Thursday, 29 April 2010

Ashes to Ashes

It looks like the volcanic cloud business is over for the moment. What a fascinating affair and a good demonstration of the inability of the media to talk sensibly about risk.

First we had dramatic stuff about volcanic dust turning to glass inside jet engines and wrecking them, based on several stories about near misses. Excellent. I always like learning from near misses, they do so much less damage but still give us knowledge.

By the middle of the crisis we had questions being raised about whether it was all a panic about nothing. Surprise, surprise, but did we have a sensible discussion? No. At no point did anyone discuss the crucial questions. The first is, I think:

“How many planes crashing are justifiable?”

If the answer is none, then the ban on flights was probably inevitable. I suspect that was the number that the air traffic control people were working on, no increase in risk.

That has a cost, millions apparently lost in cancelled flights etc. I bet some of those calculations will turn up in due course at shareholders meetings and the like. So that’s the other half of the calculation:

“How much money can we afford to lose to maintain a given level of safety?” Again a question not asked.

I heard countless interviews with poor stranded tourists and others affected by the flight ban and no one got around to asking them:

“How big a risk would you take to get home?”

It is apparently the case that the public are not good at assessing risk – people keep doing stupid things because they don’t realise how dangerous they are. Here was a golden opportunity to do something about it. Is flying through a cloud of volcanic dust more dangerous than drinking twenty pints a night or smoking twenty a day for ten years? Is driving back from Spain more dangerous than flying through the cloud?

I think I finally despaired of anything good coming out of it when I heard that Willy Walshe was flying around in the cloud. Given his gung ho approach to industrial relations he was the obvious guy for it but no one asked him the obvious questions.

“Did you restrict the flight to uninhabited areas or the sea?”

“Did you have a parachute?”

He was flying over us and we were living under him, who was taking the biggest risk?

Friday, 9 April 2010

4 Reasons why you might not trust drug companies

4 Reasons why you might not trust drug companies - or why a new drug is the background for my novel ‘A Rag Doll Falling.’

Temptation 1 The price. A patent protects the invention when a new drug comes out, but it doesn’t last forever. The company has to take out the patent as soon as they invent the drug and at that stage they have no idea what it does. They have to try it out on different diseases. Usually they’ll try it on cells in test tubes and then in animals and eventually in people. They test for safety in normal volunteers and then on people who are very ill, the last chance saloon and eventually if things go well it gets on the market, licensed for a particular set of conditions. All that testing takes time and the clock is running down on the patent. The more that the public demand safety, the longer it takes. As soon as it is on sale the company has to try to recover the investment and make a profit. So there is a big temptation to charge the highest possible price.

Temptation 2 Keep testing to a minimum. Do the shortest clinical trials you can get away with. If possible test your new drug against a placebo, rather than head to head with the best drugs so far. That way no one can tell for sure if the new drug is really an improvement.

As the New England Journal of Medicine says “Placebo-controlled trials require smaller sample sizes than active-comparator trials, are less expensive to conduct (and therefore reduce the costs of market entry), and present less risk of producing unanticipated unfavorable findings…Yet placebo-controlled trials that are not supplemented by active-comparator trials leave clinicians, patients, and payers in the dark, providing no guidance on a new product’s advantages or disadvantages relative to existing products.” From (10.1056/NEJMp0906490) published on August 12, 2009, at

Temptation 3 Stretch the licence. Encourage doctors to prescribe the drug for all sorts of other conditions where it might do some good. It’s not legal to do that and every year we hear of companies being fined by regulatory agencies for going too far. The fines often run into many million, which gives some idea of the profits that are at stake.

Temptation 4 Fund patient groups so that they demand the drug. If you can’t persuade the doctors with advertising and salesmen, maybe their patients will do the job for you. Why don’t patients tell their doctors to stick to the older drugs that are tried and tested? Mostly because illness scares people, cancer in particular, and it’s easy to assume that a new drug must be a better drug. All that media reporting about science and breakthroughs pushes us in that direction. Some of that must be set up by the dug companies mustn’t it - who else can they ask?

OK I don’t want to overdo it, but you have to admit it’s a good backdrop for a novel. Of course in fiction you can throw in some very unethical ambition and the odd murder that I’m sure don’t happen in real life – well I hope not anyway.

Read the book as an ebook at

Saturday, 3 April 2010

Living with an artist

It has finally dawned on me that I am living with an artist. I always knew that Lois could paint and draw, but facility is not necessarily art. I think it was Pissarro who warned his son against facility, though it might have been someone else. The point is that if you are good at something then you don't have to work at it. If you don't work at it then you may not really get what it is about.

Compared to me, and to many others I guess, Lois has facility in painting and drawing, but she also finds it hard to work at it. In the last two years she has discovered machine embroidery, what I call fabricollage. Collage with fabrics in other words. Embroidery as we usually know it is all detailed little stitches, careful hand sewing and nimble fingers. Machine embroidery on the other hand is a much more wild adventure.

For a start changing the foot on the sewing machine, or taking it off altogether, modifies the sewing machine. That means you can stitch anything to anything, within reason anyway. If you thing a piece of plastic or a sweet wrapper would look just right for the effect you want, then stitch it on, or glue works, or Bondaweb that you iron on will do. PVA adhesive turns out to be an embroidery material.

This freedom forces experiment. If anything goes, then everything goes, anarchy rules, and it is the final look of the work that determines what is best.

Trying things means that the house is covered with experiments and there is something exciting about living in the middle of art in creation. A writer experiments of course, my computer is full of them, but my experiments are not physical. I don’t trip over them.

It is hard to say exactly what art is, hence the multiplicity of definitions if you look for them. Inspiration is part of it, and seeing things differently and something that Nicholas Serota said about lifting the spirit. The cool thing is that Lois has an idea, sees something differently, and my spirit is lifted. It is an inspiration.