Anthony and Cleopatra: passion can both make us fools and change the world

Anthony and Cleopatra begins:

Look, where they come:

Take but good note, and you shall see in him,

The triple pillar of the world transformed

Into a strumpet’s fool. Behold and see.

And that’s exactly what we do see, with Ralph Fiennes emphasising the folly into which passion for Cleopatra has led Mark Anthony. He comes onto the stage with his shirt open, beads round his neck, and a bottle in his hand and kisses Cleopatra with the clumsiness and desperation of a lustful teenager. But Cleopatra is no strumpet: she may be moody, narcissistic, and jealous, but Sophie Okonedo shows how as a Queen, Pharoah, and mother of Julius Caesar’s child she uses her erotic power that has reverberated through the millennia.

Age cannot wither her, nor custom stale

Her infinite variety: other women cloy

The appetites they feed; but she makes hungry

Where most she satisfies; for vilest things

Become themselves in her.


Anthony and Cleopatra is simultaneously a great love story and the story of a defining moment in Roman and world history, when Rome, with its great empire, moved from being a Republic to being ruled by an Emperor. (America may be experiencing such a time.) It’s also a crucial moment in the struggle between the mysterious, passionate, erotic East and the cold, rational, warmongering West. If Cleopatra and the besotted Anthony had beaten Caesar then the East might have triumphed, and I wouldn’t be sitting here now filled with science and a medical degree tapping at a computer. But I go too far: this is Orientalism.

And perhaps Shakespeare went too far as well in trying to tell such complex, contrasting stories in one play: it doesn’t have the tragic intensity of Lear, Hamlet, Othello, or Macbeth where Shakespeare can concentrate on the stories of just a few people. But then that is the whole point of Anthony and Cleopatra: how a love affair between two people can affect an empire and world history.

The drunken Anthony says at the beginning while Kissing Cleopatra:

Let Rome in Tiber melt, and the wide arch

Of the ranged empire fail

Here is my space.

Most of us have known such a space where duty, commitments, and rationality are abandoned, but most of us are not running an empire. Anthony does for a while recover and travel to Rome to make an uneasy peace with Caesar by marrying his “holy, cold, and still” sister, such a contrast to Cleopatra. But Cleopatra and the East draw him back, and uncharacteristically, still bewitched, he makes a crazy military decision and is defeated. In the Roman way he resorts to suicide but botches the job.

Cleopatra, in contrast, dies magnificently in the way all the world remembers, bitten in the breast by a poisonous snake. The National Theatre production used a real snake (in fact three so as not to overwork one snake), and it was a fine snake–red with yellow rings.

I have immortal longings in me.

The stroke of death is as a lover’s pinch,

Which hurts and is desir’d.

That Kiss which is my heaven to have.

Shakespeare has told us already: “It is great to do that thing that ends all other deeds; which shackles accidents and bolts up change.”

But Shakespeare also lets us know that there are greater forces than Anthony, Cleopatra, or the victorious Caesar:

‘Tis paltry to be Caesar; not being Fortune, he’s but Fortune’s knave.



My letter to Kate Hoey, my MP, asking her to examine her conscience deeply in the dark night of the soul before the crucial vote on Brexit

Dear Kate Hoey,

Thank you for taking the trouble to respond to my email.

You make clear in your letter that you are a strong supporter of Brexit, which I knew. Indeed, I think that you could be called a supporter of a hard Brexit, even No Deal.

I believe in a representative democracy, which is what Britain is supposed to have, rather than government by referendum as decisions should be taken after study, deep thought, close examination of the evidence, and debate. We pay representatives to have the time to do these things and then take good decisions on our behalf. It’s the height of silliness to have decisions on matters as complex as whether or not to stay in the European Union by people who have not had the time to do those things and are fed by a torrent of misinformation.

It thus follows that you must decide how to vote after examining your conscience, although I imagine that the fact the constituency you represent voted more for remain than any other in the country must be part of your thinking–and must surely cause you discomfort if you continue to vote for Brexit.

If you vote for the government’s deal will be voting against your party and the wishes of more than three quarters of your constituents, but it is your right to do so.

The crunch will come, I suppose, after the vote on the government’s deal, which everybody expects the government to lose.

