The smell of false hope
Authors: Kamran Abbasi
Journal: Journal of the Royal Society of Medicine (2007)

Men fail to match women in many important ways: we cannot multitask and we are not multi-orgasmic, for example. And some men may have realized that their sense of smell is far inferior to the olfactory power of their female partner. Up to now I have taken this failing as a personal one peculiar to my genetic predisposition and nasal structure, but it transpires that studies document this sexual imbalance in olfaction—and there is even a reason for it. Mahmood Bhutta, in his review of sex and the nose, presents evidence that humans use odour to influence mate selection (JRSM 2007;100:268-274). Choice of mate, it seems, is much more important for women than it is for men since they make a much larger parental investment—and the more different the odour the bigger the attraction. For men in relationships this paper helps us understand one of the fundamental mysteries of the universe: why the hell did our partners choose us in the first place? For men failing to woo the object of their desires, the solution is simple: try somebody else or find yourself a new deodorant.

I wonder what the MTAS mandarins smell like to junior doctors? Judging from the myths put forward over the past few months—including the fishy tale that ‘no doctors will be unemployed in August’—they would not make desirable mates. Jonathan Rohrer, Jonathan Kennedy and William Knight seek to debunk the MTAS myths (JRSM 2007;100:252-253). One of the myths, of course, is that MTAS was about improving patient care. How was this to be accomplished when fewer junior doctors will be receiving less training than in the past? Now that MTAS has been ditched, I have to ask: what will take its place?

I write these revelations from Vienna, a city of high culture and wonderful smells—or so I am told. It was also once the home of Professor Joseph von Sonnenfels, one of the first Viennese journalists and editor of the liberal periodical The Unprejudiced Man. In 1776, Sonnenfels persuaded the Empress of Austria and her son and heir to abolish all forms of torture. Over the next decade, serfdom and the death penalty were also abolished in enlightened Austria.

In the time of torture, Austria had developed a role for physicians as ‘torture doctors’ or Folter Arzt. The job of the Folter Arzt was not to inflict torture but to protect the prisoner at interrogations, as explained by Hugh Baron in this issue (JRSM 2007;100:262-264). Professor Ferdinand Edlen von Leber was a Folter Arzt who campaigned against torture and persuaded the Viennese Faculty of Medicine to agree that ‘torture practiced in this country with thumb-screw, press and rack should be practiced without danger to life.’ Baron also draws an unfavourable comparison between the Viennese doctors of the 18th century and our modern day Folter Arzt, who comply with the torturers of Guantanamo Bay and Abu Ghraib—and most other parts of the world, if you accept Amnesty International's claims (JRSM 2007;100:265-266). In particular, he perceives a failure of national professional bodies to challenge the abuse of human rights. Over two hundred years ago, Professor Leber had observed something modern torturers are unwilling to understand: ‘Even the innocent, overcome by the intensity of pain, acknowledge crimes that they had never committed; whereas a real criminal, endowed with strong, almost unfeeling nerves, could defy the most painful torture and falsely maintain his innocence.’

Dawn Starin turns our attention to The Gambia (‘a small country in crisis’), where the president, elaborately named His Excellency Colonel (retired) Doctor (honorary degree) El Hajj Yahya Jammeh, claims that he can cure AIDS within thirty days with a secret herbal formula and verses recited from the Koran (JRSM 2007;100:294-296). In an evocative piece, she writes: ‘Every Thursday young and old, female and male, wait for the president's touch, the president's prayers, the president's secret formula to cure them from AIDS. Giving up on their anti-retroviral medicines and subjecting themselves to the president's cure, those with HIV or AIDS are probably being given false hope.’

But whether it is the allure of a mate, jobs for junior doctors, the end of torture, or the cure for AIDS, the smell of false hope always surrounds the human species.