Venice diary: Day 30 part 1: Sunday 9 March 2003

I’ve not read this diary since I wrote it, and as I read it today it gave me great pleasure to remember Ralph Crawshaw, a lovely man who features in this extract. Ralph was a psychiatrist in Oregon, and I had the strange experience of giving the Ralph Crawshaw Lecture with him sitting in the front row. Freddie, our oldest son, came with me to Oregon, and Ralph gave him a book of Walt Whitman’s poems and prose. I have it now, and in the front of the book Ralph has written: “To Freddy, with best wishes from a bit of the US. Sincerely Ralph Crawshaw MD July 17, 97.”

Ralph wrote wonderful essays in JAMA, including one accusing American doctors of greed. That did not make him popular. He is best known for driving through the Oregon Health Plan that was the first to explicitly recognise the need to ration health care. I wrote about it in the BMJ in 1991

and the article includes this marvellous quote from Daniel Fox, a Harvard historian: “What really astonished me… was the

wide open manner in which the rationing debate is being

carried out there. If one was searching for a classic exercise of

American democracy, in the sunlight, it is Oregon’s debate.”

One consequence of my friendship with Ralph was that John Kitzhaber, the governor of Oregon, came for dinner with us in Clapham. He wore cowboy boots.

I didn’t see Ralph again after our wonderful day together in Venice, and I wasn’t sure what had happened to him. But I see now that he died in 2014 aged 93:

John, I learn from Wikipedia, is still going and indeed has become the longest serving governor in the history of Oregon.

An elderly woman, perhaps 80, with a club foot on her way to see her dead husband.

I see her as I’m coming home from my morning walk and cappuccino on the Fondamente Nuove. I wonder what she’s thinking. Options:

“I wish I was with him, resting for ever under the turf of San Michele.”

“I’m longing for tonight’s match. One big push from Juve and they could win Serie A. My team.”

“I’d better be quick. Elide’s coming for lunch. She’ll go on and on about her lazy husband. I’ll have to try and find a way to cheer her up.

The first seemed the most likely to me.

But on Thursday I was with Ralph Crawshaw, an 82-year-old psychiatrist. We had a wonderful afternoon. The big boat to Burano. The best meal I’ve had so far in Venice (and they are getting better): baby squid and prawns out of the lagoon that morning. Served by an Italian waiter with a strong Scottish accent—born in Burano, three years in Edinburgh, back in Burano for eight years with an Edinburgh wife and a two-year-old daughter.

Then we went to Torcello. Everything I hoped it would be. Beautiful Byzantine church. A huge mosaic on the wall that showed everything—yes, everything—that an 11th century peasant needed to know. God in his heaven. The blessed with him. Christ in the middle, surrounded by the faithful. At the bottom skulls with worms crawling through them, people both roasting and freezing in hell, and the devil looking like a mad African with a puppet on his knee. These are your choices.

Coming back on the boat—with the light on the lagoon making me feel that perhaps I’m already in the heaven I don’t believe in—Ralph says: “I feel like an adolescent. Back in Portland people keep saying “My eyes are dropping out. My hip’s gone. I feel so depressed.” But here am I feeling like an adolescent, on a great day out. When we get back, I’ll take my last walk through Venice, have a little dinner, smoke a Havana cigar, and read Ruskin on Torcello. My taxi comes at 7.30 in the morning.”

Ralph knows this will be his last trip to the city he loves and has visited 14 times. I suppose he’s ready for death, but he’s full of books he wants to read, things he wants to do. “We are so unprepared for the 21st century,” he keeps saying. But, of course, he doesn’t need to be.

“I remember coming to Europe in 1963, and it was great to be an American. People kept talking admiringly about JFK. Now I’m ashamed. I hope nobody will notice I’m American.”

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