Author: jamescalumcampbell

Ki mai koe ki ahau

He aha te mea nui o te ao?

Maki e ki atu

He tangata, he tangata, he tangata.

 

I am told there are people who do not care for maps,

And find it hard to believe.  (Up here,

The wind is persistent, the houses still as the grave.

The sheepdogs lie on the grass

And glance philosophically about them.)

This is smoke-down time, this is your rag-butt end

Of a decaying semester, where people,

Moved by some ribald hocus-pocus of the soul

To some obscure…

And God knows what…

 

They say Captain Cook had sight of

Te Waha-o-Rerekohu, which in turn

Had welcomed the Arawa canoe of the Great Fleet,

This giant Pohutukawa on the long pathway at Te Araroa,

With her canopy spread of forty metres

The oldest Pohutukawa in the world.

These gnarled and tortured branches also stretch above

The cataract falls of Karekare, or stand alone, aflame

At water’s edge, eschewing society of trees

– Ngaio, lacebark, golden kowhai, white manuka

The rata, the kahikatea, the dead silence of the kauri forest –

The blood-red blossom bursting forth

As crimson as the redcoats lying on the beach

(Te Paranga Pa they never took by force).

Thus Pohutukawa groves make tapu

An ancient site of battle,

Metrosideros excelsa.

Nectar to the tui.

 

As kuaka godwits muster, screaming

Over Cape Maria van Diemen

Te Maori mourn another passing spirit.

Their murmuration never ceasing, Maori know

(Without recourse to social media sites)

There has been great and doleful massacre.

Where the stream Kapo-Wairua runs

Into Tom Bowling Bay, demons try

To snatch the souls, hurrying

To Muriwhenua at Land’s End,

Lacerated with obsidian flakes,

Crowns of thorns

Knotted into death’s chaplets.

Here, before the oceans’ confluence, Tatu-o-te-Po

The last Pohutukawa

Leans down to the surf.

The disembodied spirits of the dead

Follow the Ara Whanui a Tane:

Ki ro kauwhau o te riri

Ka rere koe

I te Hiki o te Ika e-e!   

What sign for those who come after?

 

Hi iwi Kotahi tatau

Perusing the book shelves in a branch of W H Smith, I picked up a couple of books more or less at random.  They both looked interesting and readable, and indeed both turned out to be so.  I read them quite quickly.  When you read books in parallel like this, they seem to augment one another in unforeseen ways, even when you wouldn’t suppose they had anything remotely in common.

The first book was War Doctor, Surgery on the Front line, by David Nott (Picador 2019). (Let me say immediately, lest I forget, that this book should be compulsory reading for any future Prime Minister minded to enlist our armed forces in some so-called “Discretionary War”.  Here is a vivid depiction of what it means to drop bombs on people.)  The second book was Feel the Fear and Do it Anyway by Susan Jeffers (Century 1987, revised and updated edition Vermilion 2012).  I knew that David Nott was a trauma surgeon with a vast experience of working in war zones, and as an emergency physician I was fascinated to read about his work.  By contrast I had no particular interest in Susan Jeffers’ work and if I’m being honest I have heretofore entertained a scepticism towards inspirational self-help books.  My preconception was that self-help was for neurotic Californians for whom having a therapist would be de rigueur.  But Feel the Fear and Do it Anyway is a famous title, familiar even to me, so I thought I would give it a go.

Self-help books were tremendously in vogue in the 1930s, and James Thurber lampooned them mercilessly in Let Your mind Alone (Hamish Hamilton, 1937).  He mined a rich seam of humour in contrasting the smug inner certainty of these Desiderata with the angst-ridden lives of nonplussed, middle-aged American men.  I wonder what Thurber would have made of Dr Jeffers encouraging us to place inspirational “affirmations” on post-its, scattered round the house?  I suspect he would have made quite a lot.  I confess that Let Your Mind Alone has prejudiced me against self-help books.  Did Thurber really despise them?  It hardly matters, as Thurber is a persona, a character in his own bizarre and unpredictable world.  It’s not that he’s in denial of the fact that he’s neurotic, merely that he can’t take seriously the off-the-peg solutions of the psychotherapists.  Maybe if they went off to Aleppo and worked as an orderly in an underground hospital in what David Nott calls an “austere environment”, they would find they didn’t have time for introspection.  Incidentally, David Nott runs a course called “Surgical Training for Austere Environments (STAE)”, which strikes me as quite a euphemism.  It might aptly be renamed, “Surgical Training for Hell.”

So I really did think that there would be no connection between these two books, and that attending a seminar on how to make your life more fulfilling would have nothing to do with how to patch up a mangled body while somebody is about to drop a bomb on you.  I mean, get real!  Susan Jeffers describes the trance-like episode which turned her life around almost in terms of a miracle.  Spontaneously, and without any forethought, she entered an academic institution unknown to her and told a stranger (who turned out to be the head of the department) that she was there to teach a course on Fear.  The rest is history.  Aye, right.  I read all this with a degree of resistance.  It’s all very well to say that all is for the best in the best of all possible worlds, but just look at Aleppo!

But then Dr Jeffers played the Viktor Frankl card.  Frankl’s Man’s Search for Meaning (Ein Psycholog erlebt das Konzentrationslager, 1946) is a book which periodically falls out of the sky upon me.  I even found a dog-eared paperback copy in a hut in the Highlands of Papua New Guinea.  Viktor E.  Frankl was a psychiatrist, a survivor of Auschwitz who averred that life was meaningful even in the direst of circumstances.  He went on to develop a system of psychological treatment known as Logotherapy which seems to me to share a lot of ideas with Susan Jeffers.  I began to read Jeffers with a new respect.  I like the message that is encapsulated in the title of her book.  She permits us to be fearful.  Angst is part of the human condition; it is not of itself abnormal.  I wonder if, amid the current epidemic of antidepressant prescribing, we have lost sight of that fact.  Dr Jeffers borrows from Viktor Frankl a technique called “Paradoxical Intention” in which a patient does not try to combat, dodge, or obliterate his fear, but, paradoxically, to reproduce it.  Somebody with a phobia of public-speaking, for example, might be encouraged to get up in a public place, make a speech, and deliberately fall apart.  The paradox is that the subject finds himself able to make the speech, but unable to fall apart.

It occurred to me that “Feel the fear and do it anyway” – recurrently – is what David Nott has done.  Sarajevo, Kabul, Freetown, Monrovia, Darfur, Rwanda, Yemen, Libya, Haiti, the Central African Republic, Gaza, and of course, Aleppo.  It clearly is a very special person who volunteers repeatedly to subject himself to this level of risk, and to operate in an environment of utter degradation, for no material reward.  What drives him?  David Nott tries to address this question in his book.  From a professional point of view, he clearly relishes the challenge of practising in the austere environment, where you have little if any recourse to laboratory and radiological back-up, and you are forced to rely diagnostically solely on your own clinical acumen.  To make the right decision, and to achieve the right outcome, is very gratifying.  This is closely aligned with the humanitarian aspect of the work he does.  You sense his sense of pride in saving the life of a terribly traumatised child.  With respect to personal risk, he admits to being something of an adrenaline junkie.  He describes watching the news in London, hearing about the destruction being wrought in the world’s latest war-zone, and having an irresistible desire to go there.

I was very interested to read about David Nott’s other professional life.  He is a pilot, both fixed wing and rotary, and he has practised that art at a high level.  I wouldn’t claim for a moment to have advanced half so far as Mr Nott in either aviation or medicine, but as an emergency physician and a private pilot I do claim a special interest here.  You might imagine going fishing (a fishing rod was his chosen luxury on Desert island Discs) would be a more therapeutic off-duty pursuit for a stressed surgeon, than flying a Lear Jet from Luton to Heathrow in the world’s busiest airspace.  But it was during the 1990s in Auckland that I began to appreciate that aviation was therapy for the emergency physician.  I would leave the madhouse of Middlemore Emergency Department in South Auckland and drive south out of Auckland through Alfriston to Ardmore Aerodrome.  I would take Whisky Alpha Echo, a Slingsby Firefly, aloft and do loops and barrel rolls and stall turns and spins.  The act of putting yourself into a situation of extreme personal vulnerability, in which you are totally reliant on your own skill to retrieve the situation, somehow invests you with the power to help somebody else in extremis.  After the sortie I’d have a pint in the club bar and then drive home to Bucklands Beach (legal there and then – couldn’t do it now).  I’d always have to stop, at the same lay-by in Alfriston, and get out and look at the view, overcome by a very strange mix of serenity and euphoria.

I would hazard a guess that something like that feeling is what drives David Nott.

But it comes at a price.  Things can go wrong.  David Nott is candid – remarkably candid for a doctor I’d say – about cock-ups, in both medicine and aviation.  That trip by Lear Jet from Luton to Heathrow did not go well.  Aviators will recognise the symptoms: if you’re not flying all the time, you lose currency.  There’s a hierarchy of multi-tasks a pilot must carry out, and if he can’t do some of them unconsciously, he gets overloaded; pilots call this being “maxed out”.  Then there was that close shave in the helicopter.

He doesn’t gloss over the medical mishaps either.  The burr hole on the wrong side of the skull, the massive transfusion reaction from incompatible blood – it’s all there. There are many extraordinary and highly dramatic scenes depicted in War Doctor – the many passionate and acrimonious disputes between colleagues in the operating theatre; the occasion of being abandoned in the pitch dark in theatre during a bombing raid; the decision to continue operating under threat of immediate obliteration; but the episode which stood out for me occurred in Aleppo when Daesh broke into the operating theatre.  David Nott’s assistant whispered to him, “Don’t say a word.”  David Nott prayed to God that his hands would stop shaking.  They did.  He was able to complete the operation.

