Author: jamescalumcampbell

To “Bard in the Botanics” on Thursday night to see The Merchant of Venice.  Party of four.  We went with some apprehension.  Outdoor Shakespeare in Regent’s Park, circa 22 degrees Celsius, is one thing; Glasgow’s Botanic Gardens, circa 16C (we were that lucky) dropping to 12 as the night wore on, quite another.  It says a lot for the players, and the people of Glasgow, that this event, especially this dire “summer”, is so popular.  It was a full “house” and as the play progressed, the noise of the traffic on Great Western Road, and the kids in the park, seemed to recede, and by the time of the great courtroom scene (“I will have my bond!”) you could have heard a pin drop.

It strikes me that The Merchant of Venice has rather an operatic quality.  If the unfolding of the plot is like recitative, then the great set piece speeches are like arias.  It reminds me of Mozart’s Cosi Fan Tutte.  The plots have similar elements of absurdity.  In the play, two women go into disguise and dupe their lovers; in the opera, two men go into disguise and dupe their lovers.  In both play and opera, things get out of hand.  There’s a tension in both works between elements of opera buffa, and matters of profound seriousness.  Everything is ambiguous, and ambivalent.

Since we are dealing in pairs of pairs, it seems to me that Shakespeare and Mozart share a quality which is the exact antithesis of a quality shared by Beethoven and Dickens.  Beethoven and Dickens wear their hearts on their sleeves.  They are profoundly involved, human, and humane.  Both have huge, indomitable personalities.  So, of course, do Shakespeare and Mozart; and they also have incredibly high spirits.  Yet there is also a quality of separation, of detachment, sometimes even bordering on indifference.  In Act 1 of Cosi, the men say farewell to their ladies, and supposedly leave for the wars, in music of heartbreaking poignancy.  In reality they are going undercover to pose as strangers and woo their lovers – they even swap the car keys – and expose their fickleness, all for a bet.  I don’t know if Beethoven heard Cosi but I think he must have found Lorenzo Da Ponte’s libretto unconscionable.  After all, Beethoven’s opera is Fidelio – the clue is in the name.  There’s Ludwig, massive genius that he is, struggling away with his deafness and his sturm und drang, endlessly working away honing and rehoning themes in his sketch books; while Wolfgang effortlessly turns out another piece of sublime perfection to a tawdry and risqué text.  When the first subject of the piano sonata K545, beloved of all aspiring young pianists, recapitulates in F major, it sounds like a toy music box, as if Mozart is saying, “You admire these baubles?  Well, you’re welcome.  Here’s another.”  Mozart has this trick of starting a piece with a call to attention in the form of a few unremarkable chords repeated in an unremarkable rhythm.  Then his next phrase completely undermines you, the way Salieri was undermined by the adagio from The Gran Partita for 13 wind instruments K 361, in Peter Shaffer’s play Amadeus.

I get the same sense of detachment in Shakespeare.  I can imagine him dashing off the St Crispin’s Day speech for Henry V, and saying to Anne Hathaway, “Are you moved by that?  Does it stir you?  Doesn’t do anything for me!”  You can never tell what Shakespeare is thinking.  Beethoven is a character in his own music, but Shakespeare is invisible in his own plays. Yet he clearly loved music.  As Lorenzo said to Jessica on Thursday night:

How sweet the moonlight sleeps upon this bank!

Here will we sit, and let the sounds of music

Creep in our ears.  Soft stillness and the night

Become the touches of sweet harmony…

The man that hath no music in himself,

Nor is not moved with concord of sweet sounds,

Is fit for treasons, stratagems, and spoils.

The motions of his spirit are dull as night,

And his affections dark as Erebus.

Let no such man be trusted.  Mark the music.        

Here’s another odd thing about Shakespeare.  He retired.  He wrote The Tempest in 1611, and then nothing for five years.  He just hung out in Stratford, chilling.   I reckon Shakespeare went a bit fey in the end.

We are such stuff

As dreams are made on; and our little life

Is rounded with a sleep.

I mean, what was he on?

Dropped my car off for a service in Stirling, nice and early, at 8 am.   And did I need a courtesy car?  I usually say yes, but as on this occasion I had no commitments I left on foot.

Abandoning the car and becoming a pedestrian was a spiritual experience.  The world may still be zooming around me, but I have slowed down into my own personal time zone, and the noise and haste are gradually losing relevance.  I began to notice things.  The walk from an industrial estate into the centre of town took me over a bridge, under an underpass, and across a piece of grassland.  A path had been hewn along the most direct route and through a rough gap in a hedge.  The path had nothing to do with town planning.  It had just evolved through the spontaneous behaviour of people.  There was something pleasing, and deeply nostalgic, about the ancient mossy stone walls, pavements, the smell of cut grass, the trees’ heavy summer foliage.  I was reminded of my childhood, and of the freedom of going out to play.  I found a coffee shop and had a flat white and watched the town gradually come to life.  Then I took the train to Glasgow.  I was happy to stare out of the window and watch the world go by, like Philip Larkin in The Whitsun Weddings.

In Glasgow, to continue with the public transport theme, I visited the Transport Museum, down by the Clyde, and wandered among the trams and trolley buses of my childhood.  The subway exhibit was best.  It’s a partly real, partly virtual experience.  Glasgow’s underground is very modest, a single loop with 15 stations.  Between stations you clatter and roar through the tunnel and feel the movement and vibration of the carriage and seem to get absorbed into the projected world of wartime passengers as they board and alight and indulge in banter, or rather “patter”, with the clippie.  It’s the nearest thing to time-travelling.  If they could add in that very characteristic smell of the Glasgow subway, the experience would be perfect.  I was amused that visitors to this attraction tended to alight when the carriage came to a virtual halt at a station.  I did so myself.

Then I took a walk along Dumbarton Road.  And the patter continued.  Glasgow is a city state.  For all its changes, it remains the same.  Exalted, maestoso Glasgow.  It’s very quiet in Glasgow just now.  The second fortnight in July is the time of “The Glasgow Fair” when traditionally the shipyards closed and everybody went to Saltcoats for their holidays.  Something of this must persist, even if the destination is Lanzarote, because there’s little traffic.  The place is almost serene.  Yet the patter goes on.  Somehow, Glasgow has retained a sense of community.

Maybe cars were a big mistake.  The acquisition of a car was a big thing for my parents’ generation.  Not only was the car a means to increased mobility, it was a symbol of social mobility.  Our first was a Ford Anglia.  LMS204.  We took it to Blackpool.  In these days to undertake such a journey you could actually write to the AA and request a route, as if you were planning a trek through the Hindu Kush. LMS204 nearly expired going through Shap.

Now it is beginning to look as though the mobility promised by the automobile is an illusion.  What good is your Lancia Flaminia Zagato Spyder if you are stuck behind a 15 mile queue of lorries on the M20 corridor?  Sally Traffic on Radio 2 talks up the torpid constipation of the M25 – “Mayhem, clock and anti!”

And maybe the concept of social mobility is just as illusory.  Just as you graduate from your Ford Anglia to your Rover to your Jag to your Porsche (midlife crisis) and become more and more stuck in traffic jams, so might you get off the dole and slog away at the checkout and go to night school and get a diploma and enter a profession and still you find you are coping with some sort of interaction with another person only somehow along the way you have lost a sense of sympathy and identity.  Somewhere along the way you have eschewed plain vanilla and become an exotic derivative.  You have become an instrument in a scam, suspicious of this person by the wayside trying to hitch a ride from you in your Lamborghini.

