I love the Canadian Medical Association Journal.
Every time I come across it, there’s something kind of funky going on. One instance of this from about a decade ago sticks in the memory. It’s the article about the dangers of the well-made bed. Written by two physicians obviously seeking to justify their own slovenly practices (the footnote at the end reads, “This article was not reviewed by the authors’ wives before publication”), it’s a clever, funny, and sympathetic portrait of humanity’s softer side. The best line of many great ones is perhaps this:
Given warmth, darkness and a smorgasbord of delectable bodily fluids, it is not surprising that the well-made bed is a fertile breeding ground for bacteria, fungi and other vermin.
It’s a lovely parody of a non-financial conflict of interest (the authors’ own desire to stop making their beds) coloring their interpretation of the scientific literature.
Thanks to Ivan Oransky’s Twitter stream, I just came across another parody, this one of the vaunted review article. Intended to portray potential dangers of the review articles (” . . . if research results are selectively chosen, a review has the potential to create a convincing argument for a faulty hypothesis . . .”), the authors dive into the scientific literature to write a well-cited and logical justification for endurance athletes taking up cigarette smoking as part of their training regimen.
The authors demonstrate their point by arguing that evidence exists showing that cigarette smoking has four potential benefits to elite athletes:
- smoking causes persistent increases in serum hemoglobin
- smoking increases lung volume
- smoking causes weight loss
- cigarettes are affordable and legal alternatives to other forms of doping that deliver some of the same benefits
The authors not only dish out this plausible nonsense with a straight face, but make the kind of passionate pleas often encountered when authors get worked up by the thrust of their own logic:
Despite this scientific evidence, the prevalence of smoking in elite athletes is actually many times lower than in the general population.19 The reasons for this are unclear; however, there has been little to no effort made on the part of national governing bodies to encourage smoking among athletes.
One important aspect of the benefits of smoking is they appear to be dose-dependent and may not develop until many years after initiation of treatment. With this in mind, smoking should be commenced at as young an age as is reasonably possible. Children who have not yet developed a pincer grasp might require modified cigarette holders, safety lighters or both.
As a recreational cyclist myself, this was especially funny because of all the furor over doping in the professional ranks of the sport, along with the legacy of cyclists smoking (the photo above is a modern recreation of a famous photo from the early days of the sport).
It’s nice to have some biting humor in the literature. As we’ve seen before, attempts at jokes don’t always result in the warm laughter and gentle acceptance you’d anticipate. It’s especially nice to see the sometimes-forced formality of the review article hoisted by its own petard.