What killed Mosely?

What killed Michael Mosely, the popular medical media star and author? Mosely did. This was not suicide. Nonetheless, the decisions that he made prior to setting out on his fatal walk on the island of Symi in Greece on June 5th at the height of the Grecian summer, would end his life even though death was not his original goal. 

To comprehend this, it is necessary to look at his life which embodies the tradition of European physicians and especially English ones of conducting potentially fatal experiments on themselves in order to demonstrate some characteristic of disease.

Other historical examples include John Hunter infecting himself with a deadly bacteria and William Stark suffering self-imposed Scurvy.

Though it may seem strange to the lay-person, nonetheless the more serious the disease the more the doctor studying it will take extraordinary risks to combat it and learn how it might be overcome by subjecting himself to it. Mosely had a history of very public self-experiment.

On the afternoon that Mosley went for his fatal walk he had obviously set himself a challenge which was essentially to see if he could walk a rocky desert Greek Island in extreme heat without enough water or nutrition and only an umbrella, according to Greek officials who examined CTG footage.

Mosely had the serious disease of diabetes, a condition suffered by his father and about which he spoke openly about in his books. Not only did he struggle with this condition much of his life but all of his life’s work was devoted to finding ways to overcome it with lifestyle choices and diet.

Mosely’s obsession with diet and exercise drove this determination to live a normal life including having a normal lifespan hoping to live well into his eighties and beyond, and so prove to the world that such a thing is possible even with diabetes. Mosely seems to have forgotten something about diabetes, however, which makes it a very dangerous condition.

It is a metabolic disease (the complex regulation of energy and the distribution of nutrients in the bloodstream where the brain is given preference over all the other organ systems) and not just a matter of weight, diet, and exercise.

The tradition of either infecting oneself with a potentially fatal disease or depriving oneself of a vital aspect of diet such as vitamins, has a rich tradition.

There are famous examples including John Hunter who allegedly infected himself with gonorrhea and syphilis because he believed that these conditions were caused by a single agent. While the facts of Hunter’s self-inoculation are disputed there is no doubt that he was part of a long tradition of self-experiment.  It is also alleged, though remains the subject of conjecture, that he died during a medical meeting when he became angry and ruptured a blood vessel damaged by syphilis bacteria.

Dr. Victor Herbert in 1961 nearly died after depriving himself of folic acid over a prolonged period. He became paralyzed and had to seek medical treatment. Until he did this experiment the role of this vitamin in diet was not understood.

In 1769 Dr. William Stark died while experimenting on himself by causing vitamin C deficiency or scurvy. Then there was the case of the surgeon Evan Kane who operated on himself removing his appendix.

Dr. Alexander Bogdanov, while working on the use of blood transfusions to extend life, fatally infected himself with a malaria parasite from the blood of a student.

Some of the doctors who experimented on themselves have received the Noble Prize for Medicine and it may be a fact that this prestigious award, given to these doctors, became an incentive for Mosley to experiment on himself. We know this because of the part he played in the election of one recipient of that prize, Dr. Barry Marshall.

This example of self-inoculation leading to a major medical advance was the work of the Australian Dr. Barry Marshall who received the Nobel Prize for infecting oneself with a bacterial agent in the 1980s. Marshall, who, against all medical belief at the time, claimed that peptic ulcers of the stomach were not caused by an over-abundance of acid but instead by a bacteria called Heliobacter Pylori.  

Surgeons made a good living before this time by operating on people to remove portions of their stomach to reduce the effect of acid secretion and most medical drug treatments were ineffective so there was a good deal of resistance and skepticism about Dr. Marshall’s claim.

Only by experimenting on himself and using the bacteria to cause inflammation of the stomach was he able to prove his surgical colleagues wrong. He was given the Nobel Prize for this. Mosley claimed that he was instrumental in Marshall receiving this award because of the attention that he gave to that doctor’s work and his public promotion of it.

Micheal Mosley was a popular media figure, and his real contributions were to make medical advances understood by the general public. He deserves high praise for this and for all the awards he received including an Emmy award. He was not really an academic or serious medical researcher and any advances he made were in the area of medical journalism, an area he mastered.