After Dumbarton Road I turned into Victoria Park.  I like to admire the fowl on the pond.  I could very easily become a twitcher.  Look at this beautiful family of swans.  The cygnets still retain their dun plumage, but are nearly as big now as ma and pa.  Pa takes to the air with much commotion in a protracted take-off run across the length of the pond.  It’s like watching a 747.  His landing is less successful.  He overshoots and crashes on to dry land, vandalising a floral display, his pride hurt more than his physique.  You don’t often see “avian error” in their world of aviation.  The birds are entirely at one with their environment.  Their long haul flights are extraordinary.  Off to Antarctica for the winter and then back to this very pond.  That’s some GPS.  I’m sure they look down their beaks at us, snarled up on the M8, and say, “Homo sapiens?  Flash in the pan.  They’ll do themselves in pretty soon, if they haven’t turned the whole place into a tip first.”

Fowl solved the transport problem millions of years ago.  For them, it just isn’t an issue.  Meanwhile our middle class mothers carry on dropping off progeny from their Chelsea tractors to the preparatory school where they can make useful acquaintance and get ahead.

Sorry I’m getting lugubrious.  Social mobility.  I ask you.  I know I’m sounding like a man in a pub with an opinion, but who is more useful to mankind?  A hedge fund manager or a conscientious lavatory attendant?  I have the highest opinion of conscientious lavatory attendants.  They should be paid danger money.  As one of them said, “The things that go on in here!  Honestly, if somebody comes in for a straightforward ****, it’s like a breath of fresh air.”

With Click, Double-Click due for publication on August 1^st, I thought the time was ripe for some reflection on the experience of winning the Impress New Writers’ Prize, and the subsequent process of preparation for publication.

It can hardly be surprising that, as a doctor, I have chosen to write about a doctor, and, to an extent, about medicine.  Therefore there is something fitting about my publication date, August 1^st, the day when new doctors start their careers, and all the junior hospital posts are rotated.

I’ve been scribbling virtually all my life.  I’m very fascinated by the phenomenon of the early recognition and identification of – call it what you will – a metier, calling, or obsession.  I was drawn to writing in my childhood by two forces.  One was the power of story-telling, and the other was the power of language.  In Primary School, I just loved “composition”, when I could spin a yarn and chuck in a few exotic words and phrases I’d picked up from somewhere, like “a farrago of heterogeneous irrelevancies” (which is usually what they were).

When you feel comfortable in your calling, there seems to be something God-given and inevitable about it.  Yehudi Menuhin described how he went to his first violin lesson with Louis Persinger, and came away convinced of what his life’s work was going to be.   And yet I sometimes wonder if that sense of vocation might not be much more haphazard than we think.  A chance exposure to a particular walk of life, a chance meeting with some charismatic and inspirational teacher, an enthusiasm for an endeavour combined with a certain talent to indulge in it – and there you have it.  But might not the same thing have occurred, on a different day, in a different location, and in an entirely different walk of life?

At any rate, as I’ve mentioned before in this blog, with adolescence I hit writer’s block and in due course realised I needed to go off and do something else for a time.  Eventually, I chose medicine.  Any notion I might have had that I was merely a writer going under cover for a bit to gather copy was soon completely and utterly dispelled.  The fact is that medicine devours you.  It certainly devoured me.  Medicine is an all-consuming devotion.  I disappeared for 40 years.

And yet here’s the thing.  I couldn’t stop scribbling.  Even supposing I was churning out the most god awful crap, I kept scribbling away.  And I thought, what is this?  Am I being mocked?  D’you know, I conceived the notion for Click, Double-Click in the sauna beside the pool at my local gym.  I’d got into the habit of running for 20 minutes on the treadmill, then the sauna and a swim.  Something about the exertion and the accompanying explosion of endorphins, combined with incipient heat exhaustion, made my brain teem with ideas.  Admittedly, once I’d dived into the cool waters of the pool, most of the ideas didn’t seem that good.  But a few stuck.

I read about the Impress Prize in Writers’ Magazine, three days before the competition’s closing date.  They were looking for an unpublished first novel, a synopsis, and a 6,000 word extract.  Serendipitously, chapter 1 of Click, Double-Click is approximately 6,000 words.  I sent it off.   That was last June.

I forgot all about it.  Then in October I got short-listed.  One of twelve.  That was very nice.  I got the tome out, and gave it a dusting down.  Just in case.  Then there was the “get to know the authors” sequence when we all had the chance to write in answer to various questions and I enjoyed that.  I was also impressed by my fellow contestants.

Then in November I got the phone call to say I’d won.  I don’t think I made much sense on the phone that day.   I was very euphoric for about 24 hours and then the anxiety set in.  Was it good enough?  What would Impress think of the Magnum Opus?  I knew they weren’t going to say, “Don’t change a word – it’s a masterpiece!” and I dreaded them saying, “This needs to be gutted radically!”

The reality turned out to be somewhere in the middle – some suggestions for a few revisions.  What was I going to do?  Perhaps be like Beethoven and fly into a rage – “Not a note to be changed!”  No.  While I may have murdered a few of my darlings with regret, most of the advice was right.  And I enjoyed the act of revision.  Soon we had a manuscript that was essentially ready for the more detailed process of copy editing.

I was deeply impressed by the copy editor.  She was incredibly astute. She reminded me of Lieutenant Columbo.  She would say, “Oh – just one more thing… just a small thing… oh don’t worry about it, it’s nothing…”

Of course it was entirely pertinent.

And my main contact person with Impress has been a delight.

Now I sit with the penultimate proof before me.  I read it through yesterday.  I hadn’t looked at Click, Double-Click for a while.  It was a slightly spooky experience rereading it.  It’s darker than I remember it.  It has been described as a “crime thriller” and it is certainly true that a crime is committed within its pages.  Yet if it lands up on the “Crime” shelf at Waterstones maybe the putative reader might feel cheated.  It’s talking heads.  It’s not so much “whodunnit” as “what have we all done?”  I hope they put it in general fiction.

For a while there, I was feeling detached about the whole thing, but now that the prospect of seeing my book between covers is imminent, I admit I’m genuinely excited.  I know the bits of my book that work, and if I suspect anything in it might be “clunky”, I’m not going to let on where.  Just so long as I don’t win the prize for Worst Sex Scene.

The young daughter of a good friend of mine has aspirations to act.  She has passion and talent and temperament and, at 17, has built up a small but impressive portfolio.  Acting can be an uncertain profession.  Between jobs you might find yourself “resting”.  While she was preparing to audition for a part, a family friend, an elderly gentleman, took her aside and said, no doubt in a well-meaning and avuncular way, “Now then Rebecca, just in case it doesn’t work out, what is your Plan B?” She replied, with some indignation. “Nobody ever asks Debbie what her Plan B is!”  Deborah is her older sister.  She studies engineering at university.  I think of Debbie and Becky as Elinor and Marianne Dashwood in Sense and Sensibility.

