A strong book that shows how with more Edmund Burke and less Boris and acolytes Britain would be a much better place

Edmund Burke (1729-1797) was a Whig who is widely regarded as the philosophical founder of conservatism. His influence was huge in the 18th and 19th centuries, particularly in the United States, but has faded in the 21st century, perhaps ironically at a time when his thinking might be most valuable as conservative parties around the world forget what it means to be conservative.

I knew Burke primarily for his [misattributed quote] that “The only thing necessary for the triumph of evil is for good men to do nothing.” Time has edited and improved his words, which were: “When bad men combine, the good must associate; else they will fall, one by one, an unpitied sacrifice in a contemptible struggle.” Through my reading of various books and articles I did have the idea that Burke would have greatly disapproved of Boris Johnson and the modern Tory party, which doesn’t seem to know what it does stand for, and I wanted to know more. The book I found was Edmund Burke: The Visionary Who Invented Modern Politics by Jesse Norman, and my suspicion of Burke disapproving of today’s conservatives was confirmed. It took me a little while, however, to grasp that the author is himself a Tory MP.

Impressed by his book on Burke and knowing that his book on Adam Smith is highly regarded, I thought that Norman might be an ideal leader of the Tory party, returning it to some sort of sense. I contemplated sending him an email, urging him to stand—but a friend who knows him warned me off. She pointed out, entirely correctly, that writing a good book is not a qualification for being a prime minister, and when I thought of Proust, Wodehouse, and Hemingway I could see that she was right.

Norman divides his book, somewhat artificially, into two parts: Burke’s life and Burke’s thinking. As much of Burke’s life was taken up by writing, the life and the thinking greatly overlapped.

Burke was a prophet of moderation and wary of radical change, particularly when that change was driven by reason. “Moderation,” he wrote, “is a virtue not only amiable but powerful. It is a disposing, arranging, conciliating, cementing virtue.” Norman summarises his views on reason: “Human reason is a wonderful thing, but Burke insists we are above all creatures of sentiment, emotion, passion and allegiance, for good or ill.” We are imperfect creatures, and when driven hard by reason can come badly unstuck.

The other things apart from his misquoted quote for which Burke bet known is his book Reflections on the Revolution in France published in 1790 in which he predicted that the revolution would descend into brutality and chaos and lead to the appearance of a despot who would create havoc in Europe. Napoleon, undoubtedly a great man, was an Enlightenment figure driven by reason and a huge ego.

Norman argues that Burke created modern politics. He was a proponent of Parliament rather than the king [or later prime minister] leading the country. Nor should it be “the people,” but their representatives in Parliament. “The fundamental constitutional principle in Britain is thus one not of popular sovereignty, but of parliamentary sovereignty. For it is Parliament that represents, distils, debates, constrains and ultimately balances the different views and interests in society.”

Burke recognised that for Parliament to work there would need to be political parties, and the Whigs he belonged to were a prototype party. “He insists that power can never be properly exercised by an individual, however distinguished, for any great length of time. Practically, then, the only solution is a principled assertion of the power of the House of Commons, through political parties: ‘Government may in a great measure be restored, if any considerable body of men have honesty and resolution enough never to accept Administration, unless this garrison of King’s men, which is stationed, as in a citadel, to control and enslave it, be entirely broken and disbanded, and every work they have thrown up be levelled with the ground.”

Read Boris for King and the government for “this garrison of King’s men.” It took the Conservative Party far too long, but they did eventually break up and disband the garrison of Boris’s men and women. Nor is there much sign that “every work they have thrown up be levelled with the ground” when the two candidates for prime minister were both in Boris’s cabinet.

Burke was also very clear that MPs, of which he was one, should not slavishly follow the line of either their party or their constituents. They have a duty to think for themselves, weight evidence, and make judgements. (This should, indeed, be true for all of us.) “But his [the MP, and please read “his or her” for “his”] unbiased opinion, his mature judgement, his enlightened conscience, he ought not to sacrifice to you; to any man, or to any set of men living. These he does not derive from your pleasure; no, nor from the Law and the Constitution. They are a trust from Providence, for the abuse of which he is deeply answerable. Your representative owes you, not his industry only, but his judgement; and he betrays instead of serving you, if he sacrifices it to your opinion….Parliament is not a congress of ambassadors from different and hostile interests … Parliament is a deliberative assembly of one nation, with one interest, that of the whole; where not local purposes, not local prejudices ought to guide, but the general good, resulting from the general reason of the whole. You choose a member, indeed; but when you have chosen him, he is not a member of Bristol, but he is a member of Parliament.”