I have the sense of a man who has taken his craft to the absolute limits and who finds himself in a zone in which he no longer has any reason to put up any sort of front.  You can sense it, if you track down his appearance on Desert Island Discs on the BBC Sounds App, and listen.  I liked his musical choices.  His soundscape had serenity.  And when he recounted his experiences, he relived them.  You are never more in touch with humanity than when on the verge of tears.  I recognise this zone myself, again, from clinical practice.  It’s a kind of catharsis.  Catharsis, the purgation of pity and terror, was for Aristotle the defining characteristic of tragedy.  I never really had an inkling of what this might mean until I saw Roman Polanski’s film of Macbeth.  The terrible world Shakespeare conjured – and Polanski recreated – might not be unlike the world to which David Nott is recurrently compelled to return.  It is a frightful place, but towards the end of the Polanski film there is an inexplicable lightening of the atmosphere which is truly cathartic.  I remember I used to experience something similar at the end of a particularly hellish and protracted shift in the emergency department.  I felt I could do anything.  I was as light as air.  Yes I will stitch up that gash on the beautiful face of the daughter of the Professor of Plastic Surgery.  No problem.  Next morning, I’d be back to my old neurotic self, braced for another day.  Feel the fear and do it anyway.

 

I pushed the twenty-three gauge hypodermic needle decisively through the skin and then infiltrated local anaesthetic as gently as I could – it is liable to sting.  I said, “All right?”

“Yes,” said Françoise.  The voice was cautious, exploratory.  She lay prone with her head lying sideways on her forearms.  I raised a bleb of white skin in a margin round the pigmented neavus.  I said, “It looks perfectly benign.  I don’t know why we’re doing this.”

“Humph.”

Actually I did know.  She was a Canadian radiology registrar, very Québécois.   I kind of knew her because we both played in the orchestra – St Matthew’s in the City.   She’d come into the department at the end of her shift and said, “Will you lop a mole off my back?”  Sometimes you do a thing simply because you are importuned.

I took a size 11 scalpel blade, on a No. 3 handle, and incised round the mole, with a slim margin of normal skin.  “Okay?”

She said dreamily, “Can’t feel a thing.  Except the touch of your fingers.  Rather soothing.  You should be a masseur.”

Concentrate on the surgery.  Don’t blur the boundaries.  I held the naevus in forceps, on its pedicle of subcutaneous tissue, and gently dissected it away.

“There!”  I dropped it into formalin, ready to send to Pathology.  I opened a packet of 4/0 monofilament nylon, and grasped the atraumatic needle with the needle-holder.

“Closing now.”  Then the lights went out.

I said, “Now there’s a thing!”  There was a screen over the theatre door and it was absolutely pitch dark.  Françoise remarked, rather redundantly, “Must be a power cut.”

“Just as well I can suture with my eyes closed.”

“Don’t you dare!”

“Only kidding.  D’you suppose the nurses will remember we’re in here and come and rescue us?  I could try the buzzer on the wall but I don’t want to lose sterility.”

“No.  It’s never a good idea to lose sterility.”

It wasn’t unpleasant to sit in the darkness.  I could feel the gentle rise and fall of her rib cage under the green drapes.  She said, “Do you know why Jimmy Galway left the Berlin Philharmonic?”

“Did he fall out with Karajan?”

“They were playing Beethoven Five in the Musickwerein in Vienna one night, Karajan conducting.  Suddenly all the lights went out.  Nobody could see a thing.  They couldn’t read the music and they couldn’t see Karajan waving his arms.  But the music never faltered.  They went on to the end, note perfect.”

“So why did he leave?”

“I guess he felt you shouldn’t live life on automatic.”  Françoise was whispering, as if the darkness were sacred.  Then, from directly above us, a shrill and persistent bell started to ring.  Françoise giggled.  “Is that a fire alarm?”  Then the theatre door opened and Karen Jones said, “What are you two up to?”

“What’s happening, Karen?”

“Power cut.  The whole of Otahuhu and Mangere are out, apparently.”

“What about the hospital generator?”

“Hang on.”  She went to the wall and threw a few switches.  An X-ray screen sprang to life.  “How’s that?”

Ghostly fluorescence.  I said, “It’ll have to do.  What about the alarm?  Are we supposed to evacuate?”

Françoise said, “I’m not going out on to the street with a hole in my back!”  We were all raising our voices because of the stridency of the bell.  Karen said, “I’ll check it out,” and disappeared.  Then, beyond the door, I heard the ambulance r/t blasting away. What now?

Three sutures were enough.  I lay some tulle over the wound, and a dressing.  Françoise said, “Stitches out in a week?”

“Longer in the back.  Maybe twelve days or so.”  Then Karen opened the door again.  “You aren’t going to believe this.  There’s a bomb scare.”

“Is that what the alarm’s for?”

“No.  There’s a fire, too.  The bomb’s at the airport.”

The Maori have a saying, that all bad luck comes in threes.  “Are we on standby?”

“It’s a full alert.  They want you.”

“Oh good.  If the hospital’s on fire, I want to go to the airport.”  Françoise had turned on her side and was leaning negligently on an elbow.  I said, “Fancy a trip to the airport?”

“Sure.”  Her voice was full of interest.

“Let’s go.”

The department was buzzing.  All the available X-ray screens had been turned on and there was that same pale phosphorescent eerie half-light drenched over everything, that we had had in theatre.  At the nurses station somebody was lighting candles.  I’m constitutionally addicted to power cuts.  I love the underground, Blitzy atmosphere.  Administrators don’t give you crap during a power cut.

I picked up the ambulance r/t report.  “Where’s the fire?”

“By the lifts.  Cigarette in a trash can.”  The ambulance report read, “AIA full alert.  United Airways 747 Auckland – Honolulu, outgoing.  Bomb scare.  Landing 2310.”  We had twenty five minutes.  At the r/t station I picked up this spiffing new device – a cell phone the size of a car battery.

“We’re off!”

It was very dark outside.  As we stepped out into the ambulance bay a fire truck pulled up and six men, heavily clad in bright yellow overalls started off-loading.  Then more fire engines pulled up at the taxi rank by the hospital front door.  I was parked 100 metres away.  There was no street lighting but the eerie glow from the hospital was enough for us to pick our way.  I started up without preamble and we went like hell down Hospital Approach Road.

There was a policeman at the intersection at the top of the bridge.  I pulled the green light from under the dash with its extensible cord attached to the cigarette lighter, passed it through my window and slapped it on like a limpet to the car roof.

“Kojak!” said Françoise.  She was enjoying herself.  The policeman on points duty waved us left.  We accelerated out along Massey Road.  I said, “I can’t tell you how wonderful it is to get out of there!”

“Does this sort of thing happen often?”

“Surprisingly often.  We have a ‘special relationship’ with the airport.  There are three echelons of callout.  Most of the calls are first echelon – ‘Stand By’.  Maybe a 747 with one engine shut down.  That happens quite a lot.  The next echelon is this – ‘Full Alert.’  Full emergency service response.  We expect a problem.  If it’s a false alarm, we’ll be stood down.”

“And the third echelon?”

“Crash.”

I had caught up with an LSU, a Life Support Unit.  I snuck into her slipstream.  I was thinking about the one ‘Crash’ call-out I’d had, and the miserable freezing night out on the threshold of Runway 05, waiting for the divers to fish the two pilots of a freight aircraft out of the Manukau Harbour.  I had the melancholy privilege of declaring one of them lifeless.

There was a points man at every intersection, and in ten minutes we had turned left down George Bolt Memorial.  The whole of Mangere was blacked out.  We turned left, then right and, down at the airport perimeter, drew up at our assembly point, a sign that said starkly, “DON’T PARK HERE EVER.”  The LSU pulled up and I drew into the kerbside beside him.  Outside, here on the airport flatlands, there was a chill in the air.  I fetched two sheepskin-lined parkas from the boot, and a couple of fluorescent bibs bearing the legend, ‘Doctor’.  “Here, put this on.  It’s going to get cold.  And this.  There.  Now you can go anywhere, do anything.”  I switched off my green light.  In contrast to the darkness of Mangere, now we found ourselves in a great, phantasmagorical, psychedelic array of multi-coloured rotating lights coming off two dozen emergency vehicles.  From the air it would be dazzling.  I said, “I hope the pilot doesn’t think we’re the runaway.”

My friend Terry Dunstaple was at the wheel of the LSU.  I effected the introductions.  He looked at his watch.  “Landing in five minutes.”  He shivered.  “Let’s hope it’s another hoax.”

“Let’s hope so.”

“Incredible when you think about it.  An aircraft with 350 people on board 100 miles out over the Pacific turns back.  They’ve just dumped 130 tons of fuel.  130 tons!  All because some joker thinks it’s a helluva dag to phone up and say there’s a bomb on board.”

I scanned the horizon.  Where was the wind coming from?  It was a south-westerly, 25, gusting to 35 knots.  They would use Runway 23 and the aircraft would come in over the Whitford Beacon and Manukau Heights, tracking more or less directly down Puhinui Road and screaming over Pukaki Creek at two hundred feet with full flap and undercart down ready to touch with the grace, lightness, and splendour of a pelican.

There she was, bang on schedule, tracking straight down the runway’s extended centre line.  I could see the wink of the wing tip lights and the flick of the undercart strobe, low over Totara heights on final approach.  Françoise gripped my arm.

