jamescalumcampbell

On Saturday night, I debated whether to tune into Benjamin Britten’s War Requiem at the London Proms (BBC Radio 3), or a documentary on Radio 4, The Ascent of Jacob Bronowski.  Spoiled for choice – something of a First World problem.  I remember being faced with such dilemmas as a child, particularly on the telly, when I really did need to choose one programme and sacrifice the other – no “sounds” or i-player.  I remember saying to my cousin, “Wouldn’t it be marvellous if there was a device, something like a tape recorder, that could record both sound and pictures together, so that we could save programmes and watch them later?”  She raised her eyes to the ceiling.  I was talking science fiction.  Presumably the BBC owned such a device, but even they were profligate with their own productions, constantly tossing chunks of the archive into a skip.  Nowadays, when every picture, or utterance, sane or mad, survives in the cloud for perpetuity, I have no interest.

In the event, I listened to the Bronowski, and then watched the Britten on Sunday evening on television on BBC 4.  I was a great fan of Bronowski’s thirteen part history of science which was first broadcast in the 1970s, and did for science what Kenneth Clark’s thirteen part Civilisation had done for art.  Both series were wonderful.  Was not the BBC more audacious then than it is now?  And more trusting of the audience’s intellect, staying power, and attention span.  Crucially, both series used “background” music very sparingly.  Now, musical gloop fills the airwaves.  Broadcasters are terrified of dead air.

I can’t say I learned much from The Ascent of Jacob Bronowski that I didn’t already know.  For all the immense success of The Ascent of Man, there was, and always has been, an academic backlash against it.  Bronowski was aware of it, and even parodied it.  “It isn’t sound you know, it isn’t sound.”  I dare say there was a certain amount of professional jealousy involved.  Bronowski was a fantastic communicator.  His appearance on the Michael Parkinson show bears this out.  Watch it, and see if I am not right.  He has a beguiling way of pausing briefly before answering each of Parkinson’s questions.  Parkie came as close as he ever did to asserting that this was his favourite of all his interviews. 

It is said that there was a dark side to Bronowski, with respect to his mathematical work during the Second World War.  He was a boffin.  I believe he worked on the destructive power of bombs.  I had hoped that The Ascent of Jacob Bronowski might cast a little light on this, but the documentary was thin on detail.  No doubt Bronowski, rather like the occupants of Bletchley Park, was sworn to lifelong secrecy.  So we are left with the rather unsatisfactory thesis that it was some internal sense of guilt that drove Bronowski to step into a pool at Auschwitz, and to let the ashes of his ancestors run through his hands.  This was the culmination of Part 11 of The Ascent of Man, Knowledge or Certainty, a little masterpiece.  There is some kind of unspoken innuendo here that I don’t understand.  You could as easily imply as much about Barnes Wallis, or Johnnie von Neumann, or R. J. Mitchell, or Frank Whittle, or Enrico Fermi, or Richard Feynman.  Or indeed, Werner Heisenberg, or Wernher von Braun.  Maybe there’s something in it.  Once you chuck your hat into the ring, once you take sides and get involved, you cannot avoid sharing your part in a collective guilt.  (Talking of hats, somebody has just bought Indiana Jones’ fedora for about half a million pounds.  He must be off his head.  I digress.) Benjamin Britten’s contribution to the war effort could be said to have been more oblique.  He had pacifist views, and was in the USA in 1940.  He accepted a commission then from the Japanese Government to compose his Sinfonia da Requiem, a wonderful work, which the Japanese politely declined to accept apparently because of its Christian connotations.  Britten returned to the UK during the war.  He visited Wormwood Scrubs to entertain the inmates, one of whom was Michael Tippett, another pacifist.  At the end of the war he persuaded Yehudi Menuhin to let him be his accompanist when he visited a newly liberated Belsen concentration camp.  So, like Bronowski, Britten had a desire to confront humanity’s darkest manifestation.  The War Requiem deals with the pity, and futility, of war.  It was composed in 1961-62, to commemorate the rebuilding, and consecration, of Coventry Cathedral following its destruction by the Luftwaffe in 1940, in Unternehmen Mondscheinsonate (Operation Moonlight Sonata.  If Beethoven had known, I think he would have obliterated the title superimposed upon his Op. 27, No. 2.)  It was blitzed, or “coventrated” (koventrieren – Dr Goebbels’ term, I believe.)  At the time, Coventry Provost Dick Howard wrote the words “Father forgive” on the ruined walls of the cathedral, and he rather got into hot water for it.  He was sent to Coventry.  The War Requiem was an attempt to put into words and music Wilfred Owen’s message that all a poet can do is warn.  The solo voices in the first recording, conducted by Britten, were English, German, and Russian, Peter Pears, Dietrich Fischer-Dieskau, and Galena Vishnevskaya.  That recording has become something of a touchstone, but the performance on Saturday under Sir Antonio Pappano was a revelation.  I had always chiefly devoted my attention to the settings of Owen’s poetry, but on Sunday it was the text of the Latin mass that gripped me.  I’m not usually much of a fan of hellfire and damnation, but in this context the mass really became a depiction of the manmade hellishness of war, and also, vividly, an expression of Britten’s anger in the face of its futility.  Sadly, the work remains as relevant to us as it ever was.  We don’t seem to have captured the knack of turning swords into ploughshares.                                            

One late night sometime in the early 1980s, I was standing with a young lady, with whom, to use an archaic expression, I was “walking out”, on a platform in Edinburgh’s Waverley Station.  I can’t really remember the occasion, or whether we were coming or going, but I remember glancing across to the platform from which the London sleeper was about to depart, and seeing Eric Liddell bid somebody farewell, and board the train.  Perhaps he was going down to the White City to take part in the 100 yard dash.  To be clear, it wasn’t really Eric Liddell; it was Ian Charleson, who played the Scottish athlete in the 1981 film Chariots of Fire.  Who does not recognise Vangelis’ music to the opening credits of that film, against the backdrop of athletes in training running along the sands of St Andrews?  Nigel Havers is mud-bespattered, and looks as if he is enjoying himself.  The scene is supposed to be set in Broadstairs, Kent, but everybody recognises the view from St Andrews’ Old Course.  I once met an athlete who had been a film extra on that set, running along the beach, and taking part in subsequent scenes.  He told me that Ben Cross, who played Harold Abrahams, had natural athletic ability, but not Ian Charleson.  Still, Eric Liddell was not a pretty runner, but, with his arms flapping and his head held back, he could achieve extraordinary speeds. 