You will say that it’s illogical of me to want another referendum when I believe in representative government, and I agree that there is some illogicality. But unfortunately I see no other way for us to remain in the European Union, which I strongly believe is the right thing to do.

You say in your letter that you want to see a future that addresses the inequalities in our society. On that you and I are in complete agreement, but I can’t see how you can examine the evidence and reach the conclusion that Britain will be better off–and more able to address inequalities–by leaving the European Union.

The biggest tragedy of Brexit to my mind is that many of the people who voted for it, people left behind by society, will be the very people who suffer the most. The rich right-wingers who believe in “taking back control” will not suffer. I won’t suffer and nor will you.

The second biggest tragedy of Brexit is that it has created, or perhaps I should say enhanced, acrimonious and hostile divisions in our country over an issue that most people thought and cared little about.

Another tragedy is that the arguments over Brexit have diverted us from much more important issues like inequalities and environmental destruction. Going forward with Brexit will mean that government and Parliament will be preoccupied with negotiating future arrangements with the European Union for five to 10 years. As you know, the hard negotiations are still to come and we have exhausted and divided ourselves over the easier part.

As you examine your conscience in the “dark night of the soul” before tomorrow’s vote, do consider a People’s Vote as a way forward. If people continue to vote with Brexit they will do so with a much better understanding of what it will mean.

I ask you as well to reflect on what this means for young people, the vast majority of whom, including my three children, are strongly for staying in the European Union. You and I, old people, will not have long to live with the consequences of the decision–but they will have most of a lifetime to do so. Think of the young when you vote.

Best wishes


Richard Smith

Clapham, London


Painting Auntie Flo: “Now you monster”

“How many minutes till Auntie Flo get up?” Alexander starts asking this at about 6.30, some four hours before Auntie Flo does get up. We’ve played tennis, which Alexander insists is cricket, written to Father Christmas, got dressed, been to buy bacon and a chocolate egg, squeezed oranges and grapefruit, made porridge, read the Quangle-Wangle’s Hat, placed notices saying “No Grandads Allowed” on the door to the front room, and told each other jokes by the time we must take tea to Auntie Flo at the top of the house.

Auntie Flo, who got in at 4.30 in the morning, is to our surprise sitting up in bed awake. I ask her about the party, while Alexander investigates her make-up. Auntie Flo, I surmise, may still be a little drunk; she’s certainly flushed and cheerful. Alexander draws a brown line across her forehead. He’s pleased with the result and returns to the make-up.

While Auntie Flo and I chat Alexander does his work. He’s careful and assiduous, daubing different colours on every part of her face. Auntie Flo is very relaxed, enjoying his small fingers and gentle touch.

Now it’s time for Alexander and I to go downstairs and leave Auntie Flo. Alexander surveys his work and says “Now you monster.”

Flo and Alexander

Saul Bellow’s “Humboldt’s Gift”: “a comedy about death” that tells us much more about death than can be found in any learned treatise

Saul Bellow was at the height of his powers when he wrote Humboldt’s Gift, which finally won him the Pulitzer Prize and was central to him being awarded the Nobel Prize. It is, he said, “a comedy about death,” and as such it is a huge success. Almost every sentence is funny or insightful about death and life and often both.

By coincidence I’m reading The Denial of Death by Ernest Becker, which was published in 1973 and won the Pulitzer prize in 1974. (It’s not a complete coincidence as I read lots of books on death.) It slowly dawned on me that Bellow must have read the book–indeed, it may well have been the inspiration for Humboldt’s Gift, which was published in 1975, winning the Pulitzer Prize in 1976. Becker’s thesis is that human behaviour and culture is driven by the plight of being both a creature who knows it will decay and die and a being who can think, manipulate symbols, and aspire to be a God. For centuries religion in some form provided meaning, an answer to death, but now man must find his own answers–and is doomed to fail.

(I realised as well that Bellow tackles some of the material raised in Ivan Illich’s Medical Nemesis, which was also published in 1975, but I’ll come to that later. It was Illich, whom I heard talk in 1974, who had such a dramatic effect on my thinking and life. Bellow had quite likely encountered Illich because he was a major cultural figure at the time.)

Late in the book Bellow refers to the task he’d set himself in writing Humboldt’s Gift:

“I had been brought up to detest self-pity. It was part of my American training to be energetic, and positive, and a thriving energy system, and an achiever, and having achieved two Pulitzer prizes and the Zig-Zag medal and a good deal of money (of which I was robbed by a Court of Equity), I had set myself a final and ever higher achievement, namely, an indispensable metaphysical revision, a more correct way of thinking about the question of death!”

