm terribly against Nature, as you know, because having spent about 38 years trying to counteract Nature, I keep saying to students, 'Nature is very dangerous', and, you know, to sort of bring them to think about it in reality. If you'd asked me what I think about herbal medicine or complementary medicine, well, at a practical level, if patients raise it, I say, 'I'm perfectly happy, this might well do you good, we don't know enough about it, and if you feel it's helping you that's fine by me as long as I don't think it's... and I'm going to stick to my own guns about, I'm a very conventional, as you know, Western type doctor.' And as long as, you know, I give them my opinion what is the right thing for their illness, if it doesn't conflict with that or do harm that's fine by me. I think the... on a more general way about the arguments about it, I think they're really on the wrong battleground actually, because people think we're talking about our medicine is good for you, and complementary medicines are not good for you. Of course that's ridiculous, isn't it? They may well be good for you, some of them, and the idea of plant medicines, well, a large number of the medicines we use are plant-based. So if you say the question: is it likely that out there in the jungles of South America there are things we would like to have and need to know? Well, I don't think it's just likely, I think it's certain there are things to be found out there and, as you know, a lot of people are working at finding them. The actual battleground is about evidence and I wouldn't give ground on that. I really do believe in scientific evidence about things and curiously enough I hadn't thought of that before curiously enough the reason why we conventional chaps are so keen on that is because our own history shows how wrong we can be with our own things. People bled for years and years and years. It was a natural, right thing to do: there are bad humours, let them out. No doubt they killed off thousands, millions of people doing that and it's the uncertainty and danger of our own things that has led us to the gold standard of proper, randomised clinical trials. I could, even in my own lifetime... many, many things we did, we now know not merely to be useless, to be harmful. And that is why I would say to the complementary medicine people: that's fine by me, but produce the goods.

British doctor Harold Lambert (1926-2017) spent his career tackling infectious diseases, helping in the development of pyrazinamide as an effective treatment for tuberculosis. He also published work on the rational use of antibiotics and was a trustee and medical advisor for the Meningitis Research Foundation.

Listeners: Roger Higgs

Roger Higgs was an inner city GP for 30 years in south London, UK, and is Emeritus Professor of General Practice at Kings College London, where he set up the department.

He gained scholarships in classics at Cambridge but changed to medicine after a period of voluntary work in Kenya in 1962. He was Harold Lambert's registrar for 18 months in the early 1970s, the most influential and exciting episode in his hospital training. He set up his own practice in 1975. He helped to establish medical ethics as a practical and academic subject through teaching, writing and broadcasting, and jointly set up the 'Journal of Medical Ethics' in 1975.

His other work included studies in whole person assessment and narrative in general practice and development work in primary medical care: innovations here included intermediate care centres, primary care assessment in accident and emergency departments, teaching internal medicine in general practice and establishing counselling services in medicine.

He was made MBE in 1987 for this development work and now combines bioethics governance, teaching and writing with an arts based retirement.

Tags: herbs, complementary medicine, conventional, plants, jungle, evidence, bleeding, uncertainty

Duration: 3 minutes, 59 seconds

Date story recorded: October 2004

Date story went live: 24 January 2008