jamescalumcampbell

On Saturday I listened to BBC Radio 4’s Any Questions with a stopwatch.  It’s a rather fine stopwatch which I picked up in an antiques shop, a Swiss-made Chronosport, 7 jewels, with an expansive 30 second dial allowing for great accuracy.  I wanted to see if there was any substance in my suspicion that the Any Questions chairman, Jonathan Dimbleby, hogs the conversation.  So I simply timed his contribution – rather an anal, but an easy thing to do because the Chronosport has a stop-start facility, and all I had to do was click a button with a thumb every time Mr Dimbleby started and stopped; thus the process hardly interfered with my attention to the debate, which was almost entirely devoted to Brexit.

He spoke for 12 minutes and 32 seconds.  The programme lasts 45 minutes.  Let us assume for the sake of argument that the audience contribution – the questions asked and the audience applause – only took 28 seconds (they clearly took longer); then this leaves 32 minutes for the four invited guests on the panel.  They have 8 minutes each in which to make their points.  The chairman speaks for more than half as long again.  The chairman is supposed to be a facilitator who keeps his opinion to himself.  I venture to say, Any Questions has a problem.

Could long-windedness be a Dimbleby trait?  I don’t think so.  David Dimbleby who has broadcast his last TV Question Time after 25 years had a knack of interjecting succinctly and cogently, when he sensed a politician was attempting to pull the wool over our eyes.  Of course the Dimblebys’ father, Richard, was the doyen of the broadcaster commentating on great state occasions, and on television he evinced an instinctive sense that less was more.

I’m very interested in the art of the interview.  Every clinical medical practitioner is, first and foremost, an interviewer.  I say “first and foremost” quite deliberately, because far and away the most important component of the medical consultation is the taking of a medical history.  I spent my career in the field of undifferentiated medicine.  The general practitioner asks an open-ended question: how can I help you today?  The emergency physician might choose to be more succinct; the most powerful question in emergency medicine is quite simply this: What happened?

Having asked such a question, it is imperative that the interviewer then shut up.  All you need to do is sit back and listen.  As a matter of fact, if a doctor just sits back and listens, really listens, nine times out of ten he will be handed the diagnosis on a plate.  Fancy that.  He sits with his patient at the front door of the hospital.  Behind him there are haematology, biochemistry and microbiology laboratories, X-rays, and CTs and MRIs and ultrasound, catheter labs and gamma cameras and you name it.  Sometimes they can all be quite useful but not half so useful as an experienced clinician who just sits and listens.

You might suppose that the art of listening is somewhat passive.  Quite the contrary.  If the doctor is silent, it is because he has entered into a trance.  He has asked, “What happened?” and then he has unstintingly entered the patient’s realm of experience.  He steps into the patient’s shoes.  For a moment, he becomes the patient.  It is through this profound act of empathy that the doctor comes to understand the patient’s predicament.

One of the most memorable medical educational experiences I can remember was a seminar on interviewing techniques given by an Edinburgh consultant psychiatrist.  He played us extracts of interviews mostly from the BBC, and asked us to critique the technique of the interviewer.  The interviewers were all very different, some flamboyant, others self-effacing, some loquacious, others virtually monosyllabic; no one style was “right”, but what became clear was that what characterised the successful interviewer was the ability to listen.  Conversely, the bad interview was characterised by lack of close attention, premature interruption, miscomprehension, and failure to pick up on the unexpected.  The interviewer that sticks in my mind from that seminar was a man who I don’t suppose a younger generation will even have heard of: John Freeman.  He would interview TV personalities of his time such as Tony Hancock, Gilbert Harding, Adam Faith.  During the interview, he himself was virtually invisible.  Actually, if memory serves me right, that was literally true.  He remained off camera, only occasionally giving the interviewee a prompt, so that the interview almost became a monologue, during which the interviewee, often an intensely private individual, would be as surprised as everybody else to find himself baring his soul.

Who has that skill now?  Since the departure (at least from Radio 4) of Eddie Mair, precious few.  The current model of the political interview is that the interviewer is determined to extract a particular piece of information from the interviewee, and the interviewee is determined to stick to a script (probably under the direction of a spin doctor) and get a specific message across.  No wonder these conversations are so arid.  But you only need to think of the last cocktail party you attended and recall the bit of chat that really took off.  Last week at such an event in Aberdeen somebody told me an extraordinary saga.  I just did my John Freeman impersonation and disappeared into the furniture.

But our public discourse is dominated by confrontation.  Television seems to thrive on it, social media even more so.  PMQs, The Apprentice, Eastenders, Bodyguard… everything is fraught.  Political discourse has itself become the script of a soap opera.  You can’t tell the difference between Today in Parliament and The Thick of It.  When Mrs May confronted Mr Juncker last week maybe she modelled herself on Malcolm Tucker.

“You callin’ me ******* nebulous, Jim?”

Monday afternoon:  I’ve just listened to Mrs May’s statement to the House (given against a background of braying and carping so incessant that Mr Speaker had to interrupt twice to restore order) announcing that she has decided to defer tomorrow’s “meaningful vote”.

In my own professional life in medicine, while reflection could often be helpful in solving a problem, I don’t recall procrastination as ever being a useful diagnostic or therapeutic tool.  Actually, in emergency medicine, it just isn’t an option.  Procrastination comes from the Latin cras, tomorrow.  Manana.  Manana is too late.  Time, specifically “the golden hour”, is the defining entity of emergency medicine.  You see a patient, you take a careful history, you conduct an equally careful physical examination, maybe you order a couple of highly specific tests designed to answer a specific question and not merely to kick the problem into the long grass; then, sooner rather than later, because maybe the situation is deteriorating and in any case loads of patients with equally difficult problems are pouring through the front door, you have to make a decision, and run with it.  You have to make a diagnosis, construct a “formulation” as to how the diagnosis uniquely affects the patient, and then you have to devise and implement a plan of management.

Maybe you make the wrong decision and achieve an outcome somewhere between less than ideal and absolutely catastrophic.  Then you are up in front of the General Medical Council which takes a week to mull over an episode you were constrained to conclude within fifteen minutes.  I’ve heard it said that with respect to a UK – EU divorce deal, two years was always going to be cutting it tight, but you will readily appreciate how odd this sounds to an emergency physician.  The government has a track record for imposing its will on various professional groups and getting off-side with them.  Mrs May who is now PM got off-side with the police when she was Home Secretary, Mr Gove who is now Environment Secretary got off-side with the teachers when he was Education Secretary, Mr Hunt who is now Foreign Secretary got off-side with the doctors when he was Health Secretary.  Then they all elided seamlessly into their next job.  But I wonder if Parliament and the body politic, the Westminster Bubble and the whole political system, realises the extent to which it is currently being weighed in the balance by the electorate, and found wanting.  Parliament might make a decision which is wrong, and harmful, in the eyes of half the people, or she might make another decision equally wrong, and harmful, to the other half; but if she fails to make a decision at all, then the entire electorate will be entitled to ask whether they are worth the candle.

Being disillusioned with the political class is not good.  Mr Trump got elected because the great American people were disillusioned with the Washington élite.  In Paris, les gilets jaunes assembled aux barricades because they say M. Macron is a toff who doesn’t know the first thing about how real people live, and struggle.  The UK has a ruling class that is predominantly public school and Oxbridge educated.  People will look at what is going on in Parliament just now and conclude that maybe PPE at Oxford ain’t all it’s cracked up to be.  After all, if the ruling class can’t even get together to make the wrong decision, and thus end up making no decision, I think we have to consider whether they are worthy of our respect.  You expect your surgeon to be a trained surgeon, you expect your airline pilot to be a trained pilot, but what sort of training should a politician have?  Maybe it would be better if we elected mature adults who had proved themselves in various other walks of life, who were of independent mind, who weren’t frightened of losing the next election, who felt they had something to contribute, and who volunteered to stand for one term only.  I can’t imagine they would make any bigger hash of it than that which we are currently witnessing.

