Hard News: A Real Alternative
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if she's going to be bashed for relying on a published account of the number of children Matheson had
This is a little relevant to the topic at hand. I'm not planning to re-listen to the interview, but according to the notes I took, Bryder imho over-emphasised the chance of hysterectomy as alternative treatment (as I've noted before), and I think actually suggested that Matheson had 4 children after her initial contact with Green. This implies that Green's 'nontreatment' allowed her to have 4 children when she otherwise wouldn't have, and that many other women wouldn't have been able to have children. Bryder also argues the cone biopsy was invasive, and that Green spared them that. Except that it seems his ring biopsies tended to be a half-arsed cone-biopsy that didn't treat, and which tended to occur multiple times (6 in Matheson's case).
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But would there have been any acceptable way for Bryder to nuance the accepted wisdom? I suspect, for some people, no.
I think there could have been an acceptable way to "nuance" it. But actually denying the experiment and rewriting history is akin to climate change denial.
Charlotte Paul said that in a way there were two groups.
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But if she's going to be bashed for relying on a published account of the number of children Matheson had, it seems a bit unfair for Coney, Bunkle and Cartwright's howler over the "two groups" -- and even given James' useful commentary, it still seems to me a truly terrible mistake -- to be deemed irrelevant.
None of it is irrelevant to the larger discourse.
However I believe that Bryder's motivation for referring to the number of children is of most interest. Having said that, the matter seems far from a significant reason why Matheson and others feel insulted.
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As I said, Barton's story was worth reading and I fail to see how it was served (let alone improved) by a lead trying to construct a Matheson vs. Bryder cat fight.
I can say with confidence that Bryder's book and people's reactions to it will destroy friendships and lead to serious arguments in the academic community. I can't begin to imagine how patients who feel strongly about what happened to them will be feeling about it.
But would there have been any acceptable way for Bryder to nuance the accepted wisdom? I suspect, for some people, no. There's just too much invested in it.
Yes. Historians and other academics do it all the time. You write a paper or book, you present your research at conferences and receive feedback and criticism from your peers. You then publish with confidence.
If you go into left/right field and your conclusions and/or methods don't match stand up to the criticism of your colleagues, and you publish anyway, you're going to catch it, which is what's happening to Bryder now.
The field would welcome solid research and revision which takes a new look at the material and comes to different conclusions.
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Yes. Historians and other academics do it all the time.
Kyle is totally right. History is basically just a series of long, nuanced arguments.
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With interspersed fisticuffs, academic and otherwise. :)
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interspersed fisticuffs
Miles Fairburn actually did throw a punch at someone else at VUW once, I hear... but he was probably 'atomised' at the time. (Nerdy historian joke alert!)
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Just found another paper Jones (2009) in Obstetrics & Gynecology (same Jones as earlier), with a few more interesting observations.
*McIndoe was reviewing Green's cases without permission *One of the reviewers of the McIndoe study wrote: "“This is an important paper. Dr. Green was the last vocal opponent to the concept of the intraepithelial phase of invasive squamous cell cancer. His unfortunate views received a ready forum at international meetings because it seldom failed to gather a crowd and he remained influential long after an overwhelming body of data made his views untenable. This paper should be the last chapter in the Green saga. The authors are correct in pointing out that it will probably be the last large series in which patients with CIS are followed prospectively. Let us hope that is true.”"(c.1984)
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...Coney, Bunkle and Cartwright's howler over the "two groups"
From Barton's Hearld piece:
Bryder argues that because there were not two groups of patients in a randomised controlled trial, there was no experiment at all, no research component to Green's 1966 proposal for the treatment of CIS.
"It's a complete non sequitur," says Manning. "The judge didn't make that mistake. She knew there weren't two groups." By the time of the inquiry, Coney and Bunkle also knew about the error they had made in their article about Green dividing the women he treated into two groups.
Manning quotes from page 63 of Cartwright's report: "Green's 1966 proposal was not a randomised control trial, but it was experimental research combined with patient care." And from page 65: "Green himself eventually conceded that his management of the patients was a research programme into the natural history of CIS."
I don't think anyone is now claiming- as perhaps Coney did initially- that Green was following a clear experimental design.
But equally clearly there could be established from the records, post factum, two "groups": those whom Green had not treated, and those who were treated 'conventionally'.
That's what the McIndoe/McLean paper did. Misinterpreting that paper was Coney and Bunkle's mistake-. whether they've owned up to it sufficiently or not.
Foisting that mistake onto the Cartwright Inquiry- and then opting for the explanation that therefore nothing at all was amiss- appears to be Bryder's. -
Belatedly- thank you James Green. Your analysis of this has been clear- as much as one can be- informed and very helpful. Respect.
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@Rob -- Thanks. I've wasted a bit much time on this, so I'm glad it's been useful.
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Yes. Historians and other academics do it all the time. You write a paper or book, you present your research at conferences and receive feedback and criticism from your peers. You then publish with confidence.
If you go into left/right field and your conclusions and/or methods don't match stand up to the criticism of your colleagues, and you publish anyway, you're going to catch it, which is what's happening to Bryder now.
And if we stoned to death every academic whose work was reduced to BBQ-flavoured FUBAR by the media, their colleagues would be spending more time on funeral leave than anything else.
Here's something else to consider: If you've got problems with The Listener (or in my case, The Herald) direct your ire at the right target. Neither Bryder nor the AUP would have gotten final approval of Black's story or the cover copy -- and nor should they.
