This week, The British Medical Journal (BMJ) published it's "Christmas Double Issue." Excited?
Here's how this highly regarded and prestigious BMJ describes itself:
The BMJ is one of the world's top four general medical journals... (the others being)...The Lancet, The New England Journal of Medicine and The Journal of the American Medical Association.
Well, I'm glad to see that, in a country with nationalized health insurance, the BMJ has managed to avoid the excesses of political budgetary exigencies, and continues to maintain the high standards of original research and reporting one would expect from "one of the world's top four general medical journals." Aren't you?
Because Chicken Littles in the United States are always warning that if one nationalizes health care, dollars will be cut from research and the quality of research -- the bed rock of medical advancements that help sick people -- will be vitiated and patients will eventually suffer in a way that is insidious and hard to see: They will get fewer innovations and therapies, fewer new treatments and diagnostic methods.
There is also the danger that, eager for funding, medical journals will become politicized, taking sides with those ideas and rulers currently in power. Editorials and even the tone and tenor of the academic presentations might stray from the empirical and wander towards polemic serrving as a grinding stone for political axes.
So here is the cover of the much anticipated BMJ's "Double Christmas Issue":
The citizens of Havana went wild with joy as they greeted Castro's revolutionary army, which liberated the city from dictator Fulgancio Batista in early January 1959.
Havana? Liberated? Christmas double issue? Why is this the cover of a medical journal? What's this all about? Sadly, it becomes obvious when reading the issue's editorial:
Freedom has become the political buzzword of the 21st century. George Bush's agenda is to bring democracy and freedom to the rest of the peoples of the world, while his own are slaves to work, crippled by personal debt, and trapped in loneliness or loveless relationships—the shackles of the rich. Now that the surviving Afghanis and Iraqis are enjoying the benefits of Western freedoms, what will this mean for their health? No empirical studies have explored the relation between the extent of freedom allowed by political regimes and the effect on a nation's health—until now.
Wow! Is that The BMJ or The Nation? He's calling us (that's you and me, fellow citizens) crippled, lonely and...loveless! And he's doing that under the aegis of the BMJ, where we would expect to be reading reports of the latest brilliant British discoveries: new epidemiological data; the latest empirical slant on arthitidies and polyneuropathies; cerebral encephalomalcia, and therapies derived from Limulus polyphemus. The editor, rather, is blasting fatuous buckshot over our loveless relationships.
Who in Sam Hill is this editor?
Who is he? The Chief of Surgery at London's Winston Churchill Cardiothoracic Clinic? The head of Hematology-Oncology at St. Paul's Cathedral?
No, Kamran Abbasi is a London-based cricket writer and acting editor of the British Medical Journal (italics mine).
A cricket writer.
You mean he's a biologist? An invertebrate zoologist?
No. He's a sports writer...AND acting editor of the British Medical Journal.
Well, maybe they just let hacks in once and a while to spice up the editorials, right? They still have the original research and articles that make them one of the four best medical journals in the world, right?
Well, let's find out. Because it doesn't matter if the BMJ has a kooky Marxist editor as long as the science lies within the magazine. As long as the clever, original research is there. Important studies designed to ferret out the truth and bring to light the clinical and research data that will put another brick down, and cement it into the wall of our knowledge about health and disease. Let's look at a representative sample of the table of contents of the special Christmas double issue:
- Magnetic bracelets relieve pain in osteoarthritis
- Amnesia in the movies bears little relation to reality
- Why the human eye cannot detect offside in football
- A field guide to experts: Are you Peacock, turkey, or dodo?
- Can you tell your clunis from your cubitus
- Polymeal reduces cardiovascular disease by more than 50%
Here's the cover of the most recent New England Journal of Medicine
Sorry. It's not very impressive. No photographs or drawings. But it does have list of the contained articles and report. Here's a sample:
- Maternal and Perinatal Outcomes Associated with a Trial of Labor after Prior Cesarean Delivery
- Palifermin for Oral Mucositis after Intensive Therapy for Hematologic Cancers
- Inflammatory Markers and the Risk of Coronary Heart Disease in Men and Women
- Risk of Myocardial Infarction and Stroke after Acute Infection or Vaccination
- Hypogonadism in a Patient with a Mutation in the Luteinizing Hormone Beta-Subunit Gene
And the editorials?
- Vaginal Birth after Cesarean Revisited
- Oral Mucositis--The Search for a Solution
It's a good comparison. And in the comparing of agendas and content, one can get a fair idea of what happens to the iceberg of health care when it comes under attack by the budgetary ice-picks of politicans. At first there are chips and divots. But the assault is continual, ever enlarging, and never ending. Death by a million blows. Large blocks crack and fall. The contours change, the essence evolves.Eventually, your iceberg is whittled down to something else. A parody of itself, or a useless remnant. In the case of the British system, it's a small frozen figurine of a nasty cricket.