Eric Liddell featured yesterday in BBC Radio 4’s Sunday Worship, on the last day of the 2024 Olympic Games in Paris.  The programme came from Liddell’s old church at “Holy Corner” in Morningside.  Of course he was famous for his appearance in the Paris Olympics a century ago in 1924, when, as a devout Christian, he refused to run in the sprint, because the heats were to take place on a Sunday.  He switched to the 400 metres, which he went on to win.  The 100 metres was won by Harold Abrahams.  The story in Chariots of Fire is built round the progress of these two athletes towards their respective Olympic finals.  Liddell had to resist pressure from the British establishment, including Lord Birkenhead, and no less a figure than the Prince of Wales, the man who was to succeed to the throne, as Edward VIII, in 1936.  Abrahams had to endure anti-Semitic barbs from his masters at Cambridge, who disapproved of his thoroughly modern, scientific approach to sport.  Of course they thought his coach, Sam Mussabini, was common as muck.  “Your approach, Mr Abrahams, is altogether too plebeian.”  And before his final, the Prince of Wales said to him, “Do your best, Abrahams.  It’s all we can expect.”  At least, so the film has it. 

Back on the Waverley platform, I think I amused my old friend by hamming up my Scottish accent and quoting from the film: “Of course we’ll go to China.  But Jenny, I’m fast, and when I run, I feel God’s pleasure.”  She also rather liked my rendition of a line from a film of similar vintage, the cold war drama The Tamarind Seed, in which Omar Sharif said to Julie Andrews, “Group Captain Patterson, was he a good lover?  Did he please you?”  Forgive these idle reminiscences. 

Sunday Worship concentrated rather more on Liddell’s subsequent career than on the 1912 Olympics.  He did indeed go to China, to become a missionary.  But then the Japanese invaded China, and Liddell found himself in an internment camp.  His ability, and devotion, to help people in the direst of circumstances, reminds me of Viktor Frankl’s descriptions, in Man’s Search for Meaning, of people in Auschwitz who were able and willing to give fellow prisoners their last piece of bread. 

I have a notion that Liddell’s positive effect on people continues on down the ages.  In a remote part of New Zealand, I once did a weekend locum for a doctor who had been born in China during the war, born, in fact, in that same internment camp, and who as a child had sat on Eric Liddell’s knee.  And there is another New Zealand connection.  In the famous, perhaps infamous, 1936 Berlin Olympics, the great New Zealand middle distance runner Jack Lovelock won the 1500 metres, in a race which is still considered by some to be one of the most perfect ever to be executed.  Lovelock was a deeply mysterious character, an Oxford student and insomniac who would run through the town, past the beautiful spires, by night.  Subsequently a doctor, an orthopaedic surgeon, practising in New York, he tragically fell to his death under a train in the New York underground.  His story is beautifully retold in two books by the New Zealand writer James McNeish, The Man from Nowhere, and Lovelock.  His connection with the 1912 Olympics?  For Lovelock’s great 1936 race, the radio commentator for the BBC was Harold Abrahams. 

Anyway, we’ll always have Paris.  The Olympic torch is on its way to L.A., by motorbike, courtesy of Tom Cruise.  I didn’t watch the closing ceremony, tuning in instead to the BBC London Prom, in which Daniel Barenboim conducted the West-Eastern Divan Orchestra.  While young Jews and Arabs sit together in the Royal Albert Hall to play Brahms and Schubert, US warships are full steam ahead to the eastern Mediterranean.  The world is on full alert.  I wonder what Eric Liddell would have made of the world today.  I suppose he would have kept calm, and carried on.  In his internment camp, there was a kid running around in bare feet, in the deep mid-winter.  So Eric gave him his running shoes.                                   

So far – at least at time of writing – the civil unrest that has swept through so many English cities has not spilled north of the border.  Knock on wood.  But there is no room for complacency.  Incidentally, somebody on Woman’s Hour (BBC Radio 4) the other day talked about “the invisible border”.  It was said in the context of a discussion about enforced marriage.  Apparently young women who are being trafficked abroad, usually by their own family, for purposes of compulsory nuptials for which they are less than enthusiastic, are encouraged to place a spoon (not a knife, or a fork) in their underwear.  That will set off the alarm as they pass through airport security, and thus they are afforded an opportunity to discuss their plight, with a disinterested party, in confidence.  In England, girls aged 16 can marry with parental permission, and those who campaign against forced marriage would like this option to be removed.  Of course, in Scotland, you can marry aged 16 without parental permission.  Is this not why Ms Lydia Bennet purportedly fled to Gretna with Mr Wickham?  The activist on Woman’s Hour certainly wanted to remove this option “above the imaginary border”. 

