The Mastodon in the Auditorium

Saturday being a beautiful day of high summer, and faced with the choice of either writing this blog, or getting some fresh air and exercise, I decided to do both simultaneously, and walked the seven hills of Edinburgh while letting my mind roam free.  On the way in, the traffic signs said, “Yellow warning: heavy rain expected”, but I hoped to get round before the deluge.

Depending on your choice of route, it’s a twelve mile walk with about 3,500 feet of ascent -something like a Munro with a long walk in.  I like to start in the north-west with Corstorphine Hill which is a bit of an outlier.  It’s sufficiently far out from the city centre that you can park your car without paying an exorbitant parking fee.  Then I take in the seven, anticlock, in a broad circle: Corstorphine, Craiglockhart, Braid, Blackford, Arthur’s Seat, Calton, and Castle Hill.  I walked west up Ravelston Dykes past Mary Erskine’s, the school rumoured to be the model for Muriel Spark’s The Prime of Miss Jean Brodie, took the lane that bisects Murrayfield Golf Course, and half an hour after starting I reached the radio mast, abeam Clermiston Tower, atop Corstorphine Hill, or, because it is fenced off, as near to it as I could attain.  Then I left the hill in a southerly direction to cross Edinburgh’s main drag at Balgreen and head for Craiglockhart.  I thought, what shall I write about?  Write about something that nobody is talking about; write about the Mastodon in the Auditorium.

Last week, while clearing out a drawer in the never-ending struggle to offload junk, I came across an ancient essay I wrote under exam conditions in the fair city of Edinburgh, in First MB.  Bacteria and Bacteriophage.

Bacteria are unicellular, prokaryotic, haploid organisms which replicate as quickly as once every twenty minutes.  Thus they are potentially able to produce a vast number of progeny in a very short time.  What happens in fact is that they very soon exhaust the medium in which they find themselves – in the lab, this might be a petri dish with a layer of nutrient agar on which the bacteria is (sic) initially placed, perhaps in colonies, or as a lawn across the total surface of the agar.  Before all nourishment has been extorted from this medium, the bacteria will pollute their own surroundings by excreting poisons – say, alcohol – by diffusion.  Thus the typical bacterial life-cycle is as follows…

(hand-drawn graphs follow)…

Poison enters the medium, growth stops, and often an equilibrium is attained, or the vast majority of cells die. 

It occurs to me: here is the Mastodon in the Auditorium.  We know it’s there; yet we pretend we don’t see it.  Here is our essential predicament.  Aside from the fact that a bacterium is unicellular and homo sapiens is multicellular, we are all inhabiting a petri dish of finite dimensions and finite resources.

(I took Balgreen Road and hung a right on to Gorgie.  This is where you can get lost in the suburbs in a maze of streets and lose time.  I took Chessar Avenue to Slateford Road thereby negotiating both Slateford Rail Junction and the Union Canal.  Then I turned southeast at Craiglockhart Avenue and headed for Napier University.  I crossed Colinton Road and passed the old Craiglockhart Hospital building, its frontage unchanged, where Wilfred Owen met Siegfried Sassoon during the Great War.  Once again I left the hustle and bustle of the city traffic for the peace and tranquillity of parkland.  It seemed that out of battle I escaped…)  I went round the back of the Craiglockhart University Campus, found a gap in a hedge, accessed the path, and then abruptly turned left up a steep grass slope toward summit number two at Wester Craiglockhart.)

The Mastodon in the Auditorium is overpopulation.  The petri dish is planet earth, and the bacteria, are us.  Last month, the human population of the world was estimated to be about 7.62 billion.  The population of the world is projected to increase in 2018 by 92,157,695.  This means that the world needs to create a city of London, with all its amenities, goods and services, once a month.  This is pretty startling, yet, so far as I can see, it is completely off the political agenda.  You can see why.  It’s dynamite.

(Next stop, Braid Hills.  More subtle route planning.  I cut down through the Merchants of Edinburgh Golf Course and emerged on to Greenbank Drive.  It doesn’t look promising on the map, but there is a pedestrian pathway that allows you to cut through to Greenbank Road, then if you take Greenbank Park you can access another path that lets you cut through Braidburn Valley and up on to Comiston Road.  Don’t be tempted to take Riselaw Road or Place, take the Crescent up onto Braid, cross over and enter Braid Hills via a bridle path that will take you up on to the golf course.  There’s a trig point, which I touched, but I also went on to the radio mast which is the truer summit.)

Population Studies, for example from the United Nations Department of Economic and Social Affairs’ Population Division, boast a considerable literature, which is seldom reported.  I’ve been listening to epidemiologists and public health gurus of one sort or another for a lifetime, but I can only recall one on the lecture circuit who made an impact with respect to overpopulation – John Guillebaud, the Emeritus Professor of Family Planning and Reproductive Health at UCL.  That he holds the only chair in the UK in his chosen discipline suggests that Prof Guillebaud is out on a limb, perhaps something of a maverick.  He spends a lot of time giving lectures on sexual and reproductive health to health professionals.  He is an expert on contraception.  He believes in contraception as a force for public good.  I have seen him in a lecture contrasting two slides – one showing an array of contraceptive devices, the other showing an array of weapons, and asking which one is the more palatable way of keeping the population at a reasonable level.   He thinks of contraception as a potential means of tackling the problem of the Mastodon in the Auditorium.  I nearly said “controlling the population”, but Prof Guillebaud specifically asks us not to juxtapose the words “population” and “control”.  To the western liberal democracies, any kind of state intervention in this regard is anathema.  Article 16 of the Universal Declaration of Human Rights states that “men and women of full age, without any limitation due to race, nationality or religion, have the right to marry and to found a family.”

Prof Guillebaud is a patron of Population Matters, formerly the Optimum Population Trust.  Other patrons include the broadcaster Sir David Attenborough, economist Sir Partha Dasgupta, biologist Prof Paul Ehrlich, and primatologist Dr Jane Goodall.  Population Matters has called upon government to develop a sustainable population policy.  In 2013, controversially, this body called for a UK zero-net migration policy, and the curtailing of child benefits to families of more than two offspring.  These policies were abandoned in 2017.  Here, tax relief benefits are available to parents.  The Scottish Government has a flagship policy of doubling free childcare hours by 2020.  Presumably this is so that both parents can go out to work.

(Blackford Hill lies to the north east of Braid but it is best to resist the temptation to make a beeline towards it straight across the golf course.  You only get tangled up in a welter of broom.  You can head for the club house and get back on the bridle path to a suitable point to cross Braid Hills Drive.  Or, as I did on Saturday, take a slalom of paths through the Braid golf course with a more direct route on to Hermitage Golf Course.  Now you need to cross the stream running through the wooded gully of Blackford Glen.  Left, right, left, right, left over a footbridge, left again, right and upwards, and you’re into the skirts of Blackford Hill.  Cross a meadow, through a gate, turn left and right, and ascend via wooden steps towards the Royal Observatory, round the shoulder of the hill to access the trig point from the south east.)

We might see ourselves as bacteria on the petri dish reproducing in vast numbers and polluting our environment so extensively that we can no longer exist in a toxic environment, and the environment becomes sterile.  But of course it is not as simple as that.  Even on the petri dish, it’s complicated.