Westminster needs to be put into special measures.

J’ai essayé d’expliquer ces choses qui dorment, sans doute, au fond de notre instinct et qu’il est bien difficile de reveiller complѐtement. 

Maeterlinck.

 

This will happen twenty years from now.

My name is David Walkerburn.  I’m an Edinburgh lawyer, a partner in the firm of Cardwell Walkerburn, Writers to the Signet, 48 Heriot Row, Of This City.  I was in the New Club, Princes Street, with my friend the distinguished emergency physician, Professor Sir Alastair Cameron-Strange.  We sat in companionable silence, reading the newspapers.

“Listen to this.”  I read aloud from The Scotsman.

“Scots Aristocrat Arrested at Uluru.  Macabre Discovery in Hot Red Centre.  You listening, Alastair?”

“Mm?”

“Police in Australia’s Northern Territory are being tight-lipped about the gruesome find, in a wild camping site in the Valley of the Winds, between Ayers Rock and the Olgas, of the dead bodies of a man and a woman, as well as of a new-born baby, alive, but in a state of severe dehydration.  A man found wandering in the vicinity, in a state of delirium, has been arrested.  He and the baby have been transferred to hospital in Alice Springs.”

“Mm.”

“Funny how the Australian outback casts up these macabre tales.  British tourists found wandering amid the spinifex in a state of confusion.  Then a dead body, or two, turn up.  Often a dingo is involved.  Intriguing.”

“Mm.”

“Professor, you don’t sound intrigued.”  I read on.  “An unconfirmed report identifies the deceased woman as the Countess of Acharacle, and the arrested man as the Earl.”

The colour drained from the face of my physician friend.  For a man who has spent the bulk of his professional life dealing with humanity in extremis, he looked shaken.  He reached forward and snatched the newspaper from my hand.

“Acharacle you say.”

He scanned the brief article.  There was a photograph of a young couple, the Earl and Countess on their Moidart estate, in happier times.  Alastair handed the paper back.  He looked abstracted.  “Excuse me.”  He rose rather unsteadily and took himself off to the lavatory.  He was gone for a considerable length of time.  When he returned I could see he had regained control of himself.  I saw him stop the waiter and order a drink.  He signalled to me across the room and I pointed to my glass and nodded.  He came back and sat down.  I said, in a lawyerly way, “Am I to suppose that the Acharacles are known to you?  Patients perhaps?”

“If they were, I wouldn’t tell you.”

“What a tragedy.  She was only twenty.”

“Nineteen.”

The drinks came.  He hesitated, then: “Perhaps I could tell you about something that happened twenty years ago.”

Alastair doesn’t talk to me about his work very often.  I laid The Scotsman aside, sat back, and took a sip of Islay single malt.  “Continuez.”

And this is what he said.

*

Throughout my hospital career I have occasionally taken time out and dabbled in General Practice, just to remind myself what real life looks like.  I particularly value the experience of the home visit.  In hospital, we don’t have the opportunity to enter people’s lives in this unique way.  Perhaps the home visit is the nearest a physician can get to understanding the dynamic of a patient’s life.  What is it that you seek?  What makes you tick?  We doctors flatter ourselves that we understand our patients, but you know, in our brief consultations we only ever get a snapshot, like a single frame in a roll of 35mm film.  The rest is mystery.

The strangest house call I ever undertook as a GP took place north of Loch Sunart, in a narrow strip of land halfway between Loch Shiel and the Ardnamurchan Peninsula.  I undertook a weekend locum for the harassed local practitioner, approaching the end of his career, his own shelf-life, and burn-out.  I’d driven up from Edinburgh on the Friday afternoon.  It was the sort of November day we call dreich.  There is an even more expressive word in Gaelic: gruamach.  Thick low cloud enshrouded Rannoch Moor, and when I entered the long defile through Glencoe the atmosphere of oppression was suffocating.  A heavy sense of deep foreboding stayed with me as I crossed the Great Glen by the Corran ferry, and I knew it would not leave me until I had escaped from the blighted north-west on the following Monday morning.  The Gàidhealtachd was one vast desolate moor of clearance and desertion, and I moved through it conscious of inescapable history, of vague whispers, subliminal allusions to the conscription of a language and the systematic persecution of a people, and a culture.  I negotiated the single track road through woodland between Strontian and Salen in a mood of complete dejection.

I met Dr McGregor, striding out of his surgery in a state of evident agitation, and in a tremendous hurry.  He only paused to thrust a Gladstone bag into my hands.  “You’re wanted at the House.”

“House?”

“Acharacle.  Himself.”

“I was hoping you could orientate me.  Perhaps a little background?”

“My haste forbids it.  Ask Morag.  Housekeeper.  Mine of information.”  As an afterthought, he literally threw some car keys at me.  “Take the Land Rover.  Heavy rains forecast.  Four wheel drive.  You’ll need it.”  I never saw McGregor again.

The House turned out to be a prehistoric keep, a Scots baronial folly, a massive crumbling pile frowning over Loch Shiel.  I accessed it by a treacherous mud track that penetrated an interminable forest.  By the time I reached my destination, darkness was falling.  Just short of the dark shadow of the ramparted castle, I noticed, on the grass verge, a small child in dungarees, perhaps eight years old, with a serious, philosophical face, leaning on a gate, calmly observing my progress.  Then I was nearly driven off the track by an agricultural vehicle careering down on me from the opposite direction.  I caught a glimpse of a wide-eyed driver staring maniacally straight ahead, hell bent on escape.  He was carrying livestock.  I could hear the forlorn bleating of lambs going to market.  I had the odd sense the child was mourning their departure.  I crossed a causeway over a moat and drew up under a wrought iron gate as massive as a portcullis.  I pressed a buzzer on the wall.

“Yes?”

“Dr Cameron-Strange.”

“Yes?”

How irritating.  I wasn’t expected.  I patiently explained I had come on behalf of Dr McGregor.  The gate opened inwards with an agonised wail.  I edged through.  There was a cobbled courtyard, and a mews.  A porter met me as I got out of the car.  “This way.”  He led me into a gloomy cloister, thence to a turret, and a narrow spiral staircase hewn out of the stone.  We emerged into a vaulted atrium dismally decorated in stags’ antlers, jaded, moth-eaten tapestries, and hideous art depicting gory hunting scenes.  There were threadbare rugs strewn around the floor.  Vacant suits of armour stood sentinel and stared impassively in my direction from each corner of the chamber.  There was an enormous grated fireplace in which logs were blazing, but failing to provide any heat.  Above the mantel, a hundred muskets in a circular array formed a giant Catherine-wheel.

Himself emerged from an armchair before the fire.  I recognised the disdain for personal grooming, the bucolic sloppiness of the aristocrat.  He sported a pair of stained, bright orange corduroy trousers, and a shapeless woolly jumper covered in holes.  I introduced myself.  The craggy, debauched grey face quivered.  He offered me a limp hand.  “Acharacle.”  Anybody who calls himself by the name of his lands must have a fine conceit.

“Where the devil’s McGregor?”

“Taking a short break.  I hope I can help.”

“Who sent for you?”  He addressed his retainer over my shoulder.  “Who phoned for the quack, Fergus?”

“I couldn’t say, sir.”