The problem with this is that he tended to offer unproven remedies for medical conditions. Whenever he was interviewed on the radio or television, he did not hesitate to give dietary and other advice for all the medical disorders he was asked questions about as though he felt compelled to provide an answer for everything.

There were many examples. Whenever he was asked by patients what they should do to improve gut health if they had to have antibiotics for an infection, he would advise them to take prebiotics, substances good bacteria feed on, and, probiotics, products containing “good bacteria.” While this sounds helpful, there is no scientific evidence to prove that these supplements make any difference.

Similarly, he was a strong advocate of Omega 3 fatty acids to prevent heart disease and the taking of vitamin D in winter and autumn to prevent colds and flu, treatments which have never been proven to have any beneficial effect despite a great deal of research.

While it could be said that Mosley should be seen in the role of a media personality and that there is no harm in taking these supplements, he always represented himself as a serious medical expert. These supplements can be expensive. No medical expert, whether in the media or otherwise, should ever be proffering advice to patients unless there is proven scientific benefit.

Despite being a highly qualified medical practitioner he tended to sound like a homeopath or naturopath whose recommendations and advice originate in tradition rather than research.

A striking example of the traditional or anecdotal lifestyle advice was his recommendation to stick to a Mediterranean diet. There is no clear example of what this is. Some twenty-two countries surround the Mediterranean Sea. The idea that the preferred diet of any of these countries consists of vegetables, fruits, herbs, nuts, beans, and whole grains, is a fiction as anyone who travels in Europe and the Middle East would attest.

Olive oil is the staple oil of most of these countries, but the common factor stops there. The citizens of these countries consume fatty meats and sweets whenever they can, and this is only limited by cost and availability. Furthermore, the idea that the lifespan of occupants of Mediterranean countries is higher than the more developed world is also not true.

Mosely spoke much about the “gut biome”, that complicated world of bacteria and other organisms that inhabit the gut. This area of research has spawned much speculation ranging from its possible effects on our mental health to its role in inflammatory disorders such as Crohn’s disease, a very severe and often fatal form of gut disease, including the noxious notion that we should consume the excrement of others, or at least the bacterial component, to treat conditions such as this.

Mosely did not make it clear that this line of research has never really led anywhere despite decades of research but, nonetheless, he spoke much about it in order to lend authority to his utterances.

Moseley’s outstanding media success is indicative of a phenomenon that characterizes most purveyors of popular medical solutions which is that the more popular and more successful the medical media star is the more their public utterances and advice should be greeted with suspicion or perhaps healthy skepticism, to use a more acceptable scientific term, and indeed Mosely, himself as a doctor and popular scientist should have welcomed the challenge that arises when someone questions his ideas and he would certainly not expect that his death would in any way enshrine his work as dogma.

Mosely’s final actions on the island of Symi are an example of him pushing himself to the limit to prove something to himself otherwise they make no sense. Why take such risks? Why did he not seem to understand the limits imposed on him by his illness and the fact that the heat and his exertions would not simply make him tired, thirsty, and, dehydrated they would trigger a fatal metabolic disorder that occurs exclusively in diabetics and leads rapidly to coma and death.

The key thing to note is that it is the provision of energy in the form of sugar to the brain takes priority in our metabolic processes. Mosely seems to have either forgotten or not realised this.

Mosley, as noted above, was part of a tradition of doctors who experiment on themselves.  This is usually to advance some important discovery in medicine, to prove that an agent or absence of an agent is an important cause of a disease. However, Mosely’s famous experiments on himself can be said to be nothing more than gimmicks and did not advance the cause of medicine or science.

These experiments sometimes were grotesque like swallowing human blood, his own, in the form of a pudding, Remarkably enough he cited the example of Countess Bathory a Hungarian aristocrat who is alleged to have bathed in the blood of 650 virgins, as a motivation for this strange experiment.