This started me thinking about Plan B.  Last September the Chancellor made a day trip to Edinburgh to inform the Scottish people that, in the event of their voting for independence, there would be no currency union with the rest of the UK.  Unequivocally.  No ifs no buts.  Then Mr Darling, leader of the No campaign (perhaps he should have called it “Oxi” to give it a bit more oomph) engaged in debate with Mr Salmond and kept hammering away – “What is your Plan B?”  Mr Salmond didn’t have a Plan B, or if he did, he was keeping it to himself.  Mr Darling upheld this as a proof that Mr Salmond was living in cloud-cuckoo land, but I have to say I rather admired Mr Salmond for his position.  He was seeking a mandate from the Scottish people that would allow him to enter negotiations that were real rather than hypothetical.  In short, he had not given up on Plan A.

He never got his mandate.  Then Scotland returned 56 Nationalist MPs of a total of 59 to Westminster.  This reminds me of “Ally’s Tartan Army” that went off to the World Cup in Argentina in 1978, got a terrible drubbing, and then beat Holland 3-2 in a game that in the end didn’t matter.  It’s a Scottish characteristic.  56 MPs are returned to a place where they don’t matter.  This is by the by.

I wonder about the Plan B advice to the aspiring actor.  It’s a very tricky business, the dispensation of advice, especially if it is not asked for, and especially to the young.  As a doctor, I have spent a career dispensing advice, but I could never get very enthusiastic about giving it out when it was unsolicited.  I suppose that is what screening and case-finding are all about.  I always preferred the patients to set the agenda.  They would outline their problem and then ask me one of two questions which they used more or less interchangeably: “What would you advise?” and “What would you do?”

But these questions are not interchangeable.  Doctors are very bad at taking their own advice.  Sometimes I would point this out to the patient and then ask him which question he would like me to answer.  Usually the patient opted for the latter.  That was because he recognised that the practice of medicine, while grounded in medical science, is really an art.  The patients didn’t solely want an explication of the evidence base; they wanted it with a human face.  But then I had to be careful.  Why should I fob off my own prejudices and preconceptions on to the patient?  Personally I belong to the “ostrich” school of health care.  Keep your head down and don’t go looking for trouble.  Just deal with it when it turns up.  Sufficient unto the day is the evil thereof.  So, asks the patient, “Should I go for my ultrasound screen for aortic aneurysm?  What would you do?”  The trouble with screening is the amount of anxiety it creates.  Your aorta turns out to be a little wide, though not dangerously so… yet.  We’ll screen you again next year.  As Job said, “I was not in safety, neither had I rest, neither was I quiet; yet trouble came.”  And again, “Yet man is born unto trouble as the sparks fly upward.”   Here is the difficulty of dispensing advice: you intend to soothe, and you end up causing harm.  You become a Job’s comforter, like one of these oily saxophones in Vaughan Williams’ Job, A Masque for Dancing.  Or like Polonius, loitering behind the arras, with his smug desiderata.    

So I don’t think I will presume to give Rebecca advice.  But if she were to ask me, what would you do? – I would answer as follows:

If I were lucky enough to have a Plan A, and if the plan were honourable, I wouldn’t even think of looking at Plan B.  Because if you do, rest assured, Plan B will begin to unfold, and before you know it you will have constructed a B-life, you will surround yourself with like-minded B-lifers, and your life will become a bit part in a B-movie.  If you’re really serious about Plan A, give it everything you’ve got.  As Brutus said to Cassius,

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.

Of course you are taking a risk.  But then life is inherently risky.  And after all, what, precisely is that risk?  If you analyse the concern and the preoccupation of the purveyors of Plan B, you will always find that at its heart lies fear.  And it is usually the fear of poverty.  Plan B is Project Fear.  Project Fear is favoured by the wealthy, preoccupied with the acquisition and the hoarding of stuff.   Yet “what shall it profit a man…?”  We are taught that the man who buries his talent in the ground will lose even that which he has buried.   And this is not because of some divine retribution, but rather because the act of repressing or suppressing a talent has already made him destitute.   The difference between Plan A and Plan B is the difference between somebody who is alive, and one of the undead.  Purveyors of Plan B (not thinking of anybody in particular) will try to frighten you with the prospect that you are imminently going to become an economic basket case.  But remember the words of the bard – the other bard:

Is there for honest poverty

That hings his head, an a’ that?

The coward slave, we pass him by –

We dare be poor for a’ that!

Reckless?  Winston said to the boys at Harrow, “Never give in. Never give in.  Never never never never…”  Yet even Winston tempered that with a rider – “…save for convictions of honour and good sense.”    Yes, you might fail.  Whatever happens, you have to be completely honest with yourself, and ask, is this worth the candle?  Nobody can advise you on that.  Plan A, unfolding, may change, and will certainly change you.  You may need to make adjustments to the plan as you go, because of events that you could never predict and you never saw coming.  That’s not a Plan B.  You just found you had to open your reserve parachute.  Yet you still made the jump.

Becky got the part.

In the review of the Sunday papers on yesterday’s Andrew Marr Show, Sarah Baxter, deputy editor of the Sunday Times, picked out of the Sunday Telegraph a story about The Beatles.  Apparently it still irks Sir Paul McCartney that John Lennon’s assassination elevated him to “James Dean” status and made him, as it were, Head Beatle. As if these terrible events outside the Dakota in New York had been some kind of career move.  I was – still am – a huge Beatle fan and, like any other aficionado, can remember what I was doing when I heard of Lennon’s murder.  For the record, I was a medical student, travelling between Edinburgh Royal Infirmary and Monkland’s Hospital in Airdrie.  It came on the car radio.  I wasn’t entirely surprised.  It seemed to me that Lennon had assumed – unwittingly for all I know – a kind of Messianic status that made him peculiarly vulnerable to attack.

Do you know that experience in which something that happens to be on your mind turns up in the Sunday papers?  The Beatles had been on my mind, for a rather odd, and tenuous, reason.  I’ve spent the last few days on the Moray Firth, in glorious summer weather.  I took a walk from Nairn, on a path by the Nairn River, to Cawdor.  I said to the hotel receptionist, “I’m just going over to pay my respects to the Thane.”  She looked blank.  And as I took that beautiful woodland walk I found myself whistling a wistful tune that hasn’t crossed my mind for years.  Lennon’s threnody to his mother, Julia.

The Thane of Cawdor was, of course, king hereafter.  I don’t care to revisit The Scottish Play but I’ve just reread J Wilson Knight’s essay on Macbeth in The Wheel of Fire – Macbeth and the Metaphysic of Evil.  Wilson Knight understood Macbeth as Roman Polanski understood it.  I went to see the Roman Polanski film of Macbeth in 1971, and within a minute of its start I knew I was going to be confronted with a terrible vision of absolute evil.  By the end of the film I had an inkling of the meaning of the word “catharsis”.  The purgation of pity and terror.

Roman Polanski was married to Sharon Tate.  She was brutally murdered in 1969.  The murderer is reputed to have scrawled on the wall, in blood, at the murder scene, the words “Helter Skelter”.  Helter Skelter is a track on the twin LP compilation officially entitled The Beatles, but commonly known as the Double White Album.

