Charles has a well-documented weakness for so-called alternative medicine (SCAM) – not just any SCAM but predominantly the type of SCAM that is both implausible and ineffective. Therefore, nobody can be all that surprised to read in THE TIMES that he has decided to use SCAM for helping women who have difficulties getting pregnant.
If one really wanted to employ SCAM for this aim one is spoilt for choice. In fact, there are only few SCAMs that don’t claim to be useful for this purpose.
A recent review, for instance, suggested that some supplements might be helpful. Other authors advocate SCAMs such as acupuncture, moxibustion, Chinese herbal medicine, psychological intervention, biosimilar electrical stimulation, homeopathy, or hyperbaric oxygen therapy.
Yes, I know! The evidence for these treatments is lousy, and I would never issue a recommendation based on such flimsy evidence.
Yet, the SCAM project at Dumfries House, the Scottish stately home Charles restored in 2007, offers acupuncture, reflexology, massage, yoga, and hypnotherapy for infertile women.
Reflexology, also called zone therapy, is a manual treatment where pressure is applied usually to the sole of the patient’s foot and sometimes also to other areas such as the hands or ears. According to its proponents, foot reflexology is more than a simple foot massage that makes no therapeutic claims beyond relaxation. It is based on the idea that the human body is divided into 10 zones each of which is represented on the sole of the foot. Reflexologists employ maps of the sole of the foot where the body’s organs are depicted. By massaging specific zones which are assumed to be connected to specific organs, reflexologists believe to positively influence the function of these organs. While reflexology is mostly used as a therapy, some therapists also claim they can diagnose health problems through feeling tender or gritty areas on the sole of the foot which, they claim, correspond to specific organs.
Reflexology is not merely implausible as a treatment for infertility, it also boasts of some fairly rigorous trial evidence. A clinical trial (perhaps even the most rigorous of all the trials of SCAM for female fertility problems) testing whether foot reflexology might have a positive effect on the induction of ovulation stated that “the results suggest that any effect on ovulation would not be clinically relevant”.
So, as so often before in the realm of SCAM, Charles has demonstrated that his lack of critical thinking leads him to the least promising options.
Well done, Your Majesty!
Last September, THE GUARDIAN published an article about the HEAD OF THE ROYAL MEDICAL HOUSEHOLD. I did not know much about this position, so I informed myself:
The royal household has its own team of medics, who are on call 24 hours a day. They are led by Prof Sir Huw Thomas (a consultant at King Edward VII’s hospital [the private hospital in Marylebone often used by members of the royal family, including the late Prince Philip] and St Mary’s hospital in Paddington, and professor of gastrointestinal genetics at Imperial College London), head of the medical household and physician to the Queen – a title dating back to 1557. Thomas has been part of the team of royal physicians for 16 years and became the Queen’s personal physician in 2014. The role is not full-time and does not have fixed hours or sessions but Thomas is available whenever he is needed. Thomas received a knighthood in the 2021 new year honours, and was made Knight Commander of the Royal Victorian Order (KCVO) – a personal gift of the monarch. At the time of the honour, in an interview with Imperial College London, he said it had been a “busy couple of years in this role,” adding that he felt “very grateful to have been recognised for my service to date”. Thomas added that being the Queen’s personal physician was a “great honour” and “a very enjoyable and rewarding role”. He said: “The nature of the work is interesting because you see how a whole different organisation, the royal household, operates. You very much become part of that organisation and become the personal doctor to the principal people in it, who are patients just like other patients.” …
In previous generations the royal doctor has caused controversy. When the Queen’s grandfather King George V was in his final hours, Lord Dawson, the royal doctor with personal responsibility for the 70-year-old monarch issued a bulletin, declaring: “The King’s life is moving peacefully towards its close.”
In 1986, four decades after Lord Dawson’s death, his diaries were made public – revealing that he had administered a lethal dose of morphine and cocaine to relieve the King’s pain, but also to ensure that the death could be announced in the morning edition of the Times, rather than “less appropriate evening journals”.
During the last few days, it was difficult to escape all the hoo-hah related to the coronation, and I wondered whether Charles has replaced Prof Thomas in his role as HEAD OF THE ROYAL MEDICAL HOUSEHOLD. It did not take long to find out. There even is a Wiki page on the subject! It provides a list of the recent heads:
List of Heads of the Medical Household
The Head of the Medical Household was first appointed in 1973.
