Author: jamescalumcampbell

On Friday I bought a new car.  Well, new to me.  A Skoda Enyaq iV, all electric, a showroom demo car, 21 months old, 11,000 miles on the clock.  My previous, a Volvo V40 diesel, had 143,000 miles + on the clock and owed me no favours.  I’d acquired it in 2015 when it was a year old and had then, as I recall, 9,000 miles on the clock.  Interestingly, it was sold to me as a “green” car.  The speedometer on the dash, or was it the rev counter – I’ve forgotten already – had a green zone, adherence to which meant you were being eco-friendly.  Then diesel started to get a bad name, not so much because it contributed to the build-up of greenhouse gases, rather because it produced particulate matter which in high concentration was bad for your health.  And some German car manufacturers got into hot water because they were allegedly fiddling their emissions data.  Since June I had been unable to drive the Volvo into the low emissions zone of Glasgow city centre.  It was time for a change.

Over the years I’ve tended to buy my cars the way you might buy a bag of potatoes.  What’s the point of agonising?  I popped into my local Skoda dealer and told them what I was looking for.  I was treated with the greatest courtesy, and they produced the goods.  Would I care to take it for a test drive?  Yes indeed.

I was surprised the dealer didn’t want to accompany me.  I just had to sign a form making me liable for the first £750 worth of damages. Fair dos.  I think this “going solo” trend was started by the pandemic, and has persisted.  I did tell the dealer that I’d never driven an electric car before, so he kindly talked me through the gizmos.  This reminded me of a time way back in New Zealand, when I was a member of the much-loved but now sadly defunct Waitemata Aero Club.  I expressed a desire to fly a Tomahawk, a two-seater trainer aircraft I’d not previously flown.  In aviation, if you fly a new aircraft type, you usually undergo a “type rating” where your competence to fly the machine is checked out.  So I was surprised when the instructor tossed me the keys and said, “You can fly a Tomahawk.”  I recall at that stage I had about three type ratings under my belt.  So I thought, “Well, if he thinks it’s okay…” and I strapped myself in and perused the manual. 

There was a knock on the Perspex canopy.  “Couple of things you might want to know about the Tomahawk…”  Only in New Zealand.

After that, taking the Enyaq out on to the Stirling roads didn’t seem so daunting.  I was, immediately, utterly, besotted.  I love the silence.  I had a second test drive, got a good offer on the Volvo, and clinched the deal. 

I was amused by the reaction of some acquaintances.  A sage shaking of heads and remarks about “range anxiety”.  In the gym, somebody said, “How far away is your house?  Ten miles?  You’ll get here okay but you’ll need to find a charger on the way home.”  Then there was, “Electric’s not the way forward.  It’s hydrogen.  And just look at the exorbitant costs of the charging facilities!”  And then, “These cars are not as green as they look.  The manufacturing process is dirty as hell.  And they send kids down the lithium mines in the Congo…”  I asked these self-appointed advisers if they had ever owned an electric car.  But none had.  At least there were no sarcastic remarks, as was once de rigueur, about Skoda.  “Chaos in Czecholand…”  As a friend of mine remarked, nowadays people swear by, rather than swear at Skoda.  

For myself, I was surprised by my own emotional and indeed visceral reaction to driving the car.  This didn’t have anything to do with green credentials or virtue signalling or the smugness of the righteous.  I just drove it and thought, instinctively, this is the future. 

I promise not to glue myself to the highway, or pour tomato soup over a Van Gogh.

Funnily enough, driving around in my new acquisition, every time I turned on the radio the topic seemed to be, one way or another, the environment.  The fact that the Tories have held on to Boris’s old seat in the Uxbridge and South Ruislip by-election has been put down to the electorate’s angry reaction to Sadiq Khan’s ultra-low emissions zone.  They say politics is the art of the possible, and no matter how worthy your aspirations, you need to take the people with you.  The Sunday Telegraph suggests a referendum to see if people still want to reach net zero by 2050.                       

I’m not sure how robust the evidence is that the ULEZ was the critical factor in Uxbridge, nor that the results of the three by-elections demonstrated much of a trend.  After all, the Tories, the Lib-Dems, and Labour each won a seat.  Mr Sunak is right to say the next general election is not a done deal, and Sir Keir is right not to be complacent.  The only thing less predictable than the result of a general election is the result of a referendum.  I think these poor people running from their hotels on Rhodes on to the beach, and into the sea, might vote for net zero ASAP.                    

Over a convivial luncheon on Saturday, six Glasgow University alumni fell to talking about James McCune Smith.  You may perhaps be forgiven if you haven’t heard of Dr Smith, because plenty of his contemporaries would have been quite content had his name been expunged from history.  The only reason why I have heard of him is that Glasgow University’s new Learning Hub building has been named after him, or as they say in the United States, named for him: the James McCune Smith Learning Hub.  Dr Smith was also an alumnus of Glasgow.  He was the first African American in the world to earn a medical degree. 

He was born into slavery in Manhattan in 1813.  (New York abolished slavery in 1827.)  He attended the African Free School in Manhattan.  He was exceptionally bright.  He wanted to study medicine but none of the US medical schools would accept him.  So of course, as you do, he came to Glasgow.  He graduated in 1837.  He worked in Glasgow and Paris, and he published academic papers in London. Then he went home.    

Back in Manhattan, he worked as a physician for twenty five years, carried on publishing, but was never admitted to the American Medical Association. His practice was in Lower Manhattan.  He opened a pharmacy at 93 West Broadway.  He was appointed the only physician to the “Colored Orphan Asylum”.  He was active in the abolitionist movement.  He encountered much professional opposition due to the colour of his skin, some of it violent, but he countered preconceptions about the supposed intellectual inferiority of African peoples by using the academic skills he had acquired in Scotland, in the emerging academic disciplines of statistics, and statistical analysis.  He refuted fallacious argument, using data. 

He died of congestive cardiac failure in 1865, shortly before the ratification of the Thirteenth Amendment of the United States Constitution which abolished slavery.