The 747 flared out over Pukaki, held off, nose up, and, as the engine note died, there was a wisp of tyre smoke off the asphalt.  Down!  The nose wheel sank gently on to the runway.  From nearby came a faint cheer and a smattering of applause.  Terry said, “They’re going to taxi to the apron just off 05 threshold and disembark there.”  I knew the form.  They would get passengers and crew off double quick, secure the area, and the bomb disposal people would move in.  The airport would stay open.  I said to Françoise, “Let’s go and get some coffee.”  Domestic or International?  I chose International.  “Terry – I’ve got the hand-held.”

He nodded and said cheerfully, “You’d hear the explosion anyway.”

 

At swimming practice (Hamilton Crescent School, relocated to Balshagray at the bottom of Broomhill Drive, Wednesday afternoons), I floundered up and down the pool and Mr Mennie barked, “Campbell, when are you are going to learn to swim?”  It was one of these occasions when the appropriate repartee only occurred to me later: “When are you going to teach me, sir?”  But then again, it was always dangerous to be precocious at school; you might get a clip round the ear.

Much later, at medical school in Edinburgh, I was studying along with some of my colleagues in the Royal Medical Society in its rooms across the quad from McEwan Hall, and above the Potterrow Bar.  A young consultant who was making a name for himself in the literary world called by to cut a swathe through our allegedly dull and studious lives.  I think he thought he was Somerset Maugham or Mikhail Bulgakov, but he was more like that grotesque James Thurber character in his laugh-out-loud piece Something to Say.  He said to me, “What are you going to be when you grow up, Campbell?”  On this occasion the apt riposte arrived on time: “A doctor.  What about you?”  He snorted and said to the company in general, “Here’s a man who knows exactly where he’s going, and nothing’s going to stop him!”  Actually he couldn’t have been more wrong.  I had no idea where I was going and, to paraphrase the late great George Harrison, if you have no idea where you are going, any road will take you there.

How do we choose our path in life?  As a kid, I think I would have been rather good at the pole vault.  I was a monkey on the rings and trapezes of Arlington Baths, swooping around over the pool to my heart’s content.  I have this fantasy of approaching Mr MacKay the PE teacher and saying, “I would like to learn to pole vault.”

“Pole vault.  Pole vault!  I’ll pole vault ye!”

(Pole faulting did not feature in the curriculum.)  But perhaps I am doing Mr MacKay an injustice, after the fashion of the driver who gets a flat tyre late one rainy night out in the boondocks.  He sees the light from a cottage in the distance, and plods his weary way in that direction, in the hope of borrowing a jack.  En route, soaked to the skin, he convinces himself he is going to suffer a frosty reception, and works himself into such a lather that when he knocks and the door is opened, he yells, “You can keep your f****** jack!”  For all I know, down at the playing fields in Scotstoun during “Games”, Mr Mackay might have produced the fibre glass pole.

But I don’t really regret not having tried the pole vault.  It strikes me that regret is a particularly redundant emotion, useless because it is incoherent.  If you no longer have the desire, what is the point in nursing the ambition?  And if you do have the desire, then, dammit, go for it.  Remember Tennyson’s Ulysses.

Tho’ much is taken, much abides; and tho’

We are not now that strength which in old days

Moved earth and heaven; that which we are, we are;

One equal temper of heroic hearts,

Made weak by time and fate, but strong in will

To strive, to seek, to find, and not to yield. 

With this in mind, at the beginning to 2019 I started a beginner’s evening class in German.  It’s something I’ve been meaning to do for a long time.  I always had the notion, listening to Mrs Merkel on the telly, that I nearly understood what she was saying.  German has a staccato quality quite unlike the syllable timed lenition and enjambment of French, and each subordinate clause is clearly punctuated both in speech and in print.  So I think it has an accessibility to the native English speaker.  I put it to an Austrian friend of mine that English was really a dialect of German but he reckoned that was going a bit far.

Anyway the German class is great fun.  It is so recreational to take up something entirely new.  Early days of course, but I do have a sense of the accessibility of the language.  One of the reasons I wanted to try was that I listen to a lot of German music, including lieder.  Listening to a Schubert song cycle and not knowing what is being said is like playing the viola at the back of the orchestra pit; you only get a partial, and distorted notion of what’s going on.  With this in mind, I listened to a performance of Mahler’s Das Lied von der Erde on Radio 3 on Friday night, and I followed the German text.  It was a Pentecostal moment.  What a revelation!  It was almost like the restoration of a missing faculty, like sight or hearing.  I thought, what on earth have I been doing for all these years, wandering around in a twilit world following the collapse of the tower of Babel?  Why didn’t I do this before?

I didn’t study German in school.  I did French and Latin, and, in my 6^th year, Spanish.  But I was never a linguist.  Indeed, looking back, I’m not sure we were ever educated to be linguists, merely to master some grammar and pass the exam.  When I started to learn French as a twelve year old I don’t think there was a single person in the class who had ever been abroad.  And there were precious few in the entire school who had come from Elsewhere, even from anywhere outside Glasgow, and even, come to think of it, from beyond the immediate precinct and catchment area of the school.  Of course it is more difficult for inhabitants of an island to master a foreign tongue, because of the lack of opportunity to speak the language in the real world.  I noticed when I lived in the antipodes that this was also true of New Zealanders, being so far removed from everywhere else.  New Zealanders are broadly as poor linguists as Brits, with some notable exceptions, usually people who have mastered Japanese or Mandarin.  The Dutch, by contrast, are fantastic linguists.  They need to be, in a country barely the size of Yorkshire, surrounded by the great European powers.  I remember a Dutch girl in New Zealand, Kate, who said, “I think I’ll learn Maori; it looks pretty easy.”  You see, there’s the difference.

There we were, in High School French class, struggling with the subjunctive.  “Il aurait fallu que nous assassinassions le Cardinal Richelieu.”  Or something.  But who cares?  Nobody talks like that.  Nobody uses the Past Historic, apart from General de Gaulle.  Learning a language is not an academic pursuit at all.  I was made sharply aware of this when as a doctor I had as a patient a teenage girl from Costa Rica, holidaying in Scotland.  My ‘O’-level Spanish was hardly up to it, so the patient’s friend, a local teenage girl, came in with her and acted as interpreter.  She had holidayed in Costa Rica and picked Spanish up.  She had sat at the feet of the patient’s grandmother, thumbing through a dictionary, saying, how do you say this; how do you say that?  She turned out to be a fantastic interpreter, and mind, the conversation, turning on symptomatology, became quite technical.  I told her afterwards that she had a great talent, and asked, might she be interested in pursuing a career using her Spanish?  Yes, she would like to, but she couldn’t see a way to do it because she had absolutely no school qualifications at all.

Well, what does passing an exam tell you about somebody?  It tells you they are good at passing exams.  And the trick of passing exams is knowing how to avoid making mistakes.  But the essence of learning a language is to make thousands of mistakes.  The essence of learning a language is not to be careful, but to be bold.  Just go out there and blurt.  Nobody gives a damn.  Put yourself in the shoes of the person listening to your efforts.  You know what it is like when a foreign visitor asks you for directions in the street.  “Can you say please me where is castle?”  You don’t discourage, do you? You certainly wouldn’t mock.  You are glad to be of help.  You use your arms, and clear, simple language.  He says, “Mine English bad,” and you reply, “Better than my Latvian.”

I suppose the study of German might be for me a route into Wagner.  But here I confess, I don’t really “get” opera.  I remember one night Paul Merton saying of opera on Have I got News for You, “It never really caught on, did it?”  In Pretty Woman, Edward Lewis takes his Vivian by private jet up from LA to San Francisco to see the opera.  He tells her that if you aren’t truly an opera lover, you might learn to appreciate the art form, but it would never enter your soul.  I guess that’s me.  I’m okay with opera if I close my eyes and just listen to an aria.  But I can’t get past the idea that there is something preposterous about the whole package.  I just can’t suspend my disbelief, voluntarily or otherwise.  In the 1987 film of The Untouchables (which incidentally has a distinguished musical score), Al Capone occupies a box at the Opera and listens to some lachrymose Verdi lament – I seem to recall it was from Pagliacci, in which a clown is heartbroken to discover that his lover has been unfaithful, yet he still must put on the greasepaint and go out on stage and be funny.  It is the most pathetic thing.  Capone sits there, weeping.  Then one of his lackeys comes in to whisper in his ear that one of the Untouchables, an Irish cop played by Sean Connery, has been bumped off.  You see Capone’s tears turn to laughter.  His tears all along had been crocodilian.

But all operatic tears are crocodile tears.  I watched a programme on BBC 4 on Sunday night when Antonio Pappano talked about the Aria throughout the history of opera, discussing arias with some of the great opera singers of our day, and rehearsing with them.  The music was wonderful, as were the singers.  But I can’t take the libretti seriously.  And the acting is so hammy.  A few weeks ago I had reason in these annals to extol Michael Caine’s memoir Blowing the Bloody Doors Off.  It’s a book that some opera singers might do well to read.  In Rep, Sir Michael was rehearsing the part of a drunk man, and the director said to him, “Michael, what are you doing?”  “I’m acting a drunk.”  “But that’s my point.  I don’t want you to act a drunk.  I want you to be a drunk.  You are trying to act drunk, but what a drunk does is try to act sober.”

