Wine without alcohol: medicine without doctors!

Blood is a constant reminder of our mortality.

Karl Landsteiner, Austrian-American biologist, immunologist Fig. 1 and physiologist. 1868–1943.

Fig. 1: Karl Landsteiner.

C 1900. Anonymous. Public Domain. Source Wikipedia.

Memory is a strange thing. Some things fade from memory and some things remain clear for many years after the event. I clearly remember working, in the summer, in a food processing factory in the UK when I was a medical student. This was common practise in those days. During my first tea break, I went to the counter where a large lady with a very large teapot said to me: ‘With or without, love’. It took me a few moments to realise that she was asking me did I want sugar in my pre-made tea. I have never taken sugar in my tea since then!

What has this to do with wine? Well in our current world, many wine producers are selling wine that is alcohol-free. This may reflect the current obsession with the evils of alcohol and the belief that leading a healthy life (free of risk [1]) is possible and can result in longevity. John Wilson [2] writing in the Irish Times in August 2024, was told by a wine importer when discussing alcohol-free wine; ‘The more I tried, the more despairing I felt. I ended delisting some of the ones I already had’. Wilson claims that alcohol-free beer has been quite successful but not being a beer drinker, I must take his word at face value.

The removal of alcohol from wine is expensive. There are various methods, including boiling (not recommended), reverse osmosis, vacuum distillation and filtration and the addition of must-concentrated grape juice. Prices of alcohol-free wine vary from country to country but where I live (Ireland) alcohol-free wine does not attract excise duty. Again, according to Wilson, the manufacture of sparkling wine seems to be quite successful although I can’t imagine having a glass of alcohol-free champagne as an aperitive! I have tasted a number of alcohol-free wines but as yet I have not found one that I would favour. Perhaps Frank Sinatra’s lyrics could apply: ‘You can’t have one without the other’.

When I was practising medicine, one lived in fear of the patient who came to the clinic armed with a lap-top, tape recorder and a lawyer. This has probably changed and patients are now armed with websites from the internet. The days when one went to a GP for a chat and discussion of one’s symptoms seem, to a large extent to have vanished. I have lost count of the number of people who have said to me: ‘The doctor never made eye contact with me, shook hands, but turned his/her back and looked at a computer screen and ordered expensive investigations’. However, it seems that many patients are satisfied with internet consultations with a website and do not value the human connection! This may be a phenomenon associated with younger patients who rely largely on social media rather than direct conversation!

When I was a Fellow at the University of Minnesota (U of M) in the early 1970s I lived with my wife and son in subsidised University housing in Minneapolis. It was ideal, and although very compact all the other residents were graduate students, Fellows or teachers at the U of M. They were an eclectic and interesting bunch. After about a year our next-door neighbours moved away (not because of us!) and an American family moved in. We were aware of some degree of hostility to doctors and their behaviour. However, we extended hospitality and to our amazement the lady of the house said, having found out that we were both doctors; I hate doctors. They are all arrogant and are only interested in making money’. Needless to say, we were both taken aback. My salary was less than the garbage collector’s. Officially we lived below the poverty line. A couple of weeks later one of her children became ill, fever and vomiting, and their mother frantically knocked on our door to enquire if we could help as we were both doctors!!!!!! This seemed like a strange request as she was the one who said she hated doctors. Of course, we helped and the child survived but her criticism of the profession was a little hard to take.

Yes, many doctors have behaved arrogantly and patronizingly in the past but many have behaved honourably and have contributed to the welfare of humanity. Vaccination programmes have been, mostly successful and many serious infectious diseases have been eradicated in many countries but alas some diseases are beginning to make a comeback due to a combination of bizarre political beliefs and war.

Unfortunately, since the Enlightenment, medicine is seen exclusively as a science. It is, in fact, an art which uses scientific methods. Our function is to make life as bearable as possible for our patients and occasionally to effect a cure. With ageing populations in many jurisdictions effecting a cure for chronic illness is becoming more difficult. As Jonathan Swift (1667–1745) [3], well-known Irish satirist author and Dean of St Patricks Cathedral, Dublin, Fig. 2, said in his wonderful novel ‘Gulliver’s Travels’ (1726): ‘Every man desires to live long, but no man wishes to be old’.

Fig. 2: Bust of Jonathan Swift near his burial site in St Patrick’s Cathedral, Dublin.

Creative commons Attribution-Share Alike. 3.0 unported license.

Changing social attitudes are always difficult to explain. In the present world of social media, it is possible that ‘influencers’ have some effect on social change. However, most changes seem to develop slowly and then suddenly become widely accepted. Whether you prefer to consume alcohol-free wine or get your medical advice from the internet, please remember that there is a huge variety of wines available from different countries and most doctors are knowledgeable and willing to help with practical advice. The words of the famous Canadian Physician Sir William Osler: (1849–1919): ‘Medicine is a science of uncertainty and an art of probability’ seem prescient.