BMJ 3 August 2011   Cite this as: BMJ 2011; 343:d4862

“I have a list,” he said. As inflammatory opening gambits go, it’s hard to beat.

Osler advised equanimity as the second most important medical virtue, next to sarcasm. So over many years I have cultivated a tranquil demeanour, which the casual observer might misinterpret as apathy. I sat back in my chair, closed my eyes, counted to ten, let peace come dropping slow upon linnet’s wings; a mote of dust floated down. Accordingly, my response was a study in restraint.

“Take your f***ing list and get the f*** out of here,” I said, “What the f*** do you think this is? A f***ing supermarket?”

“Calm down, calm down,” he said, in what I had to grudgingly admit was a passable imitation of Harry Enfield; the needle of humour can puncture and deflate even the most promising argument.

“I have only two items,” he explained, “Firstly, I want to be detoxified; my body is a temple.”

Yeah, I thought, one with a big fat hairy Buddha.

“Words are plastic,” I said. “Terrorists become insurgents; innocent victims become civilian casualties before morphing into collateral damage; Bono is an international philanthropist rather than a greedy tax dodger; and detoxification is no longer the process by which toxins are changed into less toxic or more readily excretable substances but instead a callous pseudoscience that allows the fleecing of vulnerable punters by avaricious charlatans.

“There you are,” I continued, googling “detoxification” “Detox diets, detox recipes, detox tea, detox footpads (for those of us who wish to excrete urea through our feet), and detox plutonium. Apparently any old rubbish can be flogged simply by putting the word ‘detox’ in front of it. It’s the timeless pas de deux of gullibility and greed.”

“OK, OK, it’s a crock, I get it,” he said. “Only a complete idiot would fall for it.”

“You’d have to be a real sucker,” I agreed, secretly astounded that logic had, for once, proved to be helpful during a consultation. “And your second item?”

“I added you as a friend on Facebook,” he accused, “and you haven’t answered.”

Social media are perilous; becoming overly chummy may corrode our mystique and degrade our relationship with real people.

“Let’s think about detox again,” I said.


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