Living Proof: A Medical Mutiny by Michael Gearin-Tosh, Scribner, £14.99, pp 327,
ISBN 0 7432 0677 0. Rating: ★★★★
A series of articles about Living Proof and its author—an Oxford English tutor “battling” myeloma through diet rather than chemotherapy—appeared recently in the Times. Any doctor reading them could be forgiven for prejudging Gearin-Tosh as an academic revealing nothing more than his ignorance of bell-shaped survival curves (which show that it's totally possible to live longer than the average and still not be cured). Yet one message to glean from both the press coverage and this book is that we shouldn't believe everything we read in the papers.
Living Proof is in two sections. Firstly, diary entries cover Gearin-Tosh's initial diagnosis and the turbulent year that followed. At times this sensitive, articulate man's thoughts and his interplay with an accompanying cast of friends rival journalist John Diamond's book C: Because Cowards Get Cancer Too (BMJ 1998;317:825). Living Proof is also a wonderful study in neurosis, and a warning to doctors about the futile cycles our hastily chosen words engender in susceptible people.
After seeking seven different medical opinions Gearin-Tosh discovers, almost by default, that he has rejected orthodoxy. The fact that he remained well throughout months of prevarication clearly influenced him retrospectively to embrace as the sole reason for his survival the “mild” alternative therapies that he had been dabbling with. (He doesn't state this explicitly, however.) Eight years of coffee enemas later he remains triumphantly alive.
In the second section, Gearin-Tosh discusses what exactly he thinks he is “living proof” of. He sidesteps some critics immediately by stating that it is not the diet's effectiveness that has been proven, but rather the “one size fits all” mentality of medicine that has been proven wrong. He argues that patients should be allowed time to try alternatives or to prove themselves “good” outliers on the survival curve before being rushed into chemotherapy.
Although the principle of giving treatment only when it is needed is sound, Gearin-Tosh's arguments are zealously impractical. For acute leukaemias and many solid tumours the sole therapeutic opportunity may be lost in delay. In addition Gearin-Tosh, perhaps not surprisingly given his background, is often wooed more by narrative than by scientific argument. Alternative practitioners are not all repressed seekers of truth and to give them carte blanche is naive.
Despite these faults Living Proof 's assertion that we should investigate those who do well and not dismiss them as quirks is undeniable. Perhaps it is the only way to replicate their successes. Setting himself up as the definitive outlier, updating his medical details regularly on a website, Gearin-Tosh's challenging “Explain me” ultimately stands out as laudable, brave, and a little awe inspiring.