The Beatles were an extraordinary phenomenon.  Their time in the sun was brief.  Beatlemania erupted in 1963, and by 1966 they had left the stage at Candlestick Park, entered the recording studio, and turned recluse.   Their explosion on to the scene was inexplicable.  The demo tapes they sent to Decca aren’t that impressive.  If I’d auditioned them then I doubt if I would have taken them on.   They did covers of ancient songs like Besame Mucho and The Sheik of Araby.  There’s a basic competence no doubt achieved through the endless Hamburg gigs.  But nothing terribly original.  There’s something in their early rendition of Money – a kind of upbeat, nervy intensity.

Then something happens.  Aspects of it can be described, but it cannot really be explained.  The tempo slows down, and the incessant beat is accentuated.  And there is the unique and unreproducible mix of McCartney’s lyric tenor voice, and Lennon’s, a voice of harsh, desperate passion.  And, most crucial of all, they started to sing their own music.   George Martin their inspired producer at Parlophone got them into a studio where they pretty much produced an album in a day, full of simple and ingenuous songs like Ask Me Why and P.S. I Love You.

With the Beatles came out on November 22^nd 1963 – not exactly a slow news day.  (Aldous Huxley died, et al.)  Its opening track, It Won’t be Long is utterly extraordinary.  It closes with another rendition of Money and a chance for Lennon to lacerate his voice as he did with Twist and Shout.

Then comes A Hard Day’s Night and I remember being completely beguiled by its final track, I’ll be Back, which was a deliberate contrast to the rabble-rousing finales of the previous two LPs.

I think probably the first side of A Hard Day’s Night shows The Beatles at the height of their powers.  There’s a popular notion abroad that the Beatles’ late work is the greatest.  The idea is that Sergeant Pepper was ground breaking, revolutionised popular music, set the bar, and took it to new heights.  I see it as quite the opposite – the commencement of a descent into an abyss that is as inevitable and unstoppable as the group’s extraordinary rise.   There’s already a hint of it in the last track of Revolver.  Lennon called it his “Tibetan book of the dead” phase.  Things are beginning to go a bit psychedelic.  This reaches an apotheosis at the end of Pepper in A Day in The Life, which culminates in a huge improvised orchestral cacophony.  Where will they go from here?

Answer:  The Double White Album.

I haven’t listened to The Double White Album for years.  I thought to revisit it for purposes of this blog, but, to be honest, I can’t face its unremitting bleakness.  From Back in the USSR to Good Night – “nothing is but what it is not”.  Everything is sarcastic.  This is music of absolute despair.  It can only head in one direction.  In the penultimate track, Revolution 9, we descend into a heavily drugged world of fleeting impression and psychedelic madness.  The final track is a kitsch version of how a TV transmission service might close down.  Its cynicism is complete.

The early stuff is the best.  It is encapsulated in its own time and in the world of vinyl.  And nobody other than The Beatles seem able to perform it.  All these covers of Yesterday by lush string orchestras – they don’t really work.

It seems to me that The Beatles were as surprised as anybody else by the extraordinary roller coaster ride of their brief career.  Like the characters in Macbeth, they seemed to have no control over events.  Yet it is to their credit that they somehow got together to get back to their roots in Let it Be, and express some kind of farewell in Abbey Road.  In You Never Give me Your Money, and Golden Slumbers, there’s a kind of fin de siècle frailty, the poignancy of damaged people remembering the past.

Did Helter Skelter cause a murder?  Of course not.  You might As well say Gotterdammerung caused The Third Reich.  Of course that’s rubbish.  As Mark Twain said, Wagner’s music is much better than it sounds.

In the film Dead Poets Society, John Keating, a charismatic and inspirational English teacher, returns to the school where he was a pupil, a US boys’ academy hothousing the future doctors, lawyers, bankers, and captains of industry bound for the Ivy League.  Here he offers his students an alternative and perhaps subversive educational experience.  He invites one of them to read to the class the introduction to a poetry anthology, Understanding Poetry by one J. Evans Pritchard.  This expounds a literary theory which evaluates a poem according to two criteria, perfection and importance.  These can be graphed on an x and y axis such that the overall worth of a poem is represented by an area on the graph.  Mr Keating draws the graph on the board and the class dutifully copy it down.  But they are brought to a sudden halt by his comment.

“Excrement.”

In Waterstone’s the other day I paused to look at the medical section.  I like to keep my finger on the pulse.  I noticed there was an entire shelf given over to a variety of textbooks more or less bearing the same title, “How to get into Medical School”.  I thumbed through a few of them, with a sickly fascination.  They mostly followed the same format and dealt with the same issues, in largely the same way.  Getting good grades at school is de rigueur.  In addition, you need to do well at one of the Clinical Aptitude Tests now required by most universities – UKCAT or BMAT or GAMSAT.  This needs rehearsal.  Then you would be wise to accrue some work experience relevant to the health sector, perhaps a holiday job in a care home, a hospice, or hospital.  Try to shadow a general practitioner and spend some time observing at outpatient clinics.  If you are taking a gap year, it would be good to spend time in a developing country, doing voluntary work.

With respect to your application, visit the med schools that attract you and find out what they have to offer.   Take the greatest care to hone a beautifully crafted Personal Statement, and rehearse endlessly for the interview, fielding all the standard questions as well as a few unpredictable googlies.  You get the picture.

If I were mentoring a prospective medical student, I would certainly encourage all of the above.  I would even suggest they read some of the “How to get into Med School” books.  I’ve just finished reading “Get into UK Medical School for Dummies” (Wiley, 2013) – rather an oxymoronic title considering how difficult it is to get in.  Maybe it refers to a specific institution – “I won a place at UKMSD.”  Anyway it contains lots of sound advice and I would happily recommend it.

What I would hesitate to do is tell that prospective medical student what I really think, namely, that  the whole of that particular bookshelf, the whole project, is a steaming pile of… well, what was that word Mr Keating used?

There’s a piece of medical propaganda that it suits the universities, and the profession, to peddle.  It is that, in order to study medicine, you need to be a cross between Albert Einstein and Mother Theresa.  And it would be helpful if you spent your summer holidays solving the Ebola crisis.  It’s a myth.  If you have enough native wit to gain a sound knowledge of pathophysiology, and if you are kindly, caring, and conscientious, then you can be a good doctor, perhaps even a great one.  There are plenty of young people out there with solid, if not exceptional, exam grades, who would love to study medicine, but who never get the chance.

I found myself wondering whether, if I were applying for medical school now, I would have any chance of getting in.  I was a graduate student, and I gather some of the med schools attach more weight to graduates’ UKCAT performance.  So out of curiosity I got some practice questions and had a go.  UKCAT is a psychometric test, measuring your thought processes.  It’s in five parts: verbal, quantitative, and abstract reasoning, decision analysis, and situational judgment.  No special knowledge is required to sit the test, and indeed any person who had done reasonably well academically at school could, given plenty of time, walk in off the street and make a pretty good fist of it.  What makes the test difficult is the time constraint.  To complete the test, you need to answer 231 questions in two hours.  That averages just over half a minute per question, and most of the questions are quite lengthy.

With my confidence lately boosted by imminent publication of my novel, I thought I might try the verbal reasoning subset.  You read 11 passages of prose and mark 4 statements on each passage as being “true”, “false” or, on the information given, “can’t tell”.  You have 22 minutes to complete the subtest.