So who knows, maybe opera would work if the players remembered that “less is more”.  Hamlet tells the visiting troupe at Elsinore to “speak the speech trippingly”.  I have an idea Mozart also favoured a lightness of touch.  In Così Fan Tutte the men farewell the ladies and go off to the wars in music that would break your heart.  But of course it’s all tosh.  They are not going to war at all.  They are going to play an elaborate sex trick on their lovers.  I can’t think Mozart looked to Lorenzo da Ponte, his librettist, for psychological depth.  He probably read the stuff, burst out laughing, and said, “That’ll do.”

But who knows, once I’ve got a little more German under my belt, maybe I’ll become a regular attendee at Bayreuth, solemnly responding to the summons of the Wagner tubas.

Hier wird der Vorhang aufgezogen.

Volles Wogen der Wassertiefe.

 

 

 

 

This was the prequel to Misadventure.

I still get the flashbacks, the PTSD.  I haven’t worked in the department for over twenty years, though periodically I visit, twice in the last year, like a felon drawn back to the scene of the crime.  Sometimes I dream about the place; I grapple all night, amid a zone of chaos, with an intractable problem.  I remember hundreds of these nights.  We used to think that there must be a better way of doing this.  We joined forces with our colleagues across the Tasman, in the college in Melbourne, and organised.  We had a plan, and a vision, and I think that is why there was a period in the 90s when despite the pandemonium I used to wake with buoyancy and hope.

Shortly after midnight on Sunday, December 21^st., 1991, an invisible swirl of wind darted between the Manukau Heads, flashed across the Manukau Harbour, thundered briefly through South Auckland and vanished out into the Hauraki Gulf.  In its brief and violent passage across the built-up area east of the airport, tongues of the wind flicked down avenues with the venturi effect of tremendous acceleration between tall buildings, resulting in short-lived and chaotic street-tornadoes that cut a swathe of devastation almost before people had realised that the wind had picked up.  I worked on in the bowels of the emergency department, completely oblivious to this little local natural disturbance.

It was only a forearm flesh wound requiring a few sutures, but the patient had been kind enough to inform me that he was HIV positive, and I had taken him, not into one of the main theatres, but into Room 9, a small treatment room towards the back of the department, where I had set up a suture tray, then carefully gowned, and masked, and put on the heavy Perspex visor, then the sterile gloves.  A staff nurse looked in.  No, I didn’t need any help, but could she put screens over the door, and, no interruptions please.  I sat down and, carefully and methodically, cleaned and closed the wound, then applied tulle, an outer dressing and, finally, a sling.  I had closed out all the extraneous noises coming from the rest of the department, but I had heard the snarl of the ambulance siren, and was aware that something was taking place in Resus.  I carefully disposed of all sharps, then delivered the used suture tray and all the protective clothing into a large marked laundry bag which I closed up and deposited in its place at the back of the sluice.  I competed the paper-work, handed a copy to the patient, and bade him good evening.  I walked into Resus.

“Clear!”  Yolande applied the defibrillator paddles.  The patient gave an indifferent shrug, a 360 Joule shrug.

“Back in sinus!  Have we got an output?  Yes!”

I said accusingly, “You have resuscitated Mr Proudfoot.”

Mary Heenan said, “You haven’t resuscitated Mr Proudfoot?”

Mr Proudfoot, who was in the end stages of a severe cardiorespiratory illness, had requested that the next time he was admitted in cardiac arrest, he should be left in peace.  His cardiac consultant Dr Finlayson had even taken the trouble to come down to ED.  “The next time Mr Proudfoot dies,” he had said, “(and I choose my words carefully) – the next time Mr Proudfoot dies, he should not be resurrected.”

What had we done?  He had set his lands in order, made his will, paid all his bills, said goodbye to all his friends, kissed his family and told them he loved them, and made peace with his maker.  There was nothing to fear.  This was merely part of the progression of things – birth, childhood, education, career, marriage, children, domesticity, patriarchy, the twilight years and now, another physiological entity in its due place, demise.  Yet indeed there was something to fear.  The Health Service.

The Resus door opened and a trolley was pushed in.  An agitated, fit-looking young man.  “We need to double up,” said the staff nurse.  “Push Mr Proudfoot over there.”  The doors closed then immediately opened again.  Another trolley, bearing a screaming toddler, accompanied by two desperate parents.  “Near drowning.”  We were getting crowded.  I was looking at the agitated man.  He was dressed in Lycra, with the knee-length shorts of the cyclist, and a colourful top.  He stared wide-eyed at the ceiling.  Bizarrely, he was still cycling, still on his bike, peddling furiously.  I turned to the child.  Pink, well-perfused, alert, screaming robustly.  I asked the distraught parents what had happened, and at the same time I could hear the nurses trying to deal with Mr Proudfoot.  “There’s no room for him in resus.  We can’t monitor him in the corridor.”

I said, “Take him off the monitor.  No more shocks.”

“Right.”

The near-drowning child was in good condition.  It was a classic story.  They had moved house that evening.  The parents paused for a rest during the unpacking, and noticed the child was missing.  They found him, face down in the pool.  They must have found him immediately after he’d fallen in.  No hypoxia, no aspiration, no neurological damage.  Another minute and the story would have been very different.  The mother cried tears of vexation, anger, guilt, and overwhelming relief.  I knew they would never forget this night.  Twenty five years from now, at his son’s wedding, the father would make a light-hearted and witty speech about his son, embarrassing him with a few anecdotes of childhood.  He would touch with wistful levity on this fateful night.  There would be laughter from the wedding guests, and his bride would smile fondly over the notion that she had nearly been widowed a quarter century ago.  The best man would make a lewd and raucous speech.  Dave taking a header into the family pool when he was two.  What a joke.

But amid the laughter, the mother and father of the groom would cast a glance at one another, and hold one another’s gaze fractionally, and utter a silent prayer of gratitude that fate had looked down upon them, albeit indifferently, yet chosen to let the coin fall one way.

The cyclist was still peddling.  I laid a hand on his shoulder.  “Come on mate.  Off your bike.  Was there a triathlon today?”

Karen Jones nodded.  “Pukekohe.  2.4 km swim.  180 km bike ride.  And a marathon.”

“But it’s past midnight!”

“Yes.  There are still a few runners out.”

“What’s his temperature?”

“38.”

“Good enough.  Give him some intravenous fluids and see how he goes.  Come on, pal.  Climb down.  You’re in hospital.”

He grinned.  “Hospital.”  But he kept peddling.

The ambulance R/T squawked away.  A fight, in a hotel.  Gang-related.  There were knives, and somebody had a firearm.  The Armed Offenders Squad were in attendance.

Yolande tapped me on the shoulder.  “How do you reduce a dislocated jaw?”

“Glove up, put your thumbs on the lower molars, and your fingers behind the angles of the mandible.  Pull down, then rotate the jaw forward, then push it back.”

She rehearsed it in mid-air.  “Down, forwards, back.  Okay!  Got it!”  It is sometimes said that there is no such thing as a Teaching Hospital.  There are only Learning Hospitals.  We had accrued knowledge and experience by peddling and trafficking in information by word of mouth, the oral tradition.  Thus, the nightmarish, medieval, corrupt, exploitative, sleepless training: “See one, do one, teach one.”

Mary Heenan grabbed my elbow.  “Resus.  It’s a hanging matter.”

He was middle-aged, overweight, double-chinned, balding, and moustachioed.  He wore nothing but an expensive-looking silk dressing gown, and a silk cravat in the same pattern, claret-red with Chinese lettering in green.  The cravat had become a noose which the paramedics had loosened.  I   could see the constrictive erythematous abrasion all around the neck.  The patient’s nipples were skewered by hatpins.

“What on earth…”

“Watching blue movies.”

“The things we do.”

And unlike the near-drowned child, this man was very unwell.  Airway… breathing… circulation…  Eyes open to pain, localising pain, incomprehensible grunting.  He needed a rapid sequence induction.  Could he have a spinal injury?  Better assume so, protect the neck, and paralyse and intubate in the neutral anatomical position.

Yolande came back.  “No good.  I can’t get my thumbs into his mouth.  Would sedation help?”

“What?”

“The dislocated jaw.”

“Oh that.  Unusual if he doesn’t have an open mouth.  Are you sure of the diagnosis?”

It was my mistake.  I should have gone to see the patient at this point.  Yolande shrugged. “What else could it be?”

“I’ve seen a drug dystonic reaction mimicking a dislocated jaw.  Is he on something?  Did somebody slip him something in the pub?”

“I’m not sure.  I’ll check.”

Mary Heenan said, “I’ve got as cast iron a stomach as anybody.  I don’t mind blood, I don’t mind pus, or vomit, or even sputum, and I’ll take any amount of crap, but this is too much.”

“What is it, Mary?”

A sallow, unkempt man lay in Room 10.  There was a piece of tulle over a substantial lesion on the outer aspect of the left upper arm, held in a stout Gamgee.  Mary slipped on a pair of gloves.  “Ready?”  She took the dressing down.  The patient’s wound was seething.  Maggots.  Mary said, “I’m sorry, I can’t deal with this.”

“It’s okay.  Get somebody to put hydrogen peroxide on the wound and leave it for half an hour.  Then he can take a shower.”

Yolande was back.  “I don’t think it’s a dystonic reaction.  I still think it’s a dislocation.”

“Are you still dealing with that jaw?  Come on Yolande, we need you.  Send him to X-ray for tempero-mandibular joint views, open and closed.”

