“Love loves to love love” James Joyce

Love loves to love love.

Nurse loves the new chemist.

Constable 14A loves Mary Kelly.

Gerty MacDowell loves the boy that has the bicycle.

M.B. loves a fair gentleman.

Li Chi Han lovey up kissy Cha Pu Chow.

Jumbo, the elephant, loves Alice, the elephant.

Old Mr Verschoyle with the ear trumpet loves old Mrs Verschoyle with the turnedin eye.

The man in the brown macintosh loves a lady who is dead.

His Majesty the King loves Her Majesty the Queen.

Mrs Norman W. Tupper loves officer Taylor.

You love a certain person. And this person loves that other person because everybody loves somebody but God loves everybody.

 

W B Yeats on the “the finest description of sexual intercourse ever written”

By far the most viewed blog on my website is one entitled “The best description of sex I’ve read in 50 years of reading.” In 2019 my website was viewed 52 051 timed, and 7451 views were of that blog. The next most visited, my home page, was viewed 2584 times.

People must find the sex blog through search engines, searching for some sort of sexual gratification. Most must be hugely disappointed and leave the site after seconds. Those who stay will find a long blog that begins with ludicrous accounts of sex that have won the bad sex award for the worst writing about sex. They have the virtue of being funny. If visitors get through that they will find a long section from Umberto Eco’s The Name of the Rose, not probably what they expected. I stand by my judgement of it being “The best description of sex I’ve read in 50 years of reading,” but it’s not designed for instant gratification.

Anyway, I was intrigued to hear Mary Beard, the classics scholar, talk on the radio the other days about what W B Yeats called “the finest description of sexual intercourse ever written.” It came from Lucretius’s De Rerum Natura (On the Nature of Things). I have read that long and extraordinary poem, but I had no memory of an account of sex—but it is there. (I didn’t read Dryden’s translation).

It was a quote from John Dryden’s translation that Yeats praised. Here it is:

“So love with phantoms cheats our longing eyes,

Which hourly seeing never satisfies;

Our hands pull nothing from the parts they strain,

But wander o’er the lovely limbs in vain:

Nor when the youthful pair more closely join,

When hands in hands they lock, and thighs in thighs they twine,

Just in the raging foam of full desire,

When both press on, both murmur, both expire,

They gripe, they squeeze, their humid tongues they dart,

As each would force their way to t’other’s heart –

In vain; they only cruise about the coast,

For bodies cannot pierce, nor be in bodies lost.”

But what Yeats liked was that it showed the hopelessness of sexual intercourse: the lovers struggled and wrestled to be one but never could be. As Yeats wrote:  “The tragedy of sexual intercourse is the perpetual virginity of the soul.”

I was prompted to return to the version of Lucretius’s poem that I read. It was translated by A E Stallings, an American woman born in 1968.

“So Venus teases with images—lovers can’t satisfy

The flesh however they devour each other with the eye,

Or with hungry hands roving the body can they reap

Anything from the supple limbs that they can take and keep.

Lastly, when their limbs are tangled, and they pluck youth’s bloom,

And bodies have a foretaste of the pleasures that now loom,

And Venus is about to sow the woman’s field with seed,

They grasp each other and mix the moisture of their mouths in greed,

And panting heavily, press teeth in lips, but all in vain—

There’s nothing of the other they can rub off and retain.

Nor can one body wholly enter the other and pass way—

For it seems sometimes that this is what they struggle to essay,

Such do they clasp in the chains of Venus, greedily and tight,

While limbs go limp, melted with the heat of their delight,

At last when loins erupt forth from the gathering desire,

They are allowed a brief reprieve from passion’s raging fire.

But the fever starts again, madness must soon return,

When yet again they seek to have the thing for which they yearn.

They can discover no device to conquer their disease—

But wate away from wounds unseen, amidst uncertainties.”

Any individual who finds these words in search of sexual gratification will find the opposite. Lucretius was no fan of passion and desire.

 

 

The cartoonist who infuriated Hitler and the British government tried to muzzle

I know the cartoons of David Low from before and during the Second World War, and I know that they are a high point in the cartoonists’ art. But I didn’t know today just how much he got under Hitler’s skin and how the British government tried to muzzle him.