But we are not rioting in Glasgow, or Edinburgh, or Dundee, or Aberdeen, so maybe the border is more tangible than it appears.  A young woman was stabbed in Stirling on Saturday evening.  A man was arrested.  Rumours circulated on social media, generated from south of the imaginary border, that three people had been stabbed, and the attacker was a Muslim.  Police Scotland has said that this claim is false.  This sort of thing is often called “misinformation and disinformation”, and I often wonder if there is a subtle difference between the “mis-” and the “dis-”.  To my ear, disinformation sounds more nefarious than misinformation.  Misinformation could be accidental, but disinformation is deliberate.  So, somebody south of the imaginary border wants to foment trouble in Scotland.  But it’s a strange word, and a strange notion, to disinform.  It implies a retraction, in the same manner that you might be “disinvited” from a social function.  You might inform the public that Huw Edwards is the voice of the BBC; then you might disinform the public by carefully removing all trace of Mr Edwards from the BBC archive.  Mr Edwards would be like the character Syme in Orwell’s 1984.  Syme does not exist.  He never existed.  But in fact “disinformation” is not retraction; rather it is blatant lying.  So I propose that “disinformation” should be spelled “dysinformation”.  The “dys-” prefix, as in “dysfunctional” or “dysarthria” or “dysthymia”, implies that something is ill, bad, or abnormal.

Dysinformation on social media spreads like wildfire.  Going on to social media is a bit like going down to the pub. People’s tongues are loosened.  Intemperate comments are liable to be voiced.  After all, it’s just banter.  The sorts of comments you are likely to read on social media are exactly like the sorts of comments you are likely to hear down the pub.  The one difference is that pub talk is ephemeral, but comments on social media survive in perpetuity. 

It turned out that the 17 year old perpetrator of heinous crimes in Southport last Monday was neither Muslim nor an immigrant, legal or illegal.  A judge lifted the ban on identifying him, no doubt, because it was in the public interest that these facts be known.  But it didn’t make a whit of difference.  Apparently white working class males in England feel very disenfranchised.    

There is a trope, a cliché, that social media of themselves are neither moral nor immoral; what matters is how these platforms are used.  I would challenge that.  You have to evaluate such entities as they exist in the real world, and not in some hypothetical sphere.  X is puerile, or perhaps more accurately, adolescent.  It’s the preoccupation of the teenager, to conform, be part of the group, one of the gang.  It’s an indictment of our society that our politicians feel they have to have a social media presence, or they will simply disappear.  Mr Trump uses his own platform, called, ironically, “Truth”. 

Our universities embed academic courses within social media.  I think they should stop doing this.  University would be the ideal place in which to tell people that it is time to put away childish things.  (Of course, the tech giants wouldn’t like it.  But that is because they are making a lot of money.)

But I can’t say I’m hopeful.  Universities, even, perhaps especially, north of the imaginary border, are notoriously craven when it comes to yielding to the whimsy of the Zeitgeist.  In Edinburgh, the David Hume Tower is now 40 George Square.  In Saint Andrews, the rector has been dismissed because she voiced, in a personal capacity, a view that was not remotely extreme, but was deemed to make part of the student body feel “unsafe”.                    

But I’m beginning to sound like one of the guys down the pub having a rant after a few jars.  Any more outlandish remarks and I will be cancelled, disinvited, no-platformed, and disappeared.  So on a cheerier note, let me say I’m thoroughly enjoying the BBC London Proms.  Last night John Wilson conducted his own scratch bad, the Sinfonia of London, in an all-American programme, and tonight, Benjamin Grosvenor is going to play the rarely heard, 71 minute long, Busoni Piano Concerto.  I’m almost tempted to take a trip south of the imaginary border. 

I see that Scotland has won the World Schools Debating Championships, held in Belgrade.  The Scottish team, drawn from Dollar Academy, Portobello High School, Broxburn Academy, and St Columba’s in Kilmacolm, had defeated New Zealand, Pakistan, England, and Qatar, to meet Bulgaria in the final.  They won on the motion, “This house regrets the glorification of champions”.  It wasn’t given much publicity, so maybe they argued their case rather too well!

There is a long history of healthy debate in Scottish schools.  My school in Glasgow had a thriving Literary & Debating Society.  There would be a motion.  “This house believes that censorship in all its forms should be abolished.”  There would be four principal speakers, a proposer, given the floor for ten minutes, followed by the opposition; then the motion would be seconded, and again, the opposition backed up.  The chair would preside, but only intervene to ensure that rules of fair play were adhered to.  Then the debate would be opened up to the house.  The topics were wide-ranging – political, moral-ethical, social, local, national, international.  Nothing was off limits.  People were taught to mount a cogent argument, to back up assertion with evidence, to be open-minded and, above all, to listen.  People who went on to be very effective in the political world first cut their teeth, in various schools, in “The Lit” – Robin Cook, Charles Kennedy.  The tradition continued at university level.  I remember at Glasgow, visiting politicos were given a very hard time.  I wondered then why many of them bothered to put up with the harangue.  But a few were very effective at wooing and courting the crowd.  Jeremy Thorpe.  That was before his spectacular fall from grace. 

But a chasm has opened up between civilised discourse, and political point-scoring in the real world.  You see it, and hear it, in BBC debate programmes such as Any Questions? And Question Time.  Politicians, constrained by the whip, shamelessly spout humbug.  They talk over their opponent when the opponent expresses a view they do not wish to hear, or to be heard.  The chair is partisan.

In the US, political debate has become coarse, tribal, and vicious.  The vitriol is fuelled by social media.  Last week, Mr Trump called Ms Harris “a bum”.  I presume that was a US rather than a UK bum.

Bum (1) the buttocks; the anus.

Bum (2) (chiefly N American slang) a dissolute fellow, tramp; a sponger.  Adj, worthless; despicable; dud; wrong, false. 

I don’t think Mr Trump backed up his assertion with any evidence.  In her memoir, The Truths We Hold, I don’t recall Ms Harris spending a significant amount of time on Skid Row.  And even if she had, would it matter?  In the debating world, Mr Trump’s assertion is known as an argument ad hominem.  It is a slur.  We can expect more of them.  Ms Harris’ statement, on the other hand, that Mr Trump is a felon, is a statement of fact.