Nonetheless, there may be in the culture of bacteria a single mutant which has immunity from the particular poison being excreted into the medium, and this mutant will continue to replicate and produce its own strain.  If we think of the “poison” of the medium as being, not alcohol, but phage particles parasitic on the bacteria, then the same result is apparent.  A culture containing, say, a billion bacteria, infected by five or six times as many phages, will be almost totally destroyed, but a handful of individual mutants may survive, unaffected by the phage. 

Ah.  The survival of the fittest.  The strong over the weak.  What a grim business.

This mutation was shown by Delbruke and Luria not to arise as a result of contact with phage, but to be the result of a random event which may happen in the absence of phage.  Their proof of this fact – a demonstration by an indirect approach – has been verified by experiments involving replica plating.  A mutation along the length of the single bacterial chromosome, happens to give immunity.  Such an event can happen with probability of perhaps one millionth to one billionth, for a mutation at any particular gene location.  If such a mutation does occur, the phage are somehow prevented from penetrating the bacterium and directing the DNA of the cell in the production of replica phage.  In the more usual event however, a phage particle alights on the surface of the bacterium, the phage cylinder contracts and injects its DNA complement into the bacterium.  Here, the phage DNA takes over control of the replicating processes of the bacterium, somehow overseeing its own replication.  Several phage generations are reproduced, the cell lyses, and phage disappear out into the medium ready to attack more bacteria. 

(Now run past the observatory and down to the bottom of Observatory Road and then – and this is important – don’t turn left, turn right.  That’s the trick; then take first left on to Lussielaw Road, then it’s just a little jink across Mayfield on to Suffolk Road and Craigmillar Park Road.  When Craigmillar Park Road changes its name to Minto Street turn right on to Salisbury Road and head for the Royal Commonwealth Pool.

I stopped for a diet Coke.)

So we have this scenario.  A vast human population is running out of sustenance.  The environment is being turned into a huge rubbish tip (Mr Trump is the only person in the world who doesn’t think so).  Sea water levels are rising and land masses are diminishing.  Vast numbers of people are on the move because the land is shrinking and because they are so impoverished anyway that their homeland holds nothing for them.  The wealthy countries of the world see this emerging threat and are fast pulling up the drawbridges and dropping the portcullises, terrified that the defences are going to be broached by the teeming, marauding millions.  In terms of political manifestos, drawbridges and portcullises seem to be the only options.

(Now for the biggest hill, Arthur’s Seat.  From the Commonwealth Pool I crossed Powderhouse Corner and steered a course straight for the summit, crossing Queens Drive and leaving it at the Hawse, choosing a rough path above Hunter’s Bog.  This took me to the path rising above Haggis Knowe and the remains of St Anthony’s Chapel.  Then I had to dig deep for a steeper climb, to access the twin peaks of Arthur’s Seat from the North.  Lots of tourists atop, with lots of languages in different accents.  And what a view!)

I have a notion that the people holding the levers in charge of the drawbridges and portcullises think they have things under control.  Yet the race does not always fall to the swift, nor the battle to the strong, but that time and chance happeneth to them all.  How far can I push the metaphor of the petri dish?

(From Arthur’s Seat I headed north over to Calton Hill, dodging the tourists round Holyrood Palace and the Scottish Parliament, and instead slipping past Holyrood Abbey and Croft-an-Righ to Regent Park, Regent Terrace by the old Royal High School, St Andrews House, and thus on to the hill.  I headed for the summit at Nelson Monument.  Six down.

Sometimes, however, a phage enters a bacterium and does not kill the organism.  But another sort of life cycle ensues.  The genetic complement of the phage this time becomes attached to, and indistinguishable from, the genetic complement of the bacterium.  Now the bacterium replicates as usual and a new strain is produced.  Cell lysis can at this stage be induced, for example, by action of ultraviolet light.  Phage within the bacterium acting in this way are known as prophage, and the phenomenon is called lysogeny.

So perhaps we can survive the cataclysm after all, but only if we are prepared to change, and to accommodate.  I think I’ve stretched this metaphor to breaking point.

Back down off Calton I reached the east end of Princes Street and turned south on to North Bridge.  I stopped at a Prêt for a Smoothie, and I couldn’t resist popping into Blackwell’s opposite Old College, but I didn’t buy a book.  Then I retraced my steps to the Royal Mile and headed up past St Giles towards the castle.  Outside the Camera Obscura there was a guy floating in mid-air.  He was dressed in saffron robes and his only contact with the ground was through a slender stick held in a wizened hand.  How do they do that?  I’m a pushover for magic.  The Castle Esplanade was fairly heaving but I slipped up the left side under the stanchions of the temporary seating for the International Military Tattoo, reached the castle moat, touched the wall, and thereby knocked off the seven.

Then the heavens opened.  And I’ve still got a blog to write.

 

 

 

 

 

 

Der Abschied

To the Glasgow Royal Concert Hall on Saturday night and the last concert of the Royal Scottish National Orchestra’s 2017-18 season, which also happened to be the last concert in Scotland of the RSNO’s principal conductor, Peter Oundjian.  The sole work on the programme was Mahler’s Ninth Symphony.

I’ve been listening to Mahler 9 for a long time.   When I was a teenager I heard Otto Klemperer conduct it at the Edinburgh Festival.  I used to listen endlessly to the Bruno Walter recording with the Columbia Symphony Orchestra.  I was particularly enamoured of the last movement, the Adagio, and its passionate writing for strings with these shifting Wagnerian cadences which, like Tristan, never seem to settle and resolve.  Hearing it on Saturday reminded me of my last day at school.  It was the day of my Grannie Campbell’s funeral in Skye, aged 93, but I couldn’t attend as I had to make a speech at prize-giving.  The rest of the clan headed north out of Glasgow.  I must have been a sober youth as it never crossed my mind to tell my friends I had an “empty”.  In fact I went back to beautiful Caroline’s and we sat on the floor and played records.  It felt poignant and sad.  Still I was already a bit semidetached from the world of rock and pop because I eventually got back to my deserted home, and listened to the last movement of Mahler 9.  Sad music is a bit of an indulgence to the young.  It is only later that you sometimes feel it might better be avoided.

That Mahler 9 should be associated in my mind with a funeral seems apposite, in that the number nine, symphonically, seemed to be a figure many composers were unable to get past – Beethoven, Dvorak, Bruckner, Vaughan Williams, and of course Mahler.  It is said – perhaps this is apocryphal – that Mahler cast his song cycle Das Lied von der Erde in symphonic form in order to elude the curse of number nine, but that it didn’t work; his tenth symphony had to be completed by somebody else.  The Deryck Cooke performing version is an example.  Das Lied was another obsession of mine as a youth.  Again it was the last movement, and the Walter recording.  The soloist was Kathleen Ferrier.  Walter said – and this is not apocryphal – that the two greatest experiences of his life were knowing Kathleen Ferrier, and knowing Gustav Mahler, in that order.  Listening to Ferrier sing the last movement of Das Lied, one can hear why.  The intensity of the expression is beyond description.  Ferrier was apologetic that she got a bit carried away, though Walter reassured her.  But then, Walter was besotted.  The thing about the voice of Ferrier is that this is the voice of a soul.  She cannot open her mouth but that she establishes an instant connection with her audience, and she also seems to have some sort of profound connection with the inner core and meaning of the music.  Menuhin had that same quality; he is another soul.  People like that don’t come along very often.  With Ferrier, the connection between late Mahler and death remains.  She developed metastatic breast cancer that proved intractable to treatment.  She actually broke a bone while on stage singing the role of Lucretia which Benjamin Britten created for her, and somehow managed to continue.