The first piece of prose was 250 words long, and contained a lot of detailed information.  I read it in a minute.  That left me a minute to answer the questions, but it took me two minutes, and then I got one wrong.  Then I started to pick a fight with the examiners.  “No no no.  That’s not right!”

The quantitative reasoning subset was worse.

With abstract reasoning and decision analysis, UKCAT becomes surreal.  You enter the realm of Bletchley Park and decipher hieroglyphics.  Oddly enough I did quite well at that, and that puzzled me.  Then it twigged.  I’m a crossword addict.  It’s really all about practice.

I was amused to find myself looking, as a prospective medical student would, for the tricks of the trade that would allow me to perform better in the tests.  Clearly, you can’t sit down with a cup of coffee and read these 11 segments of prose in a “normal” way.  Probably best to skim read them, then read the questions and cherry-pick the answers.  If in doubt, write “can’t tell”.  There’s no negative marking so you have nothing to lose.

Ridiculously, I found myself considering practising a bit to improve my performance.  It’s my own personal Myth of Sisyphus.  Having completed a career in medicine, I’m obliged to go back to med school and start rolling that boulder up the hill again.

But really, who makes this stuff up?  And why?  All prospective medical students have already been educated, excruciatingly, to breaking point.  Why subject them to this?  It’s a form of abuse really.  Prospective medical students are talented people.  Put a hurdle in front of them and they will probably surmount it.  It doesn’t really matter how ridiculous the hurdle is, it will be hurdled.  It’s like a concert pianist playing The Minute Waltz in 31 seconds.  You marvel at it.  Yet something is missing.  Like… Chopin.

The real irony is, while our universities are going to immense trouble to select and train these pedigree racehorses, you can’t find a doctor when you need one for love nor money.  (Well, maybe for money.)  Two weeks to see a GP, six months to see a neurologist…  All the doctors in their 20s are leaving for Australia, and all the doctors in their 50s are just leaving.  It’s enough to make you roll up to the med school interview in jeans and T-shirt and without a care in the world.

“Mr Campbell, why should we offer you a place ahead of the other interviewees?”

“Well, I don’t know any of them.  You decide!”

“You tell us about your strengths in your Personal Statement.  What would you say is your weakness?”

“I’ve got a bit of a drink problem.”

Of course it’s just a fantasy.  Like everybody else, I would present a strength disguised as a weakness.  “I’m terribly impatient.”  This can be translated as, “I’m clear headed, decisive, and dynamic.”  Sounds a bit arrogant, so needs to be tempered.  “I need to take time to listen, and to understand an opposing point of view.  I’ve been working at this, and have found the satisfaction of learning to be a team player immensely rewarding.”

Makes you want to throw up.

But if there’s one thing you learn in medicine, it’s to play the game.  So you turn up in your charcoal suit, exchange some charcoal blandishments, and recycle some charcoal ideas.  But make sure you throw in something a bit different that will make them remember you.   Like your burgundy tie, nothing off the planet.

I once went for an interview and didn’t give a damn.  I sat the Civil Service graduates’ entrance exam (in a freezing building on St Vincent St Glasgow during a power cut) and passed it, and got invited down to Whitehall for one of these intense two day goldfish bowl experiences where psychologists watch you chair board meetings.  My fellow candidates all seemed to have gone to Haberdashers and Eton.  I must have looked, and sounded, like a Martian.  And at the interview:

“What is it that attracts you to the Civil Service?”

“Nothing much.  I’m thinking of applying to med school.”

Oddly enough, they didn’t throw me out on my ear.  Well, not right away.

If you stay in medicine for long enough, eventually you cease to be an interviewee and become an interviewer, when remarkably talented people say to you, “I’ll give the job 110%.”

“Oh don’t do that.  You’ll be burned out in 2 years.”

“I’m not afraid of hard work.”

“Oh yeah?  Well I am.  I’m absolutely terrified of it!”

I thought these thoughts, but I never actually voiced them.  The fact is that, as a teacher and mentor, you have to be very careful about introducing your students to the attractions of being maverick.  There’s a subtle, barely articulated implication in Dead Poets Society, that Mr Keating, for all his remarkable inspirational gifts, was a bit naïve.  Of course it is quite right to say that when a tragedy occurs in the school, he is scapegoated and hung out to dry.  A colleague of Keating, Mr McAllister, very nice, empathetic, old-fashioned Scottish dominie tries, in the gentlest fashion, to warn him.  And just before the school lets Keating go, he and the Scotsman catch sight of one another, through a window and across a quad, and exchange a friendly wave.

Neil Perry is the boy who plays Puck in A Midsummer’s Night Dream, who wants to act, but whose overbearing father is forcing him to be, of all things, a medical student.  Neil says to Mr Keating, “I’m trapped.”  And Mr Keating says, “No you’re not.”  Within that simple exchange lies the whole beauty of the medical consultation.  UKCAT doesn’t know anything about that.

Mr Keating’s students find a copy of their teacher’s year book.  “John Keating.  Keats.  Man most likely to do anything.”  I co-edited our medical class final year book.  No, that will never do.  Far too uppity.  Rework it for the Personal Statement.  “I was lucky to have the chance to contribute to the editing of our final year book.  I was terribly impressed, and rather humbled, by the range and depth of my colleagues’ extracurricular activities…”  Well, that’s true.  One woman boosted the finances by driving a heavy goods artic down the M1, and another by shouting the odds at the dogs at Powderhall in Edinburgh.  But they didn’t do it to enhance the CV; they just had an instinctive notion of how to get a life.  Maybe Wiley and Sons could commission them to write, “How to get a life for dummies.”  It would be the absolute antithesis of “How to get into Med School”.  I think it would resemble a letter of advice I feel inclined to write to my young pre-med self:

“Relax; calm down; chill.”

I’m thinking of consulting a clinical psychologist with regard to my OCD.  I’m having the greatest difficulty getting out of the house in the morning.  Have I switched off the kettle and the toaster?  Is the hot water immersion heater on?  What about the radio, the telly, the computer, and is the back door open?  Then, getting into the car, did I lock the front door?  Did I switch the lights off?  Better go back and check. And then of course, if you get interrupted during the checks, you can’t just resume where you left off; you need to start again.  You stand staring at the cooker master switch and intone, “Off off off off off!”  But somehow, you just can’t “learn” its offness. The fridge is OK.  (As Michael McIntyre has said, why do we trust the fridge?) Then, more bizarrely, have I left the glass paperweight too near the window and is it going to deflect magnified sunlight on to my draft novel and ignite it?  In Scotland?  I ask you. But I’m going back to check.  The neighbours are beginning to suspect.  “He’s just left the house.  Watch this.  In a moment he’ll turn around and go back.  There he goes!”