I recall that in 2016, Mr Trump deployed similar tactics in debating with Hilary Clinton.  He would prowl about the stage, and position himself close right behind her.  That the chair did not put a stop to this was really a dereliction of duty.  “Go back to your lectern Mr Trump.  I won’t tell you again.”  In response to the attacks, Hilary Clinton said, “When they go low, we go high.”  It will be very interesting to see how Ms Harris handles Trump.  I think she should go low.  I don’t mean by that that she should descend to his level.  Heaven forfend.  Rather, changing the metaphor, I think she should get under the radar, and catch him unawares, in debates, at points at which he is vulnerable.  She needs to fact-check him, on the spot, in real time.  Mr Trump reminds me of a character in John Buchan’s Greenmantle, that great Prussian bruiser, Stumm.  When Richard Hannay punches him on the nose, Stumm blinked.  Stumm is a bully, and like all bullies, he does not expect to be hurt.  Not that I am suggesting that Ms Harris punch Mr Trump on the nose.  But I think Ms Harris could rattle Mr Trump.  I think she already has.    

On this side of the Pond, compared with all of that, political discourse seems almost civilised.  At least for the moment.  The first PMQs after the General Election was rather decorous.  Mr Sunak was self-deprecatory when he remarked that the Team GB Olympians might not value his advice on how to win.  Sir Keir concurred in wishing the athletes in Paris all the best.  He certainly doesn’t regret the glorification of champions, or aspiring champions.  But Sir Keir is enjoying a honeymoon period, which I dare say will not last long.  Shortly we will return to business as usual, to Ya-Boo politics.  It’s a far cry from the Literary & Debating Society.            

After the assassination attempt last week, Mr Trump said he was going to rip up, and rewrite, his speech of acceptance, due in Milwaukee on Thursday, of the nomination to be the Republican candidate for the presidency.  He said he wanted to be president for all Americans, not just half of them.  He wanted to heal divisions.  Perhaps he’s had a Damascene moment.  If you come within a quarter of an inch of losing your life, you are bound to look upon it differently. 

The events that are unfolding across the Pond have a biblical quality.  Mr Trump has attributed his miraculous escape to divine intervention.  He turned his head at just the right moment.  I was reminded of a story in The Little World of Don Camillo, by Giovanni Guareschi, concerning the activities of a parish priest in an obscure village in the Po River valley, with a Communist mayor, in post-war Italy.  Even in such a parochial environment, political tensions were liable to run high, and Don Camillo’s life was endangered because he had knowledge, obtained within the sanctity of the confessional, of the identity of a murderer.  Consequently somebody took a pot-shot at him when he was communing in the church, as was his wont, with Our Lord, on the cross.  He was given a nudge, a quarter of an inch, and Our Lord took the bullet.  Don Camillo said, “You moved my head!” but our Lord shrugged and said, “Don’t get so excited.”

Cynically, we assume that Mr Trump, in ascribing his survival to the intervention of the Almighty, is merely wooing and cultivating the evangelical vote.  But let us for a moment suppose he thinks he has been miraculously preserved for some higher purpose.  I should think his must be a common reaction to an uncommon set of circumstances.  In all the miraculous escapes afforded Winston throughout his military career, he often had the strong sense that he was being preserved for some higher calling.  Those of us who have been critical of the first Trump term might consider such a notion to be absurd.  But the bible is full of similar absurdities.  God has called upon the most unlikely individuals to be his emissary.  Noah was a figure of ridicule, building his ark on dry land.  Moses got nervous as a public speaker.  David was an adulterer and a murderer.  Saul, aka Paul, was a fanatical zealot; he held the coats when they stoned Stephen.  And so on.  It’s a bit like the 1963 film of The Great Escape.  The Forger was blind, and the Tunnel King had claustrophobia.  It’s ridiculous. 

On Thursday, Mr Trump wore a dressing on his right ear.  That’s not just therapeutics, it’s iconography.  What is it about the ear?  When they came to arrest Jesus in the Garden of Gethsemane, one of the disciples rather lost his temper and cut off the ear of a servant of the high priest.  Jesus gently rebuked him.  He might have borrowed a line from Othello.  Keep up you bright swords, for the dew will rust ’em.  The traumatic amputation of an ear once started a war between Great Britain and Spain, Guerra del Asiento (1739 – 1748), or the War of Jenkins’ Ear.  It concerned the slave trade in the Caribbean.  The conflict was subsumed within the War of Austrian Succession.  As Jesus said, those who live by the sword shall die by the sword.

One thing I’ll say about Trump: I don’t think he’s a warmonger.  He says he will end the war in Ukraine with a single phone call.  Good luck with that.  Mr Chamberlain thought he could avert war through similar diplomatic channels, not exactly a phone call, but a trip to Berchtesgaden.  That went well.

But now, all of a sudden, everything has changed.  Mr Biden has bowed to pressure.  He is like an elderly person who has finally been persuaded by his family to hand over the car keys.  He has endorsed his vice president Kamala Harris to be the democratic candidate for the presidency.  Mr Trump has said that she will be an even easier opponent to beat, than “Sleepy Joe”.  Well, he would say that, wouldn’t he?  But I don’t think so.  I’ve read her book.  The Truths We Hold.  (Why do American political memoirs always have such portentous titles?)  Incidentally, I don’t think people pronounce Ms Harris’s name correctly.  It should be “Comma-la”.  There is a gag, that if Ms Harris was your lawyer seeking compensation on your behalf, she might add a few commas on to the total sum achieved.  In other words, she’s a fighter.  Early days, but we have the possibility that the presidential contest will be between a prosecutor, and a felon.  All of a sudden, the forthcoming American election has become interesting.      