The RSNO’s performance of Mahler 9 on Saturday was magnificent.  I think everybody in the hall knew they were present at something very special.  I cannot remember a more attentive or a more appreciative audience.  During the protracted pianissimo coda, to me always reminiscent of the close of Schubert 8 (if closing the Unfinished isn’t an oxymoron), the audience held its collective breath and you could have heard a pin drop.  Maestro Oundjian acknowledged the contributions of all the principal players and all the orchestral sections in turn, and I wasn’t surprised that first horn Christopher Gough received a standing ovation.

Peter Oundjian’s association with the RSNO is not quite over.  On September 6th they travel to London and the Royal Albert Hall for the BBC Proms and Benjamin Britten’s War Requiem.  I might make the trip south.  But tomorrow I head north.  For me, the association of Mahler 9 with funerals continues.  On Tuesday Clan Campbell will be on the Isle of Skye to attend the funeral of a dear cousin, famous for her generosity of heart.  When I came back from New Zealand she lent me her croft in Camustianavaig, and I ensconced myself there and wrote a book, a precursor to that which won me the Impress Prize for new writers.  So I head north to pay my profoundest respects and express my gratitude.

In memoriam, EM, d. 25/5/18.

Madainn mhath!

On Saturday I was back in Aberdeen.  The Granite City sparkles in this glorious weather.  A friend was celebrating a very important birthday with a ceilidh.  It was a very sweet occasion.

Ceilidh is an interesting word.  Chambers: in Scotland and Ireland, an informal evening of song, story and dancing.  But in Gaelic, ceilidh has a more general meaning.  Dwelly: gossiping, visiting, visit.  These definitions remind me of the world of Jane Austen.  You might say her six novels are a depiction of a series of ceilidhs.  She says of Mrs Bennet’s life, “its solace was visiting and news.”  I confess on Saturday I did rather more gossiping than Scottish country dancing.  Terpsichore, the Muse of the Dance, gave me the body swerve.  I’ve never mastered the intricacies of the Eightsome Reel and Strip the Willow, especially the Orcadian variety.  There’s a Cary Grant – Ingrid Bergman film in which Grant finds himself floundering around in a Scottish country dance.  It’s very amusing.  I am Grant, minus the elegance.  I did however manage the occasional shuffle.  I would not wish to be Mr Darcy, hanging around, aloof.  Who is that haughty man?  Miss Bennet would tease me remorselessly.  Alas Mr Darcy, there will be dancing.  That’s the thing about a Ball.  And it would be appalling not to celebrate Auld Lang Syne, even if the occasion under the Millennium Dome, when Mr Blair joined hands with Her Majesty, was excruciating.

Meanwhile the result of the Irish referendum confirmed Friday’s exit poll with a two to one yes vote in favour of the repeal of the eighth amendment to the constitution.  Now there is pressure on Northern Ireland to follow suit in revising the most conservative abortion laws in Europe.  Because the Northern Ireland Assembly has been suspended for nearly a year and a half, this pressure is being put on Westminster.  Interestingly enough, one of the main stumbling blocks to reconvening Stormont is that Sinn Fein and the DUP can’t see eye to eye over the Irish language.  Language gets politicised.  In Scotland, Gaelic evokes similar antagonism.  People write angry letters into the newspapers complaining about the expense of producing bilingual signs at railway stations.  The Scottish Government recently put a modest sum behind a particular promotion of the Gaelic language, and an article appeared in the Herald asking the question, “If Gaelic is dying does it deserve a £2.5m kiss of life?”  In the article, the writer compared the sound of somebody speaking Gaelic to that of somebody gargling with Irn Bru.

That remark really pulled me up short.  Imagine if somebody had said that of Urdu, or Yiddish.

(Incidentally, I see that Mr Trump has banned Irn Bru from Trump Turnberry.  He says it stains the carpets.  Maybe he’ll impose a similar embargo on red wine.)

But to return to the ceilidh for a moment, I was gossiping with a couple who the previous day had spent fifteen hours out on the hill and had climbed the five Munros of the Fisherfield.  There used to be six, but Beinn a’Chlaidheimh got demoted in 2012.  The remaining five are: Sgurr Ban, Mullach Coire Mhic Fhearchair, Beinn Tarsuinn, A’Mhaighdean, and Ruadh Stac Mor.  Most of us have difficulty pronouncing these names.  Most of the 282 Scottish Munros have Gaelic names, and we can’t read them.  We find we are illiterate.  Our ancient homeland has become strange to us.

An analogous situation exists in New Zealand.  Most of the place names are Maori.  I am convinced that the predominant New Zealand national culture is Maori.  The difference is that in New Zealand this culture is held in reverence, and protected through the Treaty of Waitangi.

Even a writer as profoundly English as George Orwell recognised the value of protecting Gaelic culture.  Read “As I please, 73: Poles in Scotland; Scottish Nationalism”: “At one time I would have said that it is absurd to keep alive an archaic language like Gaelic… Now I’m not so sure…  If people feel they have a special culture which ought to be preserved, and that the language is part of it, difficulties should not be put in their way when they want their children to learn it properly.”

If you lose the language, you lose the culture.  If you lose the culture, you lose – well – everything.  Then you can say: “Now there’s ane end a’ ane auld sang.”

But not yet.  It was a wonderful ceilidh.  And we are alive and well.

Ceud mile fàilte!                                          

Love, Virtually

To Edinburgh on Thursday, for lunch with two second cousins.  Nurse, and doctor.  The nurse’s father, (the doctor’s uncle, and my mother’s cousin) was a GP in Paeroa, in the Thames Valley at the foot of the Coromandel Peninsula in New Zealand’s North Island.  I once did a locum for him and it became evident that he was held in high regard by the Maori community.  When he died, there was a tremendous outpouring of grief and a huge funeral.  I was privileged to be a pall-bearer.  The body lay in the local marae for a tangi lasting three days.  He was laid to rest to a pibroch played on pipes that had also been played at the Battle of the Somme.  There was a chant from the Maori, and the combination of Ceòl Mòr and the ululation of the Maori women was overwhelming.

In Edinburgh, we joked about the douce mores of the inhabitants of the New Town.  “I’ve only once been to Glasgow – to the opera.”  Was I going to watch the Royal Wedding?  No.  I asked my cousins what the attraction was.  The dress.  It’s a girlie thing.

Sunday was The Day of Pentecost.  In Acts chapter two St Luke records that on the day of Pentecost, the eleven were filled with the spirit of the Holy Ghost and were able to speak to men of every nation in their own tongue.  On the other hand, some people thought the disciples were just pissed.  Surely the best rendition of this episode comes from Lorimer’s Translation into Scots of “Acks”.

They war aa ‘maist by themsels, no kennin what tae think, an speirin at ilk ither, “What’s this o’d avà?” tho there wis some geckit an said, “They’r lippin fu o new wine.”  But Peter stuid up wi the eleivin aside him an, takkin speech in haund, said tae the croud: “Aa ye Jews an dwallers in Jerusalem, this is something at ye maun ken; tent ye weill what I am tae say tae ye.  Thir men isna fu, as ye jalouse: it is but the mids o the forenuin.”   

The diametric opposite to this strange tale occurs in Genesis with the description of the Tower of Babel, that absurd ziggurat and monument to man’s hubris.  When it all came tumbling down, everybody started talking gibberish and nobody could make himself understood.  So we may conclude that if we are full of pride we will be cut off from our fellow beings, but if we are full love we will be one with them.  Or, to quote that great chestnut of wedding texts: (Lorimer again)

Gin I speak wi the tungs o men an angels, but hae nae luve i my hairt, I am no nane better nor dunnerin bress or a ringing cymbal.

