DR GOLEM. How to think about medicine. By Harry Collins and Trevor Pinch.
246pp. University of Chicago Press. $25; distributed in the UK by Wiley. Pounds
17.50. 0 226 711366 3
CATHARSIS. On the art of medicine. By Andrzej Szczeklik. 161pp. University of Chicago Press. $20; distributed in the UK by Wiley. Pounds 13. 0 226 78869 5
In 1954, Linus Pauling won the Nobel Prize for Chemistry. In 1962, he was back in Stockholm, this time collecting the Nobel Prize for Peace. Eight years later, he suggested that vitamin C might be a cure for cancer and, when a fellow enthusiast named Ewan Cameron wrote to him with promising results of an early study the following year, the two men began to collaborate on further trials. Their advocacy -particularly with Pauling's powerful connections -drew attention. By 1975, the Sloan-Kettering Cancer Institute in New York reported its own early results of vitamin C in a small number of patients with advanced cancer. Unlike the initial studies, they showed no benefit whatsoever.
Pauling urged his British collaborator to improve the quality of his study design and start a randomized placebo-controlled trial in which both doctors and patients were blinded to who was getting the vitamin C and who the placebo.
Unwilling to deny a beneficial drug to half of his patients, though, Pauling's colleague refused, continuing to experiment with vitamin C in a manner desperately vulnerable to bias. The results were strongly positive and the excited media loved them. The Mayo Clinic was pressured to undertake a proper randomized, double blind placebo-controlled trial. Their results were negative: vitamin C had no impact on cancer. In the face of Pauling's angry complaints, the Mayo repeated their study, this time altering their methods to respond to Pauling's criticisms. The second study, too, found that high doses of vitamin C provided no benefits whatsoever.
The account by Harry Collins and Trevor Pinch of the whole episode, in Dr Golem:
How to think about medicine, is vivid, absorbing and intelligent. Even with their tiresome habit of beginning every section of their book with a ponderous list of what is to come, the vitamin C story has an appealing freshness to it.
Partly that is the quality of the writing, partly the intellectual appeal of the story itself.