Sir Tony Blair popped up on BBC Radio 4’s Today Programme’s 8.10 am slot one day last week, en route to opening a conference of his highly influential think tank.  He was full of enthusiasm for Artificial Intelligence (AI).  It’s The Next Big Thing.  We in the UK are already pioneers.  We must grasp this opportunity with both hands.  Sir Tony was particularly interested in the application of AI to the running of the National Health Service.  We need to digitise all our data and make it available, as an inexhaustible well of resource.  He was particularly interested in preventative medicine.  Prevention is better than cure.  Your genome, for example, might tell you what awaits you.  Then you can cut the grim reaper off at the pass.  Your laboratory results might lie slightly outwith the quoted “normal” levels.  Therefore you must have a “pre-” condition.  Treat it now.  Big Pharma have sensed this enormous commercial opportunity for quite some time.  Drive your cholesterol down as low as you can; drive your blood pressure down as low as you can; take a poly-pill, and treat half a dozen conditions that you don’t actually have.      

I suppose this is what politicians, or ex-politicians, do.  Finger in the air.  See what’s coming round the corner, get on the front foot, and don’t be left behind.       

It all reminded me of the digital revolution in health that started around the beginning of the millennium.  It was seen as an unstoppable force.  The computer infiltrated the consultation room, like a nanny in a horror movie, taking up residence in the family home, to care for the children, apparently all sweetness and light, but in reality a deeply malignant emissary of the devil.  Everything was going to run smoothly – I was going to say “like clockwork”, but of course it’s not like clockwork at all.  Now, there are 7.5 million people waiting for an outpatient hospital appointment, and that’s just south of the border.  People who can afford it elect to go privately.  I confess when in practice I would sometimes encourage my patients so to do, or at least I would give them the option, and tell them how it was.  The neurologist will see you in eighteen months, or, if you elect to go privately, this afternoon. 

You might imagine Sir Tony’s think tank might pause to consider we may have taken a wrong turn.  But no.  Rather, they are “doubling down”.  AI is the next cure-all.  Here we go again.  Naturally I wrote to The Herald:

Dear Sir,

Artificial Intelligence (AI), according to Sir Demis Hassabis and Sir Tony Blair, “could be one of humanity’s biggest ever inventions” (The Herald, July 10), but I think we should find an alternative name for this entity.      

During my 13 years in emergency medicine in New Zealand, the junior doctors went on strike twice, and the emergency department was run by consultants.  As a group, they were highly intelligent.  They didn’t spend much time perusing data, and their use of investigative technology was spare, and extremely targeted.  Instead, they spent a lot of time taking a very careful history from the patient.  They never thought algorithmically; they used a combination of knowledge, skill, and wisdom, as captured in the motto of the Royal College of General Practice: cum Scientia caritas.  Their approach was not remotely robotic.

On their watch, the recourse to laboratory and imaging diagnostic facilities, and the hospital admission rate, all went down.  Medicine, well-practised, has got nothing to do with Big Data.  Accurate diagnosis is all about filtering out white noise.  AI will no doubt be a very lucrative gravy train for somebody, but it won’t benefit the doctors and nurses, and it certainly won’t benefit the patients.  

Sincerely…

For the remainder of the week I perused my daily paper for my letter.  But it never appeared.  When this happens, I usually try and shrug it off.  After all, the newsprint will be wrapping the fish and chips by tea-time.  But I cannot deny my disappointment.  I have been dismissed as a Luddite.  Yesterday’s man.

But I was taught never to practise Blunderbuss Medicine.  There is no such thing as a “routine” blood test.  You order a test to answer a specific question that has been posed by the patient’s history and examination.  The result may or may not help you to make a clinical diagnosis.  Making a diagnosis is making a decision, and it has to be clear-cut.  There is no such thing as “a touch of diabetes” – much as Big Pharma would like you to think so.  You might as well suffer from a touch of pregnancy.  Think diagnostically.  I call this “the broad brush strokes of medicine”.  Example: don’t conclude somebody has pernicious anaemia just because they have a borderline low vitamin B12 level.  If the patient is well, that result is perfectly normal.  The last time I made a diagnosis of pernicious anaemia, I measured the patient’s B12, and the result came back: zero.  But I wax too technical. 

If you put the entire population on a spectrum of ill health, if everybody is on the borderline of something, then you effectively kill off the art of diagnosis, and the waiting lists for access to health care can do nothing other than sky-rocket.

By Saturday I had given up on my letter.  And the world moves on.  Mr Trump took a bullet in the ear.  Conspiracy theories abound.  Apparently he said to the welter of secret service personnel on top of him, “Where are my shoes?  I need my shoes.”  I suppose it’s the sort of thing that preoccupies you when you are inches away from death.  It remains to be seen whether this is an “inflection point” signalling a return of good manners to public life or, rather, the continuation of a downward spiral.

Sunday was at last a beautiful summer’s day and I found myself amid the rolling hills of Ayrshire, having a delightful lunch with family in The Blair (no relation to Sir Tony as far as I know) in Auchentiber.  Then in the evening, it became evident that football, on this occasion, was not coming home.  I watched the match.  I don’t belong to the “Anyone but England” camp; I supported my good neighbour, particularly because the fans had given the mild-mannered Gareth Southgate such a hard time.  I’d heard England were performing below par throughout the competition, but I thought they played very well, even if Spain were the better team.  If a Spaniard hadn’t headed the ball off the goal line it might have gone to extra time, thence to penalties. But these are all counterfactuals.

So life goes on.  This morning I got my paper as usual and opened the letters page with no great expectation.

I’m in!        

The silence is deafening.  Mr Trump is not passing any caustic remarks about Mr Biden’s cognitive function.  Neither, generally, is the Grand Old Party.  Mr Trump is not normally reticent when it comes to trashing the reputation of political opponents.  When he was up against Mrs Clinton in 2016 he had his rally audiences chanting “Lock her up!”  It would be easy now for him to make the current occupant of the White House an object of derision, and mockery.  One could imagine him doing tasteless impersonations on stage, perhaps following a dispute between the two old men, about their respective golf handicaps.  Bald men and a comb come to mind.  But no.  It is the Democratic Party that is making the fuss.  Gathering numbers of Congressmen, and women, on that side of the aisle, are urging the President to step aside.  But not Mr Trump.