That I think was the essential message from the Most Reverend Bishop Michael Currie to the Dumbartons on Saturday.  Not that I watched.  Bah humbug!  Instead, I walked round Loch Leven, where they locked up Mary Queen of Scots in 1567-68.  I went, as the mathematicians say, in the positive direction, anticlock.  It’s a half marathon, a walk full of variety.  The insecta are less pestilential on the outgoing, western side of the loch.  After forty five minutes I made the gentle ascent to a lookout point which affords a splendid view of the RSPB sanctuary, and on the hour I stopped for refreshment at the RSPB centre.  It was quiet.  Apparently everybody was either watching the wedding or one or other of the cup finals.  Half an hour later, at the south east perimeter of the walk, I became aware of a breath of air and a soft fluttering of wings over my head.  An elegant glider, so close that I felt I could have reached up and touched it, passed almost silently over my head and landed on the grass strip at Scotlandwell.

Next there was a woodland walk occasionally through teeming clouds of insects so dense the air was turgid.  I thought of turning away from the loch towards the inviting Loch Leven Larder.  “Two roads diverged in a yellow wood…”  But a gentle breeze helped and I stayed the course.  Back by the water’s edge the vista opened up again and I made the long walk to the sandy cove at the northern end of the loch, before turning west and then south to complete the circuit on the wharf at Kinross.  Robert Frost’s The Road Not Taken reminded me of another lunch I recently enjoyed with friends in my local, the Lion & Unicorn.  A Professor of Statistics, another statistician (retired), a mathematician who teaches in prison, and me.  In the words of Alexander Pope,

Here let us feast, and to the feast be joined

Discourse, the sweeter banquet of the mind.

Incidentally, throughout that entire meal nobody once took out their phone, tablet, or “device” (device! – it’s like some sort of therapeutic appurtenance, a prosthesis).  What a blessed relief.  The conversation turned, after the fashion of Robert Frost, to what each of us might have done, if we had not pursued our respective disciplines.

This is a strange question for me, because I have the strange notion that, in fact, I did choose the other path.  I was always a writer.  I read Eng Lang & Lit and then I went off at a complete tangent and became a doctor.  I think it was in Why I Write that George Orwell said that if he had not been a writer, he would have done violence to his basic personality.  And when I read that, I thought, that’s what I did.  Yet I can’t say it didn’t work out for me.  I guess I just got lucky.  Life is unfathomable.  But, with respect to the world of letters, I always knew I’d come back.

In the Lion & Unicorn I said I would study modern languages.  I have no German, yet when I hear German spoken, I have a sense that I nearly understand it.  I am with the eleven in the upper room.  I admit that’s absurd.  I sound like Lady Catherine de Burgh in Pride and Prejudice who says of the fortepiano, “I could have been a great proficient!”

Back home in the evening, I flicked on the telly and encountered the nuptials at Windsor.  I was about to mutter bah humbug again when I chanced to see the beautiful white apparition of the Countess of Dumbarton entering the west door of St George’s Chapel while a treble sang exalted Handelian music.  Some sort of mysterious transfiguration occurred.  I was completely undermined.

Bobotie to Die For

Yesterday at a traffic light in Glasgow I pulled up behind a car whose rear windscreen bore what at first glance I thought was a “Baby on Board” sign, but which turned out to read:

Sorry!  Black box on board.  How do you think I feel?

I think this tragic and pitiful message needs to be dismembered.  The driver of the car was a young woman and I take it the black box was a necessary prerequisite of her insurance policy.  Thus she was obliged to adhere to the speed limit, and this was why she felt the need to apologise to the other road users.  She was holding them all back, because they all wanted to speed.  Moreover, the message indicated that the young driver was as frustrated by this as everybody else.

Black box technology has been borrowed from the world of aviation.  Imagine you have just fastened your seat belt in an Airbus A380, with your seat back upright and your tray table stored, and the captain makes an apologetic announcement that he is going to have to adhere to the strictures of Air Law.  And he adds, “How do you think I feel?”  All of a sudden you might want to deplane.  The aviation industry learned a long time ago that with regard to safety there is no place for a cavalier attitude, that checking the nose wheel pressure by giving the tyre a kick, then flying on a wing and a prayer, is not good enough, and that at the end of the day “the right stuff” is definitely not the right stuff.  In other words, the aviation industry has developed a safety culture.  You adhere to the rules of the air, conscious that you are making a positive contribution to the creation of a safe environment.  Bending the rules, or breaking the rules, is just poor airmanship.  Or airwomanship.  Imagine your A380 captain is directed by air traffic control to proceed from the apron to the holding point, number two to a 747.  He gets frustrated, guns the engines, pulls out, and overtakes the 747 to get to the holding point first.  Air Traffic Control would think the A380 pilot was certifiable.

By contrast, drivers on the road who adhere to the speed limit appear to be the ones manifesting aberrant behaviour, because they are in the minority.  I know this from personal experience because – call me eccentric – I try to observe the speed limit.  Consequently I get overtaken a lot.  I noticed this again yesterday on my way into Glasgow.  As the M80 approaches Glasgow’s east end there is a 50 mph speed limit.  Very few people adhere to it.  There’s lots of tailgating, jinking and weaving.  It pays to listen to the Radio Scotland travel reports en route.  “There is a fifteen minute delay westbound on the M80 at Stepps due to an ‘accident’ (sic).”  Funny, that.

I took the last exit before the river and pulled up at traffic lights to hang a right on to the Clydeside Expressway.  The lights turned green and I saw the car in front of me give a lurch and remain stationary.  The driver had stalled the engine.  She had difficulty restarting.  I was quite content to allow another traffic light cycle to elapse, and listen to Michael Barclay’s Private Passions on Radio 3.  Not so the queue behind me.  People started blasting their horns in an irate fashion.  Naturally the lady ahead of me got flustered.  (This is another thing the aviation world, air traffic control in particular, has understood for a very long time.  Never lose your temper on the radio.  It’s very counterproductive.)  She had a little difficulty identifying which lane she wanted to utilise.  Well!  The demented mob behind went completely berserk.  Is there anybody more self-righteous, more Pharisaical, than an angry driver who blasts his horn and makes arm gestures of despair (usually by taking both hands off the wheel)?

Occasionally you find the person being blasted gives as good as they get and blasts back.  It becomes unseemly, like two men conducting a brawl in the street.  People who blast away on their car horn remind me of toddlers who sit down in a supermarket aisle and have a screaming tantrum.  I think road rage is definitely getting commoner.  I used to think some metamorphosis occurred to people when they got behind the wheel of a car.  They would be aggressive towards somebody slow to move off at the lights, when they wouldn’t dream of being aggressive towards an elderly person struggling to count change at a Post Office counter.  Now I’m not so sure.

We all need to calm down.  I have a suggestion to make.  When you embark on a car journey, first estimate the time needed for the journey.  Now add half as much time again.  I call this the Cahoots Doctrine.  (Campbell Adds Hours On Over The Schedule).  Then drive below the speed limit.  Then, when you get delayed for a while behind a tractor, your blood pressure will not go through the roof.  Will you join me in this?