“Hm.”  Himself frowned, in a perplexed way.  I had already noticed that his facial expression was one of fixed puzzlement.  It crossed my mind that he was dementing.  “Probably my son.  Bed bound for months.  McGregor knows the case.  Fergus, would you be so kind…”

But it turned out that Acharacle-fils had recovered from whatever it was that had confined him to his chamber.  He wasn’t my patient either. Must be some misunderstanding.  I was loath to head all the way back to the surgery only to be recalled again.  Back in the dismal atrium, Acharacle was staring vacantly through a long, slender, tessellated, pointed window down to the garden below.  He muttered to himself.  “What the devil’s he doing?”  I glanced down.  I saw a youngish man, prematurely grey, balancing a small child on his shoulders.  It was the child I had just seen on the roadway.  The boy was craning to look through a first floor window.  It was a bizarre vignette.  I supposed a father was playing with his son.  But it didn’t look like play; it looked like abuse.  I asked who else was resident in this ghastly edifice, who else might conceivably be my patient.  Thus I assembled my dramatis personae.  I was helped by sight of the family photographs on the mantel under the Catherine-wheel of armaments.  I expected them to have absurd names like Torquil and Rufus, but in fact the names were perfectly commonplace.  Acharacle-fils was absent, invisible; I never even got a name.  His wife was Jennifer.  They had two sons, half-brothers I gathered, Gordon and Paul.  Gordon’s wife was Melissa, and he had a son from a previous marriage, Iain.  So.  Half a dozen.  But who was I supposed to be visiting?  This was fast turning into a sardonic parlour game.  Hunt the patient.  I glanced at the photos above the log fire, marrying up names to faces.  The images that stood out were of Paul, a handsome young man, and of Melissa, very young, and very beautiful.  I decided to conduct a ward round.

I started with Jennifer.  She occupied an apartment on the top floor.  I took the lift.  It was a parsimonious and suffocating oblong cubicle barely the size of a casket.  I have a horror of confined spaces.  I bit my lip while the elevator painstakingly clanked its way upwards then lurched to a halt.  I emerged into a lady’s drawing room and a lighter atmosphere.  Jenny was a querulous, redheaded lady of middle age who looked to me to be in the prime of a robust and healthy life.  She hadn’t sent for me.  “But, doctor, while you’re here…”  I walked right into that trap.  She turned out to be one of the worried well, and she had a list.  I patiently went through it with her, and ruled her out, while she in turn ruled out Acharacle’s great-grandson Iain, a dreamy child, happily occupying his own private world.  So it had to be one of the brothers, Paul and Gordon, or Gordon’s wife.  What was her name?  Melissa.

I learned a little about them.  Melissa was Australian, from Caloundra, Queensland.  She was a teenager, half Gordon’s age.  It was all terribly romantic, said Jenny.  Gordon had gone walkabout Down Under, and when he met Melissa she was a damsel in distress, a frightened young woman who had been traumatised by some deeply upsetting experience and abandoned, lost in the middle of nowhere.  To me it all sounded a bit like Picnic at Hanging Rock.  Gordon had rescued her from whatever plight she was in, and brought her home.  Jenny had worried that Acharacle, in his patriarchal role as a clan chieftain, might object to the liaison and its precipitate nature, but he turned out to be quite philosophical about it, even fatalistic.

Fancy a young woman from the Sunshine Coast landing up in this godforsaken hole!  Had she been seduced by the idea of coming to the Old Country and joining the aristocracy?  Could she have had any idea what she was letting herself in for?

I asked if Melissa was happy.

“Happy?”  Jenny looked at me quizzically.  I don’t think she understood the question.

What about Paul?  Full of life, early twenties, just graduated (St. Andrews, fine art), champing at the bit, dying to get out of here.  He had a friend in some far off place who’d got sick, and Paul wanted to go and see him, but Himself had persuaded him to stay on until Paul’s father got better.  That now being the case, Paul’s departure was imminent.

That left Gordon.  Hedge fund manager.  Late thirties.  Intense, highly strung, prone to loss of temper and fits of rage, and something of a control freak.  That must be it.  Surely Gordon had to be my patient.  I had seen him down in the garden, balancing Iain on his shoulders.  I decided to go and find him.  I excused myself and got back into that hellish lurching coffin.

All the time that I wandered about that House I was conscious of numerous housekeepers and servants passing silently along the corridors like spectral wraiths.  The third floor was deserted.  Reluctantly I got back into my lift.  It stopped at the second floor and the doors opened on to a marital spat.  Gordon had removed the coat of his executive pinstripe suit to reveal a garish pair of bright red braces.  He was pacing the floor, multi-tasking, simultaneously taking a call on his mobile while interrogating his child bride.   He briefly clamped the mobile between cheek and shoulder and deftly loosened his tie.

“Get back to me about the FTSE and the Dow…”

But I couldn’t stop staring at Melissa.  She was one of these girls who didn’t have to dress to impress.  She would have looked good in a sack.  Actually a sack was pretty much what she was wearing, a kind of shapeless kaftan in muslin.  I should have paid more attention to that, but I got distracted by these bewitching eyes.  If I were to tell you that Melissa was, and remains, the most beautiful woman I have ever set eyes on, you will tell me that I am prone to exaggeration.  Besides, any blond-haired, blue eyed teenager on the beach at Surfer’s Paradise is likely beautiful de rigueur.  They themselves, despite the armour of hauteur, are the only ones who don’t know it.  Youth is wasted on the young.  What was so special about Melissa?

Her hair.

“Buy at four fifty. Then if the price tops five fifty, sell.  Yah yah…

“Well where the hell did you drop it?”

“Blind man’s burn.”  Melissa’s voice was soft and low.  I could hardly detect an accent.

“Well you must go and find it.  Not you, Maggie.  I’m talking to Melissa.  Yah yah.”

“Now?”

“Yes, now, Melissa.”

“But it’s dark.”

“It’s a gold wedding ring, Melissa.  Twenty-four carat.  You have to find it.  Take Paul with you.  I don’t know what the hell you and Paul were thinking of.  You are children.  Sorry Maggie.  Where were we?”

I closed the elevator doors and continued my descent.  Gordon was very exercised about that twenty-four carat ring.  He reminded me of Othello, and his preoccupation with a handkerchief.  “The handkerchief!  ‘Zounds!  My mind misgives!” Gordon struck me as a jealous, and a very irascible man.  He was a corporate man.  He was the sort of man who had decided that he was surrounded by nobody but fools and idiots and as a result he was at the end of his tether.  Back in the lift, I must have pressed the wrong button because before I knew it I was descending into the crypt of the castle, and the bowels of the earth.  I travelled so far down that I experienced the sharp otalgia of barotrauma.  Down in the vaults, I came to a shuddering halt.  The door opened on to a narrow passageway carved out of the rock.  Ahead, there was the faintest glimmer of light.  I should have closed the doors and reascended immediately, but something compelled me to step forward toward that faint light.

It was surreal; maybe I just imagined it.  I found myself in a grotto, deep below the surface of the earth.  It must be some profound underground tributary feeding Loch Shiel.  Ahead, the water appeared still, dank, black, and fathomless.  I had discovered a subterranean ocean, from which emanated a stench of rotting decay.  I sensed that if I didn’t get out of this place immediately I would lose my wits.  I was conscious of an all-pervading, crushing sense of complete terror.  I stepped back from the hidden sea and its fetid miasma, turned, and literally ran back to the sanctuary of the lift, closed the doors, and got the hell out of there.

After that, things happened very quickly.  I made my way back to the atrium where I had first met Himself, to find that the marital spat, far from blowing over, had got completely out of hand.  They were positioned, as in a tableau, in front of the log fire, a tear-stained Melissa on her knees in an attitude of supplication.  Gordon stood over her.  He was incandescent with fury.

“Bitch!  Bitch!  Seeming, seeming, scheming, ungrateful, harridan!” 

It was when he started to drag her across the floor by her beautiful hair that I had to intervene.

“Stop that.”

He screamed at me.  “And who the hell might you be?”

“Never mind who I am.  I’m phoning the police.”

“How dare you!  Why don’t you stay out of other people’s business?  Leave this house immediately!”