The silence speaks volumes.  Mr Trump would rather Mr Biden stay where he is.  Mr Trump thinks he can beat Mr Biden in November.  And, at least as I write, Mr Biden is inclined to hang on.  My pocket diary begins each week with an adage, aphorism, or piece of wisdom from some prominent sage, and it so happens the week beginning December 9^th features Joe Biden:  “Failure at some point in your life is inevitable, but giving up is unforgivable.”  No doubt he is applying this adage to himself.  He has said that nobody short of the Almighty will persuade him to give up.  Kirsty Wark, on Paddy O’Connell’s Broadcasting House (BBC Radio 4) yesterday quipped that this was why the President was aboard Air Force One yesterday.  He hadn’t heard from the Almighty, and was going up to find Him and crave an audience.   

Sir Keir Starmer, the Prime Minister, took a call from the President yesterday.  It must be slightly surreal suddenly to be propelled into that world.  “Mr Prime Minister?  It’s the White House.  Can you take a call from the President?”

“Of course.”  (I’d have asked, “Is it collect?”) 

“Patching you through to Air Force One.”    

The President sounded pretty jaunty.  “Congratulations, Mr Prime Minister.  That was the helluva result!”  Or words to that effect.

It is said that all political careers end in failure.  The minister in Dunblane Cathedral preached on failure yesterday.  The lectionary featured Mark Chapter 6.  Jesus visited his home town of Nazareth and found that none of his miracles would work there.  He was mocked and derided.  It’s the tall poppy syndrome.  The villagers remarked, “Ah kent ’is faither.”  The minister recounted the old story of King Robert the Bruce following his crushing defeat at the Battle of Methven in 1306.  He had to flee for is life, and is said to have sought refuge in a cave on the west coast of Arran, where, at his lowest ebb, he is said to have taken inspiration from observing a spider making repeated attempts to spin a web, and finally succeeding.  If at first you don’t succeed, try, try, try again. 

I thought, good heavens, in evoking one of the great proponents of Scottish Nationalism, is the minister making a barely oblique reference to the General Election, in which the SNP took a drubbing (or, Andrew Neil’s word, a skelping).  Some people in the congregation might take offence.  I could imagine some droll wit posting an aphorism in my pocket diary, along the lines of, “If at first you don’t succeed, pack it in.”  Winston Churchill, with characteristic pugnacity, told the boys at Harrow, “Never give in, never give in.  Never never never never…”  But even Winston had to add a rider – “…except for convictions of honour and good sense.” 

The turnout at the General Election was 60%.  You can imagine the remaining 40% saying, “Why bother?  They’re all the same.  In it for themselves.”  I’m told the Labour Party got approximately 60% of the seats with 34% of the vote.  Reform UK got a large popular vote, and won only 5 seats.  Nigel Farage is calling for electoral reform.  Meanwhile the new government has hit the ground running.  I doubt if electoral reform will be high on their agenda. 

Turnout in yesterday’s French run-off election was much higher than in their first election last week.  The centre left, and hard left, conspired to thwart Mme Le Pen.  Consequently, there is a hung parliament, and it is anticipated French politics will become gridlocked.  In this year when more people in the democratic world than ever before are exercising their franchise, there is a frequently expressed view that democracy is under threat, because of irreconcilably deep and toxic divisions. 

Here, one thing we must be grateful for is that the General Election result was accepted without demur.  I rather enjoyed the elaborate gavotte of the transfer of power; the gracious farewell from the Downing Street lectern, the trip to the palace for an audience with the king.  For about half an hour we were without a Prime Minister, yet the wheels did not come off the jalopy.  Then Sir Keir was asked to form a government, and it was his turn to say gracious words from the lectern.  The outgoing PM did not incite an insurrection, and nobody tried to invade the Palace of Westminster.   

But I rather wish Sir Keir hadn’t hit the ground running.  I wish he had dissolved parliament for the summer recess, and, like Sir Henry Campbell-Bannerman, had gone off to Marienbad for six weeks to read novels.  And not taken his mobile.  We should run the show like a golf club, with a captain, secretary, treasurer and committee, each member serving a single term out of a sense of civic duty.  Surely one term is enough.  Was it Calvin Coolidge who said, “I do not choose to run”?

Perhaps the First Lady will have a word with the President.  There’s another great aphorism in my pocket diary, this one from Jim Carrey, week beginning December 23^rd:

“Behind every great man is a woman rolling her eyes.”

The other day I boarded the Edinburgh tram at Ingliston Park & Ride, next door to the airport, and travelled eastward to the end of the line at Newhaven, on the Firth of Forth.  It cost me £2, which I thought was value for money.  It would have cost me £2 even if I had alighted at the first stop, Gogarburn.  You could recast the Gospel parable of the vineyard owner hiring labour at a flat rate, on to the Edinburgh tram.  £2 for one stop, £2 for 12 stops, unless you choose to go west from Ingliston, one stop to the airport terminal, when the fare is hiked up by more than a factor of 4.  Makes no sense.

It was a lovely day in Newhaven.  There was a softness in the air and, down at the harbour, I could have been in Italy.  I walked back by the tram lines, one stop, to Ocean Terminal, where the Royal Yacht Britannia is berthed.  I was minded to board, but frankly I resented paying £19.50 so I just kept walking.  Incidentally, I see that Balmoral Castle is opening up to visitors for a short summer season.  £100 for a visit, £150 if you include afternoon tea.  Are the Royals short of a bob or two?  £50 for a cup of tea?  Come on!  Extraordinarily, the place got booked up within about 40 minutes.

I walked back up Leith Walk towards Edinburgh’s Princes Street.  Towards the top end of Leith Walk on the north side there are two second-hand bookshops.  I ducked in, in my continued futile quest for two first edition Bonds – Casino Royale and Moonraker, and also for any single one of the Corrigan series of children’s books by R. B. Maddock.  But early Bonds are vanishingly rare, and Maddock I suspect has been cancelled, as the colonial outlook has expired.  When I emerged, the weather had suddenly changed.  There was a squall, so I dashed across the road to Topping, a magnificent bookshop you can lose yourself in, on another apparently futile quest, for the one Nevil Shute missing from my complete collection, The Rainbow and the Rose.