- 1973–1981: Sir Richard Bayliss, KCVO MD FRCP MRCS
- 1981–1989: Sir John Batten, KCVO MD FRCP
- 1989–1993: Sir Anthony Dawson, KCVO MD FRCP
- 1993–2005: Sir Richard Thompson, KCVO DM PRCP
- 2005–2014: Professor Sir John Cunningham, KCVO BM BCh MA DM FRCP
- 2014–2022: Professor Sir Huw Thomas, KCVO MBBS MA PhD
- 2022 – to present: Dr Michael Dixon, LVO, OBE, MA, FRCGP, FRCP
Yes, Michael Dixon! I am sure this will be of interest. Michael Dixon used to be a friend and an occasional collaborator of mine. He has featured prominently in my memoir as well as in my biography of Charles. In addition, he has been the subject of numerous blog posts, e.g.:
- Today, integrative medicine is about to make history, says Dr. Michael Dixon
- My (most forgettable) paper with Dr Michael Dixon
- Boosting immunity against coronavirus? Dr Michael Dixon’s infinite wisdom on the pandemic
- Dr Michael Dixon seems to support homeopathy as a treatment for cancer
- Should homeopathy be blacklisted in general practice? Dr Michael Dixon’s profoundly misleading comments
- Johrei healing and the amazing Dr Dixon (presidential candidate for the RCGP)
- Dr Dixon’s safe herbal medicine
- Remember the ‘Foundation for Integrated Health’? Here is a good summary of its infamous history
- Prince Charles becomes patron of the ‘College of Medicine and Integrated Health’
- Uncharitable charities? The example of ‘YES TO LIFE’
- A treasure trove of fallacies, falsehoods and deceptions
I am sure that many of my readers would like to join me in wishing both Michael and Charles all the best in their new roles.
Social prescribing (SP) has been mentioned here several times before. It seems important to so-called alternative medicine (SCAM), as some enthusiasts – not least King Charles – are trying to use it as a means to smuggle nonsensical treatments into routine healthcare.
SP is supposed to enable healthcare professionals to link patients with non-medical interventions available in the community to address underlying socioeconomic and behavioural determinants. The question, of course, is whether it has any relevant benefits.
This systematic review included all randomised controlled trials of SP among community-dwelling adults recruited from primary care or community setting, investigating any chronic disease risk factors defined by the WHO (behavioural factors: smoking, physical inactivity, unhealthy diet and excessive alcohol consumption; metabolic factors: raised blood pressure, overweight/obesity, hyperlipidaemia and hyperglycaemia). Random effect meta-analyses were performed at two time points: completion of intervention and follow-up after trial.
The researchers identified 9 reports from 8 trials totalling 4621 participants. All studies evaluated SP exercise interventions which were highly heterogeneous regarding the content, duration, frequency and length of follow-up. The majority of studies had some concerns about the risk of bias. A meta-analysis revealed that SP likely increased physical activity (completion: mean difference (MD) 21 min/week, 95% CI 3 to 39, I2=0%; follow-up ≤12 months: MD 19 min/week, 95% CI 8 to 29, I2=0%). However, SP may not improve markers of adiposity, blood pressure, glucose and serum lipid. There were no eligible studies that primarily target unhealthy diet, smoking or excessive alcohol-drinking behaviours.
The authors concluded that SP exercise interventions probably increased physical activity slightly; however, no benefits were observed for metabolic factors. Determining whether SP is effective in modifying the determinants of chronic diseases and promotes sustainable healthy behaviours is limited by the current evidence of quantification and uncertainty, warranting further rigorous studies.
Great! Regular exercise improves physical fitness.
But do we need SP for this?
Don’t get me wrong, I have nothing against connecting patients with social networks to improve their health and quality of life. I do, however, object if SP is used to smuggle unproven or disproven SCAMs into EBM. In addition, I ask myself whether we really need the new profession of a ‘link worker’ to facilitate SP. I remember being taught that a good doctor should look after his/her patients holistically, and surely that includes mentioning and facilitating social networks for those who need them.