So over lunch we were discussing this remarkable individual who, had he been present on the occasion, would have been one of seven Glas Uni alumni, and one of four statisticians present, one of whom explained, “His mother was a slave…”

“No, you can’t say that,” said I, somewhat mischievously.  “You have to say, ‘She was an enslaved person’.”  I was only quoting the author Lionel Shriver.  A New Zealand friend had happened to send me the link to a book club interview and Q & A Ms Shriver had recently undertaken at a meeting I think in London.  She was asked to talk about the phenomenon in the publishing world of the “sensitivity reader”.  (I myself have discussed sensitivity readers before in this blog, with respect to such disparate writers as Ian Fleming and Enid Blyton.)  Should an author refer to a character in a novel as a “slave”, a sensitivity reader might wish to change this to an “enslaved person”.  I can’t truthfully avow that Ms Shriver rolled her eyes to the ceiling, but I certainly felt she conveyed the sense that the distinction was somewhat precious.  Similarly, you ought not to say that somebody is “obese”, (or, indeed “fat”, the word favoured by Roald Dahl) rather that somebody “is living with obesity.”  As if, said Ms Shriver, amusingly, obesity was a flat-mate living down the hall.  Her point was that this separation of the individual from the condition was, in essence, a lie.

Much as I felt the urge to agree with Ms Shriver, I also felt it worthwhile to reflect on why such fine distinctions are made.  There is a pattern here: slave and enslaved person, obese and living with obesity.  The point is that people may not wish to be defined by a particular aspect of their situation.  I encountered this frequently in medicine: I and my colleagues might refer to “the stroke in Resus”; “the infarct in Bay 4”; “the pissed-fell-over in the waiting room…”  It is a dehumanising shorthand.  I don’t believe I ever said to a patient, “Your problem is that you’re fat.”  I would be more inclined to say, “It would be good for your health if you could lose a pound or two, and here are a couple of things you might try in order to achieve that…”  It softens the blow and is intended to be kindly.  Of course you might say these are weasel words.  I happened to read an article in The West Highland Free Press the other day about the Scottish poet Robert Fergusson, a contemporary of Robert Burns, sometimes referred to as “the other Robert”.  He died at the tragically early age of 24, I read, in “the asylum for pauper lunatics”.   They certainly didn’t mince their words then.  Nowadays I don’t think “asylum for pauper lunatics” would survive the sensitivity reader’s blue pencil.  The caring environment for people with cash-flow problems and mental health issues.    

But is it not odd that this sort of circumlocution has infiltrated the publishing world, and in particular the realm of fiction?  It might be hurtful for a person “living with obesity” to hear that he (she?) is indeed, obese, perhaps even “morbidly obese”, but why should it be hurtful for her (him? What are my preferred pronouns?  Let’s not go there today.) …for “them” to read about one fictional character imparting this same information to another fictional character?  Surely one of the great strengths of the novel is that the form allows the writer to explore issues that might well be deeply uncomfortable for us all.  Sensitivity readers bowdlerise controversy.  Why has this come about?  Ms Shriver had a very interesting theory.  She said that publishing houses are in our time dominated by women, and women have a profound desire to be non-confrontational.  I have an idea that a sensitivity reader employed by a publishing house might well have expunged that remark.

Ms Shriver is deeply concerned that universities now tend to shy away from controversy.  Whereas seats of learning used to be places which championed freedom of speech, and places where opposing views could be aired and debated, they have now become “safe places” where contentious views may not be expressed because they might be hurtful to the students.  Ms Shriver could not understand why the students were not rebelling against this trend.  She did not use the expression “snowflake generation”, but this was the implication.  Rather than “cancelling” speakers who air views contrary to some kind of perceived contemporary norm, would it not be better to debate with them?  This, after all, is what James McCune Smith spent his entire professional life doing, listening to opinions and prejudices that must have been personally deeply hurtful to him, and countering them with arguments based on science, statistical data, and sound argument.  I have a sense of pride that my alma mater should have matriculated and graduated this particular student, and is now honouring him, just as I have a sense of shame that my otheralma mater, 44 miles to the east, should have cancelled that great philosopher of the Scottish enlightenment, David Hume, because he once passed a remark, no doubt based on the received wisdom of his time, that one racial group of people was intellectually inferior to another.  As a result, the David Hume Tower no longer exists.  Cancelled.  Disappeared.  It never existed.  James McCune Smith would never have done that.  He would simply have explained, with scientific precision, why on this occasion David Hume had been wrong.                                              

A General Practice not far from my neck of the woods has sent out a text message to its flock of patients, advising that for a period of three consecutive days later this month, the practice will only be open for emergencies, and that during this time, patients will not be seen for “routine matters”, and repeat medication will not be issued.  The reason for this disruption is that the computer server requires an essential upgrade.

Well!

Nothing could be more redolent of the fact that computing, information technology, and the digital world have completely taken over our lives, than this passive assumption that general practice, or any other form of medical practice, becomes impossible just because you can’t switch the computer on.  I dare say the particular practice who has sent out this text will not be alone, and indeed I imagine this idea that outage equals paralysis has already been normalised.  When you crash, you close.  It’s de rigueur.   

But on the other hand I’m sure I’m not alone when I say I have seen all this coming since the start of the new millennium.  Champions of IT systems targeted medicine as a potential market, just as they targeted education, banking, policing, and any other public service you care to name.  Early on, I remember I questioned whether we actually needed the latest sophisticated program, and a colleague said to me, “It’s coming, James.  You can’t turn back a tidal wave.”  I was a Luddite.  I was King Cnut down on the beach sitting on my throne with the waves lapping around my ankles.  Some people think Cnut had an exaggerated sense of his own powers, others have suggested he was merely demonstrating to his people the futility of resisting the inevitable.  Either way, the tide was going to come in.

Actually I never had any problem with going paper-light, or even paper-less, so long as we had some sort of back-up system that could kick in when the systems crashed or the server required an upgrade.  At its simplest, the back-up could be pen and ink.  What I objected to was the way in which the purveyors of data processing would foist elaborate systems on us that we really didn’t need.  We needed something that would fulfil the function of the patient record.  That would contain some demographic data, and then a narrative, comprising a sequential record of doctor-patient interactions, correspondence between health care professionals, laboratory and radiological results, and a record of therapeutic interventions.  That’s all.  In that sense, the digital record didn’t offer anything substantial over and above the paper record, or, in the jargon, it wasn’t “value-added”.  Oh sure, it was, or could be, quicker to use, the record would likely be more legible, and perhaps more accessible (unless the server was being upgraded).  And that’s fine.  But look what happened.  The systems themselves rapidly developed delusions of grandeur.  They were not merely a record of the medical consultation, they began to direct the way in which that consultation would be conducted.  The sanctity of the doctor-patient relationship, a confidential interchange in an atmosphere of absolute trust, was disrupted, and entirely altered, by the presence of a third party in the room, the computer screen. 