However not only did Bathory not consume human blood, but she also never bathed in it and the remarkable stories of her mistreatment of her women servants and the women of her district are mythical. It would be reasonable to expect that Moseley, a scientist, would have checked historical facts before making unusual public announcements.

In 2014 Mosley infected himself with a tapeworm cyst to infest his gut with the parasites and then undergo a gastroscopy to examine the effects. He later had his brain “turned off” by subjecting himself to transcranial magnetic stimulation, a treatment relatively unproven for depression. This treatment had as its precursor shock treatment or electroconvulsive therapy.

It is not clear why Mosley went through these experiments, but it seems that this was part of a program of self-aggrandizement because each time he was touted by the adoring media as a ‘fearless medical warrior,” advancing the cause of Medicine even though none of the experiments he conducted on himself achieved this end.

It should also be said that the term “world’s leading authority,” is nothing more than a fiction invented by media people who, while publishing some article on a scientific topic, make it appear that some grand competition has been held among scientists rather like the world chess championships and the authority cited for their articles is the champion of the competition.

Science and academia are snakepits filled with writhing and competing serpents all struggling for dominance. Some become prominent but most are swallowed by the others and disappear. At times one or two are dominant and stand out but soon they too are swallowed by the others as the findings of new research come to hand.

So when someone in the media announces that a “world’s leading authority” is about to announce a cure for cancer or senile dementia, the reader can be sure firstly that the journalist knows nothing about science, and, secondly that the authority they are quoting has not authorized the announcement and probably not checked the article before release.

At times this can be very embarrassing for scientists who foolishly go along with this journalistic hyperbole. When researchers around the world were working on the Covid vaccine the main city newspaper in Brisbane, Australia, went to the Berghoffer Institute in that city and photographed every one of the scientists and doctors who worked there and were remotely connected to vaccine research.

The article and pictures proudly covered the first two pages of the daily newspaper, the Courier Mail, with the forty smiling individual portraits of the researchers. The paper proudly announced that the local scientists had produced the first Covid vaccine in the world.

Within two days it had to be announced that the vaccine was a total failure and could not be used. Mosley never fell into this trap because his research was never groundbreaking, and he saw himself as a darling of the media. He was never guilty of making absurd claims to cure conditions for which science, as yet, has no answers.

The disease Mosley suffered from, diabetes, has two basic forms, the first where the body produces no insulin and the second where the body becomes unresponsive to the insulin that it does produce.  Mosley had the latter. As Mosley went on his walk in the burning hot sun his body began breaking down fat stores, the glucose in his liver and stomach were unable to provide the energy to sustain him because his body was not responding to the insulin he was producing.

Breaking down fat leads to high levels of ketones, their breakdown product, and, eventually as the levels become too high coma follows. This is called Diabetic Ketoacidosis and I have seen patients die of this within an hour of onset.

Mosley became unconscious and soon died from this only meters away from the village where he was staying. It is hard to believe that he did not think that this would happen because every doctor knows about it especially those with diabetes and it was almost as if Mosely believed that his diabetes could be cured with the right exercise and diet.

There is a gruesome postscript. I mention this because image was vitally important to Mosely who would certainly like to be remembered as the smiling bespectacled medical nerd. Ironically it was not to be.

When Mosely went missing every effort was made to find him even flying a helicopter over the rocky island but as this was done on the first day he was not spotted because his skin and clothing did not standout from the colour of the rocks.

After the fourth day in the heat, his body decomposed bloated and became completely black. This was how the Mayor of Symi, who was in a boat offshore spotted him by noting a large black object among the rocks.  This was very distressing for the family and his wife could only identify him by his glasses and clothes. No viewing was possible at his funeral or for the family. This is especially tragic for such a smart image-conscious doctor that we remember Mosely to be.

In the end, Mosely died as he had lived, pushing the limits like some kind of medical mountain climber. As wonderful feats as these conquests of the various “Everests” of the world seem, they do not advance the cause of man in any sphere but merely lead to long queues of climbers near the top of the totemic mountain waiting for the chance to claim the feat, many of whom, like Mosley, do not survive.