I, therefore, fear that SP is taking something valuable out of the hands of doctors. And the irony is that SP is favoured by those who are all too quick to turn around and say: LOOK AT HOW FRIGHTFULLY REDUCTIONIST AND HEARTLESS DOCTORS HAVE BECOME. WE NEED MORE HOLISM IN MEDICINE AND THAT CAN ONLY BE PROVIDED BY SCAM PRACTITIONERS!
A “null field” is a scientific field where there is nothing to discover and where observed associations are thus expected to simply reflect the magnitude of bias.
This analysis aimed to characterize a null field using a known example, homeopathy (a pseudoscientific medical approach based on using highly diluted substances), as a prototype. The researchers identified 50 randomized placebo-controlled trials of homeopathy interventions from highly cited meta-analyses. The primary outcome variable was the observed effect size in the studies. Variables related to study quality or impact were also extracted.
The mean effect size for homeopathy was 0.36 standard deviations (Hedges’ g; 95% confidence interval: 0.21, 0.51) better than placebo, which corresponds to an odds ratio of 1.94 (95% CI: 1.69, 2.23) in favor of homeopathy. 80% of studies had positive effect sizes (favoring homeopathy). The effect size was significantly correlated with citation counts from journals in the directory of open-access journals and CiteWatch. We identified common statistical errors in 25 studies.
The authors concluded that a null field like homeopathy can exhibit large effect sizes, high rates of favorable results, and high citation impact in the published scientific literature. Null fields may represent a useful negative control for the scientific process.
The paper is perhaps not the easiest to comprehend but once you got the idea, you will agree with me that it is BRILLIANT. I warmly recommend it to all fans of homeopathy – in fact, if I could I’d offer it to King Charles as a present for the coronation.
Its authors are among the most prominent medical epidemiologist of our time with affiliations that speak for themselves:
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA; Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA.
- 2Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA.
- 3Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA; Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA; Department of Medicine, Stanford University, Stanford, CA, USA; Department of Biomedical Data Science, Stanford University, Stanford, CA, USA; Department of Statistics, Stanford University, Stanford, CA, USA.
It is, of course, a pity that the article is behind a paywall – but fortunately, the senior author, John Ioannidis, published his email address together with the abstract: [email protected]. So, if you have trouble understanding the point of the analysis, I suggest you ask for a reprint to get your head around it. I promise it’s worth it.
It has been reported that King Charles refused to pay Prince Andrew’s £ 32,000-a-year bill for his personal healing guru. The Duke of York has allegedly submitted the claim to the Privy Purse as a royal expense having sought the help of a yoga teacher.
However, the claim has reportedly been denied by the King, who is said to have told Andrew the bill will need to be covered using his own money. It comes after sources claimed Andrew has been using the Indian yogi for a number of years for chanting, massages, and holistic therapy in the privacy of his mansion. The healer has reportedly enjoyed month-long stays at a time at the £30 million Royal Lodge in Windsor.
Previously, the Queen seems to have passed the claims. But now Charles is in control. A source said: “While the Queen was always happy to indulge her son over the years, Charles is far less inclined to fund such indulgences, particularly in an era of a cost-of-living crisis. “Families are struggling and would rightly baulk at the idea of tens of thousands paid to an Indian guru to provide holistic treatment to a non-working royal living in his grace and favour mansion. This time the King saw the bill for the healer submitted by Andrew to the Privy Purse and thought his brother was having a laugh.”
How is he going to cope without his guru?
Will he be able to recover from the mysterious condition that prevents him to sweat?
Will his ego take another blow?
How will he be able to afford even the most basic holistic wellness?
How can Charles – who knows only too well about its benefits – be so cruel to his own brother?
Should I start a collection so that Andrew can pay for his most basic needs?
Yes, these are the nagging questions and deep concerns that keep me awake at night!
I have just been asked if, by any chance, the yoga teacher is a 16-year-old female. I have to admit that I cannot answer this question.
During the last few days, several journalists have asked me about ayahuasca. Apparently, Harry Windsor said in an interview that it changed his life! However, the family of a young woman who took her own life after using ayahuasca has joined campaigners condemning his comments. Others – including myself – claim that Harry is sending a worrying message talking about his ‘positive’ experience with ayahuasca, saying it ‘brought me a sense of relaxation, release, comfort, a lightness that I managed to hold on to for a period of time’.
So, what is ayahuasca?