I must admit I had the overwhelming desire to smack him on the jaw.  I think he must have sensed it because he stopped dragging his wife by her hair across the floor, and looked at me in surprise.  Maybe nobody had ever dared to cross him.  There was a pause and a brief interlude.  I remember I caught sight again of the photos on the mantel, and my gaze fell upon the image of the one person I’d not seen in the flesh – Paul.  Melissa followed my gaze and for a brief moment I captured her expression as her eyes settled on the same picture.  I might never have caught it.  It was my single frame in the roll of 35 mm film – that look of great and abiding tenderness.   Thus all was made clear to me.

Suddenly Melissa gave a strangled cry of pain.  She fell on to her left side, clutching her abdomen.  I saw the dark stain begin to spread across the muslin of her flowing dress.  Automatically, I knelt beside her and laid a hand on her tummy.  It was rock hard.  Gordon snapped impatiently, “What’s the matter?”

“She’s delivering.”

“What?”

“She’s having a baby.”

“What?”

I reached into my pocket and handed Gordon the car keys.  “It’s a Land Rover.  It’s parked in the courtyard.  There’s a large crash box in the boot.  You can’t miss it.  Get it.  Quick.”

But there was no time.  I didn’t so much manage a birth, as preside ineffectually over its inexorable progress.  I don’t know how much time elapsed as I concentrated on the technical aspects of the obstetrics, but I became aware that various servants had filed silently into the room and I was being handed clean towels.  Nobody expressed the slightest surprise at this extraordinary turn of events.  It was almost as if it were preordained.  I stared at the new arrival, the pale, flat grey sliver of life.  I estimated twenty four weeks.  The cusp of viability.  Then to my enormous relief the skin pinked up and the baby emitted a pitiful bleat.  Gordon, wide-eyed with horror, returned with the crash box, and I was able to cut the cord and deliver the placenta.

Then it all went downhill.  She just wouldn’t stop bleeding.  I called out, to nobody in particuIar, “Get an ambulance.  Blue light.”  I was vaguely aware of Gordon tapping out a number on his mobile with a shaking hand.  I forced myself to think pathophysiologically.  Why’s she bleeding?  Not retained placenta.  Not retained products.  Uterine atony?  A soft tissue laceration?  Uterine rupture?  A coagulopathy?

With a sinking heart I noted the pallid skin with its clammy frost.  The pulse at the wrist was thready.  The arm was limp and unresisting.  She had withdrawn into herself like an injured animal retreating into its lair.  I took her blood pressure.  80 systolic.  Shock.

I cursed the environment I was in.  The light was terrible.  We hadn’t even been able to get Melissa off the floor.  At least one of the servants had dried off the baby and fashioned a makeshift crib near the log fire.  I got two drips up and poured fluids in, normal saline and then colloid.  But she needed blood above all else.  Thank God I found a vial of oxytocin in the crash box.  I gave her ten units.  It didn’t make the slightest difference.  Then I gave her ergometrine, 250mg intravenously, then 250 mg intramuscularly.  How I wished I was back in Edinburgh with a six minute ambulance response time.  Here, the ambulance would take forever.  And the rains had started.  The cavalry might not reach us at all.  I set up an oxytocin infusion.  What else could I do?  Rub up the fundus.  Examine the genital tract – as best you can – for tears.  Anything else verged into surgical management and I had neither the tools, nor the environment in which to proceed.  Uterine artery, or internal iliac artery ligation?  Hysterectomy as a last resort?  Impossible.  All I could do was tamponade the bleeding as best I could, with a mass of sterile packs, and wait.  Slowly I became aware that the entire household staff had entered the room and had formed a semicircle around its periphery, like the chorus in a Greek tragedy.

Now she was deathly pale.  I had a very bad feeling about the way things were going.  As a doctor, I had never before, nor since, felt so wretched nor so helpless.   When Melissa spoke, her voice was almost inaudible, as if she were speaking from another world.

“Where is Paul?”

“He is at Blind Man’s Burn.”

“Why doesn’t he come?”

Gordon said, “I need to speak to my wife, alone.”

“I don’t think so.”

“I promise I won’t harm her anymore.  Please, see, you can leave the door open.”

But I wasn’t going to leave my patient.  As a concession I retreated a few steps.

“Melissa.  I need to know.  Did you love Paul?”

“Of course I love Paul.”

“I mean, did you love him… with a forbidden love?”

As one, the Greek chorus fell to its knees.

She whispered, “How can love be forbidden?”  I believe it was the last thing she said.

Now the eternal wait for the ambulance no longer mattered.  It didn’t even matter that the blue light approaching through the dense forest belonged not to an ambulance, but to a police car.  I gave the two startled police officers a brief handover, and suggested that one of them might wish to take a turn down to Blind Man’s Burn.  Acharacle made another brief appearance, pausing to look absently at the girl’s inert body, and then at his great granddaughter.  He never lost his mystified look of profound puzzlement.  It was nineteen years ago.  But for me the memory, the sharpness of the image, has never faded.

“Poor little mite.  It’s your turn now.”

 

 

Irrespective of one’s personal position on the Europhile/Eurosceptic spectrum, it is hard not to admire Mrs May for her determination, stamina, resilience, and sheer grit in the face of a barrage of opposition from multiple sources.  She has actually succeeded in clinching a deal with the 27 EU states.  If it were to find favour in the Commons’ “meaningful vote”, you might conclude that she had thus firmly established and safeguarded her own Prime Ministerial legacy, and who knows how long she might continue on as PM?  But at the moment, the numbers at Westminster are not stacking up in her favour.  What happens if she loses the vote?  Nobody knows.

I always thought it was a little odd that Mrs May succeeded Mr Cameron after the referendum in 2016.  Mr Cameron resigned because he was a Remainer, and therefore not in a position to lead the UK through the Brexit negotiations.  He said this specifically, in his short resignation speech from the podium outside No. 10.  Mrs May had also been a Remainer, albeit low key, but for whatever reason, she did not feel this precluded her from chucking her hat into the ring.  At the time, there was no shortage of Brexiteer contenders – Mr Johnson, Mr Gove, Dr Fox – but who knows what was going on in the cabals of the backbench 1922 committee.  Maybe they realised early on that a referendum won on a margin of 52% to 48% of the vote was barely statistically significant, and that some sort of compromise – some people would call it a fudge – would be necessary in order to give expression to what has been called “the will of the people.”  If the referendum result came as a surprise, and if   the Government, and Parliament as a whole, were broadly on the Remain side, cynics might say that the Government set out to concoct a “Brino” or Brexit in name only.  Many on the far right of the Conservative Party might say that this in fact is what Mrs May has striven to achieve.

Aware of the uphill struggle she now faces, Mrs May took to the air waves on Friday to address the people directly in a radio phone-in session.  On Sunday morning she also wrote to us all.  This might also seem puzzling, since she has taken the decision-making out of the hands of the general public by declaring there will be no second referendum or “people’s vote.”  I suppose she might think that the electorate might put pressure on MPs at constituency level to “get on with it” and wrap the whole thing up.  It seems unlikely that many members of the public will have trawled their way through the 585 pages of the withdrawal agreement, so maybe she is just relying on sheer voter fatigue to create a climate in which the exhausted public say, “Enough already.”  But you take a risk going on talk-back radio, because somebody might bowl you a googly.  On Friday, somebody asked Mrs May if the deal she’d brokered was worse than remaining in the EU, and when she spluttered and blustered I thought, she wants to stay in.  Why should that be a surprise?  She was after all a Remainer.  It’s always good to be straight.  She might have said, “Yes I’d rather have stayed in.  But since we’re out, we’d better make the best of it.”

So what now?  Say the deal gets knocked back by Westminster.  Mrs May could resign.  I think that’s unlikely.  Remember determination, stamina, resilience, and sheer grit.  She might go back to the EU and try to renegotiate.  But Mr Juncker has as good as said, “This is the only show in town.  That’s the deal.  Take it or leave it.”  Some people think he’s bluffing.  He doesn’t look like a man who is bluffing.

She might try to extend Article 50.  But if there’s only going to be one deal on the table, what’s the point?