It was my mistake again.  I should have recognised a request for help, and gone to take a look.  Instead, I looked into Theatre 1.  Lawrence was suturing to music.  Mozart.  I thought, great!  I’m running round like a headless chook, Yolande’s fixated on a jaw, and Lawrence is listening to Mozart.  Meanwhile outside in the ambulance bay in a gale force wind the ambulances were disgorging.  I spent an hour darting between the broken wrists and ankles, the dislocated shoulders, falls, assaults, crashes, collapses, and the stigmata of hitherto undescribed states.  Suddenly the department was full of big heavy tattooed men in black leather jackets.

“Mary, I don’t want to alarm you, but I’ve just seen an emblem belonging to the Power, and a tatt belonging to the Mob, and when they run into one another, there’ll be hell to pay.  Get the police.”

“They’re on their way.”

The first of the stabbings from the hotel fracas arrived.  “Tension pneumothorax.  Drain, please.  No – skip the X-ray.  Where are Lawrence and Yolande?  Get them in here.  Next!”

“Doctor to Resus 3!”  A girl of 16, unconscious, unresponsive.  The attending staff nurse held up the empty pill bottle.  “Barbiturates.”

“Really?  How old-fashioned.  How long ago?”

“Twelve hours estimated.”  That was really bad news.  Another crash induction.  Yolande came in.  “What’s that?”

“Barbiturates.”  I turned down the right lower eye lid.  “See that?  See the conjunctival oedema.  That’s ‘the tear that never falls’.”

Karen Jones and Mary Heenan came in together.  “That was ambulance control.  Big crash at Ramarama.  Car versus car versus truck.  Six patients, status 3.

Well, just keep working away.  It could be worse.  It could be an earthquake, or a volcanic eruption, or a nuclear holocaust.  I said, “I think it’s time to declare a state of ‘Acopia’.  We’ve run out of hands.  Send for reinforcements.  Are the orthopods scrubbed?”  And Yolande was still messing around with a jaw.

“I got the TMJ views.  Pity I can’t interpret them.”  I took the films and held them up to the light.

“Normal.  See, this is open, this is closed.  See the condyle of the mandible riding forward on the temporal bone.  It’s within normal limits.”

“Well if it’s not dislocated, I don’t know what we’ve got.”

I did what I should have done two hours before.  “Take me to him.  Let’s carry out a quick Grand Round, before the next wave arrives.”

They all lay around, like the wounded on a battlefield, drunks, stabbing victims, overdoses, asthmatics, dislocations and fractures, and the man with the maggots.  I counted six policemen.  The leather jackets had receded into the background.  I looked into Theatre 1.  It was empty.  Completely empty.  The portable CD player and speakers had vanished.

Yolande found her patient.  She swept the curtain of the cubicle aside.  “Here.”

I felt myself blanch.  “He’s got tetanus.”

 

 

 

 

 

 

 

 

“How did you know it was tetanus?”

At 4.30 am I was tempted to drink a cup of tea with Mary Heenan before turning in.  I shrugged, recalling the peculiar quality of the trismus, the rictus, the risus sardonicus.  “I’m lucky.  I’ve seen two cases of full-blown tetanus before, in Papua New Guinea.  They both looked just like that guy.”  I could still remember the nervousness of the wait on the postage-stamp air strip perched on a mountain top at Maramuni; the cackle of the wind through the Pandanus trees, the monotonous buzzing of the flies in the afternoon sun, and the hot stench of the red-brown New Guinean earth.   

“Well,” said Mary, “I’m impressed.”  I swaggered off to bed.  Pride cometh before a fall.

I climbed into the sleeping bag on the floor of my office.  Light filtered through the chinks in the curtains.  I shivered and felt vaguely sick.  It was horrible, going to bed at dawn.  We had a debate one night in the Edinburgh Royal Hospital for Sick Children – “Sick Chicks” – about whether it was better to go to bed for one hour, or stay up all night.  The definitive answer was supplied by a Shetland girl who spoke with a beautiful, sing-song, almost Nordic accent.  “Go to bed and get rid of the ankle oedema.”  And what was that desperately poignant thing a prisoner in Auschwitz had said?  “How do I get rid of my oedema?  I weep it away.”

I slept.

In the exhausted, hospital semi-sleep snatched after the false dawn, one dreamed vividly.  These dreams were intense and could be remarkably coherent.  They were a combination of the rational and the surreal.  They could be monodelusional.  Somewhere, lurking within the confines of the dream, would be a stark anomaly.  This morning, my dream was all of a piece.  I entered in on it fully furnished with the prior information to make sense of it.  Dr Da Silva was a research haematologist, middle-aged, of mysterious mulatto-creole origin.  He was carrying out research under the auspices of, and with the aid of a substantial grant from a wealthy Japanese pharmaceutical company.  He was researching the oxygen-carrying capacity of various synthetic molecules.  In particular he was looking for a molecule which, while it mimicked the oxygen dissociation curve of adult human haemoglobin, was neither carcinogenic, nor allergenic, nor teratogenic; in addition, it had to be stable in plasma, and had to have certain properties of pliability, fragility, and viscosity.  In short, Dr Da Silva was trying to make artificial blood.  We were interested in Dr Da Silva’s project because we were always running short of blood.  Our patients were always running short of blood.

Dr Da Silva’s research was far advanced.  Results from experiments with an animal model were proving extremely promising.  But he had run into problems with the Medical Ethics Committee.  Meanwhile the Japanese stock market was unusually edgy, and Da Silva’s sponsors, though polite as always, were fidgeting.  They needed a break-through.  Desperate times demand desperate measures.

That was my dream’s back-story.  Where did it come from?  I have no idea.

I was standing in Resus tinkering with a Hamilton blood-warmer when Dr Da Silva floated silently in.  I looked up, and gasped.

“Dr Da Silva!  What has happened to you?”

Dr Da Silva gave me a ghostly grin, raised a white hand in a salute as from a great distance, and floated on.  I followed him through the department.

“Dr Da Silva!  Wait!”

As he passed down the corridor, two nurses standing together in earnest conversation looked up, gasped, and I saw one of them put a hand up to her mouth.  They separated to let him pass.

“Doctor!  You are so pale!”

He was, in fact, deathly white.  Yet still ostensibly Caribbean.  He looked like something out of Voodoo.  A zombie.

I followed him down the medical corridor, a few steps behind, and to his right.  I noticed he placed his steps with exaggerated care, careful not to bump into anything.  I imagine even minor trauma might have been a concern.  He could not be sure how his molecule would affect the clotting factors, the cascade mechanism.  Outside Physiotherapy, the Professor of Medicine was talking to his secretary, a well-dressed middle-aged lady, holding a pair of ornate horn-rimmed spectacles several inches in front of her eyes, squinting at a file.  As Da Silva passed, she looked up, uttered a soft, strangled scream, and dropped the file.

Dr Da Silva reached the end of the medical corridor.  I had the impression that, all the way along, his feet had not actually made contact with the floor.  He put a hand gingerly on the door handle at the end of the corridor and turned to stare at me with his sickening, bloodless smile.  “Do you think I should risk going outside?”

I thought, why not?  After all, being dead already, a zombie cannot be killed.  I said, “Dr Da Silva, are you all right?”

“Perfectly.”

But I had the notion that when Dr Da Silva had performed the exchange transfusion on himself, he had lost his soul.  Perhaps there were functions that the red calls performed, vital neuropsychiatric functions, about which our physiologists knew nothing.

Dr Da Silva passed through the door and floated across the car park.  A 1962 Hillman Minx, making its way from Occupational Health to the main hospital thoroughfare, seemed to become momentarily confused, meandered over the kerb, and slumped gently against an empty dustbin.  My eyes flickered at this minor diversion.  When I next looked, Dr Da Silva had vanished.

My locator sounded.  “Beep… beep… beep…”  I switched it off and turned to walk back down the medical corridor.

“Beep… beep… beep…”

I opened my eyes.  The room was full of pale grey light.  I reached for the phone, dropped it, retrieved it, and spoke into the ear-piece, inverted the phone, and spoke again.

“Whassis?”

“Are you awake?”

“Was mah?”

“We need you to do an arm block.”

“Fetch Dr Da Silva.”

“You there?”

“Car hit a dustbin…”

“Doctor!  Get up!  Both feet on the ground!”  Was not this how they came for you, in the middle of the night, to disappear you into the Gulag?

I pulled myself up.  “What is it?”

“Can you put in an arm block for a broken wrist?”

“Get Lawrence or Yolande to do it.”

“They’re not credentialed.”

“Get them to do an ischaemic block, a Biers’ block.”

“Come on doctor.  You know we’ve banned them in the department.”

“Oh Hell.”  I got up and staggered across to the nurses’ station in the acute assessment area, in rumpled theatre blues.   I couldn’t get Da Silva out of my head.  He’d seemed so real.  I could not begin to fathom how I’d dreamed him up.  Did he exist?  If so, who was he?  Had I invented him?  If so, who was I?

“Where’s the wrist?”

“In there.”  The staff nurse pointed.  “Here’s the x-ray.”

I gave it a cursory glance.  “It’s broke, that’s for sure.”  I checked the label.  The X-ray belonged to a certain Mr Wilson.  Resus room 3.  A placid, bald-headed gentleman sat by his bedside.

“Morning sir.”

“Good morning doctor.”  He was disgustingly cheerful.

“Which is the sore wrist?”

He may have paused uncertainly for an instant before answering, but then he lifted his right arm.

“I’ve been asked to pop the arm off to sleep.  Then I believe the orthopaedic surgeons will be looking after you.”

“You’re the boss.”

I even got him to sign the consent form.