This paper explains it quite well:
Ayahuasca is a hallucinogen brew traditionally used for ritual and therapeutic purposes in Northwestern Amazon. It is rich in the tryptamine hallucinogens dimethyltryptamine (DMT), which acts as a serotonin 5-HT2A agonist. This mechanism of action is similar to other compounds such as lysergic acid diethylamide (LSD) and psilocybin. The controlled use of LSD and psilocybin in experimental settings is associated with a low incidence of psychotic episodes, and population studies corroborate these findings. Both the controlled use of DMT in experimental settings and the use of ayahuasca in experimental and ritual settings are not usually associated with psychotic episodes, but little is known regarding ayahuasca or DMT use outside these controlled contexts. Thus, we performed a systematic review of the published case reports describing psychotic episodes associated with ayahuasca and DMT intake. We found three case series and two case reports describing psychotic episodes associated with ayahuasca intake, and three case reports describing psychotic episodes associated with DMT. Several reports describe subjects with a personal and possibly a family history of psychosis (including schizophrenia, schizophreniform disorders, psychotic mania, psychotic depression), nonpsychotic mania, or concomitant use of other drugs. However, some cases also described psychotic episodes in subjects without these previous characteristics. Overall, the incidence of such episodes appears to be rare in both the ritual and the recreational/noncontrolled settings. Performance of a psychiatric screening before administration of these drugs, and other hallucinogens, in controlled settings seems to significantly reduce the possibility of adverse reactions with psychotic symptomatology. Individuals with a personal or family history of any psychotic illness or nonpsychotic mania should avoid hallucinogen intake.
In other words, ayahuasca can lead to serious side effects. They include vomiting, diarrhea, paranoia, and panic. Ayahuasca can also interact with many medications, including antidepressants, psychiatric medications, drugs used to control Parkinson’s disease, cough medicines, weight loss medications, and more. Those with a history of psychiatric disorders, such as schizophrenia, should avoid ayahuasca because this could worsen their psychiatric symptoms. Additionally, taking ayahuasca can increase your heart rate and blood pressure, which may result in dangerous consequences for those who have a heart condition.
Thus ayahuasca is an interesting albeit dangerous herb (in most countries it is illegal to possess or consume it). Currently, it is clearly under-researched, which means we know very little about its potential benefits and even less about the harm it can do.
Considering this, one would think that any half-intelligent person with loads of influence would not promote or encourage its use – but, sadly, it seems that one would be mistaken.
A recent article in ‘The Lancet Regional Health‘ emphasized the “need for reimagining India’s health system and the importance of an inclusive approach for Universal Health Coverage” by employing traditional medicine, including homeopathy. This prompted a response by Siddhesh Zadey that I consider worthy of reproducing here in abbreviated form:
… Since the first trial conducted in 1835 that questioned homeopathy’s efficacy, multiple randomized controlled trials (RCTs) and other studies compiled in several systematic reviews and meta-analyses have shown that there is no reliable and clinically significant effect of non-individualized or individualized homeopathic treatments across disease conditions ranging from irritable bowel syndrome in adults to acute respiratory tract infections in children when compared to placebo or other treatments. Even reviews that support homeopathy’s efficacy consistently caution about low quality of evidence and raise questions on its clinical use. The most recent analysis of reporting bias in homeopathic trials depicted problematic trial conduction practices that further obscure reliability and validity of evidence. Homeopathic treatments have also been linked to aggravations and non-fatal and fatal adverse events.
The Lancet has previously published on another kind of harm that uptake of homeopathy encourages in India: delay to evidence-based clinical care that can lead to fatality. Authors have pointed out that evidence for some of the alternative systems of medicine may not come from RCTs. I agree that more appropriate study designs and analytical techniques are needed for carefully studying individualized treatment paradigms. However, the need for agreement on some consistent form of evidence synthesis and empirical testing across diverse disciplines cannot be discounted. Several other disciplines including psychology, economics, community health, implementation science, and public policy have adopted RCTs and related study designs and have passed the empirical tests of efficacy. Moreover, the ideas around mechanism of action in case of homeopathy still remain controversial and lack evidence after over a century. On the contrary, biochemical, molecular, and physiological mechanistic evidence supporting allopathic treatments has grown abundantly in the same period.