Then, scurrilously, the systems became inextricably linked with emolument.  Adoption of computerised systems got written into the contract.  Doctors had to tick boxes to make money.  One was required, for example, to record whether or not a patient had the smoking habit.  I don’t recall being rewarded for getting anybody to kick the habit, nevertheless I usually attached some health advice to the tick box exercise.  “Do you smoke?  Yes?”  Tick!  “Just in case nobody has ever told you, it’s very bad for you.” 

The designers of the new contract with these contractual obligations clearly had no idea how good doctors would be at jumping through hoops.  But most doctors have been performing gymnastics of one kind or another since they were groomed for medicine while still at school.  No matter how outlandish the hurdle, the GPs leapt over it, and mostly fulfilled 100% of the prescribed tasks. 

So the systems got more complicated.  Before long, the medical consultation got drowned out by the incessant jibber-jabber of the computer’s pop-up screens.  Have you done this?  Have you done that?

Information Technology worked its way into continuing medical education.  Doctors went on courses, not to learn more medicine, but to learn how to operate increasingly complex computer systems.  The sessions were dismal in the extreme.  Scroll down the page to find the drop down menu.  Click on blah.  Right click on blah-blah.  We were put into “break-out groups” that usually had a thinly-disguised political/managerial motive.  Consider three ways in which you might be able to reduce your rate of referral to hospital.  As if we were making these referrals on a whim. 

But I can’t say the doctors were exempt from blame.  After all, we accepted it all.  We just said, “It’s coming.  You can’t turn back a tidal wave.”

But that was profoundly fallacious.  General Practice is, or could be, a very powerful body.  All we needed to say to the sharp-suited computer whizz kids was, “No, we’re not doing that.”  All the English docs needed to say to erstwhile Health Minister Matt Hancock, when he insisted all routine general practice went on line was, “No, we’re not doing that.”  But I’m afraid we are not very good at sticking our heads above the parapet.  Why not?  Maybe the medical leadership is too preoccupied in pursuit of a gong.         

For myself, I finally snapped.  I remember once in my previous life as an emergency physician attending a Morbidity & Mortality meeting in Middlemore Hospital in South Auckland, New Zealand.  There had been a tragedy.  A child, a victim of abdominal trauma, had been transferred from Middlemore to Auckland Hospital.  Auckland had taken a “conservative” approach to the child’s management, and had not operated.  The child died.  With the aid of the so-called “retrospectoscope”, an operation would have been the better option.  At the time, relations between Auckland and Middlemore Hospitals were not that good.  I remember a friend of mine in Middlemore, an intensivist, got up and delivered a “speech” – I won’t say of denunciation – but of sharp criticism.  There is no more intimidating audience than a sophisticated medical audience, and I remember thinking at the time, “I could never have done that.” 

Fifteen years later I found myself in Scotland at a medical meeting which was championing a computer system for so called “Whole Systems Working”.  I got up and delivered a “speech” – I won’t say of sharp criticism – more of denunciation.  It was met with a stunned silence.  The meeting came to an end.  I thought, “That went down like a lead balloon!”  I think it was at that precise moment that I realised that I needed to get out.  In fairness, a colleague came up to me afterwards and said, “I’m sorry I didn’t support you.  You were only saying what we were all thinking.”

But I did think of my friend in Auckland.  I’d thought I’d never make a speech like that, but in effect I did.  Subsequently, another colleague told me that my “speech” came up for discussion at another medical meeting, and a young GP had said, “Oh that guy.  He’s a legend.”  Of course that could mean anything, but I take it as a compliment, and if it is indulgent of me to record this, then as mitigation I can only say that that was the proudest moment of my medical life.                                                                     

Yesterday in Dunblane Cathedral the minister prefaced his homily, mischievously, as is sometimes his wont, with the remark, “You know, I’m not very good at forward planning.  If I was, I would have anticipated today’s lectionary and made sure I was on holiday.”  Not that Church of Scotland ministers need necessarily stick to the prescribed texts, one of which was Genesis 22: 1-14, but in the event he bit the bullet and talked about Abraham’s abortive attempt to immolate his only beloved son on the altar of… well, of what, exactly?  What would be worth such a sacrifice? 

It’s a well-known tale but, if you don’t know it, may I refer you to Wilfred Owen’s poem The Parable of the Old Man and the Young, which recounts the tale faithfully in fourteen terse lines, after the manner of a sonnet, and then adds a couplet and a fatal twist, literally a fatal twist, at the end.  From a technical point of view, Owen clearly recognised the enormous power of the 1611 King James translation, and plundered it, piecemeal and wholesale.  It is a story often recounted by people who are antagonistic towards religion of any description, to demonstrate that the God of the Old Testament is a Nasty Piece of Work, and his acolytes not much better.  I was intrigued to hear whether the minister in Dunblane would attempt some sort of justification for the behaviour of the protagonists, and I confess I attempted to send him a telepathic message: “Remember the words of Alexander Pope:

Know then thyself, presume not God to scan;

The proper study of mankind is man.

So talk about Wilfred Owen!”   He didn’t.  But he is a remarkably gifted man and he certainly needed no help from me.     

Owen’s theme is always the same – the pity, and the futility, of war.  Even when, ostensibly, he is not writing a war poem, he always returns to the war.  Take Miners.

There was a whispering in my hearth,

A sigh of the coal,

Grown wistful of a former earth

It might recall…

Then, midway through the poem, an abrupt change of tone:

But the coals were murmuring of their mine,

And moans down there

Of boys that slept wry sleep, and men

Writhing for air.

And I saw white bones in the cinder-shard.

Bones without number…

Similarly, The Parable of the Old Man and the Young only becomes a war poem in its last couplet.  

But the old man would not so, but slew his son,

And half the seed of Europe, one by one.

Sometimes with Owen there is a stark and sudden flash of anger.  It is at its most explicit in the most uncompromising of all his poems, with its grim exposure of “The Old Lie”, Dulce et Decorum Est.

