The Doctor’s Surgery

When I read in a paper in the Journal of the American Medical Association that the consumption of sweetened drinks was associated with an increased death rate, I experienced a frisson of malicious pleasure. No doubt it is the sign of my bad character.

I abominate these drinks and it infuriates me that people drink such muck. The worst thing about them is that consumers (especially young consumers) tend to throw their highly coloured cans from car windows into the countryside.

Actually, the consumption of fruit juice was just as bad for you as ingesting the vile concoctions of the comestiblechemical companies. Natural, or relatively natural, is not necessarily good.

The association between death and sweet drinks (when controlled for other obvious factors) was disappointingly small – disappointing to me, that is. Indeed, it might be so small as to be a mere statistical artefact.

But there is worse: as far as I could tell, the association was found by means of a trawl through possible risk factors for death by heart attack and stroke. The fact is that, if you examine enough risk factors, you are bound to find associations that appear not to be by chance but that are, in fact, by chance.

The better way to go about things is from prior hypothesis to statistics, not from statistics to subsequent hypothesis: in this case, the reasons sweet drinks supposedly kill people.

In the same journal, there was another paper that examined that important subject, the determinants of longevity.

The authors hypothesised that older people with a purpose in life live longer than those without. Those authors found a strong association between purpose and longevity or, to put it another way, between purposelessness and death.

Following a cohort of people aged at the outset between 50 and 60, who were followed for about 16 years, the authors found that people with the weakest sense of purpose in life had a mortality rate of two and a half times that of people with the strongest. The authors advocated that everyone should have a purpose in life.

Amen to that! There is a slight problem with such advocacy, however: how does a person without a purpose in life go about finding one? A nihilist can easily make mock of any purpose.

My reservation about the paper resides in its treating a sense of purpose as if it were a medicament. Had the paper found no association between lack of purpose and earlier death, would one conclude that it was all right, then, to have no purpose? Or, even worse, suppose that early death had been associated with a sense of purpose (as it might be, if purposes were generally associated with hazardous activities, such as being a war photographer). Would one then advocate that people abandon their purpose in life, and live instead a long but vegetative life? The world, said Boswell, is not to be made a great hospital; but does not treating purpose as if it were an antibiotic risk precisely that?

Nevertheless, this paper had an effect on me. I dislike intensely the phenomenon of charity shops disfiguring our high streets. When I examine their economics, they seem to me almost criminal enterprises – at least morally fraudulent. But they undoubtedly give the old ladies and gents who work in them a sense of purpose and therefore may actually be doing some good, though not in the way most donors suppose.

Many an oldie in Britain is kept alive by serving in a charity shop, though they probably imagine they are saving life elsewhere.