She might call another referendum, and broaden the options – In, Out, Shake it all about, Canada-plus, super-Norway…  But there would be no guarantee at all of getting an answer clearer than the one that already exists.

And she could call a general election.  This seems to me to be the least likely option of all.  The Conservative Party may be riven, but one thing it has always put ahead of all other considerations is self-preservation.  And Mr Corbyn might win the election.

So what’s left?  Only one thing: we crash out.

Cliff edge Brexit has always been regarded as the nightmare scenario, but not by everybody.  Some on the right would be happy with the cleanest of clean breaks.  Mrs May herself used to say “No deal is better than a bad deal” but I note she has stopped saying that.  After all, the prospect of the entire population signing on to the local food bank is beyond frightening.  So crashing out, heretofore, has not been an option, but the odds on it are shortening, because, if Parliament can’t make up its mind what to do, we will default to no-deal simply because we run out of time.

Who was it said politics is the art of the possible?  You stop an Irishman in the street to ask for directions, and he says, “If I were you, I wouldn’t start from here.”  But we have no other choice but to solve the conundrum as it now presents itself.  It will be a terrible indictment of our Body Politic if it cannot come to an agreement within itself, and with Europe.  We may not much fancy Mrs May’s deal, but at least it’s on the table.  As Ken Clarke pointed out on Any Questions at the weekend, most people admire the PM’s tenacity.  Ken Clarke was reminded of a conversation he had with Malcolm Rifkind in which he referred to Mrs May as a “bloody difficult woman.”  A panel member characterised this as a sexist remark, but Mr Clarke defended himself by saying he knew plenty of bloody difficult men.  And besides, he said, it was meant as a compliment.  After all, both he and Mr Rifkind had worked for Mrs Thatcher!  I have a notion he was digging a hole for himself, but that he didn’t much mind.

Of more serious import was the accusation that Mrs May’s return from Brussels resembled Mr Chamberlain’s return from Munich in 1938, waving his piece of paper.  I thought that was a crass remark.  But then, it is seldom constructive in contemporary political discourse to invoke, even obliquely, the spectre of the Fuhrer.  Still, the reference did remind me of Winston’s critique of the Conservative Government in the 30s, and I wonder if it could be applied now to Parliament as a whole, verbatim:

So they the Government go on in strange paradox, decided to be undecided, resolved to be irresolute, adamant for drift, solid for fluidity, all powerful to be impotent…  

In the cramped shoebox that is my bijou cottage – I call it the Yellow Submarine – stowage becomes an art form.  I’m minded to upsize – an unusual ambition for one who has matriculated in the University of the Third Age.  But upsize to what, and to where?  Wait until 29/3/19.  Then, when the road system has become a gigantic lorry park, and the supermarket shelves are empty, all will become clear.

In the meantime, to keep my lobby open and passable, I must ruthlessly dispose of junk.  And not only junk.  Things of value, sentimental or otherwise, must go.  There is, literally, no room for sentiment.  But there is an upside to all this.  I’ve become quite good at decluttering, simply because I have no choice.  People talk about “retail therapy”, but of course it’s addiction to retail therapy that lands us in this jam.  You buy your way into a corner and then you can’t get out, a prisoner of your own possessions.  Every therapeutic regimen has its unwanted effects, and the main side effects of retail therapy are guilt, and over-satiety.  Even as you make the purchase, and pass your debit card over the contactless console like a magic wand, the still small nagging voice of conscience interrogates you: you may want this commodity, but do you need it?

On the other hand, letting stuff go is largely a guiltless procedure.  Maybe it really is true that it is better to give than to receive.  This week I had another book cull, loaded up the car, and went to the local charity shop.  I started with a taster, and offered half a dozen hardback books of good quality.  They were gratefully accepted.

“Do you gift aid?”

“No.”  I affected the demeanour of a mysterious tax exile.

“Not a problem.”  (I’m on a solo and forlorn anti-gift-aid mission.  The tax system is far too complicated.  If HMRC didn’t sanction gift aid then presumably she could recoup all that tax and be in a position with the increased revenue to tax us less.  Then we in turn would be in a position to increase our donations to charity if we so wished.  Then everybody would know who was paying what to whom.)

“I’ve got another 200 books in the car.  Do you want them?”  I felt it was only fair to warn them they were about to be inundated.  But they seemed to be delighted, so I started to lug them in, in rubbish sacks.  I don’t think there was a single dud among them.  They fell broadly into three categories: (a) books I’d read and probably wouldn’t read again (example – Madame Bovary);  (b) books I’d always meant to read but would probably never get round to reading (example Lanark);  (c) books I’d partially read/skim-read/plundered in one way or another (example Finnegans Wake).  I suppose if I’d had a library at home large enough I wouldn’t have parted with any of them.  But in that case, I might have been the laird of a vast estate, occupying a huge pile and flaunting, in addition to the library, a music room, gymnasium, swimming pool, cinema, and private chapel (God knows I’d be in need of the latter).  Anyway I was glad to get them off my hands and if somebody out there buys one of these books at a snip, reads it, and profits by it, then I am delighted.

Next up, I dismembered my bulky photograph albums.  I can’t justify the shelf space.  I separated the cardboard from the plastic and put the remnants into the green and blue bins respectively.  That left a vast pile of old photos.  If I didn’t recognise the people, or the scene within the photograph, I binned it.  It’s always a poignant experience, going through old photos.  You have this recollection of the richness of an epoch in your life that you were barely conscious of at the time.  I tipped all the surviving loose photos into a filing cabinet.  My “filing cabinet of memory” is not metaphorical but real.

Next up: textiles.  I counted fifty ties.  I only ever wear four – two medical college ties, the clan tartan, and a black tie for funerals.  (The black tie is not entirely black; a subtle texture is apparent, like Hawking radiation.)  Also I’ve kept my father’s RAF tie.  As someone once in the RAF volunteer reserve I might even be entitled to wear it, but I never have.

Next up, tired old suits…

You get the sense I’m on a roll.  I said that, unlike retail therapy, declutter therapy is without side effects, but I’m not sure that’s entirely true.  My penchant for relinquishment can get out of hand.  I think I’m wedded to the Shakespearian notion of periodically being cast away, and washed up naked on an unknown beach, to start again, to fend.  The perusal of all these ancient photographs reminded me of the episodic nature of my life, and the way I strived to attain some position, only to give it away and start afresh.  I don’t think the idea of constructing a life, adopting a strategy, and planning the next move, has ever crossed my mind.  Eighteen months after I got the senior lectureship at Auckland University Medical School, I quit, and vanished, and buried myself in a tiny hamlet in North Skye.  A colleague told me I was utterly mad.  I guess he was right.  I remarked to somebody that I suspected I might have a self-destructive nature, and she replied, “You’ve only just noticed?”

There’s that guy in the gospels, a virtuous young man who kept all the commandments, who asked Our Lord what else he needed to do to gain the life more abundant.  Well, he was nearly there.  All he needed to do was sell all his possessions and give the proceeds to the poor.  That came as a bit of a blow, and he departed, exceeding sorrowful.  Sometimes I think that if I’d got the call, I would have said, “Cool!  I’m up for that!”  But, precisely because of my dangerously mendicant tendencies, Our Lord would never have commissioned me.  He would probably have looked at my twelve year old self and asked, “How much does Mr Winning pay you for your paper round?”

“£1.00 a week, with a £1.00 bonus in the week of your nativity.”

“Bank it every week for a year.  When you attain £53, come back and see me, and I’ll tell you what to do.”

But that would have been too much of an ask for somebody who never really grasped Gerard Manley Hopkins’ notion that “sheer plod makes plough down sillion shine”, and I, too, would have departed, exceeding sorrowful.

Actually I held on to Finnegans Wake.  You never know.