In all my dreams, before my helpless sight,

He plunges at me, guttering, choking, drowning…

I dare say Siegfried Sassoon, a harder, harsher poet than Owen, must have greatly admired Dulce et Decorum Est.

Owen depicts the war as an act of gross abuse perpetrated by the old upon the young.  Wars are fought by youth.  In the Battle of Britain, most of the “few” were barely out of their teens.  The old are not conscripted.  I wonder why not?  I suppose an old man, or woman, handed a tin hat and a rifle, would say, “What am I supposed to do with these?”  Two of the compensations of growing old are that you are unlikely to be called for jury service, and unlikely to be called up.  The young do well to be critical of their elders when failed policy and failed diplomacy plunge the world into war.  Perhaps we are witnessing something similar across the world when every year statesmen and diplomats jet into exotic locations for a Conference of the Parties, and proceed to ratify a piece of humbug.  Blah blah blah.  The world is on fire, and it is the young who will pay the price.                  

Benjamin Britten set Owen’s The Parable of the Old Man and the Young in the Offertorium, part of his War Requiem.  The setting is surrounded by the echoing choir of young boys and their ghostly chant of the Latin Requiem Mass.  War always looks futile, even absurd, from a distance.  Nowadays we think of the Great War as complete madness, a grotesque Blackadder sketch.  Field Marshall Viscount Montgomery thought the generals of the first war were complete amateurs.  Thirty thousand British soldiers, said Monty in his wide-eyed way, were killed on the first day of the Battle of the Somme, before lunch.

“Before lunch!”

And the Second World War was partly made possible by the crippling reparations exacted by the Treaty of Versailles, resulting in the sort of inflation which threatened to price a loaf of bread at around a billion Deutschmarks.  Churchill of all people called the second war “the unnecessary war”.              

I was intrigued to hear that a stash of wrecked Hurricane fighter planes have been found in a gorge in Ukraine.  A large number of them were shipped across to the Soviet Union during the war, to assist in the war against Nazi Germany.  And now we are sending ordnance and matériel to assist in the defence of Ukraine against Russian aggression.  Who was it said that history does not repeat itself, but sometimes rhymes? 

Or perhaps, as with Wilfred Owen’s poetry, half-rhymes. 

If, in the unlikely event I ever get round to writing a personal memoir (nothing so hifalutin as an autobiography), I might encapsulate the whole shambolic roller-coaster ride in a terse executive summary, to wit…

From age seven, I discovered a fascination for words, and I knew I wanted to write.  And indeed I scribbled away.  With adolescence came writer’s block, and with adulthood, the realisation I needed to go off at a tangent and do something entirely different.  I disappeared into medicine.  Forty odd years later by some gift of benevolent providence I was permitted to return to my first love, and publish.

Codswallop.

You must realise, that is a version of the truth, a cosmetic, sanitised version.  But I thought of it when I listened to Desert Island Discs yesterday.  Lauren Laverne interviewed Kate Mosse (the writer, as opposed to Kate Moss the supermodel, whose own recent outing as castaway I thought rather impressive).  Anyway Ms Laverne asked Ms Mosse what advice she would give to up-and-coming young writers.  She advised them to emulate Picasso, who went into his studio every day, even as an elderly man.  When he was asked why he persisted in doing this, he said that if and when inspiration struck, he wanted to be there.  So writers have to report to their desk every day, even when they don’t feel like it.  You might not write your novel that day, but you might, for example, pen a description of steam coming out of a kettle.  So when the time comes, you are match fit.  

It’s good advice.  As a matter of fact I’m following it, even now, as I write.  But it’s not the whole story.  I might rather be inclined to state, ostensibly, something diametrically opposite: don’t live in a garret.  Go out into the real world and live a life.  I think it was Doris Lessing who said that the problem for a writer was not how to write, but how to live.  (She won the Nobel Prize for Literature in 2007, like Bob Dylan in 2016, with apparent reluctance.)  The fact is that if you live most of your life hunched over a keyboard, in front of a computer screen, you are not likely to know much about real life.  And you are also likely to get very lonely.

Another invaluable piece of advice often given to writers is to read widely across time and space, in different genres and different languages.  Wise counsel again.  But this too has its limitations, which run parallel to those of the recluse occupant of the garret.  The experience you accrue is second-hand.  The life you thus choose to lead through reading is vicarious.

(And you are also likely to get very lonely.)

So there is a balance to be struck between leading a life and then producing something, in letters, born of your own personal experience.  The writers I have most admired have had hinterland; more, they have led another life.  Ian Fleming was in wartime intelligence.  He was an unsuccessful stockbroker and later a successful journalist at the foreign desk of the Times.  John Buchan was also in wartime intelligence. He was a publisher, an MP, and Governor-General of Canada.  Somerset Maugham qualified as a doctor and he said himself that he wished he had spent more time in the profession, precisely because it would have afforded him a very special and privileged way of entering people’s lives.  This I can attest to.

T. S. Eliot (Nobel Laureate 1948) was a banker, and a publisher.  (Incidentally Four Quartets was Kate Mosse’s Desert Island book.)  Sorley MacLean was a school teacher.  Albert Camus (Nobel Laureate 1957) was a philosopher and a political activist, as was George Orwell.  Churchill, who even surprised himself by winning the Nobel Prize for Literature in 1953, had so many second jobs that it would be hard to compile a comprehensive list.  Bertrand Russell (Nobel Laureate 1950) in a very long life was a mathematician, a logician, a philosopher, and again a political activist.    

But hinterland brings its own problems, precisely because it is hinterland.  I think this is what Doris Lessing was alluding to when she talked of the writer’s difficulties in leading a life.  You can have a hobby, or a pastime, or a profession, and you can approach it with profound interest, conviction, enthusiasm, effectiveness, and even passion.  You may do it well.  You might receive plaudits.  To all outward appearances, and to all intents and purposes, you might be deemed “a success”. 

But there is one thing you cannot do.  You cannot give it your all.  Because that has been reserved, like it or not, for something else.   

So, in the unlikely event that I am cast away (but I can’t be cast away as I am cast away already… fetch me my viola…) and Ms Laverne asks me for advice for aspiring writers, I will say, go for a walk.  I get my best inspiration out of doors.  Out in the real world, you will find your subject matter.  And if your idea is truly original, then you will find our way back to the writing desk.  But you might take some unexpected diversions on the way.  As John Lennon said, life is what happens to you, while you’re busy making other plans.                         