I put the X-ray of the fractured wrist up on the viewing box, drew 40 mls of 1% prilocaine with adrenaline into a 50 ml syringe, and attached it to a 45 degree bevelled needle via an anaesthetic extension set.  I invited the patient to lie supine on a trolley, and he complied.  I brought his right arm into abduction and full external rotation at the shoulder such that the hand and wrist were lying behind his head.  I found the axillary pulse in the right axilla, and injected into the surrounding sheath of the neurovascular bundle.

“Feel a tingling?”

“Slight, in the fingers…”

“Hand’s going numb…”

“Good.”  I injected the entire content of the syringe.

“Okay?”

“Good as gold.”

I glanced again at the X-ray.  It was a Colles’ fracture, quite severely displaced, comminuted, and foreshortened.  Funny how the wrist clinically hadn’t looked so bad!  I peered at the X-ray.  I felt an insidious gnawing emptiness create itself in the pit of my stomach.  There was a large letter “L” superimposed in the top left corner of the X-ray plate.  It was an X-ray of a left wrist.  If I felt angry at Mr Wilson, it was only because I felt twice as angry with myself.   But how could he lie there and let me anaesthetise the wrong limb?  Did he think we were performing some esoteric therapeutic manoeuvre at a remote site?  What did he think I was?  An iridologist?  Only one thing for it.  It’s always the same in medicine.  If you make a mistake, own up.

“I’m terribly sorry.  I’ve numbed the wrong arm, Mr Wilson.”

I bit my lip.  He nodded comfortingly at me, and said, without rancour, “I’m not Mr Wilson.”

“Beep… beep… beep…”

This time I woke up in a cold sweat.

“Fellow citizens,” said President Lincoln at Gettysburg, “We cannot escape History.”

You feel it as you take the ferry from the west coast of Scotland, cross the Irish Sea, and proceed slowly up the long inlet of Belfast Lough.  You feel something remarkably similar when you cross out of Spain from La Linea on to the Rock of Gibraltar.  There is a cemetery at the foot of the rock full of the dead from Trafalgar.  You had thought that the past was a distant foreign land only alluded to in textbooks.  But the rock remains a citadel and a fortress, littered with ancient redoubts and buttresses.  Union flags are scrawled on pavements.  No surrender!  It’s here, it’s now.

Mrs May features heavily in February 3^rd’s Sunday Telegraph (Page 1: “May: I’ll fight for Britain in Brussels”.  And on page 19 she writes to us personally (“I’m going to battle for Britain in Brussels”).  The phrase “Battle for Britain” resonates of course.  Earlier in the week, one of the last of The Few died.  It was announced on the BBC, and then we heard the voice of Winston: “Never in the field of human conflict…”  Nothing is accidental.

Basically, Mrs May wants to renegotiate the Irish “backstop” which now appears to be the main impediment frustrating a UK/EU deal.

I was about to write, “Well, good luck with that.”  But that is not a constructive way to speak.  I really do wish her all the luck in the world.  But all the luck in the world cannot change the unalterable fact that when the UK leaves the EU, there will be a border between the Irish Republic, and Northern Ireland.  From this perspective, it now seems incredible that in 2016, politicians on both the Remain and the Leave side did not draw our attention to this fact.  It just shows you – all these patricians nurtured to lead are just as fallible as the rest of us.

So now they are scrabbling to find some means to square the circle – to take the UK out of the EU while simultaneously maintaining the island of Ireland at least as some kind of economic entity.

I’m not sure that Westminster has the credentials to step up to this problem.  I remember during the troubles John Major commenting on the latest Belfast bombing: “Imagine if this sort of thing were going on in Surrey…”  As a comment it was well meant but it merely served to emphasise the point that Belfast is not Surrey.

I have this notion that our ruling class does not really appreciate the cultural rifts that exist within the regions of the British Isles.  Of course England with its disproportionately huge population (and also its very remarkable history) dominates the nations of the UK.  The other nations tend to be depicted in the mass media in rather cartoonish fashion.  The Scots occupy a Celtic twilight full of whisky and heather and doomed romanticism.  The Welsh are all black-faced coal miners with wonderful tenor voices.  The Irish are whimsical and funny and fey.  It seems inconceivable that peoples so obviously lacking (didn’t an Australian call the Welsh “the village idiots of rugby”?) should want to control their own destiny.

So over the course of the next few weeks we are going to witness Westminster’s attempt to solve the problem of the backstop.  Where to begin?

I wish to make a constructive, if rather unusual, suggestion.

Begin with the second movement to the First Symphony of Arnold Bax.

If I am besotted with the music of Arnold Bax (1883 – 1953), I think it is because he is the only great classical composer whose music might be described as “Celtic”.  Born in London, he early showed signs of remarkable technical music facility manifest in his ability to sight-read complex orchestral scores at the piano.  But in addition, he had a profound creative instinct.  He led what some people would describe as a Bohemian life which took him to Russia, and crucially, to Ireland.  He lived in Dublin, learned the Irish language, and wrote literature under the name of Dermot O’Byrne.

He had a huge compositional output.  He wrote seven symphonies between 1921 and 1939.  I would love to tell you all about them but I really need to tell you about the slow movement to the first symphony, and I mustn’t get side-tracked.

Well, let’s be side-tracked for a moment.  All seven symphonies have three movements.  They are composed, and wonderfully orchestrated, for a very large orchestra.  He was very fond of the device of the epilogue – a quiet and contemplative close to a symphony following its climactic apotheosis.  Epilogues feature in Symphonies 2, 3 (perhaps most notably), 6, and 7.  The epilogue to the second symphony states to the listener quite clearly, “This is not the end; this is merely a pause on a very long journey.”  By contrast, the epilogue to the seventh and last symphony states, in a manner rather subdued but so poignant, “Symphonically, this is everything I have to say.”

He used to come up to Morar, by Mallaig in the Scottish north-west, in the winter, to score his symphonies.  He stayed at the Morar Station Hotel.  I have stayed there a couple of times, on a pilgrimage.  There is no blue plaque.

Who are the great English symphonists?  Elgar, Vaughan Williams, Bax, and Walton.  Yet Bax is almost never heard.  He was knighted, he was Master of the King’s Music, and he is almost never heard.  Why is that?  Is it possible that his political sympathies have relevance?

It is often said that the second movement of Bax’s First Symphony, which is very dark – I’d go so far as to say it is the most sombre piece of music I know – mourns the loss of Bax’s friends in the First World War.  It may be so, but it is more.  I am convinced it is a commemoration of the friends he lost in the 1916 Easter uprising, and, more, it is a graphic and overpowering depiction of an execution.  You cannot hear it without thinking of Yeats’ poem Easter 1916.

And what if excess of love

Bewildered them till they died?

I write it out in verse –

MacDonagh and MacBride

And Connolly and Pearse

Now and in time to be,

Wherever green is worn,

Are changed, changed utterly:

A terrible beauty is born.                                                                      

Somebody tried to use my credit card last week, twice.  I learned about it when the fraud squad of a well-known financial institution left a message on my mobile asking me to call them urgently.  They left a number.  Well, I thought, you say you’re the fraud squad but you could be anybody.  So I phoned a different number, the one embossed on my credit card, and asked to be put through to the fraud squad.  This was clearly an unusual route to go down and I had to negotiate so many menus and make so many digital choices that it all melded from the absurd to the farcical to the surreal to the fantastical.  But I eventually got there.  Only to be met by a robotic voice.  Did I recognise the following four transactions?  If so, say “Yes”, if not, press 1 to speak to a human being.  I recognised two out of four.  I pressed 1.

My circuitous route was prompted by another telephonic experience I had a few months ago when a representative of the self-same institution, a financial adviser, called me on my mobile and asked if it was a convenient time to conduct a consultation about my financial affairs.  I must have been in an unusually benign mood that day because I said yes.  “Superb.”  (You’d think he’d just won the lottery.)  “Just a few security questions before we begin.  Is that okay?”  Fine.  “Perfect.”  (If you want to recreate his voice, think of the voice of Martin Patience, the (actually superb) BBC foreign correspondent who reports from some of the world’s most troubled regions.  It is a particular West of Scotland voice, that of a man who might go to rugby practice at Hughenden in the west end of Glasgow on a Thursday night and have a few jars with the guys.)

“Now you must understand that we will never ask you for your passwords in full, so I’m only going to ask you…”  You know the sort of thing.  What is the second letter of your mother’s maiden name?  What is the ninth letter of your password?  I supplied the info.  And then we got on with it.  It was a perfectly amicable conversation.  I won’t say it was productive, as I had no agenda.  But he seemed a nice enough guy.  We chatted about this and that.

It was only later that it occurred to me, in a slow-witted way, that while he had taken pains to establish my identity, I had not taken pains to establish his.  Maybe he was a scammer who had just hacked his way into my account, and was now about to clear it with a series of extravagant purchases.  With that thought on mind, I went on line and researched him.  (Fortunately I had remembered his name.)  Yes, he was a financial adviser with said financial institution.  But I could hardly be reassured.  My caller might have borrowed this particular identity just as, I feared, he was about to borrow mine.

So I contacted said financial institution by another route, and ascertained that he was, insofar as I could tell, who he had said he was.

But I was far from reassured.  I think at this point my worry about the situation had slightly altered focus.  I was less concerned by the idea that I had been scammed, and more concerned by the idea that I might have been scammed.  I was ashamed by the idea that I might have been gullible. I should have said to the guy, “Well you say that’s who you are, but how do I know?”  Maybe I should have been armed with a series of security questions to ask him.