Eureka!  Who would have thought it?  I bought it, got another £2 tram ticket at Picardy Place, and hopped on a tram back to Ingliston.  A hapless fellow traveller didn’t have a ticket and was faced with the choice of alighting to buy a ticket at the tram stop for £2, or buying one on board for £10.  Like the airport tariff, it makes no sense.  It’s a gravy tram.

En route, I settled down with The Rainbow and the Rose, and was immediately hooked.  The title is borrowed from a beautiful sonnet by Rupert Brooke, The Treasure, initially mysterious yet, on finishing the novel and in retrospect, entirely apposite.  Like Corrigan, the Shute is politically completely incorrect.  It was published in 1958 by William Heinemann, but the edition I picked up in Topping was a Vintage Classic, published in 2009.  Congratulations to Vintage for not employing “sensitivity readers” to attenuate Shute for modern sensibilities.  I dare say Shute novels are dated.  They are certainly of their time.  The style is often said to be pedestrian, more resembling an academic report than a novel, the plots predictable, and clunky.  And yet many of these books have never been out of print.  Shute was a pilot and an aeronautical engineer, aviation is a recurring theme, and the books are full of technical detail.  The Rainbow and the Rose paints a picture of civil aviation as it was, particularly across the South Seas, in 1958.

Many of the books have a fey, dreamlike, supernatural quality, and this is certainly true of The Rainbow and the Rose.  Here, Shute employs and evokes an elision of personalities that might confuse the non-alert reader.  You stop and say, who is the narrator?  It’s a very clever idea.  A recurring theme of Shute’s is the idea of the independent man forging a career, and a life, through self-will, determination, and hard work.  I’m not sure what his politics exactly were, but I have a notion that the post war government in Britain was not to his taste, so he upped sticks and moved to Australia, where enterprise and entrepreneurship he considered were valued, and rewarded.  He left a drab, bankrupt country in search of life, hope, and colour.  I wonder what he would have made of the choices on offer here at the General Election on July 4^th.  It would not appear that the main political protagonists, or antagonists, are stirred and moved by any compelling or inspirational idea.  We have a contest between bureaucrats determined to persuade us that they are not going to wreck the economy, and similarly determined not to make a big campaign gaffe at the last minute.  I am reminded of a remark passed by a tutor of mine at Glasgow University back in the Dark Ages.  “The only difference between Mr Heath and Mr Wilson, so far as I can see, is that they are both exactly the same.”                                         

The Prime Minister is due in Edinburgh today, ten days shy of the General Election.  His welcome may not be as warm as that recently afforded to Taylor Swift.  He certainly doesn’t have his troubles to seek.  The number of “flutters” on the date of the election, allegedly placed by people in his party with insider knowledge, seems to be increasing.  Mr Sunak is “incredibly angry”, and no wonder.  Only last week, the psephologist Sir John Curtice was discussing the fact that trust in politicians among the general public, is apparently at an all-time low.  Fluttergate has been likened to Partygate – one rule for us, one rule for them. 

So it might have been fortunate for the Conservatives that Crapgate only came to light yesterday, perhaps a good day for burying further bad news.  At a private function, James Sunderland, aide to Home Secretary James Cleverly, described the plan to send asylum seekers to Rwanda as “crap”.  I first heard of this yesterday on the news on BBC Radio 4.  Radio 4 doesn’t normally use words like “crap” on the national news, but I guess they must have decided on this occasion that plain speaking was in the public interest.  Before he gave this utterance, Mr Sunderland asked everybody in the room to switch off their devices, a sure-fire way, I’d have thought, of making sure he was going to be recorded.  Mr Cleverly toured the Sunday morning TV studios to reassure us that Mr Sunderland was simply using the word “crap” for dramatic effect.  The Rwanda policy was not crap. 

True enough, Mr Sunderland had gone on to point out that the policy had been modelled on a similar initiative in Australia, which had proved very effective in deterring migrants down under.  So, what exactly was he referring to as crap?  One interpretation might be that the offer of asylum in Rwanda is a crap offer that nobody would wish to accept.  Perhaps Mr Sunderland asked everybody to switch off their mobiles, because it is necessary to insist that Rwanda is a safe destination, whilst sending out a subliminal message that it is a crap destination – a classic example of cognitive dissonance.  Another interpretation would be that the depiction of Rwanda as a favourable destination is crap, or, another apposite word, bullshit. 

But I suspect this story will just peter out.  Fluttergate, on the other hand, has legs.  The media may have the opportunity to drip feed further allegations.  Drip, drip, drip.  In Edinburgh, Mr Sunak will wish to discuss the economy, jobs, and hospitals, but the reporters will keep asking him for more flutterers’ names. 

Likewise, amid the furore, Mr Farage will not be much damaged by his alleged remark that the West, and the expansion of NATO to the East, is at least partly responsible for the war in Ukraine.  One of the problems of obsessing over a scandal like Fluttergate is that we are inclined to take our eye off the ball, especially with regard to foreign affairs.  The relationship between Russia and the West was brought into sharp focus for me last week when I read Giles Milton’s wonderful book The Stalin Affair, The impossible alliance that won the war (John Murray, 2024).  I was put on to it again by BBC Radio 4 which has been serialising it, read most beautifully by Nigel Anthony.  When the Nazis launched Operation Barbarossa on midsummer’s day, 1941, and attacked Russia, Churchill, who had been an implacable foe of Communism since 1917, immediately pledged Stalin the support of Great Britain.  He was criticised for this; many thought that the Nazis and the Reds should be allowed to get on with it and destroy one another, but Churchill argued that if Germany had an easy victory, as seemed likely, then the Nazis could turn their entire attention to the west, and Continental Europe would become an impregnable fortress.  He made the famous remark that, if the Nazis should attack Hell, he would not hesitate to make a pact with the devil.  That was in essence what he thought he was doing. 