In Travels in the Americas, Notes and Impressions of a New World, by Albert Camus (University of Chicago Press, 2023), I read this arresting entry:

Here in New York, thousands of would-be admirals and generals are doormen, captains, and boys.  The elevator operators like so many bottled genies going up and down in their big boxes. 

Sometimes you read a sentence and it’s not so much that you wish you’d thought of it first, more that you aspire to utter something equally original.  Camus visited New York just after the end of the Second World War.  We all have a notion of what New York must have been like then, because of the movies.  For post-war Britain, which had been starved not quite into subjugation, but nearly so, the New World seemed impossibly glamorous.  Cary Grant and Myrna Loy and Claudette Colbert and Lauren Bacall and so on.  I got a sense of it back in the 80s, when I saw Lauren Bacall perform in Melbourne, in Sweet Bird of Youth.  She was wonderful, and still very glamorous.

But I don’t think Albert Camus was taken in by the bright lights, even although he had just emerged from the blackout in Europe.  Churchill, who was half American, said that the US and the UK were two countries separated by a common language.  The common language may tempt the Brit to forget that he is venturing abroad into foreign territory.  When Churchill looked the wrong way in NY in 1931, stepped off the kerb and got run over, he committed a cultural faux-pas in a very stark manner.  You think you know the norms and customs, and then you foul up.  Camus didn’t share a common language and so he never made this mistake.  (Perhaps that’s a little crass.  In 1960, three years after winning the Nobel Prize for Literature, he was killed in a car crash.)  He was fascinated by the USA, but it remained very strange to him.  In Travels in the Americas, there is a picture of a huge billboard on Times Square, advertising Camel cigarettes.  As Camus says, “A G.I., his mouth wide open lets out huge puffs of real smoke.  All of it yellow and red.”  Only in America.  I can once remember coming out of the theatre in Broadway and passing a man taking his llama for a walk, while somebody in a kiosk at a street corner offered to take my blood pressure.  That would have been equally ridiculous to Camus.  Under the intense glare of the city lights, he saw the benighted plight of the individual trapped on his own peculiar treadmill, swallowed up by the maw of unfettered and insatiable capitalism.  To him, it seemed quite absurd.                 

My father had an extraordinary experience in New York during the war.  What on earth, you may ask, was a young man from Saltcoats, Ayrshire, doing in NY, NY in 1942?  Well, long story short, he had been a policeman in Glasgow when the Nazis bombed Clydebank, he took umbrage, joined the RAF, and crossed the Atlantic on a troop ship to Canada in order to learn to fly.  I have pictures of him, lying on a beach on Prince Edward Island, surrounded by beautiful women with big hair, and, like Lauren Bacall, “the look”.  During a period of leave, he visited New York with a comrade-in-arms.  They were dining in a restaurant when the actor Paul Douglas spotted them in RAF uniform, and invited them to dine at his table.  That is one trait you cannot deny our American cousins evince in spades.  Hospitality. 

My mum’s brother went to live in NY back in the 1930s, as a result of which I have extended family in the Big Apple.  When I first visited in 1982, my uncle met me at JFK and said, with a sense of profound irony, “Welcome to the land of the free.”  Like Camus, he too saw through it all.  I think he just missed Scotland.

I first encountered Camus a lifetime ago when I studied French in a liberal arts course in Glasgow for a year. We read La Peste.  I have vague memories of an allegorical tale of Nazism infiltrating the French colonial territory in Oran.  This was near the North African port of Mers el Kébir where the French fleet was anchored and sequestered at the time of the defeat of France in 1940.  Britain gave France an ultimatum that unless the French fleet were delivered to the British, it would be sunk.  The French called the British bluff that wasn’t a bluff, and the fleet was attacked and disabled, with great loss of life.  And we wonder why De Gaulle said “Non” to the UK’s application to join the Common Market (he probably anticipated what trouble the Brits would be), and why M. Macron is saying “Non” to the appointment of Ben Wallace as Secretary General of NATO.

Camus constructed an entire philosophy out of his sense of the absurd.  I can even remember a young female French lecturer advocating the adoption of the principles of the Absurd, the way you might proselytise on behalf of a religion.  I was aware at the time of The Theatre of The Absurd, as typified by Tom Stoppard’s play Rosencrantz and Guildenstern are Dead.  Then there was Eugène Ionesco’s Exit the King.  I saw a performance which took place, for some obscure reason, in Glasgow Unitarian Church on Pitt Street.  I can see the attraction in looking upon everything that occurs in life as being inherently ridiculous.  I thought of this when I heard Mr Gove yesterday touring the television and radio studios to apologise unequivocally about the latest Partygate video footage.  I took it all in with a shrug, a pout, and a Gallic flick of the wrist.       

The French can be every bit as absurd as the Americans.  A strange event took place on June 4^th on the Champs Élysées when 1,650 people seated at desks in serried columns took dictation longhand from a man on stage with a mic.  They were trying to get into the Guinness Book of Records.  Why on earth? 

But I find myself nowadays more drawn to the east than to the west.  Frankly, the Americans all work too hard in endless pursuit of the dollar.  Why would you want to hold down three jobs, and only take two weeks’ vacation, if that, once a year?  I would much rather chill out in some remote sun-kissed village in Provence, playing pétanque in the heat of the afternoon, and paying homage to the great French Holy Trinity of bread, cheese, and wine.                      

Occasionally I take The Sunday Telegraph, principally – at least this is what I say, apologetically, to the newsagent – in order to attempt the cruciverbalist’s Nemesis, Enigmatic Variations.  Though I have occasionally solved this most obscure of crosswords puzzles, I have yet to win the prize, a Telegraph fountain pen and notebook.   So I persevere.  I imagine people who write with fountain pens belong to a species as endangered as those who still read their news printed on actual paper.  So I am happy to join that group, though The Sunday Telegraph is hardly my preferred echo chamber.  Still, moving out of one’s comfort zone does one no harm; some of the writing is very good, and I do like to listen in, from north of the border, on what some of our English cousins are thinking.    

