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Cock-up theory

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Conspiracy theorists can be difficult to argue against. I’ve had a few experiences of lively debates with people who think that the moon landings were staged on a set in California. If you really want to, you can pass an enlightening evening chatting on the internet to people who believe the Bush administration rigged the World Trade Centre with explosives. Whenever the majority of opinion tends in one direction, there will be people who see this as conclusive proof that the truth lies elsewhere. This is especially so if strong or unpopular authority groups are supported by the general consensus.

Once a conspiracy theory has developed, there’s no point trying to counter it with evidence. That will just confirm you as either a stooge or a simpleton. In the case of the Moon landings, don’t waste breath addressing specific points about the angles of shadows, or exactly how a flag should move in a vacuum. I used to think that the best counter-argument was that the Soviets were monitoring the mission, and never thought to mention that the astronauts were actually staying in a small motel outside Los Angeles. But even this argument is trumped by cock-up theory. First developed, I believe, by the comedian David Mitchell, it states that grand conspiracies are unlikely because they demand too much competence from their perpetrators. A faked moon landing would require thousands of people to do their jobs flawlessly, and then never brag unguardedly or take the tabloid editor’s shilling. It couldn’t happen. Somebody would cock it up.

But what is the relevance of all this to general practice? The answer is that cock-up theory has the potential to turn our day of strike action from a dithering debacle into a triumph. Recently, I had the unusual experience of knowing exactly what was wrong with a patient and, stranger still, that it could be easily cured. She needed an antibiotic – the indication was unequivocal, it would almost certainly work, and without it she was likely to get very much worse. Inevitably, she didn’t want my antibiotic. It was “unnatural”, a “chemical”, and I was probably in league with Big Pharma. She didn’t actually check me for a store cupboard full of Pfizer-branded pitchforks, but only because the case was so cut and dried. I had obviously sold my soul to the drug companies, and that was that.

Except it wasn’t. Usually, I’d witter endlessly about balancing risk and benefit, the fact that everything you eat is a chemical, and so on. But post-strike, I could deploy cock-up theory. I asked her if she really thought rank-and-file GPs were capable of running devilish international plots, when we can’t agree on what to do for one day to save our own pensions. She left with her prescription. There’s an outside chance she may even have cashed it in..

Dr Nick Ramscar is a GP in Bracknell, Berkshire

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