So she cancelled her dinner engagement with Rob and stayed late again, agreeing to meet him for a drink when she’d finished.  But she was hungry.   Was there anything in this Godforsaken hole that she could eat.  Ah, the baked beans!  She fed them to her volunteers and measured the hydrogen they exhaled.  There were cans of them stacked all around the room, enough to launch a Zeppelin.  OK, she’d fart all night but what the hell.  She was hungry. 

So she opened a can and stuck it on a tripod and lit the Bunsen burner.  Then the phone rang in the office.   ‘Could we talk about this last set of experiments.’  ‘Could you open up the database and just check…..’   By the time she’d finished, she’d forgotten all about her beans.    Bloody smoke alarm was blaring somewhere.  But, it was always going off.   Fuck it, she was late and needed a glass of wine.  And now the bastard lift wasn’t working and something had happened to the lights.  Nothing for it but the stairs, but she was on the eleventh floor.   

It still didn’t register when she saw the fire engines.  There were five of them lined up in the road, sirens still blaring,  blue lights sweeping the buildings on either side.  Firemen in helmets and bright yellow overalls with axes and torches were tumbling from the cabs and rushing past her to the stairs.  Funny time for a fire drill, she thought, as she rushed out into the cool night air. 

Rob was none too pleased about being kept waiting, but he could see she was flustered,  ‘Did you get anything to eat, love?’ he asked.

She stared  at him, with focussing, unfocussed,  then  her eyes grew wide and her mouth opened    ‘Oh fuck! Oh fuck, fuck, fuck!      

They’d started evacuating the patients by the time she got back.  Some were standing there in little groups, shivering in their light green hospital dressing gowns, more were coming out in chairs or on stretchers.  She tried to get in but a policeman stopped her. ‘You can’t go in there miss; there’s a bomb.’

‘No there isn’t, it’s only a can of beans.’

‘Aye, you might say that, but move along now.’

When she got back to Rob’s, the news was on.  ‘We break into the programme to report a possible terrorist attack on Sheffield’s Royal Hallamshire Hospital.’  She listened in shocked silence.  She could see it all, the beans charring, catching fire, setting the papers and the boxes alight, the cans exploding, the sprinklers going off, the lights shorting, panic, evacuation.  Oh fuck!  It was the only thing she could say. 

It was all over the newspapers the next morning.  Terrorist attack in Sheffield!  There were even  questions in the house.  ‘Why had the right honourable gentleman ignored our warnings?’  ‘Why hadn’t this government improved security in our public institutions?  Why had they cut funds to the fire service and the police?    There was no way the government, already in trouble, could survive a vote of no confidence.  They held  a snap election and lost.  ‘Fired’, the headlines screamed.  The Conservatives got in on a ticket of Health and Safety.  And six months later, Britain joined the Americans and declared war on Iran.

It’s all chaos. A butterfly flaps its wings in West Africa and there’s a typhoon in the South China Sea.   Karen cooks beans on toast ……. and well, anything could happen.

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Chaos is evident in all aspects of life.  Weather forecasting is an exercise in probabilities because we can never be sure of the starting conditions.  We can’t factor in  all the variables.  This is why it is said that a butterfly flapping its wings in West Africa will result in a typhoon is south- east Asia.  It’s not meant to be taken literally, just a mathematical possibility to illustrate how small unconsidered variations can cause enormous effects.   

And take sport.  They said England had a good chance of winning The World Cup this year, but what went wrong?  Could a glance across the table by a teammate’s wife have set in train a sequence of events that unsettled the captain, led to a players revolt against the coach and culminated in a catastrophic collapse of confidence?

And what about politics, computing, and the stock market?  Somebody can’t sell his house in Wisconsin and we end up with a global recession.   Or the rail network.  The wrong leaves on the line in the Home Counties and business in the City of London slithers to a halt. Small variations can have massive effects.  A tiny wobble in the orbit of an asteroid could destroy all life on earth. 

And in medicine, a small change in environmental conditions, a particular event, can so easily bring about illness.   Perhaps a tune on the radio could revoke a memory that could upset the gut and result in an argument that ends a marriage.  With no chance at resolution the gut upset persists as unresolved IBS.   When scientists do trials of treatment, they try to hold all the conditions constant.  This is what is called a controlled study.   It relies on certain  assumptions about which factors are important.  Age and gender may be controlled,  diet might be in a few studies, emotional factors almost never and yet these may be crucial.  So they can never really control the outcome.  If they make the same measurements 100 times in the same patient and they will come up with a hundred different results.  So what do they do?  Employ a statistician to tell them an answer they might (or might not) be able to rely on!  But  they still might be ignoring certain crucial factors because they don’t think they count or they are impossible to control.  As Albert Einstein declared, ‘Not everything that counts can be counted.  And not everything that can be counted, counts.’  

Irritable Bowel Syndrome is an idiosyncratic disease.  It is more an expression of the personality, life experience and life style than those variables that can be easily measured.  Moreover it can’t be easily defined because there is no identifiable change in body structure or chemistry.  It is whatever doctors say it is.  No wonder treatment is so variable and so personal.  It’s an exercise in chaos; a bit of a lottery.  What works for one person may not necessarily work for another.  But you can cut down the variability by reading the self management programme and getting to know about your illness, yourself and with some guidance managing your own symptoms.

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