Owing to lack of evidence on its efficacy and safety, the World Health Organization had previously warned against the use of homeopathic treatments for severe diseases. Additionally, multiple countries, including Germany where the practice originated, have initiated mechanisms that discourage uptake of homeopathy while others are considering banning it. Homeopathy doesn’t work, could be harmful, and is not a part of Indian traditional medicine. While we should welcome pluralistic approaches towards UHC, we need to drop homeopathy.
(for references, see original text)
Yes, in the name of progress and in the interest of patients, “we need to drop homeopathy” (not just in India but everywhere). I quite agree!
The UK mainstream media have so far failed to report on this new and highly worrying development: in a rare show of unity, the UK practitioners of so-called alternative medicine (SCAM) have formed the ‘SCAM Union’ (SCAMU) – pronounced ‘scam you’ – and decided to go on strike. Their demands are straightforward:
- increase pay in line with inflation;
- full recognition of their profession;
- right to regular 15 min tai chi breaks.
Already last week, they staged a two-day nationwide walkout.
- Homeopaths stopped seeing patients and some had to start taking remedies at the C 2000 potency to keep calm but NOBODY NOTICED AND THE EFFECT ON THE NATIONS HEALTH WAS NOT NOTICABLE.
- Chiropractors did not adjust a single subluxation and started cracking jokes instead but NOBODY NOTICED AND THE EFFECT ON THE NATIONS HEALTH WAS NOT NOTICABLE.
- Naturopaths failed to detox a single patient but NOBODY NOTICED AND THE EFFECT ON THE NATIONS HEALTH WAS NOT NOTICABLE.
- Crystal healers kept their crystals under wraps but NOBODY NOTICED AND THE EFFECT ON THE NATIONS HEALTH WAS NOT NOTICABLE.
- Osteopath mobilized not a single joint but NOBODY NOTICED AND THE EFFECT ON THE NATIONS HEALTH WAS NOT NOTICABLE.
- Acupuncturists failed to insert a single needle but NOBODY NOTICED AND THE EFFECT ON THE NATIONS HEALTH WAS NOT NOTICABLE.
- Vaginal steamers only steamed the odd dim sum for lunch but NOBODY NOTICED AND THE EFFECT ON THE NATIONS HEALTH WAS NOT NOTICABLE.
- Ear candlers did not light a single candle and instead aligned them in a visual picket line but NOBODY NOTICED AND THE EFFECT ON THE NATIONS HEALTH WAS NOT NOTICABLE.
- Aromatherapists refused to open any bottles with essential oil but NOBODY NOTICED AND THE EFFECT ON THE NATIONS HEALTH WAS NOT NOTICABLE.
- Herbalists simply said ‘Thyme will tell’ but NOBODY NOTICED AND THE EFFECT ON THE NATIONS HEALTH WAS NOT NOTICABLE.
- Bach flower therapists had to consume their own Rescue Remedies in large quantities but NOBODY NOTICED AND THE EFFECT ON THE NATIONS HEALTH WAS NOT NOTICABLE.
- Holistic practitioners claimed to be wholly distraught but NOBODY NOTICED AND THE EFFECT ON THE NATIONS HEALTH WAS NOT NOTICABLE.
Perhaps the most outrageous thing about these events is that the UK press studiously ignored the all-out strike (one broadsheet editor commented: “if it’s not about Megan, we are not interested). Merely King Charles seemed alarmed and was overheard privately mumbling to Camilla: “What next?”
I have been told that some of my readers have difficulties knowing when I am pulling their legs. So, let me confirm: every word here is uninvented – or was that uninventive?
About 3 years ago, I reported that the Bavarian government had decided to fund research into the question of whether the use of homeopathy would reduce the use of antibiotics (an idea that also King Charles fancies). With the help of some friends, I found further details of the project. Here are some of them:
The study on individualized homeopathic treatment to reduce the need for antibiotics in patients with recurrent urinary tract infections is a randomized, placebo-controlled, multicenter, double-blind trial. Frequent urinary tract infections (more than two infections within six months or more than three infections within twelve months) occur in up to three percent of all women during their lifetime and represent a high risk for increased antibiotic use in this population.
The current guidelines therefore also provide for therapeutic approaches without antibiotic administration under close monitoring. The approach to be investigated in the study is the administration of a homeopathic medicine individually selected for the patient for prophylaxis. The number of urinary tract infections and the need for antibiotics will be recorded and evaluated at the end of the trial period, around mid to late 2023.