I’ve learnt more from reading Tim Bouverie’s absorbing book Appeasing Hitler. In the late 30s Neville Chamberlain, the prime minister, and Lord Halifax, the Lord President, wanted to “create a positive atmosphere from which it would be possible to ‘discuss with Germany the practical questions involved in a European settlement’.” To that end Halifax went on a trip to Germany where he met Hitler and other senior Nazis.

At a dinner “Goebbels asked the Lord President to try to stop the attacks on Hitler in the British press, claiming that ‘nothing caused more bitter resentment in Germany’. In particular, he complained about cartoons lampooning Hitler and seemed to have singled out for special criticism…David Low.”

In retrospect Chamberlain and Halifax are dismissed as naïve appeasers, and Low, a New Zealander by birth, is a national hero. But it wasn’t so clear at the time, and Bouverie begins his book by listing the horrors of the First World War, explaining why any sane person would go to great lengths to avoid a repeat of such horrors.

Halifax tried leaning on Lord Beaverbook, who owned the Evening Standard, which published Low’s cartoons. But Beaverbrook explained that Low had a contract that gave him editorial freedom, and Low lampooned Beaverbrook in his cartoons. (Rupert Murdoch, I speculate, would never allow such freedom to a cartoonist, editor, or journalist.) Beaverbrook suggested that Halifax meet with Low himself.

As Bouverie observes, “This was a pretty unorthodox suggestion – rarely, if ever, can a senior British Cabinet Minister have had to personally censor a newspaper cartoonist – yet…Halifax was prepared to do [so] ‘in the interests of the good cause’. Meeting in Wardell’s Bayswater flat, Halifax asked Low to tone down his cartoons since they were having a detrimental effect on the Government’s quest to secure a lasting peace.” Low replied that he didn’t want to be responsible for a world war and, although he thought Hitler awful, would “slow down a bit.” He did slow down a little, substituting a composite dictator, Muzzler, for his strip cartoon about “Hit and Muss” (Hitler and Mussolini).

I wonder how much Muzzler referred to Halifax. Bouverie notes that “Although he claimed in his memoirs to have a great respect for that ‘chartered libertine’ the British press, he was, in reality, hardly less keen on stifling newspaper criticism of Germany than Dr Goebbels.”

The tasks of the Holy, according to James Joyce

Casting out devils

Raising the dead to life

Multiplying fishes

Healing the halt and the blind

Discovering various articles which had been mislaid

Interpreting and fulfilling the scriptures

Blessing

Prophesying

 

[It’s a busy life.]

Visiting my 90-year-old mother after five months

It’s five months since I last saw my 90-year-old mother. There have been times—a year in New Zealand and a year in California—when I have been as long without seeing her, but I was seeing her almost every week until lockdown began in March. Until a few weeks ago I could see her only if she was dying, which she wasn’t, or distantly across a fence and a garden and through glass. As she doesn’t miss me, it seemed pointless. I worried that I might confuse or disturb her. (But might some part of her faded brain miss me? Was I really thinking of myself?)

Now it is possible to see her—by appointment and with a fence between us. It felt horribly like visiting a human zoo, thoughts of Bedlam when the fashionable went to see the chained lunatics. My brother went and found it distressing. He wept.

But during Sunday night—prompted perhaps by reading Kevin Toolis’s powerful book My Father’s Wake—I thought I must see her. I phoned and made an appointment. I was to go at 4pm and walk round the nursing home, past the bins, and see her in the home’s garden through the fence.

I cycled there though the humid 35 degree heat and did as instructed. There was my mother walking through the garden. I shouted to her: “Hazel.” She looked around in all directions but eventually saw me. She came over smiling, showing the gap in her teeth. She was as I last saw her, only wearing a completely new set of clothes and shoes—cast offs from the dead presumably. The fence between us was only about five feet, so I could see over it. If it is like a zoo, it’s not a grim one.

I’d debated with my wife whether to remind her who I was or just launch into conversation. I favoured the former, my wife the latter. When it came to it, we just began to talk. My mother talks like the oracle at Delphi: her words don’t all make exact sense, but they have an oracular, philosophical, prophetic feel.

“Should I come round?” Hazel asked. “We could go for a walk.” We usually go for a walk: it’s her greatest pleasure. I explain that because of “health issues” we can’t go for a walk.