So I phoned said financial institution back and said that I thought their modus operandi was suboptimal. No, not suboptimal, dammit: inadequate.  I was advised that if I had that concern, the next time I was contacted, I should hang up and re-contact the institution by a number I knew to be valid.  This advice was delivered as if, so to say, if you want to be that pernickety, here is a solution that might suit you.  There wasn’t a recognition that the fault might not lie in my paranoia, but in their complacency.

Anyway, to return to last week, we established that two of my credit card transactions were valid, and two were bogus.  My credit card was cancelled and a replacement with a new number sent to me.

Small beer, I hear you say.  And indeed, I wasn’t that much exercised myself.  Scams on the telephone and on the internet have become commonplace.  But I think we have to put this sort of episode into a wider picture.  I venture to suggest that if we think cyber-crime is bad now, we ain’t seen nothing yet.  There are obvious reasons why cyber-crime is bound to expand.  The criminal doesn’t need to visit the scene of the crime.  He can be on another continent and he doesn’t need to rise from his armchair.  He won’t leave his fingerprints or his DNA.  If somebody gets on his trail, he can shut himself down.  He can, essentially, cease to exist.  He can reincarnate himself as another persona.  He can be a thief, or a slanderer, or a stalker; he can drive people to suicide.

And yet our society is besotted with the digital world.  In every walk of life, politics, social services, education, health, law and order, vast sums of money are spent on sophisticated computer systems which often prove unfit for purpose.  They frequently break down or, worse, malfunction as if out of control in the hands of a sorcerer’s apprentice.  The systems are not secure.  They are easily compromised.  They are porous.  Confidentiality can never be guaranteed.  They are vulnerable to hostile and malignant imported malware.  I think of my own field, medicine.  I have a suspicion that in medicine, the devotion to IT comes in inverse proportion to the appreciation of the invaluable commodity that is human kindness.  Of course computerised technology has a place.  You can’t run a CT or an MRI scanner without it.  And yet it so easy for people to forget that far and away the most powerful tool in medicine is the kindly and experienced doctor, or nurse, who closes out the mad clamour of the world, sits down in a safe sanctuary with the patient, asks: what is it that is troubling you? – and then listens.

Robots can’t do that.

In the 2016 referendum we placed Parliament in a double bind.  Half the electorate said, “Keep us in the EU and we will love you”, and the other half said, “Take us out of the EU and we will love you.”  (I say half and half: a 52 – 48 majority in favour of leaving is barely statistically significant.)  In psychiatry, the double bind was first described by Bateson and his colleagues in the 1950s.  A subject was given two conflicting commands by somebody in a position of authority, and was denied the freedom to articulate that the dilemma was impossible to solve.  To be in a double bind is to suffer extreme anxiety.  It was thought that prolonged exposure to a double bind might be a potential cause of schizophrenia.  In that sense, we may conclude that the House of Commons, collectively, has gone mad.

Mrs May is repeatedly subjected to the double bind.  Last week her government suffered the worst defeat in parliamentary history, and then almost immediately she was reassured by the House in a vote of confidence.  This is like a parent saying “I love you” to a child, while administering corporal punishment.  Mr Corbyn told her to take “no deal” off the table, while the right wing of her party told her to keep “no deal” on the table.  But the EU has told her that her deal is the only deal available, and the House has told her that the only deal available is off the table.

Santayana taught us that those who cannot remember the past are condemned to repeat it.  Has Westminster been schizophrenic before?

For his preface to Volume 2 of his Autobiography, Bertrand Russell chose The Defiled Sanctuary, by William Blake:

I saw a chapel all of gold

That none did dare to enter in,

And many weeping stood without,

Weeping, mourning, worshipping.

 

I saw a serpent rise between

The white pillars of the door,

And he forced and forced and forced

Till down the golden hinges tore:

 

And along the pavement sweet,

Set with pearls and rubies bright,

All his shining length he drew, –

Till upon the altar white

 

Vomited his poison out

On the bread and on the wine.

So I turned into a sty,

And laid me down among the swine.   

Volume 2 of Russell’s Autobiography starts on the eve of the First World War.  Russell thought of himself as a Faustian figure, for whom Mephistopheles was represented by the Great War.  He thought that Britain’s declaration of war on Germany was an act of collective madness.  He saw the war as a descent into barbarism.  He would have fits of black despair.  He had visions of London as a place of unreality – its inhabitants hallucinations – in which bridges would collapse and sink, and the whole city vanish.  He told T. S. Eliot about it, and Eliot put it into The Waste Land.  Russell’s apocalyptic vision reminds me of the atmosphere of more than one television drama by Nigel Neale – reaching an apotheosis in the sixth episode of Quatarmass and the Pit – in which all the characters, including the protagonists, become mesmerised by a force of evil, and are on the brink of losing their humanity.  The descent into barbarism was experienced by people who were not in charge of their own psyche.  To say that the First World War was “caused” by Prussian aggression or an upset in the European Balance of Power is a bit like saying that the tragedy of Macbeth, Macbeth’s destruction, was “caused” by his vaulting ambition.  Russell realised that the impulse to war had to be understood in psychoanalytical terms.  We go to war, apparently, because it is in our nature so to do.  It is sometimes said the outbreak of the Great War was governed solely by railway timetables – a flippant remark no doubt, yet it carries the sense that events developed a momentum of their own, and people were powerless to influence them.

We see something similar happening in the thirties, and in the run-up to World War Two.  Between 1936 and 1939 Churchill wrote a series of fortnightly letters which appeared in book form in 1939 (Step by Step, Oldhams Press Ltd 1939).  In the second of these, Stop it Now! (April 3^rd 1936) he pleaded with the European powers to come together under the auspices of the League of Nations to curtail Nazi aggression.  “Stop it!  Stop it!!  Stop it now!!!  NOW is the appointed time.”  Churchill lamented the fact that people seemed incapable of seeing an approaching agony, and taking effective measures to prevent it.  Rather, they were “amused from day to day by headlines and from night to night by cinemas.”  Again, there is a sense that people are living in a trance.

If The Defiled Sanctuary is the poem that defines the world just before the Great War, then surely in respect of the eve of the Second World War we must look to Yeats:

Things fall apart; the centre cannot hold;

Mere anarchy is loosed upon the world,

The blood-dimmed tide is loosed, and everywhere

The ceremony of innocence is drowned;

The best lack all conviction, while the worst

Are full of passionate intensity.   

And now?  Our problem now is not that we are about to make the wrong decision and go down the wrong path, but that we are not even able to articulate the nature of our predicament.  One possible reaction to finding oneself in a double bind is to switch off.  I find myself listening to the news and the wall-to-wall Brexit coverage with a degree of detachment, the way King Lear wanted to sit and listen to the court news with Cordelia when he was withdrawing from life –

Who loses and who wins, who’s in, who’s out…

But then, Lear went mad.

What poem should we choose to reflect our life and times?  Well, it’s Burns season.  What about To a Mouse?       

But Mousie, thou art no thy lane,

In proving foresight may be vain:

The best-laid schemes o mice an men

Gang aft agley,

An lea’e us nought but grief an pain,

For promis’d joy!

 

Still thou art blest, compar’d wi me!

The present only toucheth thee:

But och!  I backward cast my e’e,

On prospects drear!

An forward, tho I canna see,

I guess an fear!  

 

 

 

 

 

 

I said to Big Jobs, “Can you get hold of some Kina Lillet for me?”

Big Jobs frowned.  “What the hell’s that?”  I said truthfully, “I don’t know.  I think it might be some kind of Italian vermouth.  Gin and It.  It’s part of a cocktail called a Vesper.”  Big Jobs raised his eyebrows enquiringly.  I had memorised the recipe.  “Three measures of Gordons, one of vodka, half a measure of Kina Lillet.”

“Crikey.  Sounds a bit posh.  I don’t think they’ll have it in Agnews.  Leave it with me.”

It was like asking the Scrounger in Stalag Luft III for a crow bar.

*

What is the trick of life?

I had been watching her for weeks, walking dreamily along the open-air corridors of the New Building, always en route to a class.  She wore her school uniform with elegance and distinction.  Sometimes she carried her schoolbag in front of her, like a child.  Her perfect deportment emphasised her tallness.  She had long dark brown hair which sometimes she tied up but more often was free.  Her name was Jennifer Marsden.  She was two years ahead of me in the school.  That alone made my worship of her, if touching and sentimental, futile and pointless.  How could I possibly ache for someone I had never spoken to and only occasionally caught sight of from a distance?  How come she could do this ethereal walk-the-corridor-between-classes thing?  I was sure she could come and go as she pleased.  Nobody would ever tell her off.  It would have been an affront.

And I only ever saw her in the corridor. I fantasised that one day I would walk right up to her and without preamble ask her out.  I would say something like this: “Hello.  It’s Jennifer isn’t it?  I’m James.  I’m in 3AB.  I know this is very sudden, but do you want to come and see the Beatles in Greens Playhouse?”

Impossible.

And yet…

And then one day suddenly and without warning I rounded a corner on the first floor corridor and there she was coming in the other direction doing the holding-the-baby thing this time with a big pile of books and papers and precisely as I walked by and essayed a watery smile the pile of books and papers went everywhere and I had about two seconds to make up my  mind and as I swithered and as she knelt to retrieve her stuff I had passed her and then a class door opened and a teacher emerged and got down to help her and as I walked on I could hear them talking and laughing and I could feel a great taut chilled fist gripping  my heart.