So yesterday I was intrigued, and a little bemused, at the wall-to-wall coverage of the resignation on Friday, as MP, of Mr Johnson.  I trawled my way through a mass of material, with sickly fascination.  To give you a flavour, Return of Tory psychodrama is the banner headline, in red, at the top of page 1.  Johnson orchestrates attack on PM over ‘swindle’ is the main page 1 report.  “Sources close to the ex-PM” say that three Tory MP resignations amount to an attack on Rishi Sunak.  Two more MPs (page 5) are on “resignation watch”.  Johnson supporters may be sanctioned for criticising the committee that (we are told) has found against him (pages 4 – 5).  The Sunday political editor has written an extensive piece on page 4 about a secret meeting between Boris and Rishi on Friday afternoon, in the Palace of Westminster.  Did Rishi disapprove of Boris’ honours list, or did he merely leave it up to the House of Lords?  Fraser Nelson on page 5 contrasts the dislike of many MPs for Boris with his popular appeal.  Johnson was right, he says, to suspect foul play.  On the same page, a KC criticises the procedures of the Privileges Committee who found (we are told) against Mr Johnson.  It is alleged the committee was not impartial. 

David Frost writes an extensive piece on page 6.  The tragedy is he didn’t realise he would never be forgiven for Brexit.  It is a theme taken up by Nigel Farage on page 21.  Johnson’s right: there is an establishment plot to reverse Brexit.  He anticipates a Keir Starmer Labour Government which will make the UK an associate member of the European Union. 

Yet more.  Page 6.  Lord Cruddas: Boris has been stitched up and the Conservative voters betrayed.  Page 7.  Don’t stand in Johnson’s way to a safe seat, PM is warned.  This must refer to Boris’ Cincinnatus ambitions. 

We move on to Comment.  A Leader article on page 19.  Tories must stop tearing themselves apart.  Then Letters to the Editor.  22 letters.  13 of them about Boris.  Mixed feelings, and a broad spectrum of opinion. 

Page 20.  So it goes on.  A cartoon of a retreating Boris stomping rough-shod through Rishi’s five priorities.  Leader articles all preoccupied with the Boris brouhaha.  Remainers have become diehard imperialists, and We need proper Conservatism now to save the economy.  Page 21.  Nigel Farage I have mentioned.  Daniel Hannan – Lockdown finished Boris, but for all the wrong reasons.   

Did anything else happen at the weekend?  Back to page 1.  City clinch the treble.   

Now as we enter a new working week the furore has not let up.  The 8 o’clock news on BBC Radio 4 led with stories of Boris’ allies impugning the integrity of the Privileges Committee which is allegedly about to find against the ex-PM.  Boris in his resignation statement called the committee a kangaroo court.  Its seven members (four Conservative, two Labour, and 1 SNP), have been afforded additional security.  At 8.10 am Mishal Husain interviewed Michael Gove, Minister for Levelling Up, etc.  Was it right that Boris was able, with all this going on, to forward a resigning PM’s honours list to the House of Lords?  Apparently Mr Johnson followed due precedent.  Meanwhile the government is focused, every minute of every day, halving inflation, fixing the NHS, stopping the boats…

Now here is a stark contrast.  North of the border: today’s Herald (celebrating 240 years – I think The Herald has a claim to be the oldest newspaper in the world).  The banner headline, in green, is Sir Andy smashes back with first grass court title since 2016.  The main Page 1 report: I am innocent, Sturgeon insists after arrest in SNP funds probe.  Scotland has preoccupations of her own.  There is nothing about Westminster on page 1.  Actually throughout the entire newspaper there is only one very brief article alluding to the Westminster psychodrama, a report on page 4 of Grant Shapps’ appearance on the Laura Kuenssberg Show.  Apparently Westminster has “moved on” from the Boris Johnson era.  Aye right.  On the double-page Letters spread there are eleven letters (The Herald tends to publish fewer, but longer, letters).  None of them mention Mr Johnson.

It’s a completely different country.      

If ever I needed confirmation of the utility of the 20 mph speed limit, increasingly common in our villages, towns and cities, it came at around 5 pm on Friday, as I drove home from a walk round beautiful Loch Leven.  I swung into a connecting road between two arterial routes in the village next to my own, and fifty metres ahead of me was a toddler in nappies, unaccompanied, toddling down the middle of the street.  I decelerated to dead slow, pondering what to do.  A hundred metres further on I’d decided to stop the car in the middle of the road with the hazard lights on, get out, lift the child off the road, and then decide what to do next.  I was well aware that this could be a hazard for me, too.  Man abducts child. 

Then off course the traffic behind me, who couldn’t see what was going on, grew impatient.  PAAAARRRRP!  Clearly somebody hadn’t paused to wonder what hazard might possibly lie ahead.  I was obviously just some loonie driver crawling along in a reverie, oblivious to the world around me.

Fortunately, some pedestrians at the end of the road saw what was going on, and a lady with a kindly demeanour stepped out to rescue the child.  We exchanged bewildered shrugs.  I switched the hazard lights off and proceeded on my way. 

Anecdotally, my personal experience is that the environment of the highway is becoming increasingly toxic.  But this is not mere anecdote.  The following day (as I was walking the seven hills of Edinburgh), two pedestrians were killed in separate incidents in Glasgow.  Ten people have died on Glasgow’s roads this year, compared with seven for the whole of 2022.  Yesterday, a cyclist who had been involved in a crash in Glasgow in May, died in hospital.  But it’s not just Glasgow.  Nearly 2000 people were either killed or seriously injured on Scottish roads in 2022.  There were 174 deaths. 

In Glasgow, a team of road safety experts, together with the police, have visited the various crash sites, and advised the council that no action need be taken.  That is to say, there was no apparent intrinsic danger evident in the environments of the crash sites.  

It seems to me that the problem is not environmental; it is cultural.  You only need to drive into Glasgow from the north east to see this.  There is a 50 mph speed limit on the M80 commencing about seven miles from the city centre.  It is almost universally ignored.  In fact, exceeding the speed limit on this stretch of motorway is completely pointless, because shortly after you merge with the M8 the road is “up” and diminishes to two lanes.  There is a bottleneck due to road repairs which have been going on now for years.