“Are you coming round?” she asks. I explain that I can’t and persuade her to sit in a chair that is facing the fence. This presumably is the chair where all the residents sit when being visited. The ground has several fag ends. I regret that nobody has picked them up.

A tall, wild-eyed woman comes to join us but soon retreats.

I ask Hazel how she is, and she says fine.  “I like it here. I feel safe.” I’m pleased to hear this.

I bring out the letter that I’d written for her. The content of the letter is mostly four A4 size pictures of her four great grandchildren. I remind her that she has six grandchildren, five boys and one girl, and four great grandchildren, one boy and three girls. “It’s the other way round,” I observe with sparkling intelligence.

We are diverted for a moment because she thinks I’ve asked if she speaks Welsh. I hadn’t, but now I do. “You spent those years in Wales when you were evacuated. Perhaps you learnt some then.”

“Only a few words,” she answers, “but I can’t remember them.”

I have a memory of my father rehearsing his one word of Welsh. What was it? “wacky die, sine die,” no that’s Latin.

“I don’t speak any Welsh either.”

We’re back to the pictures. I pass her one after another: Alexander a brightly coloured parrot on each arm, Marina beside a pool with a beach ball, Betty drawing in our garden, and Thirza with a mouth covered in chocolate.

I realise that I shouldn’t be giving them to her for fear of infection, but it seemed very natural. And it would have seemed very unnatural to hold them against the fence with Hazel four feet away.

Hazel bursts into song. “Oh, oh, Antonio….”

I remind her that when my brother visited they sang “Daisy, Daisy.” We hesitantly sing a few verses.

I then have the idea of videoing her, getting her to send a message to her two other sons. The video lasts about a minute, and she is surprisingly coherent. She talks about her “four sons” (as are as we know there are only three, but who knows?) and remembers the name of one of them.

After about 20 minutes I say that I’m going to go. A couple of year ago she became upset when I left, but not anymore.

I walk round to the front of the nursing home where, in contrast to normal, all the doors are wide open. This is sound public health: the more fresh air the better. I walk in to deliver my letter, and see Victor, the manager, on the phone. He smiles. I wave, and he waves back. I’m full of gratitude to him and his staff. Victor summons an assistant, and I tell her that I’ve left a letter for my mother. She says it will have to be quarantined for 24 hours. I confess that I handed copies to Hazel. She smiles.

(I was thinking that it was irrelevant to point out that Victor is Nigerian and the assistant South Asian, but I think now that it isn’t: these are the people who are caring for those we love at risk to themselves. How I hate the Little England mindset that sees these people as problems when they are clearly the opposite.)

I cycle away, not weeping like my brother, but pleased to have gone and determined to go again soon. My mother, I reflect, is in many ways in a better place than many—not least in that for her there is no pandemic, no Brexit, no climate change, and no fear of the future.

 

The history of natural death is the history of medicalisation of the struggle against death. Ivan Illich, 1976

I’ve used these quotes from Ivan Illich’s “Limits to Medicine” (1976) to illustrate his argument of how death has been steadily medicalised, reaching its apotheosis perhaps with people dying of Covid-19 surrounded by gowned and masked nurses and able to communicate with those they love only electronically.

[In the Middle Ages] The imminence of death was an exquisite and constant reminder of the fragility and tenderness of life.

[At the end of the 15^th century] From a lifelong encounter [a dance], death has turned into the event of a moment.

Once death had become such a natural force, people wanted to master it by learning the art or the skill of dying…[The Ars Moriendi ] was a ‘how-to’ book in the modern sense, a complete guide to the business of dying, a method to be learned while one was in good health and to be kept at one’s fingertips for use in that inescapable hour.

After the Reformation, death became and remained macabre.

[In the 15^th and 16^th centuries] The question whether medicine ever could “prolong” life was heatedly disputed in the medical schools of Palermo, Fez, and even Paris. Many Arab and Jewish doctors denied this power outright, and declared such an attempt to interfere with the natural order to be blasphemous.

Paracelsus (1493-1541) wrote: “Nature knows the boundaries of her course. According to her own appointed term, she confers upon each of her creatures its proper life span, so that its energies are consumed during the time that elapses between the moment of its birth and its predestined end…A man’s death is nothing but the end of his daily work, an expiration of air, the consummation of his innate balsamic self-curing power, the extinction of the light of nature, and a great separation of the three: body, soul, and spirit. Death is a return to the womb.”