The narrator Charlie Citrine, a writer, is clearly an alter ego of Bellow, but both are also infused with the spirit of Humboldt, the dead and crazy poet. Bellow/Citrine emphaises the importance of tackling the question of death:

Ignorance of death is destroying us. No honorable person can refuse to lend his mind, to give his time, to devote his soul to this problem of problems. Death now has no serious challenge from science or from philosophy or religion or art….”

Intellectuals have not done well with the question of death, the main question:

“Oh, I admired some of these intellectuals without limits. Especially the princes of science, astrophysicists, pure mathematicians, and the like. But nothing had been done about the main question. The main question, as Walt Whitman had pointed out, was the death question.”

Like Becker, Bellow recognises that those animals, all the others we know of, that are simply creatures untouched by knowledge of their own deaths, have no problem with death:

“All around the lake the Forestry Service posted natural-history placards about the beaver’s life cycle. The beavers didn’t know a damn thing about this. They just went on chewing and swimming and being beavers. But we human beavers are all shook up by descriptions of ourselves.”

And, as in Becker, knowledge of or terror of death drives everything:

“On the metaphysical assumptions about death everyone in the world had apparently reached, everyone would be snatched, ravished by death, throttled, smothered. This terror and this murdering were the most natural things in the world. And these same conclusions were incorporated into the life of society and present in all its institutions, in politics, education, banking, justice.”

But Citrine/Bellow is finding no comfort in his quest:

“Thinking how the death problem is the bourgeois problem, relating to material prosperity and the conception of life as pleasant and comfortable, and what Max Weber had written about the modern conception of life as an infinite series of segments, gainful advantageous and “pleasant,” failing to provide the feeling of a life cycle, so that one couldn’t die “full of years.” But these learned high-class exercises didn’t take the death-curse off for me. I could only conclude how bourgeois it was that I should be so neurotic about stifling in the grave. The human being, more and more oppressed by the peculiar terms of his existence—one time around for each, no more than a single life per customer—has to think of the boredom of death. O those eternities of nonexistence! For people who crave continual interest and diversity, O! how boring death will be! To lie in the grave, in one place, how frightful!”

But he attempts an answer, an unsatisfactory one:

“Suppose, then, that after the greatest, most passionate vividness and tender glory, oblivion is all we have to expect, the big blank of death. What options present themselves? One option is to train yourself gradually into oblivion so that no great change has taken place when you have died. Another option is to increase the bitterness of life so that death is a desirable release. (In this the rest of mankind will fully collaborate.) There is a further option seldom chosen. That option is to let the deepest elements in you disclose their deepest information. If there is nothing but nonbeing and oblivion waiting for us, the prevailing beliefs have not misled us, and that’s that. This would astonish me, for the prevailing beliefs seldom satisfy my need for truth. Still the possibility must be allowed. Suppose, however, that oblivion is not the case? What, then, have I been doing for about six decades? I think that I never believed that oblivion was the case and by five and a half decades of distortion and absurdity I have challenged and disputed the alleged rationality and finality of the oblivion view.”

Later he reaches the same conclusion as Becker, that man needs faith:

“Now we must listen in secret to the sound of the truth that God puts into us.” Faith was called absurd. But now faith will perhaps move these mountains of commonsense absurdity.”

Citrine’s buxom, much younger girlfriend, Renata, who eventually abandons him for a rich undertaker, is unimpressed with Citrine’s efforts to answer the problem of death. She has a much simpler view of the problem, one shared by most people:

“You work, you get bread, you lose a leg, kiss some fellows, have a baby, you live to be eighty and bug hell out of everybody, or you get hung or drowned. But you don’t spend years trying to dope your way out of the human condition.”