As an example, I drove up to Aberdeen for lunch on Saturday.  It’s a two hour journey.  I allowed three.  I listened to Villa-Lobos’ Bachianas Brasileiras, complete (1 – 5 up, 6 – 9 back), and stopped at Finavon for coffee.  It was a sun-kissed day of rare quality.  John Buchan might have said, “The air was tonic.”

There are average speed cameras on the A90.  I’m a fan.  They actually work.  People actually adhere to the limit, and there is evidence that road carnage is reduced.  This should not surprise us, as there is a clear relationship between kinetic energy and trauma.  Now kinetic energy is not merely proportional to mass and velocity, but to the square of its product.  It is a grave misfortune to apprehend this law of physics only when you come to a sudden and abrupt halt.

I will now get off my high horse-power Lamborghini.  It is better to arrive than to travel hopefully.

In Aberdeen we dined al fresco.  My friend the Viking is a virtuoso cook.  She prepared a South African dish, bobotie.  Truly scrumptious.  She is a great fan of cooking programmes.  She asked me if I can cook.  I said, well I can boil a potato and fry a steak.  How hard can it be?  Food-wise, I’m a complete philistine.  Yet even I can appreciate classy bobotie when I taste it.  Oddly enough, I get mistaken for a foodie.  I’m told I have a passing resemblance to Michel Roux Jr.  Can’t see it myself.  One day in the Glasgow Royal Concert Hall the gentleman sitting on my left actually informed me that I was Michel Roux Jr.  He confronted me after the fashion of Stanley meeting Livingstone in the jungle.  I denied it but he wouldn’t take no for an answer.  He laid a comforting hand on my sleeve as if to say, “Don’t worry Michel, I will protect your anonymity.”

There is an off-shore wind farm rising up outside Aberdeen Harbour.  I think it would upset Mr Trump.  When I heard that Mr Trump was being touted for a Nobel Peace Prize I was reminded that Caligula made his horse a senator.  Wouldn’t it be great if wonderful things happened on Mr Trump’s watch?  Things look hopeful on the Korean Peninsula.  Maybe after that, he will go on to secure peace in the middle-east.  On the other hand, if he gets the gong from Sweden, maybe all the other laureates, Mr Obama, Mr Kissinger et al, will send theirs back, just as the retired colonels from Tunbridge Wells did when the Beatles got the OBE.  Now Ringo has his knighthood and Sir Paul has just been made a Companion of Honour.  That’s very high.  To go much further, you really need to acquire lands after the fashion of the aristocracy.  Last week in Dunblane Cathedral the minister prayed for the Earl and Countess of Strathearn (aka Duke and Duchess of Cambridge).  Strathearn is very beautiful.  I wonder what great tract of Scotland Ms Markle might acquire?

Yet she could avoid all of that.  There’s still time.  She and Harry could do what my grannie and grandpa did – elope.

The Man with Diogenes Syndrome

This week I won £580,000.00 on the Euromillions Commonwealth Lottery.

The letter looked very official.  The address was a Head Office in Zurich but the letter had been sent from within the UK, franked Royal Mail, second class.  My address within the envelope’s window was accurate.   The letter bore a number of logos in technicolour and was covered in serial numbers and reference numbers of such prolixity that I will not weary you with their detail.  (Incidentally, didn’t the letter to the PM from SPECTRE say precisely that, when the Special Executive stole two atomic bombs and held the world to ransom for £100,000,000?)  Perhaps the PM, and M, and 007, might have reached the conclusion I have reached and decided the whole thing was a scam, and rather an amateurish one at that.

In my case, the following awkwardly constructed sentence seemed a bit of a giveaway:

Please to help us proceed with your claims, this information must be kept away from public to avoid unwarranted abuse of the program or fraudulent acts from criminal minded and unauthorized person(s).

I am invited to make contact to claim my prize.  The contact is an 0161 number.  Where’s that?  Manchester?  It crossed my mind to take the letter to my local police station and ask them if they would be interested in investigating it.  I rather imagine the policeman at the desk would raise his eyes to the ceiling.  Perhaps I’d be done for mischievous misuse of police time.  What’s that expression used to describe people who make nuisances of themselves, for example, with outlandish requests under the Freedom of Information Act?  Vexatious.

I remember one night in Auckland getting home just past midnight to find I’d been burgled.  I called the police.  “We’ll try to get round to you, sir.  But you are the sixth tonight.”  I was being vexatious.  A relative in Glasgow had a similar experience, phoned the police, and said, “I’d like to report a burglary.”

“Not a burglary, sir.  In Scotland, the offence is house-breaking.”

It’s hard to impress the police.  They’ve seen everything.  One evening a few years back I conducted a GP home visit to a remote cottage in a rural location, where lived an eccentric and reclusive gentleman.  I had often visited patients living in conditions of neglect, but I’d never seen squalor quite like this.  I wondered if he was suffering from the hoarder’s obsessional condition, Diogenes Syndrome.  Basically, he was sitting in the middle of a tip.  He was boiling up some water in a billy-can balanced precariously on a gas canister and a naked flame.  He was surrounded by several tons of newspaper.  He also had, within easy reach, a .22 rifle.  I asked him what the rifle was for.  He said it was to protect himself against unwelcome guests.  I offered to arrange hospital admission for him; it seemed an appropriate way to get him out of this dire situation.  He politely declined, pointing out that there was nothing wrong with him.  It crossed my mind to have him sectioned under the Mental Health Act, but the process would take forever and in any case the psychiatrists would probably agree with the patient’s own assessment.  I suppose I might have concluded that the patient was quite entitled to live life as he saw fit, provided he wasn’t harming anybody else.  But sometimes as a doctor I think you have to put your middleclass liberal instincts to one side in favour of common sense.  After all, he was to all intents and purposes sitting in his own funeral pyre.

I decided to call the police.  In medicine, when you want something to happen, you learn to press the right buttons.  If my patient had been willing, I would have known how to persuade the ambulance to pick him up and the hospital to receive him.  But how could I persuade the police to act as an ambulance?  This was where the rifle came in.  They would not be able to ignore the rifle.  I went outside and made the call on my mobile.

There was a protracted silence, followed by a sigh.  I was reminded of the Two Ronnies sketch in which Ronnie Corbett and an attractive young lady are served in a restaurant by Ronnie Barker’s remarkably cheesed-off waiter.  There was nothing on the menu but rook.  My policeman was Ronnie Barker.  I was being vexatious.

“Is the gun loaded?”

“I don’t know.  I didn’t check.”

“Ah.”

But I knew I had him.  The rifle was the clincher.  If he ignored it, and it all went pear-shaped…

Anyone whose profession involves dealing with the public has to be mindful of the potential pitfall of sneering at that which is apparently trivial.  Doctors, particularly primary care doctors, have to be especially on their guard.  First up, we should never call a complaint “trivial”.  It begs the question, trivial to whom?  It can’t be trivial to the patient otherwise he wouldn’t bring it along.  Of course, many medical conditions are self-limiting and for those, the best possible treatment is reassurance.  A doctor who is overwhelmed by a plethora of self-limiting conditions can actually stop believing in the existence of serious pathology, and start believing it’s all in the patient’s mind.  I can well imagine a policeman could develop a similar lack of respect for the endless complaints of the public.  When a policeman, or a doctor, starts to think that everybody is just bonkers, it’s time to take a sabbatical.