Frances Bacon (1561-1626) was the first to suggest that physicians might prolong life. He divided medicine into three offices: “First the preservation of health, second, the cure of disease, and third, the prolongation of life…[the] third part of medicine, regarding the prolongation of life: this is a new part, and deficient, although the most noble of all.”

[ By the 18^th century] a new type of rich man refused to die in retirement and insisted on being carried away by death from natural exhaustion while still on the job. He refused to accept death unless he was in good health in an active old age.

[By the beginning of the 19^th century] To die while courting one’s grandson’s mistress became the symbol of a desirable end.

[By the 20^th century] Death had paled into a metaphorical figure, and killer diseases had taken his place.

The hope of doctors to control the outcome of specific diseases gave rise to the myth that they had power over death. The new powers attributed to the profession gave rise to the new status of the clinician.

While “timely” death had originated in the emerging class of consciousness of the bourgeois, “clinical” death originated in the emerging professional consciousness of the new, scientifically trained doctor,

In our century [the 20^th] a valetudinarian’s death while undergoing treatment by clinically trained doctors came to be perceived, for the first time, as a civil right.

The right to a natural death was formulated as a claim to equal consumption of medical services, rather than as a freedom from the evils of industrial work or as a new liberty and power for self-care.

When the doctor contrived to step between humanity and death, the latter lost the immediacy and intimacy gained four hundred years earlier. Death that had lost face and shape had lost its dignity.

We cannot understand the deeply rooted structure of our social organisation unless we see it as a multifaceted exorcism of all forms of evil death. Our major institutions constitute a gigantic defense programme waging war on behalf of “humanity” against death-dealing agencies and classes. This is total war.

The myth of progress of all people towards the same kind of death diminishes the feeling of guilt on the part of the “haves” by transforming the ugly deaths the “have-nots” die into the result of present underdevelopment, which ought to be remedied by further expansion of medical institutions.

The expectation of medicalised death hooks the rich on unlimited insurance payments and lures the poor into a gilded death-trap.

Thanks to the medicalisation of death, health care has become a monolithic world religion.

“Natural death” is now the point at which the human organism refuses any further input of treatment.

Dying has become the ultimate form of consumer resistance.

Health, or the power to cope, has been expropriated down to the last breath, technical death has won a victory over dying. Mechanical death has conquered and destroyed all other deaths.

A society’s image of death reveals the level of independence of its people, their personal relatedness, self-reliance, and aliveness.

The white man’s image of death has spread with medical civilisation and has been a major force in colonialisation.

 

 

 

 

 

 

 

 

 

A compelling rant against how we have allowed the virus to enslave us

 I’d never read any of the books by Bernard-Henri Lévy (BHL), but a friend recommended to me an interview he gave on his new book The Virus in the Age of Madness—and the interview was enough to inspire me to read the book, which is short and can be read in less than two hours. BHL writes entertainingly with great swagger, switching with ease from Plato to the Torah to Youtube.

His book is a rant, a polemic. His central argument is that those of us in the rich world have been driven made by Covid-19, allowing the virus to take over our lives. The world seems to have stopped while we indulge ourselves with the virus.

There is, he insists, nothing positive about the pandemic. He rails against people rediscovering nature, delighting in empty cities, burrowing deep into themselves, and particularly those who see the pandemic as a warning, a wake-up call to achieve a better balance with nature, and argue that positive developments can emerge from the pandemic.

I’m guilty of all those crimes and don’t wholly agree with BHL.

But I’m more sympathetic to the idea that we have become too preoccupied with the virus, allowing the world’s dictators—Xi Jingping, Putin, Erdogan, Orban, Bolsanaro, and the like—to advance their particular forms of madness unhindered. More broadly he argues that we have allowed the virus to take us away from action and all that matters in life.

He ends the book with this long scream:

“A life in which one accepts, with enthusiasm or resignation, the transformation of the welfare state into the surveillance state, with health replacing security, a life in which one consents to this slippery slope: no longer the old social contract (where you cede a bit of your individual will to gain the general will) but a new life contract (where you abdicate a little, or a lot, of your core freedoms, in return for an antivirus guarantee, an “immunity passport,” a “risk-free certificate,” or a new kind of get-out-of-jail-free card, one that lets you transfer to another cell).