And so to Illich, an intellectual and Jesuit excommunicated by the Catholic Church, who argued that medicine had tried to replace culture in dealing with pain, sickness, and death with an empty if implicit promise of defeating all three. It had expropriated health. Illich, it seems, was a follower of Goethe:

“Goethe was afraid the modern world might turn into a hospital. Every citizen unwell. The same point in Knock by Jules Romains. Is hypochondria a creation of the medical profession? According to this author, when culture fails to deal with the feeling of emptiness and the panic to which man is disposed (and he does say ‘disposed’) other agents come forward to put us together with therapy, with glue, or slogans, or spit, or as that fellow Gumbein the art critic says, poor wretches are recycled on the couch. This view is even more pessimistic than the one held by Dostoevski’s Grand Inquisitor who said: mankind is frail, needs bread, cannot bear freedom but requires miracle, mystery, and authority. A natural disposition to feelings of emptiness and panic is worse than that. Much worse. What it really means is that we human beings are insane. The last institution which controlled such insanity (on this view) was the Church—”

This is the most magnificent of books, a worthy winner of the Nobel Prize.


Immanuel Kant on the iniquity and consequences of the European empires

Much of this militarism, in Kant’s judgment, was due to the expansion of Europe into America and Africa and Asia; with the resultant quarrels of the thieves over their new booty.

“If we compare the barbarian instances of inhospitality . . . with the inhuman behavior of the civilized, and especially the commercial, states of our continent, the injustice practiced by them even in their first contact with foreign lands and peoples fills us with horror; the mere visiting of such peoples being regarded by them as equivalent to a conquest. America, the Negro lands. The Spice Islands, the Cape of Good Hope, etc., on being discovered, were treated as countries that belonged to nobody; for the aboriginal inhabitants were reckoned as nothing . . . . And all this has been done by nations who make a great ado about their piety, and who, while drinking up iniquity like water, would have themselves regarded as the very elect of the orthodox faith.”


Why are so many people so obsessed by shoes?

Something like a third of women in Britain own over a hundred pairs of shoes. Many men feel equally strongly about shoes. Most people have shoes that they wear only rarely or not at all. Why are we so obsessed by shoes?

I have stumbled across the answer–or at least one answer–in an unlikely place, Ernest Becker’s Pulitzer-prize winning book The Denial of Death. The obsession with shoes has to do with death–as does everything, according to Becker. The route between death and shoes lies through fetishism, a subject much loved by psychoanalysts and artists. Shoes are one of the commonest objects of fetishism. “The fetishist,” writes Becker, needs some object like a shoe or a corset before he can begin to make love to a woman.”

The thoughts and feelings of the fetishist are beautifully described in this case stufdy:

“Whenever he saw or touched [ladies boots] “the world changed miraculously,” he [the patient] said. What had just appeared as “grey and senseless within the dreary, lonely and unsuccessful everyday, then suddenly drifts away from me, and light and glamour radiate from the leather to me.” These leather objects seemed to have “a strange halo” shedding its light upon all other things. “It is ridiculous, but it feels like being a fairy prince. An incredible power, Mana, emanates from these gloves, furs and boots, and completely enchants me.” … Naked women or a woman’s hand without a glove or especially a woman’s foot without a shoe … seemed to be like lifeless pieces of meat in a butcher shop. In fact, a woman’s naked foot was really repulsive to him…. However, when the woman wore a glove, a piece of fur, or a riding boot, she was at once “raised above her arrogant, too humanly personal level.” She then grew above the “pettiness and vicious concreteness of the common female” with her “abhorrent genitals” and she was raised into the super individual sphere, “the sphere where superhuman and subhuman blend into universal godliness.”

Shoes and boots make the fetishist feel like a fairy prince and are a common objects of fetishism because feet are ugly things that make us think of death, decay, and our creatureliness, whereas shoes, which by necessity are foot-shaped, are like false feet, can be exquisite creations, symbolising our potential to rise above death–to be immortal, among the gods.

“It [the foot] is the closest thing to the body and yet is not the body, and it is associated with what almost always strikes fetishists as the most ugly thing: the despised foot with its calloused toes and yellowed toenails. The foot is the absolute and unmitigated testimonial to our degraded animality, to the incongruity between our proud, rich, lively, infinitely transcendent, free inner spirit and our earth-bound body….the foot is its own horror; what is more, it is accompanied by its own striking and transcending denial and contrast—the shoe.”