The symbol of the poppy has been the subject of much heated conversation over the weekend.  The first question on Radio 4’s Any Questions was, “Has the time come for a more inclusive symbol to mark Remembrance Day?”  The programme was coming from a village in Devon, in the middle of a storm and a power cut, hence was conducted by candle light, and only went on air thanks to a local farmer’s tractor and generator.  This scenario evoked a Dunkirk spirit and a Blitzy atmosphere the more so as apparently the generator failed three minutes after the end of the programme.  They got through by the skin of their teeth.

One of the panellists, Aaron Bastani, had apparently put out a piece on U-tube characterising the poppy as “racist”, a symbol of “white triumphalism”.   Another panellist accused him of having said, “F*** Invictus”.  I did notice that Jonathon Dimbleby effectively abandoned the neutrality of the chair and joined the panel in confronting Mr Bastani, which I venture to say he ought not to do.  The other panel members are perfectly capable of articulating the opposing point of view.  The audience member who posed the question pointed out that the debate had gone off in a different direction and never really addressed the issue.  That is so often what happens when things get heated.

On Saturday evening I attended the Glasgow Royal Concert Hall and a concert given by the Royal Scottish National Orchestra in conjunction with Poppyscotland, commemorating the centenary of the 1918 armistice and the end of the First World War.  Driving home, I caught The Moral Maze, again on Radio 4.  Once again, the poppy came under scrutiny in a debate concerning whether we should continue to commemorate the Great War, or whether we should let it go.  The first witness was the historian James Heartfield, author of The Blood Stained Poppy, who thought that Remembrance Day was a military victory parade attended by a degree of hokum.  Melanie Phillips, who writes for The Times, expressed outrage at his point of view, and indeed sounded pretty angry.  James Heartfield remained remarkably calm, and thanked Ms Phillips for expressing herself so eloquently.

Clearly, our collective memory of the First World War continues to rouse strong passions.  Any Questions and The Moral Maze reminded me of the response of the establishment to another BBC creation, The Monocled Mutineer.  This was a dramatization by Alan Bleasdale of the 1978 book of the same name by William Allison and John Fairley, broadcast in four episodes in 1986.  The first instalment went out on August 31^st and was watched by an audience of over ten million.  It centred round an historic event, the Étaples Mutiny.  Apparently all official records of the Étaples Board of Enquiry pertaining to this event have been destroyed, which makes it difficult to know whether or not the historic events of the television drama were inaccurate or, as we would say now, “fake news”.  But I recall a lot of people at the time got very hot under the collar.  The apologists on behalf of The Monocled Mutineer made the case that certain liberties taken with historical fact were justified as poetic licence, and the depiction of the cruelty and folly of the war was broadly accurate.  What I will never forget about The Monocled Mutineer was the re-enactment of the execution of a soldier, shot at dawn, for cowardice.  It was utterly horrific.

One hundred years past, we still haven’t recovered from the First World War.  On Sunday evening, the BBC broadcast on Radio 3 a live performance from Cardiff of Benjamin Britten’s War Requiem, while on Radio 4 they conducted a retrospective of the series Tommies, which has already run for more than four years.  Meanwhile in Westminster Abbey, a service of remembrance took place, attended by members of the Royal Family, who were also present at a similar event on Saturday evening at the Royal Albert Hall, and again, of course, at the cenotaph on Sunday morning.  Across the channel, M. Macron and Frau Merkel had met, symbolically, in the replica of the railway carriage at Compiѐgne, and subsequently, with Mr Trump, Mr Putin, et al, in Paris. For myself, I was present for the two minutes silence at Dunblane Cathedral.  Meanwhile, all over the beaches of the British Isles, images of figures from the war were etched into the sand, transiently, to be obliterated by the incoming tide.  And still, this morning, the papers are full of the War.  We debate whether we should remember, or forget, but I doubt if we really have a choice.  Perhaps we suffer from a collective Post Traumatic Stress Disorder.

Of all the images broadcast by the BBC over the weekend, the most striking one to me was that of Wilfred Owen, etched into the sand at Folkestone.  It seems to me that the people getting upset with one another on BBC debating programmes would do well to take a two minute silence, and go back to the poets.  Over the past hundred years, the war poets have become rather sanitised, elegiac figures.  It is easy to forget just how subversive their work was.  If you doubt it, read Owen’s Dulce Et Decorum Est.

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.

One thing the panellists on The Moral Maze seemed in broad agreement about was that there would never be another First World War.  I thought this was an extraordinarily complacent point of view.  A century ago, didn’t they think the same of the war to end all wars, when they signed the armistice at Compiѐgne?  Perhaps even then, Corporal Hitler was making plans to reconvene at the same location.  It took him only 22 years to get there.

Another famous peroration worth reading alongside Owen’s Dulce Et Decorum Est is Churchill’s most famous speech of all, culminating in the rallying call, “We shall fight on the beaches, we shall fight on the landing grounds…”  This is another poem – if you will – that has become sanitised, its true meaning lost.  We think of it as a stirring and inspirational offer of Hope, but in fact it is an instruction to an entire population to indulge in Total War to the last man, and woman.  When – rather than if – the enemy landed, it would be met sequentially at every location – beaches, landing grounds, fields, streets, hills…  “We shall never surrender.”  Randolph’s wife Pamela asked Churchill how he could expect her to do this when she was unarmed.  “You can always use a carving knife.”  Churchill said, “I do not intend to be taken alive.”  And, “If this long island story of ours is to end at last, let it end only when each of us lies choking in his own blood…”  The imagery is exactly that of Owen’s Dulce Et Decorum Est.

Owen wrote a preface to a putative anthology of his poetry, that he never saw.  It says everything that needs to be said, and renders all these BBC panel shows rather redundant.

This book is not about heroes.  English poetry is not yet fit to speak of them.

Nor is it about deeds, or lands, nor anything about glory, honour, might, majesty, dominion, or power, except War.

Above all I am not concerned with Poetry.

My subject is War, and the pity of War.

The Poetry is in the pity.                                                                                                                                                                                                               

I read two books last week, one short, one long.

The short one was No.  More.  Plastic.  What you can do to make a difference, by Martin Dorey, Founder of the @twominutesolution (Ebery Press 2018).   According to Mr Dorey, the Great Pacific Garbage Patch is estimated to cover more than 60 times the UK’s land mass.  Soon, there are going to be more pieces of plastic in the ocean, than fish.  While recycling has a place, and indeed is essential, we actually need to stop producing this superabundance of plastic.  What can we all do on a personal level?

You might answer, on a personal level, nothing.  The problem is so vast; what does it matter what I do?  But then, you might as well say that of any human problem.  The sum total of human achievement, or human folly, is nothing more than an integral of all the infinitesimal activities of us all as individuals.

So I attempted a plastic-free week.  I have two very good farm shops close to where I live so I didn’t really need to visit a supermarket.  I can buy vegetables unwrapped, or in brown paper bags.  The butcher counter uses very light transparent bags – as does the local fish van – of whose constituents I am uncertain.  I’ll have to check it out.  I can get soup in tins or in cardboard cartons.  The bread is unwrapped.  I get bottled milk, and butter in greaseproof paper rather than a plastic tub.  Gewürztraminer still comes in bottles.  God bless New Zealand.

So the inner man is sorted.  What else?  Clothes.  To be honest, I have enough clobber to see me out, but if I start to look particularly shabby with my frayed collars I’ll buy a shirt hanging on a (wooden) coat hanger and avoid the shirt in the box with all that plastic packaging.  Moreover I’ll make sure its 100% cotton.  Apparently non-biodegradable fibres work their way from the washing machine into the ocean.

Soap.  I found some packaged in cardboard.  Deodorant.  I actually found some in a glass bottle – my find of the week.  Shaving.  These sophisticated five-bladed devices are full of plastic.  I resurrected my electric razor but it’s not that effective and all week I’ve been walking around with a permanent 5 o’clock shadow, looking a little down on my luck.  I remember from the dim and distant past having a metal safety razor into which you inserted metal blades.  I seem to recall giving myself multiple lacerations with this device and wandering around for the first after-shave hour with pieces of loo paper stuck to my face.