I’m thinking of writing out a checklist that I could use to facilitate my morning egress, ticking off each item as I go.  Checklists have a noble provenance and a fine track record for safety.  Think of aviation.  I have a PPL and, oddly enough, I can sit at the holding point and carry out the “vital actions” (they really are vital) once, and then forget about it.  People have tried to export checklists out of aviation and into medicine.  The surgeon Atul Gawande is a fan.  See his book “The Checklist Manifesto: How to Get Things Right” (Metropolitan Books, 2009).  In theatre, I always found the ritual of two nurses counting the swabs out loud, in unison, deeply comforting.  Then, as the surgeon is closing up, they repeat the mantra.  “I counted them all out, and I counted them all back.”  Yet many surgeons grumble about checklists.  They say they get in the way.  Actually I think they have a point.  People can get obsessed with process.  GPs now complain that their consultations are constantly being disrupted by a welter of checklists appearing on the computer screen.  Have you checked smoking status, cholesterol, weekly alcohol units, weight…  when all the time the patient wants to talk about something completely different.  Even aviation recognises that checklists are subsidiary to the art of flying.  When your engine fails, the first thing to do is not reach for the checklist, but fly the plane.

Yet some checking procedures are so vital that they are best learned by rote and committed to memory for ever.  I remember when I did a twin engine type-rating in New Zealand (the aircraft was a Beechcraft B76 Duchess with the beguilingly affirmative call sign Yankee Echo Sierra), I had difficulty mastering the procedures, and enacting them, following the failure of one engine after take-off.  From time to time you hear on the news of such an event, the pilots being unable to avert a tragedy, and indeed precipitating it, by shutting down the wrong engine.  You can see how such a thing would happen; two hundred feet off the ground there is a catastrophic loss of power, and the aircraft is yawing all over the sky.  This is when you need to enact a response so hard-wired as to be unconscious and automatic.  So there is a mantra you learn.  I remember – it was 1997 – I was on the phone to my father in Scotland describing all this.  He had been a pilot in RAF Coastal Command.  The last time he had flown a plane in earnest was on September 9^th 1945 when he flew from Ikeja to Accra.  (I have his log books in front of me now.)  He said to me, immediately and without hesitation, “Mixture, props and throttles forward, gear up, flaps up, identify, verify, feather!”

This business of rehearsing for an emergency is very important.  One of the most enlightening presentations in medicine I ever went to was one which in my ignorance I tried to avoid.  But it turned out to be compulsory – part of some damned bureaucrat’s checklist.  It was given not by a health professional but by a Fire Prevention Officer with a laconic US drawl and a dry sense of humour.  He was a terrific communicator.  For the first time, I understood fire risk.  He showed a brief – how brief – video of the inside of a department store filmed from a CCTV security camera.  Some draperies caught fire and within the course of two minutes the entire store was a raging inferno.  Then we all went outside and practised extinguishing fires.  Fire extinguishers are designed to be simple but you still need to know which extinguisher to apply to which fire, and how to turn it on, point it, and, as it were, fire it up.  It’s exactly like so many instruments in medicine.  The first time you use a cricothyroidotomy set, you don’t want to be in earnest.

So nowadays I take fire seriously.  If I’m staying in a hotel I actually read that notice about fire exits on the inside of the door, then I rehearse the route, and imagine finding it in the dark, or in thick smoke.

And that’s the trouble with my OCD.  It has a perfectly rational basis.  The laconic US Fire Prevention Officer told me never to leave the house empty with an appliance running.  So I shut my computer down and it says, “Checking for updates.  Do not switch off your computer.  It will turn off automatically.”  Aye right.

Clearly then, it’s all a question of balance.  Maybe if I can whittle the list down to three, at most four vital actions.  And do them once and once only.  Pretend you’re in the cockpit.  The Cherokee Warrior 2 has an avionics master switch.  One switch shuts everything down.  That’s what I need.  To hell with it.  I’d rather the place went up in a puff of smoke than that I continue to live in fear and trembling.  It’s a form of timidity really.

At last!  I’m out, into the car, and away!  No regrets.  Make the journey, park the car.  Brake on, into first gear, steering column locked, lights off, windows closed, valuables out of sight.  Off we go.

Did I lock the car?

Did you watch Napoleon last Wednesday (9.30, BBC2)?  Since he was 10 years old, historian Andrew Roberts has held Bonaparte in high regard.  Bony has had rather a bad press for two centuries now, but according to Professor Roberts, he was a splendid chap.  Hell of a fellow, actually.  Well, it’s a timely revision; next Thursday is the two hundredth anniversary of the Battle of Waterloo at which it is estimated 47,000 soldiers were killed or wounded.

I slept on it.  Have you noticed the way a TV programme or a film stays with you, and resonates throughout the following day, the themes, the dramatis personae, the script, the music.  Yet, unaccountably and apparently irrelevantly, I woke up thinking about Beethoven, and about two contrasting chords – E minor, and E flat major.

At the start of his novel The Unbearable Lightness of Being, Milan Kundera remarks on the way that History is expunged of the agony of the present precisely because it has been consigned to the past.  He found himself looking at pictures of Hitler and recalling memories of his childhood with nostalgia.  Could we bear to examine the French Revolution if its existence were ongoing?  An eternity of heads being chopped off.   He muses throughout the book about the contrast between the importance western culture places on gravitas, and the gossamer transience of a life lived solely in the present.  And, towards the end of the novel, he recalls the rather portentous quotation Beethoven places above the last movement of his last work, the string quartet Opus 135 – weightily, and in F minor, Muss es sein? – and then lightly, and in F major, Es muss sein!  It sounds like something from the Heiligenstadt Testimony – I will seize fate by the throat!  But it turns out to be a joke about Beethoven’s laundry bill.  It seems extraordinary that even Beethoven is capable of self-parody in the style of Presley in sequins, doing Elvis impersonations at Vegas.

Is there some way of recapturing the agony of the past?  Yes.  Visit a place that is locked into the past and incapable of breaking free.  Gibraltar.  Strange place.  Reminiscent of Belfast, full of union flags and ancient parapets scrawled with graffiti – No surrender!  In Gibraltar, we are still fighting the Peninsular Wars.  Young men cruise the streets in open top sports cars with the sound system blaring, a remnant of imperialist tub-thumping.  If you come down off the rock, past the Rock Hotel and the Botanic Gardens towards the ancient naval battlements, you come upon a cemetery full of sailors from Trafalgar.  The names on the headstones bring the past into the present; two hundred and ten years is but the blink of an eye.

Another way of visiting the past is to read the words of contemporaries.  Beethoven again.  Napoleon was born in 1769, and Beethoven in 1770.  Beethoven had dedicated his Eroica Symphony to Bonaparte, but when he learned that France’s First Consul had crowned himself Emperor on May 20^th, 1804, he famously flew into a rage, and said, “Now he, too, will trample on all the rights of man!”  He tore the symphony’s title page in two, and scratched out the name “Buonaparte” with such ferocity as to dig a hole in the paper.

Lord Byron also had a change of heart about Napoleon.  He was born in 1788.  His Ode to Napoleon Buonaparte is caustic in the extreme.

Thine only gift hath been the grave / To those that worshipped thee; / Nor till thy fall could mortals guess / Ambition’s less than littleness!

When Arnold Schoenberg set Lord Byron’s Ode to music in 1942, he was doubtless thinking of another “little corporal”.  It is a serial work based on a tone row – E – F – D flat – C – G sharp – A – B – B flat – D – E flat – G – F sharp, but it is surely no coincidence that its final chord is E flat major, the home key of the Eroica.

