The Doctor’s Surgery Theodore Dalrymple
To grasp at therapeutic straws is a natural human response to a serious illness for which there is as yet no known cure.
I am not sure that I would not do it myself if I found myself in a desperate situation. Let he who has never been close to death mock at credulity.
In France, a man who has the air of both mad scientific genius and cult leader, Professor Didier Raoult of Marseille, who affects an appearance that is half-asterix and half-ageing-rock-star (which, on his own admission, he adopted to irritate his colleagues), has become as instantly recognisable to the man or woman in the street as Prince Harry. He is a hero to some and a nuisance to others.
There is no doubt about his eminence as a clinical microbiologist; he has many discoveries to his name. He has also long promoted a drug, hydroxychloroquine, as a cure for serious viral illnesses, including (now that it has emerged in force) COVID-19.
There is some evidence in the drug’s favour. It kills the virus in vitro; that is to say in laboratory culture. But that is not the same as showing that it works in vivo, on actual patients. After all, a well-known brand of household bleach was said to kill 99 per cent of household germs, but that was not to say that drinking it cured 99 per cent of infectious diseases.
There have also been some small trials conducted by Professor Raoult, but they are inconclusive, to say the least, and have been widely criticised by other clinical scientists for their bad methodology.
The professor is not impressed by these criticisms (which seem to me justified). He says that properly controlled double-blind trials are not the only way in which medical knowledge is obtained and there, in the abstract, he is quite right. No one needed to do a double-blind trial to show that anaesthetics worked; nor did Pasteur need to do double-blind trials on his treatment for rabies, because without it every patient without exception died.
The professor says that there is no other treatment available for COVID-19, and that therefore prima facie evidence is enough and justifies his continuing to use it. The trouble is that hydroxychloroquine is not an otherwise innocuous substance. It sometimes has dangerous side effects, which those who have taken the professor at his word and gone in for a little self-medication have discovered. There have even been deaths.
Nevertheless, he has a following of almost religious intensity, and the fact is that quite a lot of what he says makes good sense. He says that the scattergun approach adopted by many European countries is wrong, indeed harmful. It would have been much better (and would still be much better now) to perform mass testing and isolate those who test positive; not those who test negative. To lock positives in close proximity with negatives is not the best way to prevent the spread of the disease, and Professor Raoult says that it has never worked in history.
He also advocates vigorous treatment of those who test positive, and this is where he alienates many in the profession, who deny that any such treatment exists other than assistance with breathing when it becomes difficult or impossible.
His institute in Marseille had the imprimatur of the French Institut National de la Santé et de la Recherche Médicale withdrawn from it in 2018 because of allegations of sexual impropriety that took place within it – not on his part, but also not taken sufficiently seriously.
How trivial, how decadent, this now seems in the light of the present situation! It was never alleged that Professor Raoult was anything other than a leader in his field.