It is well known that 2012 is the year of the London Olympics. What is less well-known, at least at present, is that 2012 is also the bicentenary of the birth of Charles Dickens.
Born on the 7th February 1812, Dickens was at heart a social reformer, and many of his books reflect his first-hand experiences of the struggles of the working class population and the effect of poverty on their lives. His own life was fairly short by our 21st century expectations, as he died of a stroke at the age of 58 years.
One of Dickens’s books, Barnaby Rudge, was an historical novel using the clash between the English Protestants and Catholics as its theme. The differences between the two religious movements came to a head in 1780, when there was widespread anger against the Papists Act of 1778. The Act allowed a softening of attitude towards Roman Catholics in England, and essentially reformed the Popery Act of 1698. Such was the unhappiness of the dissenters that riots ensued on the streets of London where, according to a writer of that time (Joseph Nightingale), destruction and looting became the worst that 18th century London experienced. The riots became known as the Gordon Riots; named after the leader (Lord George Gordon) of the Protestant Association, formed to overturn the new legislation. Such was the violence in the capital that the constabulary were unable to contain the mobs and the army was called in. It is recorded that the riots greatly damaged the reputation of Britain in Europe and posed questions in respect to the stability of British democracy as a form of government. Of course, many readers will no doubt by now have started to draw parallels between Barnaby Rudge, the Gordon Riots and the recent violent uprisings in London and other English cities. Once again, the international reputation of Britain has been damaged, and the validity of our system of government called into question by more authoritarian states.
Whatever the precise triggers in 1780 or today, it is clear that a significant percentage of the population is unhappy with their lot in life. Happiness is of course a very subjective feeling, meaning different things to different people. The Oxford English Dictionary defines ‘happy’ as ‘feeling or showing pleasure or contentment’. Being unhappy is not necessarily the same as being depressed, which has far more medical connotations. It is said that G. K. Chesterton knew what being happy was all about. A recent article by Bernard Manzo (Times Literary Supplement, 10 June 2011) discussed the life of this writer and journalist, who is probably most famous for his Father Brown detective stories. Chesterton apparently claimed that throughout his life he had ‘been indefensibly happy’; a claim which gives rise to at least two questions around what it was that made him so happy, and whether being in a permanent state of happiness is wrong. It is difficult to believe that Chesterton would ever have felt the need to join a riot on the streets of London. Manzo thinks he has the answer, attributing Chesterton’s happiness to his Christian beliefs, and more precisely, the sense of hope his belief brought to him.
In the diagnostic phase which will follow these present day riots, our politicians might do well to consider the lessons to be learned from the writings of Charles Dickens and G. K. Chesterton and the insights they give to the workings of society and the need for the human mind to be given at least a sense of hope. A state of hopelessness often leads to despair and depression. If social reform is to work, a sense of hope is possibly what is most needed as the foundation of that reform.
(First published in the Scunthorpe Telegraph, Thursday 18th August 2011.)
Wednesday, August 31, 2011
Wednesday, August 24, 2011
Is Medicine Society's Nemesis?
‘The medical establishment has become a major threat to health.’
The line is taken from the opening paragraph of the introduction to Ivan Illich’s book, Limits to Medicine. First published in 1975, the book takes a philosophical and cynical look at what Illich classes as the rituals of medicine, the lack of evidence supporting the idea that medical interventions have played a major part of the increase in life expectancy, the senselessness of the medico-political game of football, and the inconsequentiality of most contemporary medical care in curing disease. I thought it was a book I would hate reading. As it was, I found myself warming to the argument and, by the time I reached the final page, I had become a distant admirer of Illich, if not a converted acolyte.
Limits to Medicine concludes by stating that ‘only a political program aimed at the limitation of professional management of health will enable people to recover their powers for health care.’ Of course, that view would not find any supporters amongst the current political health reformers. However, I suspect that Illich, eccentric social commentator that he was, had a good point. The basis to his argument is the concept that the curing of disease is often coincidental to medical care; an argument that raises a question about modern western society’s fixation on seeking a GP’s advice for every ailment, however minor the condition may be.