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And if we stoned to death every academic whose work was reduced to BBQ-flavoured FUBAR by the media, their colleagues would be spending more time on funeral leave than anything else.
Exaggeration, much? I can't think of many academics who would publish something without first subjecting it to peer review as Kyle says. Bryder at least makes a change from the usual racism of those who do. And reminds us of her profession's usual high standards, although I agree the subsequent reporting can leave much to be desired in any case.
Sadly, the Science Media Centre does not seem to have anything at all about the underlying science of this topical health research issue to guide journalists.
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Exaggeration, much?
While the sole daily newspaper in New Zealand's largest media market routinely struggles to get its head around the idea that correlation and causation aren't the same, I'd say: Not much.
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it seems a bit unfair for Coney, Bunkle and Cartwright's howler over the "two groups" -- and even given James' useful commentary, it still seems to me a truly terrible mistake -- to be deemed irrelevant.
Russell, if you were to listen again to the Paul/Hill interview, in particular at 4.50-7.05 and again around 32 mins, I doubt that you would consider that there was a Coney Bunkle Cartwright 'howler' and 'terrible mistake' in the matter of the two groups, that there was in principle an experimental study.
Paul seems totally credible, given her direct role in what seems to have been an exhaustive inquiry process - Green chose one group of women semi-randomly in advance (prospectively) for an "intervention" consisting of monitoring only, for comparison with the other one to receive conventional treatment.
But it was a "bad experiment" by which in context I think she means the prospective groups were not clearly defined and recorded, treatments were not by consistent protocols and that of individual women evolved from one group to the other in response to clinical decisions, and it was not properly analysed and reported.
When after Green's retirement McIndoe et al. analysed the data, they could not use the prospective grouping. Instead they grouped the patients retrospectively, nominally using clear smear tests (or not) at 2 years as the basis for their grouping. There is strong overlap but not complete matching between their retrospective group 2 and Green's prospective group for monitoring-only. Paul is also clear that the inquiry did not rely on the McIndoe et al analysis, but went well beyond it in thoroughness, though the impression and inherent confusion in this remains.
The McCredie et al 2008 analysis after subsequent follow-up takes fortunate advantage of the unethical, never-to-repeated, unfortunate experiment, to establish the frequency and rate of progression of untreated "carcinoma-in-situ" (CIN3) to invasive cancer - c. 31% after 30 years.
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@Rob -- Thanks. I've wasted a bit much time on this, so I'm glad it's been useful.
I certainly wouldn't say your time has been "wasted", James. It's greatly appreciated.
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Paul seems totally credible
Charlotte Paul has also been the clinical director of the current national cervical screening programme for some time. Must check if she still is.
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Uh, that may have come up in the RNZ interview which I still haven't listed to yet.
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More caffeine..
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History is always going to be contested. Just ask other members of your family about a significant event in your collective past - there will be a huge range of interpretations. But that is the fascination of history.
I have no problem with Linda Bryder writing her interpretation of the written account (although I'm not sure if her funders who were expecting a history of National Women's will be so happy, and I'm not sure about the publisher's role). It will be another useful part of our historical record. But she has to front and defend it.
What I do have a problem with is with others assuming this is somehow a definitive view - that she is right and others are wrong. It is merely another interpretation, using a particular set of sources with a particular methodology.
Just imagine if someone reviewed the written record around the Springbok tour and came to the conclusion that the Rugby Union and Ron Don had been unfairly treated and the protesters had got it wrong about apartheid. It wouldn't be received reverentially and quietly.
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Just imagine if someone reviewed the written record around the Springbok tour and came to the conclusion that the Rugby Union and Ron Don had been unfairly treated and the protesters had got it wrong about apartheid. It wouldn't be received reverentially and quietly.
But the Springbok protesters were doing something *important*. Not just being all humourless and feminist about ladybits. </withering>
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What I do have a problem with is with others assuming this is somehow a definitive view - that she is right and others are wrong. It is merely another interpretation, using a particular set of sources with a particular methodology.
I think the debate in the field is going to be between those who argue this, and those who are just flat out saying she is wrong wrong wrong. That's pretty much always Charlotte Paul's answer.
History is often a non-definitive field. But sometimes people stray far enough from the path of a broad truth and they get called on it rather than some wiffle-waffle "I think their interpretation differs from mine in emphasis..."
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Just imagine if someone reviewed the written record around the Springbok tour and came to the conclusion that the Rugby Union and Ron Don had been unfairly treated and the protesters had got it wrong about apartheid. It wouldn't be received reverentially and quietly.
Wow... why don't I save everyone some time and compare Bryder to David Irving? </I raise Danielle's withering and see her>
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why don't I save everyone some time and compare Bryder to David Irving?
The analogy Hilary is drawing is between protest movements, not between injustices or their apologists. Don't Godwin us man!
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The analogy Hilary is drawing is between protest movements, not between injustices or their apologists. Don't Godwin us man!
Oh... I'm still wondering where the point of similarity between Bryder and an apologist for apartheid (let alone a Holocaust denier who has been comprehensively exposed as falsifying data and distorting sources, come to that) lies. Still, I guess any historian who dares to question whether economic, cultural and sporting sanctions against South Africa really hastened the fall of apartheid shouldn't expect a quiet life around these parts.
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