Loo paper!  Not a problem.  I can get rolls wrapped in paper.

So it goes on.  Nobody said it would be easy.  But in fact it’s been quite fun.  We don’t need all that packaging.  I might start proselytising, and become a right pain in the neck.  At the Glasgow Royal Concert Hall on Saturday I got a filter coffee, served in a cardboard beaker, and I tried to turn down the plastic lid.  But no.  Apparently it was a health and safety issue.  I sympathised.  I didn’t say to the barista, “It’s health and safety gone mad!”  I just said, “You put the lid on and I’ll burn my fingers taking it off.”  She laughed.

Then I got the gift of some Christmas Cards (already) from a well-respected charitable organization, accompanied by a plastic pen.  I’m thinking of writing to them (with the pen) to suggest they stop sending out the pens.  The November issue of the British Journal of General Practice arrived, wrapped in transparent cellophane.  I might write to the BJGP and suggest they change to paper envelopes.

But before I turn completely into a smug, self-satisfied virtue-signaller, I must mention the other book of the week, the long one.  It was Churchill, Walking with Destiny by the historian Andrew Roberts (Allen Lane, 2018).  It comes in at 1105 pages, but I romped through it, partly because it’s very readable, but also because I’ve read so much Churchilliana over the years that the subject matter is not unfamiliar to me.  Yet I’m not sure if I know anything at all about Churchill as an environmentalist.  His greatest insight lay in his recognition in the 1930s of the true nature of Nazism, an insight that made him very unpopular and an outcast in his own party; he was very nearly deselected.  He had another great insight after the war when he made his Iron Curtain speech in Fulton, Missouri; this also made him initially very unpopular.  On both occasions, he was vindicated.  But would he have recognised the threat inherent in a plastic drinking straw?

In his autobiographical My Early Life, he gives this rallying call: “Come on now all you young men, all over the world…  ‘The earth is yours and the fullness thereof’… You cannot hurt the world or even seriously distress her…  She has lived and thrived only by repeated subjugations.”

Well, that’s just tosh.

While driving round the Kilcreggan Peninsula on Saturday afternoon I caught The Road on BBC Radio 4.  This was an adaptation for radio of a drama for television by Nigel Kneale (pen name Nigel Neale).  It was first broadcast in September 1963, but there is no recording extant.  Prior to The Road, the BBC had shown the six part serial for which Kneale is perhaps best known, Quatarmass and the Pit.  I was 7 years old when the Beeb put on Quatarmass.  I was simultaneously enthralled, and frightened out of my wits.  A couple of years ago I tracked down Quatarmass somewhere on the net, and watched it again.  It hadn’t lost any of its power.  I was still frightened out of my wits.  Of course the technical production would now be regarded as clumsy, even amateur.  But, as in the theatre, you voluntarily suspend your disbelief, when you know you are witnessing the creation of a powerful imagination.

I was gripped by The Road.  It seemed to share some common features with Quatarmass.  The Road is set in an English village in the early eighteenth century.  The peasantry know the local woodland is haunted, and the village squire, of enquiring nature and scientific bent, decides to investigate.  He is visited by an urbane, rational and sceptical gentleman (I take it from London) and his man Jethro who I gathered (it’s hard to tell on the radio) is black.  They interview a local wench who describes terrifying “manifestations” in the woodland.  She has witnessed a road, a mass of people in flight, the trundle of chariots, and a massacre.  There is a superstition among the people that echoes may still be heard, of a conflict between the invading Romans, and Queen Boadicea.  Yet there was never a road in this woodland.  The visiting toff puts it all down to the hysterical ravings of an impressionable young girl, but the squire is not so sure.  Following a protracted conversation in which the visitor extols the virtues of scientific progress and its potential to solve human problems,    they go to investigate, and enter the woodland.

In case you want to catch it on the i-player, I insert a spoiler alert here.  If you don’t wish to know the score…

We discover quite suddenly – it is the pivotal moment of the drama – that our preoccupation with the past should have been directed towards the future.  They witness a nuclear attack.  As in Quatarmass, the culmination of The Road is apocalyptic.

I think I must be of a nervous disposition.  I had a disturbed night.  I am still the same 7 year old child, watching Quatarmass from behind the sofa.  The distinctive quality of Nigel Kneale’s work is its memorability.  If it refuses to leave us, it is because it seems to tap into our deepest, primeval fears.  There is a sense that the supernatural elements are metaphorical representations of those aspects of human nature that we do not understand, and are beyond our control.  Perhaps his main theme is that civilisation is a veneer, and we are on the brink of complete anarchy.  Something comes along, something happens, and with all our scientific rationality we are still incapable of avoiding Armageddon.  That chilling notion seems to me to be particularly relevant to the world in its current state.

It is hardly surprising that Kneale adapted Wuthering Heights, and 1984, for television.  1984 was so disturbing that questions were asked in the House about its suitability for the general populace.  In The Year of the Sex Olympics (1968), Kneale describes a near-future dystopia in which the populace are fed a diet of reality TV pornography.  In The Live TV Show, a family are cast away on an isolated island and observed 24/7, struggling to survive.  He saw it all coming.

It’s ironic that I should have picked up The Road on the car radio in Kilcreggan.  I went round the peninsula, clockwise.  It was a very beautiful autumn day, and this is a singularly beautiful part of the world, blighted by the endless barbed wire surrounding Faslane and, the spookiest place in the United Kingdom, Coulport.  After Coulport the road turns abruptly south-east, then north-east back towards Garelochhead.  A not very welcoming road sign announces, “You are entering MOD territory.”  You find yourself on a fast road, very well maintained.  In fact, you find yourself on The Road.  This is where the convoys without a name, in the inimical dark green livery, commence the journey to Aldermaston.

Last week, Mr Trump pulled out of the Gorbachev-Reagan 1987 Intermediate-Range Nuclear Forces Treaty.  But nobody seemed to pay much attention.  There has been another mass-shooting in the USA, when Jewish people were specifically targeted in Pittsburgh Pennsylvania.  Mr Trump’s solution is to arm the synagogues.  It could have come straight out of a television drama by Nigel Kneale.

Word of the week: Backstop.

Chambers: backstop a screen, wall, etc. acting as a barrier in various sports or games, e.g. shooting, baseball etc.: (the position of) a player, e.g. in baseball who stops the ball: something providing additional support, protection, etc.

The last time – no, the second last time – I visited Ireland it was to climb her highest mountain – Carrauntoohil (1038 metres), in the heart of Macgillycuddy’s Reeks.  In the absence of a bridge that will one day I’m sure cross between the Mull of Kintyre, and Antrim, I drove to Cairnryan and took the ferry to Belfast, then drove south west to Kerry.  Just south of Newry the A1 became the N1 and the speed limits were given in kilometres rather than miles per hour, but other than that, I wasn’t conscious that I had crossed a border.

Kerry is very beautiful.  The summit of Carrauntoohil is dominated by a huge cross; standing under it and looking south west, the view to the Irish coast is stunning.  I stayed in Killarney, and the following morning drove east to pick up the ferry from Rosslare to Fishguard.  I could as easily have been taking the ferry from Stornoway to Ullapool.

I wonder what that trip is going to be like after March 29^th next year.