So I’ve decided not to burden the harassed police force with my Euromillions.  I imagine the paperwork involved would be enough to furnish the slum of the man with Diogenes Syndrome.  And yet, I’m leaving a tiny gap in the crime statistics.  And I suspect that the millions of unreported scams that occur every day, millions of tiny gaps, must add up to a giant lacuna in our understanding of the world of lies and deceit we have somehow unwittingly created.  Sometimes I’m tempted to think the whole of human interaction is nothing but One Great Scam.  Maybe governments are the biggest scammers of all.  Aaron Copland has a song – Everyone’s a Dodger.  Even the parson’s a dodger.  What a thought.

Such accidie.  I am become the cynical doctor and/or policeman who stops believing anybody.  I’d better take a sabbatical.

 

Does Bystander CPR Work?

Last Thursday evening I had the privilege of addressing the Friends of Aberfoyle & Buchlyvie Medical Practice and I talked about some personal experiences of off-duty or “opportunistic” medicine.  Three of these experiences involved bystander cardiopulmonary resuscitation or Basic CPR, which was serendipitous as this patient group is very involved in community “heart start” and “heart smart” initiatives.  I wanted to express the idea that knowledge of CPR and skill in its delivery is a gateway to every other type of First Response.  So with your indulgence, I reproduce here this segment of my talk.

Does bystander CPR work?

In 1988 I attended the 2nd International Conference on Emergency Medicine, held that year in Brisbane, Queensland, Australia.  I know the fair city of Brisbane quite well because I worked there for a GP locum service in 1985.  The 1988 conference was very good.  It culminated with a lively debate entitled, “Does bystander CPR work?”  This was before the days of community automatic external defibrillators like the one in the phone box at Arnprior, and many people believed that to invest in CPR training and to create the necessary infrastructure would not be cost-effective.  I had some sympathy with that view because in 1985 while driving to a GP surgery in Brisbane’s northern suburbs I encountered a major road crash and attempted unsuccessfully to resuscitate a young woman.  I can remember her quite clearly, and I still remember her name.  I was upset.  But if I was partly upset at my own inability I shouldn’t have been.  This girl had suffered what is known as “blunt trauma arrest”, and the outlook for that condition remains dismal.

I don’t remember the conclusion reached by the 1988 Brisbane debate, but I do remember what happened after the conference had adjourned.  I stepped out into the Queensland sunshine and went for a walk over the Brisbane River to the Cultural Arts Centre, via the Victoria Bridge.  On the bridge, a man walking in front of me collapsed with a cardiac arrest.  I commenced basic CPR with cardiac compressions and was immediately joined by a nurse from the conference who provided mouth-to-mouth respirations.  An ambulance came – I don’t know how it was summoned because mobile phones then were a rarity and looked like bricks of the sort John Wayne used on Omaha Beach.  But the paramedics arrived quickly, successfully defibrillated the patient, and transported him to hospital.

I don’t know what the final outcome was in that case, but I can tell you what it was the next time I carried out bystander CPR.  Flash forward to Auckland New Zealand a few years later.  In Auckland – actually about this time of year – they hold a huge road-run called “Round the Bays”.  It starts on the wharf in downtown Auckland and proceeds east for about 9k round the Waitemata Harbour to end in the suburb of St Heliers.  I took part many times.  On the occasion in question the field was about 80,000 runners.  After about 3k something in my left calf went “twang”.  I debated whether to run through the pain, slow to a walk, or just stop.  The decision was made for me when the runner in front of me collapsed.  I stopped.

He was non-breathing, pulseless, and unconscious.  I commenced CPR.  I was joined again by a nurse who undertook mouth-to-mouth respirations.  With 80,000 people on the road, the paramedics understandably took a long time to reach us.  We continued basic CPR for some 30 – 45 minutes.  During this time a large number of doctors and nurses running by asked, “Need any help, James?” to which I replied, “Not unless you’ve got a defibrillator.”

When the paramedics finally arrived the defibrillator duly shocked the gentleman back into normal heart rhythm.  He woke up, but because of the hypoxic insult to his brain – lack of oxygen – he was what we call “combative”.  I gave him a little intravenous sedation and accompanied him in the ambulance to the emergency department of Auckland Hospital.  He was admitted to the Department of Critical Care Medicine and walked out of hospital a week later, as we say, “neurologically intact”.  He was entirely well.

So if you are asking me, I think bystander CPR works.

Yet this issue doesn’t go away.  In the British Journal of General Practice of January 2010 a GP wrote an article questioning the cost-effectiveness of CPR training.  I wrote a letter in defence of CPR training which the journal published in February 2010.  In the letter, I pointed out that the benefits of CPR training extend far beyond the particular scenario of a cardiac arrest.  If you can respond effectively to a cardiac arrest, you carry with you the conceptual armamentarium to respond to any medical emergency.  If you undertake a course of First Aid – an undertaking which I strongly recommend – you will, or you should, be taught basic CPR.  Allow me to put on my pedagogic hat for a moment and share with you this one visual aid which I would suggest, if you have an interest in being a first responder, you memorise and hold in your head, heart, and gut.

Here it is:

 

The Emergency:

Breathlessness, Shock, Coma

The Response:

Patient safe?  Am I safe?  Extrication?

Primary Survey:

Airway, Breathing, Circulation, Disability, Exposure & Environment

Vital Signs:

Respiratory rate, Oxygen saturations, Pulse/Blood Pressure, GCS, Temperature

 

Professors of Medicine are wont to put up masses of data and say, “I apologise for this busy slide.”  So I’ve kept it simple.  This is all of emergency medicine on the back of a postcard.  This is what an emergency physician does every single time he – or she – approaches a patient.  The doctor works through this mantra.  On first laying eyes on the patient, the doctor asks, “Is this patient fundamentally well, or fundamentally ill?”  A very sick patient will have at least one of these, the triad of decompensation.  Breathlessness, shock, coma.  Breathlessness: some people call it respiratory embarrassment, but I’ve never seen a breathless person look embarrassed.  Shock – shock isn’t what the daily papers think it is; shock is circulatory collapse, characterised by low blood pressure.  Coma – unconsciousness.

So you see your patient is very ill and you rush to help.  But don’t rush headlong.  Have a care for the situation in which both you and the patient find yourselves.  You may need to move the goal posts.  People fall ill in awkward places.  You may need to shift the furniture.  You may need to move the patient.  Is there a science of extrication?  We will pass over this huge subject this evening.

Next comes your initial assessment of your patient, known as the Primary Survey.  First Aid is as easy as ABC.  Airway – breathing – circulation.  Fix them in that order.  Make sure the airway is open and make sure, if you can, that oxygen gets to the lungs, and that way the circulation has something to transport.

Disability stands for “neurological disability”.  I always think it’s a bit of a lame mnemonic.  “Diminished consciousness” would be better.  You ask, how diminished?  Well, we can quantify it, using the GCS or Glasgow Coma Scale.  Yes, worldwide, Glasgow is home of the coma.

Notice also the way that the vital signs, pulse, blood pressure, temperature, respiratory rate and GCS marry up with the triad of decompensation and our response to it.  To the vital signs we may add oxygen saturations if we have a pulse oximeter, an ingenious device the size of a memory stick which, when attached to a fingertip, or an ear lobe, will tell us the percentage of haemoglobin, the blood’s oxygen- carrying molecule, that is saturated with oxygen.