It is evident that the majority of people who choose to break the speed limit consider that the limit is inappropriate, and that people who adhere to it are merely being pedantic.  The trouble with this is that you now have two classes of driver, one observing the rules, the other flouting them, and there is no agreed convention as to how to use the highway.  That is to say, there is no universally accepted culture.  In other words, there is anarchy.  And then people wonder why 174 were killed on Scottish roads last year. 

You see the same phenomenon no matter what the speed limit is.  75 mph in a 70 mph motorway, 35 mph in a built up area.  And the 20 mph limit is blatantly ignored, even by the police.  I was intrigued by the brouhaha surrounding Home Secretary Suella Braverman’s recent speeding ticket, and her attempts to seek the advice of the Civil Service on how to organize a one-on-one speed awareness course.  The Civil Service couldn’t help, so she declined the course, paid the fine, and took the penalty points on her licence.  In my opinion she should have joined the class and taken the course.  She might have learned something useful.  At the time, BBC Radio 4 interviewed the actor Nigel Havers, who apparently has taken the course three times.

Three times? 

Does that signify he has been caught speeding three times?  This would imply he has learned nothing.  Or maybe he found the course so interesting that he wanted a refresher, twice.  This is unlikely.  Mr Havers pronounced the class “boring”.  He did say he learned that driving on a motorway at 77 mph is “apparently very dangerous”.  Duh.  I was disappointed, because I rather admire the stance he has taken on drivers who sit stationary with the engine idling.  He makes a habit of tapping on the driver’s window and politely asking them to switch the ignition off.  I have previously in this blog strongly advised Mr Havers not to attempt this in Glasgow.  It would be like telling somebody not to drop their half-eaten kebab in the gutter in Sauchiehall Street.  At any rate I wish he could get as exercised about speed as he obviously is about exhaust fumes.  (Incidentally, on June 1^st, Glasgow city centre’s low emissions zone became active.)

There is in fact a parallel between the flouting of speed limits, and the flouting of laws against littering, and these are both evident in the extreme in Glasgow.  Both bespeak a lack of ownership, because of a lack of a sense of belonging.  If you don’t have a vested interest in your community, if your opinion doesn’t count, if the establishment is elsewhere, then why bother?  Not my problem, mate.  The council can pick up the litter.  And road crashes only affect the feckless. 

Speeding should carry the same stigma as drink driving.  We need to adopt the attitude of the airline industry and say, “Safety is our highest priority.”  We need to take ownership of the problem.  This is my problem, because it is everybody’s problem.  It is a combined, collegiate activity.  A sense of belonging.  The Germans have a beautiful for that.  Zusammengehörigkeitsgefühl. 

Frustration plays a role, often pivotal, in many road crashes.  People tail-gate, grind their teeth, and pull out on blind corners.  When it all goes pear-shaped, they are inclined to blame the driver ahead who was adhering to the limit.  Here is a tip to avoid frustration.  I’ve mentioned it before, but I will not apologise for this reiteration.  I call it the CAHOOTS Doctrine: Campbell adds hours on over the schedule.  Estimate the duration of your journey.  Then add on half as much again.  If it takes ten minutes, give yourself fifteen.  If it takes two hours, give yourself three.  Then you will find yourself happy to adhere to all the speed limits, and if you find yourself behind a slow moving farm vehicle, you will thank the driver for putting bread on your table.       

Yesterday was Pentecost.  In the second chapter of the Acts of the Apostles, a strange power was bestowed upon the eleven, and suddenly they developed fluency in foreign languages.  Or did they?  Some people thought they were just plastered.  “What?” said Peter.  “At nine o’clock in the morning?”  I wouldn’t rule it out.  I’ve met plenty of people, plastered, at nine o’clock in the morning. 

Pentecost is an obverse to another biblical tale, that of the Tower of Babel, a civic project gone wrong, an enormous skyscraper and a monument to humanity’s pride that collapsed in a heap of rubble.  Then everybody began to talk gibberish.

I once imagined I had a Pentecostal moment.  Having no German, I heard Mrs Merkel speaking on the telly and thought I could understand her.  But when I subsequently attended a German class, I had to conclude that I must have been drunk after all.  However I persevere.  Maybe Pentecost doesn’t happen in an instant, but takes a lifetime.

Peculiar to the German language is the entity of the separable verb.  An example would be aufstehen – to get up.  The prefix auf separates from the rest of the verb and goes to the end of the clause or sentence.  Er steht um 7.00 Uhr auf.  He gets up at seven.  On the other hand, verstehen – the verb to understand – doesn’t behave like this.  Ich verstehe nicht, said the man in the rubble of the Tower of Babel.  I don’t understand.  He doesn’t say Ich stehe nicht ver.  That would truly be gibberish.  Verstehen is therefore an inseparable verb.  Tipp – the separable verb has its accent on the first syllable, but the inseparable verb does not.

If there’s another verb in the sentence it usually sends the separable verb to the end where it joins itself up again.  Ich muss morgen früh aufstehen.  I have to get up early tomorrow.  But then if you are going to modify the infinitive aufstehen it is liable to separate again, at least partially.  Yesterday I got up early. Gestern bin ich früh aufgestanden.  Sorry.  Too much information.  Zu viel Information.         

When I first discovered separable verbs and realised how ubiquitous they were, it crossed my mind that there must be some separable verbs in English.  After all, the languages are alike in so many ways.  The German for interview is Interview.  A ghetto blaster is a Gettoblaster.  We may say in our complacent way that these are loan words, words the English have deigned to rent out.  But then, the German for brutal is brutal, and who can lay claim to being first to plant the national flag in the realm of brutality? 

So I’m on the hunt for a separable verb in English.  How about to understand?  I stand the meaning of life under.  To withdraw.  I drew from the conflict with.  Construe.  I strued the German prose in English con.  Not quite.  How about uphold?  I held these values up.  Close, but no cigar.    

So I’m thinking of starting a campaign to introduce separable verbs into English.  This could have a moral, ethical, political undertone (or perhaps, to borrow another German trait, a Moralethicalpoliticalundertone).  I might say that I self-identify as separable, and, incidentally, my preferred pronouns are… (or rather, my ferred pronouns are… pre).  I might accrue acolytes.  The separable community would get short shrift and, much like the apostles, become objects of scorn and derision.  We might deface statues in order to make prefixes migrate.  We would be arrested, and then we could insist on speaking separable English, via an interpreter, in court.  Parliament, ever sensitive to the rights of minorities, would debate the introduction of bilingual signage on our roads, railway stations, ambulances, and police cars.  Ware the gap be.  You must in the back upbelt.  It is the law.  Irate letters would be written to the Herald by Disgruntled of Duntocher: “The separatists, and those of their ilk, should hang their heads in shame.”  I would reply, “Gruntled the correspondent from Duntocher may be dis, but he only carps and snipes in order the course of justice pertovert.