Sir Walter Scott’s one essay into biography was The Life of Napoleon Buonaparte.  Scott was born in 1771.  The first edition of The Life, published simultaneously in French, German, Italian, and Spanish, was a spectacular commercial success.   Of particular interest with regard to Andrew Roberts’ programme is Scott’s treatment of the taking of Jaffa by the French in 1799:

The place was carried by storm – 3000 Turks were put to the sword, and the town was abandoned to the license of the soldiery, which, by Buonaparte’s own admission never assumed a shape more frightful.

And of the Egyptian prisoners taken –

This body of prisoners was marched out of Jaffa, in the centre of a large square battalion… They were escorted to the sand-hills to the south-east of Jaffa, divided into small bodies, and put to death by musketry.  The execution lasted a considerable time, and the wounded were despatched with the bayonet. 

And one final near contemporary – Thackeray, born 1811.  Musing on the night of June 18^th, 1815:

There is no end to the so-called glory and shame, and to the alternations of successful and unsuccessful murder, in which two high-spirited nations might engage.  Centuries hence, we Frenchmen and Englishmen might be boasting and killing each other still, carrying out bravely the Devil’s code of honour.

So we return to the present, and to Prof Roberts’ ongoing assessment of his childhood hero.  Part of the young Napoleon’s spectacularly successful Italian campaign was the pillage of Milan and Padua, the systematic looting of Michelangelos, Raphaels, and Caravaggios, and their transport in carriages to the Louvre.  Some people have been critical of that.  Mr Roberts’ comment – “They need to get over themselves.”  Then we come to that segment which, I confess, really got up my nose and made me write this blog, the treatment of the Jaffa atrocity of March 9^th 1799 when Napoleon exacted reprisals on up to 4000 prisoners by systematically bayoneting them to death on the beach.  Prof Roberts admitted that such an event would now be regarded as a war crime.  But not then.  The most Prof Roberts could bring himself to say of his great hero was that this was “not his finest hour”.

It’s a common enough argument, the idea that in assessing the actions of the past, we must have due regard for the mores of the time, and not apply the standards of our own morality retrospectively.

I don’t believe in this argument; I don’t buy it.  For as long as Homo sapiens has walked the planet, and perhaps for even longer, any of our ancestors being marched down to the beach to be bayoneted has felt – aside from terror – a sharp sense of disgruntlement and injustice.  Murder is as old as time itself.  Is this why we appear to be the only “sapient” species on earth, because we have killed off all the opposition?  Cain murders Abel in Genesis chapter 4.  The archetypical stories of our collective consciousness tell us we have always known that murder is the greatest wrong.  Yet in the dismal recapitulation of blood and gore through the centuries that continues to be our idea of the study of History, we continue to spew out the usual apologias – he solved the unemployment problem…  he got the trains to run in time… okay it wasn’t his finest hour…

Waterloo is a little distraction from the current, burdensome four year celebration of war we are less than a year into.  I’d like to hear a bit more Sassoon –

“He’s a cheery old card”, grunted Harry to Jack / As they slogged up to Arras with rifle and pack.

But he did for them both with his plan of attack.

I’d like to hear a bit more Owen –

My friend, you would not tell with such high zest / To children ardent for some desperate glory / The Old Lie: Dulce et decorum est / Pro patria mori. 

Now I know why I woke up thinking about Beethoven, and E flat.  But why E minor?

The answer lies in the Sixth Symphony of Ralph Vaughan Williams.  RVW quotes the Eroica in the second movement of the sixth.  He takes the repeated three note motif of the introduction of the last movement of the Eroica and transforms it into something inhuman, mechanistic, and hellish.  The last movement of the sixth, so reminiscent of Neptune, the last of The Planets by his good friend Gustav Holst, never rises above pianissimo.  Some people think of it as a depiction of a nuclear winter.  RVW, great exponent of the Anglo-Saxon litotes tradition, always abhorred the imposition upon music of a programme, but at least he admitted that that very beautiful but deserted music is “full of meaning, and tension”.  In the end, it settles on a chord of E flat, which is a chord of resolve, and of resolution.  Then it elides into a chord of E minor, which is a chord of anxiety and trepidation.  And you wonder which way it is going to go.  So finally, it settles on to a chord of E flat, and fades out towards silence, much as Holst’s Neptune fades out.

Then, almost inaudibly, it slips back into E minor.

Around the millennium I took a sabbatical from the world of medicine, buried myself away in a croft on the Isle of Skye, and wrote a book (or at least, put a series of black marks on paper).  Then my mother’s cousin broke her leg.  She was the front seat passenger in a car which suddenly decided to traverse Somerled Square and crash into the Portree Hotel.  I visited her in Broadford Hospital, where the medical director said to me, “You’re the doc who’s holed up in Camustianavaig writing a book.  Do you want a job?”  I have no idea how he knew where I was.  Anyway I did a locum.

Then the 2001 general election came along and the local MP, Charles Kennedy, dropped into the hospital with his (then) wife Sarah.  They were both very nice.  Mr Kennedy had a self-deprecatory sense of humour and was entirely lacking in pretence.  We had a very easy conversation.  I think the reason why the news of his death has caused such genuine sorrow is that he had a warm personality and an ability to connect with people.  I for one felt a sharp pang of dismay when I first heard the news last Tuesday morning.  I was reminded of the sudden death of another Scottish politician, Robin Cook, who collapsed and died in August 2005 while walking on Ben Stack, in Sutherland.  Mr Kennedy and Mr Cook both opposed the 2003 Iraq war, a stance which was, amid the prevailing attitudes of the time, courageous.  Robin Cook’s memoire of the run-up to the war, The Point of Departure, ends with his House of Commons speech of resignation from the government. It is very compelling.  This also reminds me of Mr Kennedy, when he was leader of the Liberal Democrats, arguing in the House that he was not persuaded of the justification to go to war.  A background to his speech was the inane hubbub coming from the opposite benches.

Mr Kennedy’s ability to connect also reminded me of New Zealand.  In an Auckland emergency department one night I looked after a government minister who came in with an acute medical problem.   We were so busy that at one point I had to wheel his trolley out into the corridor (sounds familiar?) to free up a resuscitation room.  I was apologetic but he just wanted to be treated like everybody else.  (Incidentally we sorted the overcrowding issue out; it took a decade, but that’s another story.)  I was reminded of this Kiwi egalitarianism when in February this year the British Government appointed a New Zealand judge, Justice Lowell Goddard, to lead the independent enquiry into child sexual abuse in England and Wales.  She was the third appointee; Baroness Butler-Sloss and then Fiona Woolf had taken on the task only to withdraw, because it was felt they were both too close to the Establishment they were being asked to investigate.  Justice Goddard, on her arrival in the UK, was asked if she might not also have links with the British Establishment.   She replied that she had had to check out what British people meant by “establishment”.  She said, “We don’t have such a thing in my country.”

I think she’s right.  That is not to say that there isn’t a degree of class consciousness in New Zealand.  Most of it comes as a legacy from Great Britain.  A posh New Zealand accent is a kind of approximation of BBC RP, although it is beginning to sound very old fashioned.  I have dined in Auckland restaurants when I’ve seen New Zealanders cringe to hear the waitress (sorry, I believe the current idiom is “wait-person”) announce, “The fush of the dee ees sneepah.”  And, later, “Would yous like to see the dessert menu?”  (The latter made me feel right at home.)