I said to myself, “Never mind.  Next time…”

But I knew there would never be a next time.  Oh yes, I might by good grace have another chance but it would never be that chance.  That particular amalgamation of circumstance, with its unique atmosphere and flavour and poignancy, was lost, irretrievably lost.  That was why my heart was so icy.  I remembered these famous lines from Julius Caesar:

There is a tide in the affairs of men

Which, taken at the flood, leads on to fortune;

Omitted, all the voyage of their life

Is bound in shallows and in miseries.

I began to realise why people said Shakespeare had said the definitive word on every human circumstance.  I has missed the tide!  Shallows!  Miseries!  Evermore.  The thing about a window of opportunity is that it is temporal and fleeting.  You have to recognise it, evaluate it, and seize it, all within the space of a split second.

Gone!  Yet Hope returns.  You say to yourself, okay, you blew it, big time.  You stuffed up.  There’s no denying it.  You can’t undo it and you can’t attenuate its effect.  All you can do is forgive yourself; and give yourself another chance.  The trick is to recognise the opportunity when it arises.  Of course the hard bit is that the next opportunity will not look remotely like the last one, the one you missed.  All you can do is keep an open heart and stay alive to opportunity.

*

 

“I’ve got the stuff,” said Big Jobs, speaking in flat tones with the expression of a ventriloquist, barely enunciating though clenched teeth like the Duke of Edinburgh.  “Found it in a place on Woodlands Road.”  He might well have.  Pub land.  The Three in One.  The Halt.  The Arlington.  “5s 6p.  There’s no hurry.  Got your bag?”  I nodded.  The Kina Lillet was passed over in one smooth motion.  It was Friday afternoon break.  He said, “Going to-night?”  There was a party on Banavie Road.  I nodded.  “I’ll bring some along.  You can try it.”

He looked dubious.  “Think I’ll stick with the Pally Ally.  Maybe just a taste.”

Back home, I was in luck.  Mum was out at the shops.  I had the place to myself.  I’d decided to make the Vespers up rather than take all the ingredients with me.  I could reasonably conceal one bottle in my coat, but three… the clanking would have given me away.  So I set to with the precision of a laboratory technician.  Three measures of Gordons… two of vodka… half of Kina Lillet… I put it all in a thermos flask.

At the tea table, I endured the inevitable interrogation.  Dad asked, “Who is throwing this party?”  He was a policeman, taking a statement.

“Elaine Cochrane.  Girl in my class.  It’s her birthday.  Quite a lot of the class are going.”  Safety in numbers, I thought.

It was a massaged version of the truth.  Elaine’s birthday had been last week and it wasn’t really a birthday party.  She was in Fourth Year.  Elaine’s younger sister had been allowed to invite a handful of friends.  But I had an instinct that that intelligence might be dynamite.

“Elaine’s parents will be there?”

“Yes.”  I didn’t say, “Yes, I think so.”  I didn’t want to give him any room to manoeuvre.

He gazed at me thoughtfully.  “You’ll be home at ten sharp.”

It wasn’t a request, or a piece of advice, or a guideline.  It wasn’t even an order.  It was a statement of fact.

On the way out, Dad cast a critical eye over my attire.  I’d borrowed my cousin Johnnie’s bronze shortie coat which I wore over a fawn polo neck, my black jeans, and a pair of brown chisel-toed shoes.  He said, “You look like a spiv,” but at least he didn’t order me to change. Mum said, “You look very nice, dear,” and kissed me on the forehead.  “Have you got a present for Elaine?”

Once you start lying you have to keep going.  “She stipulated no prezzies.”  I was acutely aware that my father was an expert in detecting fraud and deception.  “See you at ten.”

I sloshed out of the house.

At that time, l I was obsessed with Bond, and was working my way through the canon.  I’d reached The Spy Who Loved Me.  There was a general consensus that it had been a bit of a misfire from Ian’s pen (for some reason I thought I was on first name terms with the author), and on Desert Island Discs he had more or less acquiesced to this view.  Certainly it had turned out to be less of a commercial success, and Ian’s readership longed for a return to the old formula.  But I can’t think that Ian was displeased with the result of his effort.  I thought it was a wonderful idea, to make the girl the “I” of the story.  It appealed to the true Bond aficionado, this opportunity to see one’s hero from another perspective.  It was a brave thing for Ian to do, frankly, to imagine what it is like to be a woman.  He was always being accused of being a misogynist.  He was certainly blatantly sexist.  When at work, women were an encumbrance, with their frightful emotional baggage.  Look at these remarks about women drivers in Thunderball!  Yet somehow he gets away with it, maybe because many of his heroines go against James’ stereotypic notion, and show themselves to be truly gritty.  Vivienne Michel is a case in point.  I think Ian had this notion (even if James didn’t share it) that men and women were not so different after all, and that if Vivienne spoke and thought much as Ian did, it would sound perfectly natural, come to life, and work.  I thought so anyway.  But how would I know?  You’d have to ask a woman.  It raises an interesting point.  Do women read Bond books?   You might want to ask a woman if she can voluntarily suspend her disbelief, if The Spy Who Loved Me works, if she reads it and is convinced she is listening to the story of a woman.  But first you have to find a woman who has read the book.  Bond books appear to be the playthings of heterosexual males passing a train journey with a little Kiss Kiss Bang Bang fantasy.  Female Bond readers are as rare as female chess players.  If Faye Dunaway plays chess with Steve McQueen, maybe that is just Steve’s fantasy.  Stroking the bishop’s mitre like that.

The party at Banavie was heaving.  It was a party on many levels, parties within parties.  There was a party in the big front lounge with the bay window, and the dining room, and on the stairs, and on the landing, and in the queue to the bathroom, and downstairs in the basement rumpus room which had been cleared for dancing.  And in the kitchen.  Always the best parties are in the kitchen.  I got tapped on the shoulder.  My heart leapt into my mouth.  It was Jennifer Marsden in a pair of jeans and a T-shirt.  She gestured at my thermos.

“Wassat?”

“It’s a Vesper.”

She held up her glass.

“Yes please.”

I poured her a double.

Of course, The Spy Who Loved Me is not only unusual because the female character is the narrator.  James doesn’t even appear until two thirds of the way through.  It’s not a conventional Bond thriller at all.  So what’s it all about?

Sex.

I had another illicit substance with me, more easily concealed about my person.  A packet of Wills’ Whiffs.  Ever since I’d seen a picture of President Kennedy out on a yacht looking very macho with a stogie between his teeth I’d thought, yep, that’s the image for me!”  Looking back on it, I had some pretty dodgy role models.  I was under the misimpression that it was JFK who had said

A woman is only a woman

But a good cigar is a smoke.

He didn’t.  But he could easily have done.  For JFK, sex was even more purely recreational that it was for James.  Actually, James by comparison is almost puritanical, certainly more gentlemanly.  JFK warmed to James, had From Russia with Love among his top ten favourite books.  And interestingly, his most cherished book, his Desert Island book if you will, was Pilgrim’s Way, The US title for John Buchan’s Memory Hold the Door.

Anyway, JFK didn’t compare women with cigars, although he did have something to say about smoke.

“There’s no smoke, without a smoke machine.”

The target at the centre of the world’s greatest conspiracy, was himself a conspiracy theorist.

So who did promulgate this unconscionable philosophy?  About women and cigars I mean.  I could propose a likely short list, like a multiple choice question:

A  Winston Churchill

B  Mark Twain

C  Rudyard Kipling

D  George Bernard Shaw

E  Groucho Marx

In the end, I didn’t smoke my Wills’ Whiff.  I felt like too much of a prat.  Instead, I bummed a Stuyvesant off Big Jobs.

Down in the rumpus room, shoulder tap again.  “It’s Vesper Man.”  Jennifer giggled.  She was gone. Vespered.  “Dance?”

“Sure.”  I couldn’t believe my luck.  She took my hand and pulled me on to the middle of the floor, centre of the throng.  Abruptly the rock’n roll stopped to be supplanted by a ballade, Roy Orbison’s In Dreams.  Normally it was one of these little awkward social corners you needed to negotiate, to dance a slow number with a stranger, not be a masher, not be too gauche.

But she grabbed my arms and pulled them round her neck and buried her sweet alcoholic breath in my neck.  And for three minutes the world came to a stop.  Four minutes.  It’s quite a long track.

I love In Dreams.  Its form is curious, not like a pop song at all.  It doesn’t have two or three verses and a chorus.  It just starts with one idea and then moves to another idea, and another, and yet another. Its growth is organic.  It is like a symphonic rhapsody.  And it works.

And I loved the Big O.  Didn’t Elvis say he had the best voice in the universe?  There was a disparity between the way the Big O looked and the way he sounded.  He sounded superb and he looked a bit geekish.  That was why he wore the dark glasses.  The shades helped the man to become the voice.  And the voice helped me to become the man.  Periodically her friends would shriek at her, tease her.  “Jennifer!  What you doing?  Child snatcher!”  But she would just laugh uninhibitedly and ruffle my hair.   At the end she gave me a big vodka-soaked snog.

In Dreams…

I loved Jennifer Marsden for giving me the time of day, not because of her friends, but despite them.  She was a free spirit.  She didn’t give a damn.  I thought of her as a girl who would quite happily have gone into a bar and ordered a pint of lager and drank it, alone, if she felt like it.  She had no need to hide behind anybody, man or woman.  She was her own dazzling self.  And she gave me a moment of stillness, arrival, of blessed release from striving.  I would even get home for ten, without remorse.

I retrieved my bronze shortie and struggled through the throngs and found Big Jobs and handed him the thermos.

“Enjoy!  Shaken, not stirred.”