The aim of the study is to find out whether patients taking homeopathics need antibiotics for the treatment of urinary tract infections less often compared to the placebo group. This could lead to a reduction in the use of antibiotics for recurrent urinary tract infections.
Project participants: Technical University of Munich, Klinikum Rechts der Isar
Project funding: 709,480.75 Euros
Project duration: January 1, 2021 to December 31, 2023
This sketch is of course not enough for providing a full evaluation of the study concept (if someone has more details, I’d be interested to learn more). From the little information given above, I feel that:
- the design of the trial might be quite rigorous,
- a fairly large sample will be required to have enough power,
- the closing date of 31/12/2023 seems optimistic (but this obviously depends on the number of centers cooperating),
- I, therefore, predict that we will have to wait a long time for the results (the pandemic and other obstacles will have delayed recruitment),
- the costs of the trial are already substantial and might increase due to delays etc.
My main criticism of the study is that:
- I see no rationale for doing such a trial,
- there is no evidence to suggest that homeopathy might prevent recurrent urinary tract infections,
- there is compelling evidence that homeopathic remedies are placebos,
- the study thus compares one placebo with another placebo (in fact, it is a classic example of what my late friend Harriet Hall would have called TOOTH FAIRY SCIENCE),
- therefore, its results will show no difference between the 2 groups (provided the trial was conducted without bias),
- if that is true, enthusiastic homeopaths will claim that the homeopathic verum was inadequate (e.g. because the homeopaths prescribing the verum did not or could not do their job properly),
- when that happens, they will therefore not stop claiming that homeopathy can reduce the over-prescribing of antibiotics;
- that means we will be exactly where we were before the trial.
In other words, the study will turn out to be a waste of 709,480.75 Euros. To express it as I did in my previous post: the Bavarian government has gone barmy!
In case you have categorized Harry Windsor as an ungrateful brat, you are entirely wrong! He did thank a lot of people – Ophra and Gwyneth Paltrow, for instance. No, I did not read Harry’s bestseller ‘SPARE’. But I did, of course, read the odd report about it simply because it is almost impossible to escape the current press hoo-ha about it.
Most of what I learned is of no interest to me. Some of it, I have to admit, made me concerned about Hary’s wellbeing – after all, we know that chronic drug-taking can severely affect one’s mental health! However, one recent article in Newsweek managed to reassure me on that score:
Among the “professionals, medical experts, and coaches” thanked by the prince for “keeping me physically and mentally strong over the years,” is John Amaral, a Los Angeles-based chiropractor, energy practitioner, author and educator. Amaral is known for his self-developed “energy flow formula,” which combines body and energy work to include mindfulness, meditation and breathing.
This sounded sufficiently relevant for me to look up Amaral. This is what we learn from one website:
Dr. John Amaral is a holistic chiropractor that practices Network Spinal (NSA). This technique helps people release stored tension in their muscles and joints through gentle force adjustments, also known as entrainments. Instead of the traditional cracking or popping of bones that you’re used to seeing at chiropractic offices, John Amaral leverages different energetic intelligences to help people heal physically and emotionally.
Another source tells us the following:
John Amaral is a chiropractor, energy healer and educator who works behind the scenes helping celebrities, entrepreneurs, pro athletes and influencers elevate their energy so they feel and perform their best. John has worked with thousands of people from over 50 countries. He is the Founder of Body Centered Leadership… How much do his sessions cost? According to the Wall Street Journal, a healing session with Amaral will run you $2,500.
And a third website informs us that:
Amaral works with what he calls the “subtle energy body”, which is the energy field around the body that can extend around 3 to 8 feet from the physical body. His work is primarily focused on shifting the tension state of the body and help in freeing up bound-up energy that’s held in different parts of the body. He accesses the energy around the body to achieve this.
In case you have not yet got the drift, take a look at this video; impressive isn’t it?
Yes, Amaral is not cheap but he must be worth it! And because he is such a genial healer, I am confident that we can all relax now knowing that Harry’s health is in such good hands. Personally, I am thrilled by Harry’s hint that there might be a second book in the offing – one with the really dirty linen. I think I might actually buy that one, now that I know how badly he needs the money for keeping healthy.