For most GPs this argument will be nothing new. We know that our surgeries are full with people who do not really need to see a doctor. That is not the same as saying that we do not care. The point is would you really seek the assistance of a bank manager to count the change in your purse, or a tree surgeon to dead-head your roses, or a car mechanic to top-up your windscreen washer bottle? No, of course you wouldn’t. So why do people take trivial issues to their doctor? By ‘trivial’, I mean complaints that will either be self-limiting or that the person could do something about themselves without the assistance of a highly trained professional (not to mention one who is an expense to society).
To some extent, our modern society is to blame. We have become used to the concept that there is an answer for everything, and that someone else will provide that answer (preferably free of charge). Over successive generations we have forgotten how to think for, and look after, ourselves. Self-care is nothing new to those living in the remote islands of Scotland, or even on Lundy (referred to in my column last week) where a visit to a GP requires a two-hour boat ride across an often rough Bristol Channel, followed by another two-hour nausea-inducing crossing to get back home. The inhabitants do not seem any the worse off for their isolation from the NHS; they are a hardy bunch, some of whom I have known for the past twenty years. They just use common-sense and good wholesome home remedies or over-the-counter preparations for most of life’s minor illnesses. For them, an urgent condition is one that requires the input of an air-ambulance; anything else they deal with without immediate medical assistance.
In Illich’s view, what society needs is the de-professionalisation of medicine and a fostering of people’s will to self-care. His ideas may not be before time, as by 2020 it is estimated that there will be a European Union shortfall of one million doctors and nurses (BMA News, 23 July 2011). Even now, 37% of UK-registered doctors have been trained over-seas. However, the last word must surely go to Voltaire, a 17th century philosopher who reached the same view two hundred years before Illich when he said: ‘The art of medicine consists in amusing the patient whilst nature cures the disease’. Time for some NHS sponsored clowns, perhaps?
(This article was first published in the Scunthorpe Telegraph, Monday 8th August 2011)
The line is taken from the opening paragraph of the introduction to Ivan Illich’s book, Limits to Medicine. First published in 1975, the book takes a philosophical and cynical look at what Illich classes as the rituals of medicine, the lack of evidence supporting the idea that medical interventions have played a major part of the increase in life expectancy, the senselessness of the medico-political game of football, and the inconsequentiality of most contemporary medical care in curing disease. I thought it was a book I would hate reading. As it was, I found myself warming to the argument and, by the time I reached the final page, I had become a distant admirer of Illich, if not a converted acolyte.
Limits to Medicine concludes by stating that ‘only a political program aimed at the limitation of professional management of health will enable people to recover their powers for health care.’ Of course, that view would not find any supporters amongst the current political health reformers. However, I suspect that Illich, eccentric social commentator that he was, had a good point. The basis to his argument is the concept that the curing of disease is often coincidental to medical care; an argument that raises a question about modern western society’s fixation on seeking a GP’s advice for every ailment, however minor the condition may be.
For most GPs this argument will be nothing new. We know that our surgeries are full with people who do not really need to see a doctor. That is not the same as saying that we do not care. The point is would you really seek the assistance of a bank manager to count the change in your purse, or a tree surgeon to dead-head your roses, or a car mechanic to top-up your windscreen washer bottle? No, of course you wouldn’t. So why do people take trivial issues to their doctor? By ‘trivial’, I mean complaints that will either be self-limiting or that the person could do something about themselves without the assistance of a highly trained professional (not to mention one who is an expense to society).
