I undertook my nurse training nearly 40 years ago and of course I often use much of the knowledge and experience gained and built upon since then. Strangely there are a number of ‘call out’ memories that just stick in my mind, and are as vivid today as they were all that time ago. Weil’s disease is one of those memories. When I learnt about Weil’s disease (pronounced Veil’s disease) I was told it was a disease from the past and very rarely seen. It is a disease that is spread to humans through the urine of rats – and as chicken keepers of the world will tell you (and I have kept them for some 40 years), keep chickens and sooner or later you will get to know about rats. They can get in anywhere, and when they do, they cause enormous amounts of damage, steal eggs and will often kill baby chicks.
There is a persistent urban myth that we are never further than 6 feet from a rat. I’m not sure why this enduring myth is so well known, particularly as there is probably little truth in the assertion. The environmental health and housing consultant Stephen Battersby has researched British rats for much of his career. He estimates that there around 10.5 million rats in the UK and given there are over 60 million people in the UK we outnumber the rats 6 to 1. So if you divide the total urban area of the UK, around 16,000 square miles, by hypothetically distributing rats evenly across this space, you would actually be (at most) 164 feet from a rat.
All of the above came to mind as read the report last week of the death of a New Yorker, with 2 others made very ill from Leptospirosis (the medical name for Weil’s disease). All 3 cases came from the Bronx area of New York and occurred in the last 2 months. In the last 10 years there has been 26 cases. Given the nature of how the disease is spread, it is perhaps not surprising that all these cases but one, involved men. As far as I am concerned however, the wild rat has absolutely no redeeming features.
One of the other ‘call out’ memories from my nurse education is that vitamin D is not a vitamin at all. Vitamin D is actually a hormone, and as such, it is our bodies that makes most of the vitamin D we need. 10% comes from our food, but it is the action of sunlight on our skin that first produces cholecalciferol, which gets converted by the liver to calcidiol – the active form of vitamin D is then produced by the kidneys. Too little vitamin D is most often associated with calcium deficiency and healthy bones, causing rickets in children and osteomalacia in adults. It has also been linked to the development of diabetes, multiple sclerosis, depression, heart disease and last week, research published in the British Medical Journal argued it could help spare 3 million people from suffering from cold and flu each year.
It’s true that our body’s immune system uses vitamin D to make antimicrobial ‘weapons’ that puncture holes in bacteria and viruses, and so could help prevent colds and flu. However, 1 in 5 people (1 in 10 for those aged 40 or over) in the UK have such low levels of vitamin D that they would need to take supplements to gain this protection. And that’s the rub. The team that undertook the research advocated that vitamin D supplements should be added to food or milk, which to me is taking population health to a new and unacceptable level.
Choice is everything, and these days digital technology increasingly enables us take a proactive approach to maintaining our health and wellbeing. There is a huge resource of advice available in many different media to help us make such choices and sustainable lifestyle changes. It should not be the role of the State to use and draw upon ‘scientific knowledge’ to exert social control in any form. My favourite philosopher, Foucault returned to this theme in much of his work, noting that there is a relationship between power and knowledge - and power (political, hegemonic or otherwise) should never be used to control and define knowledge.
Coming at the same issues from a slightly different perspective was Burrhus Frederic Skinner, the famous American psychologist. Skinner believed that free will was an illusion and that human behaviour was dependent on the consequences of previous actions. You can see where Skinner took these ideas too in his famous book Walden Two. Here he describes how it’s possible to achieve an utopian society through the application of his beliefs on how behaviour can be controlled. This book can still be found and purchased on Amazon, but all I would say, before you rush out to buy it, is perhaps it is also worth remembering that Skinner was most famous for his experiments with rats.