Knickers, bras, suspenders, and the like are just not as good as shoes, explains Becker:

“The genitals and breasts, it is true, are contrasted by underclothing and stiff corsets, which are popular as fetishes, but nothing equals the foot for ugliness or the shoe for contrast and cultural contrivance. The shoe has straps, buckles, the softest leather, the most elegant curved arch, the hardest, smoothest, shiniest heel. There is nothing like the spiked high heel in all of nature, I venture. In a word, here is the quintessence of cultural contrivance and contrast, so different from the body that it takes one a safe world away from it even while remaining intimately associated to it.”

Becker himself seems to be turned on by the thought of “the spiked high heel,” and this does seem to be a very male view of fetishism. I must seek out a feminist view–or maybe you can send me one–but Becker was writing his book in the early 70s when feminism was just getting going and nobody seemed to object to “he” substituting for “he and she.”

But if shoes don’t turn you on, stop to reflect what does–because, as Freud observed, fetishism is universal. Becker concludes: “all cultural contrivances are self-hypnotic devices—from motorcars to moon rockets—ways that a sorely limited animal can drum up to fascinate himself with the powers of transcendence over natural reality [decay and death].”



Tempting the middle classes away from the NHS by offering rapid access

I live in a well-to-do street in Clapham, making me and my neighbours a perfect target for those trying to promote immediate access to care and potentially, whether they mean it or not, potentially the NHS. Well, let me not resort to euphemism: we may not be as wealthy as people in Chelsea or Mayfair (many of whom are not there anyway), but we are rich. A house in this street costs over £2m, and most new purchasers start by gutting the houses they buy and completely refurbishing them for six months before they move in. Plus the street is full of writers and opinion-leaders: one resident has even written a best-selling novel televised on the BBC based on the street. We are the quintessence of the chattering classes.

So I wasn’t surprised when not one but two leaflets promoting immediate access to health care came through our letter box yesterday. The first came from the Lister Hospital, which is about a mile and half away over the river in Chelsea. “Just walk in, be seen quickly…Instant access to private care in CHELSEA…No appointment is needed…80% of our patients are seen within 15 minutes.” The leaflet also advertises care in four other sites.

The middle classes in this street know full well that if they go urgently to St Thomas’s or St George’s they are likely to find themselves in a zoo and wait four hours to see an inexperienced junior doctor. Many of the residents are “Bollinger Bolsheviks” with loyalty to the NHS, but waiting four hours to be seen by a junior doctor is no fun, especially if it’s your precious child. You can have cuisine from every country in the world delivered to your door in less than an hour, why should you have to wait four hours for an experience likely to be unsatisfactory? The leaflet doesn’t mention price, but people here could easily pay £200: we do that regularly for a meal out.

The other leaflet is subtler, offering NHS care via an app made by a private company. Babylon GP at hand promises “Get well soon [with the soon crossed out] now….Free NHS GP appointments on mobile 24/7, and at our clinics in London….Every session is free no matter how long…Prescriptions delivered to the pharmacy of your choice within an hour…Face to face appointments available across five London locations,” one of which is 15 minutes’ drive from our street. Very small print explains that you need to switch from your current GP. Some 35 000 people have done so.

Babylon argues with some justification that it is not about destroying the NHS but about reforming it–albeit through disruption. Probably at least 40% of consultations (and probably many more) can be comfortably managed online, and if you add in apps to measure blood pressure and the like it’ll be more. A few GPs have been using phone consultation for years, but a combination of financial arrangements and “that’s not how we do things” mean that most do not offer online or phone consultations. The appearance of Babylon and changes in payment are likely to encourage them to do so with benefits to both patients and practices.

The great criticism of Babylon is that they cream off younger, tech savvy, mostly well people leaving the old and multiply sick to existing services. Sensitive to this, Babylon’s leaflet emphasises that it takes patients with “complex health needs.”

Everybody in this street, where we don’t have many, if any, frail elderly people with multiple conditions, is comfortable online, doing their tax returns, travel booking, finances, and shopping online. They will welcome the chance to consult online.

As I said in an editorial I wrote nearly 20 years ago and posted in a blog yesterday, the NHS will crumble away if the middle classes desert. Ironically–with their sharp elbows and felicity with words and bureaucracy–the middle classes benefit more from the NHS than the disadvantaged, who get lost in the complexities of the NHS. But the middle classes will be unwilling to pay for an ever more expensive NHS if access and quality decline too far. So far its access not quality that is the problem, particularly access to general practice, and the Lister Hospital and Babylon see a business opportunity–hence the leaflets through our swanky doors.