The Big Three, Churchill, Stalin, and Roosevelt, and the famous summits at Teheran, Yalta, and Potsdam form the backdrop to Giles Milton’s book, but the focus is on subsidiary characters, Roosevelt’s representative Averell Harriman, the British ambassadors Sir Stafford Cripps and subsequently Archie Clark Kerr, the Russian foreign commissar Molotov (“Old Bootface”), and the interpreter Arthur Birse.  This focus on (not quite) ordinary people caught up in extraordinary affairs gives the book an atmosphere not unlike that of a historical novel by Walter Scott.  It is certainly as vivid.  But the star of the show is Harriman’s daughter Kathy, who accompanied her father, got involved in his work, and learned to speak Russian.  She saved a file of letters and documents which has only recently come to light.  She comes across as a thoroughly modern woman. 

Churchill’s power on the world stage waned throughout this period, just as Roosevelt’s health deteriorated.  It is really Stalin who dominated the Big Three, and got most of what he wanted.  It was perhaps Averell Harriman who was the first to realise that Stalin was going to become an enormous threat to the west. 

And here we are again.  The riddle, wrapped in a mystery, inside an enigma.  The US has given Ukraine permission to launch missiles deep into Russia.  A factory producing drones has recently been attacked.  As the Government never tires of telling us, we are living in an incredibly dangerous world.  But not so dangerous, apparently, that some people don’t have time for a flutter at the bookies.                                        

There was an odd juxtaposition of two reports in one of the Scottish Sunday newspapers yesterday.  The first indicated the overwhelming support in the Scottish Parliament for buffer zones outside abortion clinics, wherein “pro-life” people would not be allowed to demonstrate.  The second indicated that Glasgow City Council is not minded to support similar buffer zones outside Roman Catholic churches, wherein members of the Orange Order would not be able to march.  I wondered what distinction was being made by our legislators and our city fathers, who chose to uphold the right to demonstrate in one case, but not in another. 

(Incidentally, with respect to termination services, why not just absorb them within women’s health generally, and offer them within the gynaecology clinic?  Nobody has a right to know why somebody is attending hospital.  I suspect the answer is that the juxtaposition of women happy to bear a child, with those unhappy to find themselves pregnant, would be too hard to bear for both parties.)  

But why this proposed curtailment of the right to demonstrate, either in front of clinics or churches?  Perhaps the police have advised that one of these scenarios is just potentially too volatile.  We know for example that “pro-choice” workers receive death threats in the United States; indeed some of them have been carried out.  But this has not occurred on this side of the Pond, where the demonstrators are often characterised as grandads and grandmas, holding placards offering help, while silently praying.  Many of these demonstrators, though not all, profess a religious faith, and indeed many of them are Roman Catholic…

…which takes us nicely to the other demo.  Here, the marchers are Protestant, though the profession of a religious faith may be less obvious.  The marches, in Glasgow, take one of several routes which seem to pass within sight, and sound, and often directly, by an inordinate number of Roman Catholic churches.  These demonstrations are much larger than those taking place outside abortion clinics, needing a police presence, and they are certainly much louder, aided as they are by substantial bands of fifes and drums.  By and large the marches take place peacefully enough, although there have been episodes of intimidation occasionally leading to violence.

In the Scotland of my childhood, you were expected to be either blue or green.  I was brought up on the blue side of the tracks.  My father was in the City of Glasgow Police.  The police held their annual sports day in Ibrox, the home of Glasgow Rangers.  I first attended a football match in Ibrox, when I was a child.  My uncle lifted me over the turnstile.  (For the record, Rangers beat Stirling Albion 4 – 1.)  Many of my uncles were freemasons.  They attended Burns suppers.  I don’t think I knowingly met a Roman Catholic until I was about 12 years old.  Then I met two cousins – an uncle had married a Roman Catholic girl; what a scandal that was.

This great sectarian divide dates back to ancient history – Luther’s 95 Theses and the Reformation, Mary Queen of Scots, James VI and I, the gunpowder plot (“Remember, remember…”), James II, William and Mary, the Battle of the Boyne…  The Reformation was triggered by doctrinal differences, theological arguments, and perhaps more importantly, accusations of corruption.  I think Luther thought the sale of indulgences was a scam.  But I don’t suppose many of today’s Orange Order could discourse on a single Lutheran thesis, or upon the doctrine of transubstantiation.  Yet the great divide remains.  Not only ancient history, but also modern history, is seen through the prism of the sectarian schism.  Many people regard the cause of Scottish Nationalism as a Popish Plot.  Before the 2014 referendum, a very large Orange March took place in Edinburgh, which was largely an expression of Unionism.  Many people went across from Glasgow to “the far east” to attend that rally.  Edinburgh is often regarded by Glasgwegians as a kind of toffee-nosed little England, but in truth, Glasgow, the second city of empire, is less Scottish than Edinburgh, and far more “British”.  I have a notion that when the Scottish football team lost 5 – 1 to Germany the other night, lots of Rangers supporters wouldn’t have been much bothered.

The championing of the ancient language of Gaelic is another Popish Plot, inspired by the Irish Republic.  People write irate letters in to The Herald, expressing outrage that our road signs and our emergency vehicles should bear Gaelic names.  The Northern Ireland Assembly was out of action for over two years, partly, and significantly, because Stormont couldn’t agree about support for Irish Gaelic. 

For myself, I think people should stop beating the antique drum, and let it go.  The trouble is that for many, the drum is not antique, and I suspect that is what underlies the difference in attitude of our representatives, and city fathers, with respect to abortion clinic and church buffer zones.  Protestantism remains in the ascendancy.