To some extent, our modern society is to blame. We have become used to the concept that there is an answer for everything, and that someone else will provide that answer (preferably free of charge). Over successive generations we have forgotten how to think for, and look after, ourselves. Self-care is nothing new to those living in the remote islands of Scotland, or even on Lundy (referred to in my column last week) where a visit to a GP requires a two-hour boat ride across an often rough Bristol Channel, followed by another two-hour nausea-inducing crossing to get back home. The inhabitants do not seem any the worse off for their isolation from the NHS; they are a hardy bunch, some of whom I have known for the past twenty years. They just use common-sense and good wholesome home remedies or over-the-counter preparations for most of life’s minor illnesses. For them, an urgent condition is one that requires the input of an air-ambulance; anything else they deal with without immediate medical assistance.
In Illich’s view, what society needs is the de-professionalisation of medicine and a fostering of people’s will to self-care. His ideas may not be before time, as by 2020 it is estimated that there will be a European Union shortfall of one million doctors and nurses (BMA News, 23 July 2011). Even now, 37% of UK-registered doctors have been trained over-seas. However, the last word must surely go to Voltaire, a 17th century philosopher who reached the same view two hundred years before Illich when he said: ‘The art of medicine consists in amusing the patient whilst nature cures the disease’. Time for some NHS sponsored clowns, perhaps?
(This article was first published in the Scunthorpe Telegraph, Monday 8th August 2011)
Saturday, August 13, 2011
Quote of the Day
This resentment ... had to do with feeling shut out. A library, I used to feel, was like a cocktail party with everybody standing with their back to me; I could not find a way in.
Alan Bennett on libraries of a lifetime
http://www.telegraph.co.uk/culture/books/8696077/Alan-Bennett-on-libraries-of-a-lifetime.html
Alan Bennett on libraries of a lifetime
http://www.telegraph.co.uk/culture/books/8696077/Alan-Bennett-on-libraries-of-a-lifetime.html
Friday, August 12, 2011
Thought for the Day
‘Poetry can save nations and people.’
Czesław Miłosz (1911 – 2004)
Polish Poet Laureate & winner of Nobel Prize for Literature
Czesław Miłosz (1911 – 2004)
Polish Poet Laureate & winner of Nobel Prize for Literature
Thursday, August 11, 2011
Quote of the Day (2)
Medicine stands in his way. He would have been a much finer writer if he hadn't been a doctor.
Count Leo Tolstoy
Count Leo Tolstoy
Quote of the Day
Medicine is my legal wife, literature my mistress. When I am bored with one I spend the night with the other. This is irregular but at least not monotonous and neither suffers from my infidelity. If I did not practice medicine, I could not devote my freedom of mind and my stray thoughts to literature.
Anton Chekov
Anton Chekov
Wednesday, August 10, 2011
Time Out
My wife and I have just returned from a week in the Kingdom of Heaven.
For the benefit of those who have their doubts about such a destination, we had a most enjoyable time and, once there, had no desire to make a hasty return. That said, the crossing from this land to that was rather turbulent at times; a process which took just under two hours and involved high winds and tempestuous waters. Nonetheless, it was worth the struggle, with sunshine, peace, tranquillity, and a high level of hospitality. I was also reminded of St Matthew’s gospel (it is easier for a camel to pass through the eye of a needle than for a rich man to enter the Kingdom of Heaven); providing an interesting reflection of the effects of our straightened national economy on those working within the National Health Service!
As one would expect, a dominant feature on the landscape in the Kingdom of Heaven is a church, which can be seen from some distance. However, contrary to expectation, there is also a very welcoming tavern, with lengthy licensing hours and a very good home-labelled draught bitter. Indeed, I confess that our time there was indulgent, with no work and hours free for idleness or leisurely pursuits. Sadly though, all good things must end and we were only able to spend one week in the Kingdom of Heaven before being forced to return; although the journey back was considerably easier, with calm water and a gentle breeze easing our passage. Back in this land, we are mentally and physically revived and looking forward to entering the Kingdom of Heaven again at our earliest opportunity.