I say this slide encapsulates all of emergency medicine.  In a sense it informs every medical consultation.  I’m fond of stating that “all medicine is acute”.  By that I mean that every time a doctor goes to the waiting room to summon the next patient he is looking at the patient as he steps forward and, albeit unconsciously, he is going through this mantra.  We doctors sometimes, rather self-servingly, say we have a mysterious “sixth sense” for detecting a patient who is very sick.  But there’s nothing mysterious about it.  It’s a skill that can be taught and can be learned, and it is encapsulated in this mantra.

 

 

 

 

 

 

 

 

Log Off!

In Middlemore Emergency Department in the 1990s we introduced lightning packs.  Their first use was in extreme emergencies, when we wished to rush a patient from ambulance to resuscitation room, and to medical or surgical intervention, with absolutely no delay.  The pack was an envelope containing a form in triplicate to serve as a handwritten clinical record, an array of x-ray and laboratory investigation request forms, principally biochemistry and haematology, an accompanying array of specimen bottles, and a hospital identification wrist-band.  The pack, the wrist band and all the other articles were tagged with a “sticky label” which shared the same unique hospital patient identification number.  Thus an unknown unnamed patient could be identified by his or her unique number and the task of recording patient demographics could be deferred.

We thought we would only use lightning packs occasionally but they were seen to be immediately useful in a variety of situations.  For example it was clear that they would be invaluable if a major incident unfolded and the department received a sudden influx of a large number of patients.  They became an integral part of the hospital’s Disaster Plan.  Initially we held 150 packs in readiness.  We had a low threshold for using a pack in an isolated situation because it was essential that all clinical and clerical staff be familiar with the packs and how to use them.

Then the digital world, the world of the internet and email and information technology erupted, and it became clear that the process of becoming more electronic while going paper-light would be inexorable.  But the lightning packs became all the more important to us.  The systems at the front desk kept crashing.  The front desk would revert to paper, pen and ink, but if we were in a hurry we would just use a lightning pack.  We increased the number of packs held in readiness so that if the lights went out we had a system that could identify and track a 24 hour patient load.  The system was low-tech and that was its power.  It could not be sabotaged.

I thought of lightning packs in May last year when NHS Scotland was targeted by hackers who disrupted IT systems and demanded ransom in Bitcoin.  The attack was named “WannaCry”.  Another attack, “BitPaymer”, was launched in August.  It came in the form of a piece of spam email.  On both occasions patient appointments and procedures were cancelled.  As a result, much money was spent shoring up cyber defences, and more cyber security specialists were recruited.

Now I read in the Sunday Herald that the UK’s National Cyber Security Centre (NCSC) are warning of the possibility of future state-sponsored offensive operations.

Computing power is now very important in clinical medicine.  You can’t run a CT or an MRI scanner without computing power.  That is why it is vital that these systems be quarantined from any potentially malignant outside influence.  But aside from that, there are sound reasons why a Health Service of all things should be particularly robust in the face of a cyber-attack.  In order to function, doctors and nurses might find computers, at least when they work, a convenience, but fundamentally, they are not really needed.  In terms of the trafficking of information they don’t serve any function that can’t be fulfilled by paper and pencil and a telephone.  The beauty of the diagnostic medical consultation is that it relies mostly on the knowledge, skill, wisdom and kindness of the attending physician.  I can’t think of a reason on earth why any general practice or hospital department should cease to function simply because the computers have crashed.  All it takes is for the clinicians to put their heads together and come up with a low-tech plan and a modus operandi for working under such conditions.  Make up some lightning packs and stay open for business.

Meanwhile today’s (Monday) Herald front page is dominated by two headlines:

Protect workforce from the rise of robots, warn unions.

And:

NHS staff taking early retirement doubles in eight years.

Scottish Health Secretary Shona Robison is under huge pressure just now.  NHS Tayside (Ms Robison’s constituency) has come under fire over its use of charity cash to cover general running costs.  This includes the financing of an IT project.

South of the border, I see that Jeremy Hunt is warning the big Social Media empires that if they don’t do something to sort the content on their respective platforms that is damaging the mental health of young people, he will step in and do it for them.

Most people will take a nuanced approach towards the digital world and say that there is nothing intrinsically good or bad about it; it all depends how you use it.  I suppose I must agree with that; why else would I write this document on Word and then post it on my blog?  Yet sometimes I wonder.  I’m beginning to think there is something inherently malevolent about this Brave New World in which we find ourselves.  Clearly we are not in control of it.  Like the Sorcerer’s Apprentice, we are floundering.  It seems to me that IT is a bit like alcohol.  It might be safe and even beneficial in small doses.  (Actually the medical profession is now even questioning that.)  But take too much of it and it will destroy you.  Remember Tiger Tanaka’s remark to Mr Bond in You Only Live Twice concerning saké, that the man drinks the first flask, the second flask drinks the first, then the saké drinks the man.  That truth must be recognised cross-culturally because it is almost exactly replicated in a proverb in Scottish Gaelic which roughly translated says, “One drink: the better of it; two drinks: not the better of it; three drinks: the worst of it!”

So it is with the lap top and the tablet and the desk top.  Remember, you always have the option of switching the contraption off.  I was never so happy in medicine as on the days when the computers crashed.  Suddenly I was no longer under the baleful cyclops eye of the computer screen, and I found I could communicate with my patient without the intrusion of a malevolent third party.  So Log Off! You can have the satisfaction of knowing that the cyber moguls of the great multinational conglomerates won’t like it.

I’m beginning to think the Luddites were right.

 

The Common Touch

What is it about Prague and the nasty habit of falling out of a window?  It was the Defenestration of Prague that started the Thirty Years War.  Then in 1948 Jan Masaryk the Czechoslovakian Foreign Minister was found dead in a courtyard beneath a window.  You can read about it in Marcia Davenport’s Memoir Too Strong for Fantasy.  Fell or was pushed?  Hold that thought.

I was in the dressing room of my local gym in Stirling the other day eavesdropping on a lively conversation between two local worthies.  The topic, I think, was football.  If I’m a little uncertain, it’s because the Scottish urban central belt patois was so idiomatic, so rough and so fast, that for all I knew they might have been speaking Serbo-Croat.  And mind, I’m a Glasgow boy.  Yet I kid you not, I didn’t understand a word.  As I left the dressing room one of them paused to address me.  He only said something like, “Cheers mate. See you next time.”  But I realise he had courteously altered his register in order to communicate with me.  I fell to wondering how universal was this ability to alter one’s register to the occasion, and whether such alteration is to be applauded.

Is it an affectation to “walk with kings – nor lose the common touch”?  Should we be the same to all men and women?  I dare say most people adjust their mode of speech to suit the occasion.  When I was young a regional accent was a social disadvantage.  If you wanted to get ahead certainly in any professional field, you needed to acquire some sort of approximation of BBC Received Pronunciation.  That is not to say that, even then, you could not use your natural accent to advantage.  A doctor, for example, with a cultured Scottish accent, might yet sound extremely erudite and authoritative.  But the accent is on “cultured”.  If the accent was Glasgow, and working class Glasgow, say from Partick or the Gorbals, people, including people from Partick and the Gorbals, would cringe.

This is why parents sent their children to elocution classes.  Elocution classes taught you to “talk proper”.  Do they exist now?  I have no idea.  These parents were doing their best to give their children a social advantage.  I guess the ultimate expression of this was seen in Gaels from the Highlands who migrated to Glasgow and made a point of not talking Gaelic at home in case their children picked it up.  Gaelic was low class.  It would hinder their off-springs’ progress.  The irony of course is that now, middle-class parents in Glasgow clamour to get their children into Gaelic medium schools because the advantages of a bilingual upbringing is now recognised, and these schools perform extremely well across the board in the academic league tables.