In the process, a profound break has been made with what all the wisdom of the world, notably but by no means exclusively Jewish, has striven to say: that a life is not a life if it is merely life.

It is the wisdom of every philosophy, truly, every one. Though they may disagree on everything else, philosophies are in accord on the idea that humanity is never identity in and for itself, never reducible to itself, but that it thrives only if—whether by action, contemplation, Spinozan effort to increase its power to be, or the divine spark—it leaves the confinement that is life in its native state. It is the message of every human adventure.

It is the message of art.

It is the message of literature

What is most intimate will be revealed to us in the blinding light of the city, the crowd, the world.

A world of dog-masters—that is, masters who are dogs and train a race of beings that has the right only to bark when reminded that it is made up of people, to whine when it catches a virus, and to yap when Corona, our king, arrives to give us its lesson, using carrots and sticks. The world is made for us to huddle up in, says King Corona. It is made to lie down in. And if sleep is slow in coming, one must count sheep, or one’s money, if one has any, or one’s viruses.

Life isn’t beautiful yet?

Can’t we get everything we need with a couple of clicks—basic necessities but also, ultimately, sex, imagination, death? Remember the other meaning of mundus . . . clean, neat, tidy, and, as we say in French, net. That is the lesson of the virus.”

 

 

Quotes from The Virus in the Age of Madness Bernard-Henri Levy (BHL)

This boils down to more Father Paneloux (from Camus’s The Plague), ending his sermon on the victims of Oran’s epidemic with a peroration on the virtues of suffering: “This same pestilence which is slaying you works for your good and points your path.”

And I, too, dream of seeing the ecological principle become a permanent part of our legal codes.

But not like this. Not all of a sudden. Not through this catastrophic, even apocalyptic interruption, with its incalculable consequences.

As Canguilhem taught us, the questions of immunity, recovery, and biological innocence, the relations between the normal and the pathological, health and illness, and life and death, are, epistemologically, much murkier than we have been led to believe over the past few months.

What is interesting about a given subject is not what he is but what he does and, in doing what he does, how he inhabits the world, shapes it, takes from it, and gives to it. Edmund Husserl’s phenomenology,

Humanity, for Levinas, begins with an injunction that is exactly the opposite: others first.

“If I am not for myself, who will be for me? If I am only for myself, what am I?” Hillel the Elder

A strange saying from the Talmud that I heard long ago from the lips of Emmanuel Levinas on one of the last visits I paid to him: “The best of doctors are destined for hell.”

Death itself. The right to die and to live one’s own death. That moment for each of us, as Michel Foucault said, the most private and secret of our entire existence, the very last instant, the limit, when power no longer has any hold over us and when we call out (as Foucault did, with his last breath, “Call Canguilhem, he knows how to die!”) for the one who will help us cross over. All of that, all that knowledge, that immemorial and decisive scene, yanked away for a period of weeks in a gesture of prophylactic impatience that you never thought could happen that way—bodies wrapped in white plastic, like letters dumped in a mailbox; corpses found decomposing in trucks outside a funeral home in Brooklyn, where the director said “bodies are coming out of our ears”; cursory funerals; goodbyes on WhatsApp.

For the first time in a century, the world is going through a grave crisis and yet expects nothing from the United States. Worse still: the country’s enemies, which are the enemies of freedom, are crashing through the world as if America no longer counts for anything, carries no weight, no longer exists. We are entering a strange, pre-Columbian universe.

Portrait du philosophe Bernard Henri LÈvy ‡ Paris le 21/03/2018 Photo Jean-Christophe Marmara / Le Figaro

The faults and dangers of an iatrocracy

The first thing that struck Bernard-Henri Lévy, arguably France’s leading public intellectual, about the Covid-19 pandemic was the rise of “medical power.” In his short, enjoyable, and provocative book The Virus in the Age of Madness he explains why such power is both undeserved and dangerous.

Now aged 71 Lévy is one of the Nouveaux Philosophes inspired by among others Michel Foucault, and he reminds us that Foucault observed that governments have learnt as much from the hospital as the prison. In The Birth of the Clinic Foucault described the management of outbreaks of plague in the 18^th century:  in Lévy’s words, “exile to an island or a ghetto on the outskirts of the city, as was the practice with lepers and the insane, gave way to confinement of entire cities, where all citizens were under house arrest and neighborhood watch patrols wrote up holdouts. Once night fell, everyone was out on their balcony, not to applaud the caregivers but to enable the sanitary authorities to tally up the dead, the dying, and the living.”