I know what you’re thinking.  I’ve lost the plot.  Incidentally, I’ve had a wonderful musical weekend.  Can you believe it – on Saturday Nicola Benedetti, Sheku Kanneh-Mason, and Benjamin Grosvenor played, to a packed Glasgow Royal Concert Hall, Beethoven’s Triple Concerto.  What a coup for the impresario.  And on Sunday I played my viola in a concert with the Dunblane Chamber Orchestra.  Mozart and Mendelssohn.  Beautiful music.

Why didn’t I write a blog about it all?  I suppose it’s human nature, or at least my nature.  Even when we have nothing to moan about, we are always liable something uptodream.                                                               

If you chance to browse through a textbook of medical ethics, you will sooner or later come across the four principles of Beauchamp and Childress (Beauchamp TL, Childress JF, Principles of Biomedical Ethics, 7^th ed. Oxford: Oxford University Press; 2012).

1.  Respect for patient autonomy
2.  Beneficence
3. Non-maleficence
4. Justice

These principles are said to underpin our entire approach to patient care, and to remind us at the deepest level of not only what we do, but why to do it.  One could write a textbook on each of these four elements alone, but here are just a few notes. 

1.  Autonomy captures the idea that patients are entitled to be fully informed as to the nature of their condition, and the therapeutic options available, in order to give consent, or not, to a proposed course of action.  It may be surprising that it is often the patient who is first to surrender this right, with a shrug.  “You’re the doctor.  You know best.”  Patients may think better of medical paternalism than do doctors.  And then, some patients are more autonomous than others.  How autonomous is a child, or a patient with dementia, or with a psychotic illness?

• Beneficence requires that a proposed treatment be to the patient’s advantage.  That seems self-evident, but what if the patient exercises his autonomy to request a treatment that the doctor considers futile, or even harmful? 

• Primum non nocere.  First do no harm.  Non-maleficence might be taken as a synonym for beneficence, therefore redundant.  But then, there is no therapy in the world that is not attendant with unwanted effects.  Every proposed therapy requires a risk-benefit analysis.  There is a saying in medicine: show me a drug that has no side effects, and I’ll show you a drug that doesn’t work.

• Justice reminds us that every individual patient is part of a community.  If the health budget is finite, then spending the entire budget by prescribing an exorbitantly expensive drug on an individual, is going to be unjust to the rest of the community.  Hence, bodies such as the National Institute for Clinical Excellence in England (NICE) must make decisions as to whether certain drugs can be prescribed on the NHS.  “We have had to make some hard choices.”

Whenever I come across Beauchamp and Childress’s Four Pillars, I always think of a scene from the film Dead Poets Society, in which the English teacher John Keating (Robin Williams) has a pupil read aloud in class the introduction to a textbook of poetry, in which the anthologist provides the reader with a systematic approach to the estimation of a poem’s intrinsic worth.  Two critical criteria – I forget what they were – are pinpointed on a graph’s x and y axes in order to produce a curve, or perhaps an area under the curve, that will represent a quantification of poetic value.  Mr Keating draws the graph on the blackboard, and the pupils dutifully copy it down.  But then they are somewhat taken aback by Mr Keating’s next comment.

  “Excrement.”

I have to admit I tend to respond to Beauchamp and Childress with Mr Keating’s reaction.  The four principles represent medical ethics in retrospect.  You can imagine a hapless medical practitioner falling short of B & C’s standards, and finding himself up in front of a medical disciplinary committee, a group of august dons who take several days, or even weeks, to mull over a decision that the practitioner might have had to make in ten minutes.  By and large, people who work in front line medicine don’t utilise an ethical calculus.  Rather, they do their best, quite simply, to give tender loving care.

Mr Keating was teaching in a posh New England boarding school for boys, cramming the next generation of Ivy League scholars, in 1959.  I wonder if he was aware of an event that took place across the Pond on 7^th May, 1959.  C. P. Snow gave the Rede Lecture in the Senate House in Cambridge, entitled The Two Cultures.  I have an idea that Keating might have applied the excrement word to Snow’s thesis, just as F. R. Leavis did in his Cambridge Richmond Lecture in 1962.  Snow thought that society was fractured, and therefore harmed, by a schism between the arts and the sciences, or more exactly between artists and scientists.  The fact that Leavis’ reaction to this was viscerally antagonistic reminds us of a polemic that has dominated English letters really since the industrial revolution.  Leavis was antagonistic towards the theories of utilitarianism, and it is no surprise that the only Dickens novel he admired was Hard Times, Dickens’ own reaction to the utilitarian calculus of “the greatest good for the greatest number”, and thus, the quantification of human souls.  Dickens wanted to help the poor individually, but he didn’t want to create a welfare state.  Perhaps George Orwell turned out to be more of a utilitarian champion when he realised that liberalism, romanticism, and sentiment can only take you so far.  Who was it said, campaign in poetry, govern in prose?     

I thought of all this, of Beauchamp and Childress, Mr Keating, Dickens, Orwell, Snow and Leavis, when I heard Sarah Montague conduct an interview last week with some health care gurus on BBC Radio 4’s The World at One.  Digitalisation is apparently the coming thing.  (Didn’t England’s erstwhile Health Secretary Matt Hancock tell us as much?)  The NHS lags far behind.  Everybody needs to be on line.  The benefits are immeasurable.  All that data will be available to all these health care professionals at the click of a mouse (except the data I never recorded, because the patient told me something in deepest confidence).  When I was in practice, I was never so glad as when the computers crashed.  The third eye in the room went blank and I could turn my undivided attention to the living individual in front of me.

But now, apparently, if you are a Luddite, perhaps because you are elderly or decrepit or demented or just plain bloody-minded, then frankly you are going to get a poorer service.  It’s regrettable, but there it is. 

I wonder what Messrs Beauchamp and Childress would have made of that.