Perhaps I should at this stage give a little explanation. In the Bristol Channel lies the magical island that is correctly called Lundy (http://www.lundyisland.co.uk). Over the centuries it has been owned by several wealthy families, including one whose surname was Heaven. Amongst the family was one Reverend Heaven, and it was he who was responsible for building the church; hence the sobriquet, ‘The Kingdom of Heaven’. Lundy is now owned by the National Trust, and the properties on the island are rented to holiday makers by the Landmark Trust. There are no cars on the island, and to get there, involves a two hour crossing by boat from one of two ports in Devonshire. The island is a wonderful nature reserve, with only one shop and a tavern. Once there, one has three miles of unspoilt and uncrowded rural beauty to relax in.
Having had one of your questions answered, you are possible now asking what relevance this has to someone reading this newspaper. My answer is that it has every relevance, especially in economically chastened times. Holidays are meant to provide the panacea to our daily toil. Sometimes, going somewhere close to home (by that, I mean staying within the British Isles) and doing something very simple which does not involve large daily expenditure, can be just as restful (if not more so) than travelling half-way round the world. You don’t even need to travel far from Northern Lincolnshire to achieve that, as we are blessed with some beautiful rural areas in Lincolnshire, Yorkshire and the adjacent counties. Simplicity is sometimes the answer to life’s daily stresses.
This article was first published in the Scunthorpe Telegraph, Wednesday 3rd August, 2011.
For the benefit of those who have their doubts about such a destination, we had a most enjoyable time and, once there, had no desire to make a hasty return. That said, the crossing from this land to that was rather turbulent at times; a process which took just under two hours and involved high winds and tempestuous waters. Nonetheless, it was worth the struggle, with sunshine, peace, tranquillity, and a high level of hospitality. I was also reminded of St Matthew’s gospel (it is easier for a camel to pass through the eye of a needle than for a rich man to enter the Kingdom of Heaven); providing an interesting reflection of the effects of our straightened national economy on those working within the National Health Service!
As one would expect, a dominant feature on the landscape in the Kingdom of Heaven is a church, which can be seen from some distance. However, contrary to expectation, there is also a very welcoming tavern, with lengthy licensing hours and a very good home-labelled draught bitter. Indeed, I confess that our time there was indulgent, with no work and hours free for idleness or leisurely pursuits. Sadly though, all good things must end and we were only able to spend one week in the Kingdom of Heaven before being forced to return; although the journey back was considerably easier, with calm water and a gentle breeze easing our passage. Back in this land, we are mentally and physically revived and looking forward to entering the Kingdom of Heaven again at our earliest opportunity.
Perhaps I should at this stage give a little explanation. In the Bristol Channel lies the magical island that is correctly called Lundy (http://www.lundyisland.co.uk). Over the centuries it has been owned by several wealthy families, including one whose surname was Heaven. Amongst the family was one Reverend Heaven, and it was he who was responsible for building the church; hence the sobriquet, ‘The Kingdom of Heaven’. Lundy is now owned by the National Trust, and the properties on the island are rented to holiday makers by the Landmark Trust. There are no cars on the island, and to get there, involves a two hour crossing by boat from one of two ports in Devonshire. The island is a wonderful nature reserve, with only one shop and a tavern. Once there, one has three miles of unspoilt and uncrowded rural beauty to relax in.
Having had one of your questions answered, you are possible now asking what relevance this has to someone reading this newspaper. My answer is that it has every relevance, especially in economically chastened times. Holidays are meant to provide the panacea to our daily toil. Sometimes, going somewhere close to home (by that, I mean staying within the British Isles) and doing something very simple which does not involve large daily expenditure, can be just as restful (if not more so) than travelling half-way round the world. You don’t even need to travel far from Northern Lincolnshire to achieve that, as we are blessed with some beautiful rural areas in Lincolnshire, Yorkshire and the adjacent counties. Simplicity is sometimes the answer to life’s daily stresses.
This article was first published in the Scunthorpe Telegraph, Wednesday 3rd August, 2011.
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