“But,” observes Lévy, “until now, never had things gone quite this far.” He emphasises the uniqueness of how we have responded to this latest in a long line of pandemics, including to the “Hong Kong Flu” of 1968 that killed a million people. “Never had we seen, as we did in Europe, heads of state surrounding themselves with scientific councils before daring to speak.”

After praising the health professionals who put themselves at risk by treating those sick with Covid-19, Lévy  writes “but to make physicians into supermen and superwomen and to endow them with extraordinary powers requires a leap that can be taken only with the help of several misconceptions.” He then explains those misconceptions.

Firstly, doctors and scientists do not always know more than others. Lévy, who is equally comfortable quoting Plato and Youtube, tells us that the French philosopher Gaston Bachelard observed that “scientific truth”  is never more than a “corrected mistake.” The British philosopher of science Karl Popper also argued that the only “truth” in science is the hypothesis that has not yet been falsified, with the implication that one day it may well be falsified. Lévy supports his argument by quoting just some of the many doctors who have made statements like the “coronavirus is way less serious than influenza” that have proved badly wrong.

Secondly, doctors and scientists do not speak with one voice, as even the most casual reader of the BMJ knows well. Having been “fortunate enough to have arrived at philosophy through the door of epistemology,”  Lévy notes that “the ‘community’ of scholars is no more communitarian than any other…is riven with fault lines, divergent sensibilities and interests, petty jealousies, esoteric disputes, and, of course, fundamental differences. I know that the research world is a Kampfplatz, a battlefield, a free-for-all no less messy than the one Immanuel Kant bemoaned in metaphysics.”

“The emperor has no clothes, even if he is a physician,” concludes Lévy. “Especially [his emphasis],” he continues, “if he is a physician. The renowned doctor, the big shot, however formidable and learned he may be, is naked under his white coat. And in that he reconnects with and shares the fate of the rest of humanity.”

Lévy’s third anxiety is the most worrying. He warns against what he calls “hygienics.” He defines it thus: “health becomes an obsession; all social and political problems are reduced to infections that must be treated; and the will to cure becomes the paradigm of political action.” We all know, he writes, where such a doctrine can lead, arguing unphilosophically it seems to me that one example will suffice. He tells the story of eugenics, which gripped France and other countries in the 1930s before being taken to its hideous extreme in Nazi Germany.

I’ve heard several philosophers say that the history of philosophy is essentially a matter of understanding Plato, and Lévy describes how in his dialogue The Statesman Plato considers a country run by physicians. After advancing several reasons in favour of an iatrocracy, Plato abandons the idea: in Lévy’s words, “Politics, he says, is an art that, since the retreat of the gods, deals with a chaotic, changing world, swept by storms and rudderless. But, in a storm, what is the point of a Hippocratic nosology of ‘cases’? Do not the difficult times call instead for citizen-guardians possessing the audacity and strength to think through, carve into stone, and proclaim legal ‘codes’?”

Doctors have important roles to play in a pandemic—primarily in treating the sick and advising on prevention—but they cannot become rulers, and politicians cannot hide behind them. And we, the people, must never succumb to the idea that a world run by doctors would be a better world.

 

 

More NHS IT absurdities (but a happy ending)

NHS patients are on a long march from having no access to their health and social care records to not only having access to all of them but also controlling them. I have a vested interest in this march not only because I’m an NHS patient but because I’m the unpaid chair of (but have equity in) Patients Know Best, https://patientsknowbest.com/ a company that brings together health and social care records and puts them under the control of the patient. I have just made a big leap forward on the march by signing up to the NHS App, https://www.nhs.uk/using-the-nhs/nhs-services/the-nhs-app/ but the leap comes after an absurdity.

About eight years ago I asked for access to my general practitioner records. No patient of the practice had ever made such a request, but the practice manager was helpful, saying that she thought that I would be the first of many. It took about six months and many twists and turns to give me access, but I was able to access something. I could make appointments and order repeat prescriptions (not that I have any), but I couldn’t access my records.