With regard to the land border between the United Kingdom and the Republic of Ireland, the EU and the UK signed up to the backstop agreement in December 2017.  The agreement was that, regardless of the detail of the Brexit deal, the border would remain frictionless, and the Good Friday agreement would be protected.  You can see right away (at least, people living on the border saw right away) that this poses a difficulty.  The main motive force for Brexit was that we “take back control of our borders.”  This presumably includes our only land border with the European Union.  The EU’s proposed backstop was that Northern Ireland stay in the Customs Union, large parts of the single market, and the EU VAT system.  This effectively transplants the border into the Irish Sea.  Such an arrangement however crosses the one red line of Northern Ireland’s Democratic Unionist Party, that there will be no border between Great Britain and Northern Ireland.  Is it not profoundly ironic that Mrs May called a general election in 2017 in order to increase her majority and bolster her negotiating position in Europe, only to lose her overall majority in Parliament and to become reliant on the support of the ten returned DUP Westminster MPs?  If Mrs May loses the support of the DUP, her already precarious grip on power may be critically damaged.  Mrs May’s response has been to propose that the whole of the UK remain aligned with the Customs Union for a limited time after 2020.  She is effectively kicking backstop into the long grass (excuse the mixed metaphor – I’ll come back to that) and postponing making a decision.  This does not satisfy the Irish Taoiseach Leo Varadkar: the backstop cannot have a time limit.  It occurs to me that here is a conundrum that, like squaring the circle or finding the roots of an irrational number, is insoluble.   Unless the UK stay in the EU, or Northern Ireland unite with the Republic, any other solution will be the softest of soft Brexits, a fudge.

One proposed solution involves “maximum facilitation” (Max-fac).  This involves the use of digital technology in order to render the border so virtual as to be invisible.  This idea seems to me to be quite sinister.  You replace the barbed wire and the goon boxes and all the paraphernalia of border checkpoints, with the apparatus of surveillance.  So next time I climb Carrauntoohil I will be watched all the way.  CCTV will observe me driving my car (driver identified and registration number clocked) on to the ferry at Cairnryan, disembarking at Belfast, crossing the border at Newry…  Then picked up again at Rosslare and monitored as I re-enter the UK in Wales.

Max-fac is a kind of reciprocal Emperor’s New Clothes.  The Emperor was a nudist streaker who told everybody he was wearing a fancy suit; his subjects were so keen to please him that they developed hysteria and believed they all saw the suit.  With Max-fac, the Irish border will be real, but the people need to be convinced that it does not exist.  When the EU asks the UK to come up with a solution to the problem of the Irish border, I wonder if they know they are asking the impossible.  This is why nobody really understands the meaning of “backstop”.  It is a metaphor that refuses to function because it refers to the solution to a problem that cannot exist.  Rather than backstop, a better term would have been the Scots’ bourach.  Look it up.

The reason why the Brexit referendum in 2016 went the way it did was that all the passion was on the leave side.  Or at least, those remainers who were passionate didn’t seem to get air time.  Perhaps Jo Cox was passionate.  Mr Cameron (remember him?) used to ask people to “stop banging on” about Europe.  Mr Corbyn gave the EU “7 out of 10.”  How can you possibly promote a cause by awarding it 7 out of 10?  I remember plenty of people saying that membership of the EU “on the whole” made sound economic sense, that if we wanted a say in European affairs we had better grit our teeth and stay in.  I don’t remember anybody championing the EU’s four freedoms, the freedom of movement of goods, people, services, and capital.  I can’t recall anybody stating (aside from the migrants risking their lives to cross the Mediterranean) that to be a European, and to have these freedoms, was a wonderful thing.

When I was a kid I hated getting up in the morning.  The adjustment to vertical life was agony.  And I could never figure out why.  In part I knew it was because I was knackered all the time because I went to bed too late, but I knew that was not the whole story.  What was it?  I didn’t hate school, although I was as susceptible to its amalgam of boredom and danger as everybody else.  I was never bullied, unless the strident ranting of some of our teachers constituted a kind of institutionalised bullying.  But I don’t think so: we were all yelled at with parity.  And surely the essence of being bullied lies in being singled out.  The essence of being bullied is not that you are in agony, but that you are alone.  Graham Greene describes one of his characters as being “not one of the torturable classes”, and if it was a conceit that I held myself to be invulnerable, it was one that gave me confidence.  I had sufficient popularity because I never courted it.

Not so the new boy, Stobo.  He threw a tennis ball without warning at me in the playground and I did well to stop it but I couldn’t hold it.

“Butterfingers!”

He was extremely well turned out.  The white shirt was freshly laundered and there was even a crease in his grey flannel shorts.  He lived up in Kelvindale, in the street next door to my father’s friends Mr and Mrs Train.  His father dropped him off at school in a Wolseley.  None of it made any sense.  He should have been at the High School, or the Academy.  And he was a Christian.  I had heard him “bear witness” in the playground.  He carried a neat pocket-size New Testament.  He asked me, “Are you saved?”

“That remains to be seen,” I replied, enigmatically.  “You?”

“Natch!”

Even at the time, his slang was anachronistic.  He belonged to the interwar era of muscular Christianity.  On the playing fields he would play hard, but never dirty, with an oval and not a round ball.  A wing three quarter rather than an outside right.  I looked at him pityingly and thought, “You are a martyr.  Get out now before the wolves pick up your scent.  Get your father in his Wolseley to drop you off at Kelvinside Academy where you can survive with your own.”

I had anticipated a siege, a war of attrition, or the slow wearing down of a lamed fugitive by a remorseless pack.  I was not prepared for the suddenness, the viciousness, and the unutterable brutality of Stobo’s destruction.

He fell within the ambit of Taxi’s demesne, passed within the visual field of the Bad Thing, the school psychopath.  Taxi’s nostrils flared.  He sensed Stobo’s Otherness, and he was outraged.  He tore him to pieces.

Stobo lay weeping and bleeding in the shadow of the playground sheds for half an hour.  It wasn’t that my friends didn’t want to help him.  They were waiting for leadership.  I realised with a sinking heart that they were waiting for me.  The lot was going to fall on me.  Had already fallen on me.

I helped him up in his torn shirt and his bloodstained trousers and together we limped into the cloakrooms.  Word must have passed through to the girls’ playground because Joyce Cochran came through and helped to clean him up with a wet handkerchief.  Joyce was like Mother Theresa.  She had taught me to tie my tie and my shoelaces when I was five.  She had not humiliated me when I had poor sphincter control.  I don’t think Stobo told on his assailant and we would certainly never have clyped, but word must have reached the teachers because the Wolseley drew up at the school gate, there were raised voices in the Headmaster’s office, and the shrivelled, pathetic bedraggled creature was driven off.  We never saw him again.

I ran into Taxi at the school gate.  It was inevitable.  I gave him a long hard stare, all the time thinking, why are you doing this?  He’s not your problem.

“You lookin’ at me, Jim?”

I just carried on staring.

Taxi took out his chib, a door hinge.

“Ah um gonnae rearrange yoor f****** face.”

“Oh no you’re not.”  It wasn’t courage.  It wasn’t even bravado.  I was just playing a part in a masque.  I was with my pals Adam and Wally.  Taxi was alone.  He had no friends, only a couple of weasel minions and they weren’t there.  Adam said uneasily, “Let’s go.”  Taxi made a couple of threatening passes at my face with the door hinge.  I had a talent for brinkmanship and I knew they were only for show.  He was certainly a very frightening boy.  But there was a sense of caution there as well.  My father had told me that all bullies were cowards.  I wasn’t sure if that were so but I had the sense that they would always pick the easiest fights, like a big cat on the Serengeti selecting out the weakling, the runt, amid the panic-stricken herd.  All you had to do was hold your nerve.  We backed away from one another, slowly, saving face.

How can you develop an attitude towards your existence when you are not armed with criteria of value?  How can you know to be out of kilter, malcontent, if you don’t know anything better?  What is the origin of vision, of hope?  You get up in the morning feeling like death; you eat a bowl of cornflakes in warm milk that smells of wet dog fur; you put on your duffel coat and walk through the drizzle, day after day, to a building that resembles a penitentiary.  You have the prospect of doing this for thirteen years, a sentence handed down to you at a time in life when it might as well be an eternity.  There is no perceptible end to it.  Whence the resource that will confront your imagination with another existence?

Between the covers of a book.