Nowadays, a regional accent can no longer be considered an impediment.  Much of this has to do with the rise of popular culture.  The Beatles spoke Liverpuddlian unapologetically and, crucially, the Americans could understand them.  Around the same time, Sean Connery gave James Bond a Scottish accent.  Ian Fleming was initially sceptical about the choice of Connery for the role, but he was reassured when an American woman told him Connery had “it”.  Nowadays, if you hear a Scottish actor like James McAvoy expounding on Graeme Norton’s couch you almost have the sense he is hamming his Scottishness up because it’s such an asset.

It’s really because of these powerful icons of entertainment that the upper classes have felt the need to modify their fruity accents.  It’s most obvious in the Etonians’ use of the glottal stop.  Not entirely convincing to a man from Glasgow, home of the glo’’al stop.  Sometimes when I hear a member of the establishment saying something which I suspect might be fatuous, I subject the suspect statement to what I call “the stairheid patois” test.  I translate the statement into Glaswegian, repeat it, and see if it stands up.  You can use any urban working-class accent to effect this test – Liverpool, Newcastle, east-end London.  In fact I think Peter Cook and Dudley Moore invented this test in the Pete and Dud sketches when two geezers discussed High Art over their beer.  Peter Cook was so dead pan that he would make Dudley Moore corpse with laughter.  I was thinking of them the other day when my hugely entertaining barber and I had our usual barrack room lawyer conversation (scissors flashing in front of my eyes) and solved the problems of the world.

“Novichok onna doorknob?  Talk aboot Smersh!  Wurld’s gaun bananas!  And as for the Donald!”  He produced a noise approximating a thermonuclear explosion.  “Story’s endi’, pal.”

I thought it safer to change the subject.  “Any holidays lined up?”

“Well, ah thought of Prague, but the missus didnae fancy it so that’s oot the windae.”

 

The Sinews of Peace

In these troubled times in which we live, and mindful of George Santayana’s famous remark that those who do not learn from history are doomed to repeat it, this week I read two books which seem to reverberate into our own dislocated world, and cast light upon our own multi-faceted predicaments.  The books were Churchill’s Legacy: Two speeches to save the world by Alan Watson (Bloomsbury 2016) and The Shortest History of Germany by James Hawes (Old Street Publishing Ltd, 2017).

In the latter half of 1945, Churchill, having lost the General Election after VE day but before the capitulation of Japan on September 2nd that marked the end of the Second World War, became His Majesty’s Leader of the Opposition.  For a man who basked in the limelight and who loved to be at the centre of things, it must have seemed a terrible climb-down.  One moment he was deciding the future of the world first with Stalin and Roosevelt, then with Stalin and Truman, the next moment he was out of office, powerless, unable to influence affairs other than by writing newspaper articles and asking questions in the House.  No wonder he was visited by his Black Dog.

Then he got an opportunity.  On October 3rd, the president of Westminster College in Fulton Missouri invited him to give the annual John Findlay Green lecture to the college.  Crucially, the letter was endorsed by a handwritten appendix from the 33rd President of the United States:

This is a wonderful school in my home state.  Hope you can do it.  I’ll introduce you.  Best regards, Harry S Truman.                 

On 5th March 1946 Churchill gave a speech at Fulton that was to become almost as famous as the great orations of 1940.  It was entitled The Sinews of Peace.  Perhaps its most famous line is:

From Stettin in the Baltic to Trieste in the Adriatic, an iron curtain has descended across the Continent.

Churchill was alerting the world to the threat of a totalitarian regime’s expansionist ambitions towards the west.  Initially (how true this is of many of Churchill’s speeches) the response was negative.  Stalin, Uncle Joe, was a popular guy.  In 1945 at Yalta, an ailing President Roosevelt had accommodated him to the extent of excluding Churchill from some of their negotiations, and he acceded to many of Stalin’s territorial demands.  Now in 1946, the last thing the American people wanted to hear about was the prospect and possibility of further war.  Truman probably recognised this when he distanced himself from Churchill’s message and denied that he had had prior knowledge of its content. Yet he was sympathetic to the idea that the US needed to prop up a bankrupt and exhausted Europe in order to counter the Soviet threat.

From these deliberations arose the Truman Doctrine – a resolve financially to support Greece and Turkey against the threat of a Communist takeover, and the Marshall Plan – an injection of capital into Europe to kick-start its ailing economies.

Churchill gave another speech of great significance in 1946, in Zurich.  It was entitled Europe Arise.  Here are the crucial sentences:

I am now going to say something that will astonish you.  The first step in the re-creation of the European family must be a partnership between France and Germany…  There can be no revival of Europe without a spiritually great France and a spiritually great Germany. .. If we are to form the United States of Europe or whatever name or form it may take, we must begin now. 

When the first volume of Churchill’s six volume history of the Second World War was published in 1948, its first page declared: Moral of the Work: in war: resolution.  In defeat: defiance.  In victory: magnanimity.  In peace: goodwill.  But De Gaulle was appalled at the notion of a regenerated Germany.  He wanted to replicate the 1918 Armistice reparations arrangements and permanently disable Germany.  The idea of a swift reconciliation between France and Germany must have seemed very strange.  Yet it was this very idea that was to make possible the creation of the European Coal and Steel Community that was the precursor of the European Union.

People have used the Zurich speech to argue that today, in the context of Brexit, Churchill would have been a Remainer.  Yet the close of the Zurich speech would suggest otherwise:

Our constant aim must be to build and fortify the strength of the United Nations Organisation.  Under and within that world concept, we must re-create the European family in a regional structure called, it may be, the United States of Europe…  In all this urgent work, France and Germany must take the lead together.  Great Britain, the British Commonwealth of Nations, mighty America, and I trust Soviet Russia – for then indeed all would be well – must be the friends and sponsors of the new Europe and must champion its right to live and shine.  Therefore I say to you: let Europe rise!          

Churchill’s view of the post-war world, as expressed in The Sinews of Peace and Europe Arise, reverberates right down to our own time when the UK is revaluating its relationship with the US, Europe, and Russia.  Churchill wanted to construct and bolster multinational institutions that would preserve the peace.  In his second premiership, by which time the USSR had become a nuclear power, he recognised the threat of all-out nuclear war and he devoted what mental and physical energies he had left to find a way to avert world annihilation.  He tried to convene a “Summit” – he coined the term – of World War II’s “Big Three” – Britain, America, and the Soviet Union.  But he did not succeed, and this is perhaps the chief reason why he remarked that he had achieved a lot in his life, in the end to achieve nothing.

James Hawes’ Shortest History of Germany shares this dark outlook.  The West is in full retreat.  The Anglo-Saxon powers, great and small, withdraw into fantasies of lost greatness.  In 2016 Joschka Fischer, Germany’s Foreign Minister from 1998 – 2005 said, “The Western World as virtually everyone alive today has known it will almost certainly perish before our eyes.”  Yet, like Churchill, Hawes is not at heart pessimistic.  He sees Germany as “our last hope”, provided – and this echoes Churchill’s Zurich speech – she remains at the very heart of the west.

Things do feel extraordinarily precarious in the world right now.  I have the sense that some minor ruction in an obscure corner of the world, something apparently insignificant, could set off a train of events that could easily spiral out of control.  Bismarck predicted the First World War.  He said it would be sparked off by a minor event, or, as he put it:

Some damn stupid thing in the Balkans.