I kept asking to be able to access my records, but it didn’t seem to be possible until recently. Now it does seem to be possible, and I completed a form asking for access. The practice asked me to provide photo identification, which I did by emailing a copy of my passport. They then sent me the form below.

The form says: “To access online services create an account with one of the following service providers,” and there are 18 providers listed. But there is no information on the providers. What services do they provide? What are there advantages and disadvantages of each of them? It seemed odd that there was no such information, but I was excited to see Patients Knows Best on the list. I tried to access it using the account details I was given (I’ve redacted those from the form). The details provided did not fit what Patients Know Best asked for, but I tried fitting them anyway. I failed and became frustrated.

Days later I spoke to somebody at Patients Know Best, who explained to me that of all the providers named on the list the only one I could access was the one at the top, which is the connection provided by EMIS Health, the supplier of records. Indeed, many of the other providers don’t exist anymore. It seemed absurd to me that I was give such a list, but evidently practices are required now to give out such a list: nobody seems to care that it’s largely useless

The person at Patients Know Best advised me simply to connect to the NHS App, saying that it was easy to do and would give me access to my GP records and much more. Were my practice to sign up to Patients Know Best, which might happen because of a regional contract, then I would also be able to access hospital records and much else.

This morning I did sign up the NHS App, and it was remarkably easy, I could do it all from my desk. I didn’t need to know my NHS number but only things like name, address, and date of birth, which everybody knows. I had to send photo identification (my passport) and then I had to film myself saying a number that was below my picture. Within two hours I was approved and given access to my GP records and more.

Why, I wonder, did the practice not advise me to access the NHS App rather than provide me with uninterpretable and mostly meaningless information?

 

Competing interest: RS is the unpaid chair of Patients Know Best but has equity in the company. Patients Know Best is at the moment the only private provider connected to the NHS App.

 

 

 

 

 

 

 

 

 

 

 

“Stop having children? That’s the Devil talking.”

I read the words below this morning from James Joyce’s Ulysses, and they brought back a memory.

“Fifteen children she had. Birth every year almost. That’s in their theology or the priest won’t give the poor woman the confession, the absolution. Increase and multiply. Did you ever hear such an idea? Eat you out of house and home. No families themselves to feed. Living on the fat of the land. Their butteries and larders.”

My memory comes from 1976 when I was working as a junior doctor in the Eastern General in Edinburgh. I admitted a woman in her 80s. I can’t remember what was wrong with her, but I can remember what she told me.

Her story probably arose when I was taking her family history: “What did your parents die of? How many children do you have? Are they all alive and well?”

(This in turn evokes another memory, asking a Maori man in New Zealand how many children he had. “Maybe 10, maybe 11.” I couldn’t believe that he wouldn’t know how many children he had (which now makes m think of Boris Johnson, scattering his seed across a blasted land—see how reading Ulysses is getting to me). “Are they all alive?” “One boy go to Vietnam. Maybe dead. Maybe alive.” Now age 68 I’m not at all shocked that a man should not know how many children he had or whether they were all alive—but I was young and green and singing under the apple bough.)

The woman in Edinburgh had many children. “I wanted to stop,” she said. “I had to be rowed across the Forth each time. One time it was the middle of the night. I was exhausted by too many children. I went to the priest and asked if I could stop. He told me that that was the Devil talking. I had to go on.”

Was she really rowed across the Forth from Fife to Edinburgh? She must have had her children in the 1920s and 30s. The road bridge didn’t open until 1964, and the train bridge in 1890—but a train would have been impractical. But surely there were services in Fife, but perhaps she needed a Caesarean.

Perhaps my memory is wrong, but I’m sure about the priest part of the story. The woman though it unjust; the injustice still rankled after half a century. But she obeyed the priest. Perhaps if she hadn’t the priest would, as Joyce writes, have refused her confession—and condemned her to hell.

A few pages later Joyce returned to childbirth:

“Sss. Dth, dth, dth! Three days imagine groaning on a bed with a vinegared handkerchief round her forehead, her belly swollen out! Phew! Dreadful simply! Child’s head too big: forceps. Doubled up inside her trying to butt its way out blindly, groping for the way out. Kill me that would….They ought to invent something to stop that. Life with hard labour. Twilightsleep idea: queen Victoria was given that. Nine she had. A good layer. Old woman that lived in a shoe she had so many children.”