Yet I think the real reason why New Zealand doesn’t have an establishment is that it has unicameral government.  The upper chamber was abolished in 1950.  They decided they didn’t need it.

Back here, after this year’s general election there was the state opening of parliament with the arrival of the Queen in a gold horse-drawn carriage, the usual Black Rod flummery and the MPs filing in pairs through to join the ermine in the Lords, before the thrones, the page boys, the ladies in waiting.  This is the fundamental problem with the UK – the complete disconnect between the establishment and the commonweal.  I think most people living in the UK look at this spectacle and conclude that they have nothing to do with it, and it has nothing to do with them.

Of all the anecdotes I’ve heard about Charles Kennedy over the past week, the one I liked best concerned an elderly pensioner who came to see him in his constituency surgery.  She had been complaining to the council for years about a dripping tap in her kitchen, and nobody was bothering.  Mr Kennedy said, “I will fix it.”  He took along his tools and replaced a washer.

Actually I’m a bit worried about our Lords and commoners.  They don’t have enough room.  For the Queen’s speech they’re packed in like sardines.  Any time I go to a medical conference one of the first house-keeping notices in the plenary session is to go over the fire drill and indicate the location of the fire exits.  Do they ever have fire drills in the Lords?  Remember, it’s still legal to smoke in parts of the Palace of Westminster, and the glorious interiors are made of wood.  It’s a disaster waiting to happen.

We pass from last week’s dreams to, this week, The Dream, via politics.  On Wednesday May 27^th in Edinburgh the Scottish Parliament debated the Assisted Suicide (Scotland) Bill (it was knocked back by 82 votes to 36), and on Saturday May 30^th in Glasgow the Royal Scottish National Chorus and Orchestra performed Elgar’s Dream of Gerontius.

While it is not illegal to commit suicide in Scotland, it is not lawful to assist someone to do so.  This is what the Bill seeks to change.  I thought it would be worthwhile to give the Assisted Suicide (Scotland) Bill close scrutiny.  It’s not a lengthy document – 20 pages, including the 9 forms that it would be necessary to fill out if one chose to go down the assisted suicide route.  It’s worth talking through the forms, because this gives a sense of what it would mean in reality if the Bill were to become law.

You start by filling in “Preliminary declaration of willingness to consider assisted suicide”.  It’s a very simple form: name and address, date of birth, medical practice name and address.  You sign and date a declaration that you are willing to consider requesting assistance to commit suicide.  You need to be registered with a medical practice, and over 16.  You need to be making the decision voluntarily having been neither persuaded nor influenced by another person to make it.  At this stage, you can be in perfect health.

The preliminary declaration must be witnessed.  The Witness Statement is the next form.  Name and address, date of birth (over 16 again), signed, dated.  You must be acquainted with the applicant, but not a relative, spouse, in-law, civil partner, or cohabitee.  You mustn’t stand to gain financially from the proposed suicide, and you mustn’t be a doctor or nurse providing care to the person in relation to their illness or condition.  The same disqualifications apply to proxies and persons providing assistance in the act of suicide, “licensed facilitators”.

Next is a “Note by Registered Medical Practitioner” to state that the first two forms have been accurately filled in.  Name and address, signed, dated.

Now at least a week must elapse, for reflection.

Next is the “First request for assistance in committing suicide”.  Name and address, date of birth, medical practice name and address, signed, dated.  You declare that your quality of life has become unacceptable, because you have an illness that is either terminal or life-shortening, or you have a condition that is progressive and either terminal or life-shortening, and you see no prospect of any improvement in your quality of life.  The apparent distinction between an “illness” and a “condition” is not explained.

Next form is “First registered medical practitioner’s statement on first request”.  Name and address, signed, dated.   The doctor is not being asked to make any kind of value judgment as to whether or not the first request is justified, merely that the first request form has been properly filled out and that the information it contains is “not inconsistent” with the facts currently known to the doctor.

Next form is the “Second registered medical practitioner’s statement on first request”.  This is essentially the same form as the above.  The second doctor needs to interview the applicant.

At least 14 days must now elapse.

Next form is the “Second request for assistance in committing suicide”.  Name and address, date of birth, medical practice name and address, signed, dated.  This is largely a repetition of the first request with the additional declaration that you have arranged to have the services of a “licensed facilitator”.

Next form is the “First medical practitioner’s statement on second request”.  Name and address, signed, dated.  This is essentially the first statement reiterated.

Next form is the “Second medical practitioner’s statement on second request”, and another reiteration of the first statement.   Name and address, signed, dated.

That completes the form-filling.  The act of suicide must take place within two weeks of the second request, or the procedure is no longer legal.

This walk through the form-filling allows us to draw some conclusions about the proposed process. They can be drawn quite independently of any ethical opinion one might have.  It is clear that the Bill is proposing to legalise assisted suicide on request.  To qualify, all you need to have is a condition that is life-shortening and which, in your opinion, renders your quality of life unacceptable.  I can’t think of a single significant chronic pathology that does not shorten life and diminish its quality.  Implicit in the wording of the forms is the idea that it is the patient, not the doctor, who can best evaluate his own quality of life.  As politicians are wont to say, “This is all about choice.”

The second thing to note is the way in which the patient’s loved ones have been removed from the process.  Indeed, they are disqualified from the process.  They have been replaced by a bureaucracy, as depicted by the forms.  An entire new discipline with its associated industry is being created; we might call it “thanatology”.

On Saturday I went to The Dream.  Based on a text by John Henry Cardinal Newman, Elgar’s is an intensely personal, religious and indeed Catholic work.  I think of it as a hymn to palliative care.  We meet Gerontius, first on his death bed, then when he has passed beyond death.  We experience the palliation of his fear.  I like to think of Gerontius’ Guardian Angel as a palliative care nurse.  Sir John Barbirolli recorded Gerontius in 1964, with Dame Janet Baker singing the part of the Angel, but he had first performed it in Sheffield in the 1940s, with Kathleen Ferrier in the role.  Apparently she sang with such searing intensity that the composure of the bass soloist David Franklin was shaken.  The thing about the voices of both Ferrier and Baker is that they are remarkable instruments.  I like to think of Baker’s voice as the “ex-Primrose” Guarneri viola of 1697, while Ferrier’s is the Archinto Strad of 1696.  The voice of the viola is dark, mellow, compassionate, and palliative.  In this context, there is a poignancy in Ferrier’s death in 1953, from metastatic breast cancer, at the age of 41.

On Saturday evening, Sarah Connolly was the Amati viola of 1600.

Who can say what he might think, or wish for, in an extremity of condition?  Who would not have compassion for someone moved to put an end to the torment of a loved one?  Who indeed would not wish our parliamentarians well in trying to clarify the law?  Yet I cannot believe compassion will ever be captured in a series of bureaucratic forms.  No matter how clever your jurisprudence, the next unique situation will always confound it.  It’s like the Heisenberg Uncertainty Principle.  The closer you scrutinise something, the fuzzier it becomes.

It is not behovely for one who has not been put to the test, to make sanctimonious remarks about the sanctity of life.  Yet recently I’ve had a strange experience.  Walking by a field of rapeseed, stopping to gaze at a river, standing under the burgeoning leaves of a Scots pine, I’ve become aware of a palliative sense of companionship, quiet, friendly, benign.

Maybe it’s just a dream.