I have never voted Conservative in any election and can’t imagine that I ever will, but I find that I empathise with much of what Burke writes, but it’s clear to me that Burke is much closer to parties that occupy the centre ground of politics than he is to the modern Conservative party.

Two other things that I liked particularly from Burke were his ideas on reform and his recognition of the importance of future generations. “The classic Burkean idea [is] that to be effective reform should be early, cool in spirit and proportionate, governing with the temper of the people.” My instinct is to be more radical than that—for example, in hastening our response to the planetary crisis–but I recognise that getting too far ahead of the people leads to failure. Burke would very much have approved of the Wales Future Generations Act, and I hope that we might soon have a similar act in England. Society, for Burke, was ‘a partnership not only between those who are living, but between those who are living, those who are dead, and those who are to be born’.

But perhaps most his far-sighted thinking was to recognise that we should think of human beings not as individuals but as members of families and communities. I have blogged about this already, https://richardswsmith.wordpress.com/2022/06/05/the-starting-point-to-thinking-about-people-is-to-recognise-that-they-are-not-individuals-but-social-creatures/ but let me repeat this quote: “For Burke man is a social animal, a politikon zoon, an animal whose nature is to be in society. Indeed, there is little or no sense to be attached to the idea of man as an atom, wholly cut off from human society. The human self is a social self. This is an idea with vast and often still unrecognized implications.”

Here are other quotes I took from the Book:

Burke’s philosophy

For it insists that reason is guided by the emotions; that power is a trust; that the social order is a priceless inheritance; that there are no new moral principles, or principles of government; and that the proper attitude of those who aspire to power is humility, modesty and a sense of public duty.

For Burke the essentials of political leadership remain the same: modesty, restraint, attention to history, judgement in fitting the action to the need, trust, consensus, coolness, a wholehearted commitment to public service and the preservation of the nation.

There can be little doubt that Burke falls on the conservative side of the argument [of liberalism versus conservatism]. As we have seen, liberalism – like its modern offshoot, libertarianism or neoliberalism – emphasizes the primacy of the individual; Burke emphasizes the importance of the social order. Liberalism sees freedom as the absence of impediment to the will; Burke sees freedom as ordered liberty. Liberalism believes above all in the power of reason; Burke believes in tradition, habit and ‘prejudice’. Liberalism stresses universal principles; Burke stresses fact and circumstance. Liberalism is unimpressed by the past; Burke quarries it. Liberalism admires radical change; Burke detests it. The liberal will cannot be made the subject of duties; Burke insists upon them. The evidence is clear.

Burke is, then, the first conservative. But he has no monopoly on conservatism, and his own version has a strongly Whiggish flavour to it. It supports Parliament over the executive, and favours toleration. It emphasizes free economic and social institutions at every level and in every part of society, and it is deeply suspicious of great concentrations of power, be they those of the monarch, the East India Company or the modern state.

The thought that there can be no absolutely consistent worthwhile ethical theory is a rather Burkean insight,

The best virtues

‘Those which engage our hearts, which impress us with a sense of loveliness, are the softer virtues; easiness of temper, compassion, kindness and liberality; though certainly these are of less immediate and momentous concern to society, and of less dignity. But it is for that reason that they are so amiable.’

Observations on politics

Politics ought to be adjusted, not to human reasonings, but to human nature; of which the reason is but a part, and by no means the greatest part’.

The British constitution

Burke likens the British constitution to an old building, which ‘stands well enough, though part Gothic, part Grecian, part Chinese, until an attempt is made to square it into uniformity. Then it may come down upon our heads altogether, in much uniformity of ruin; and great will be the ruin thereof.’

MPs are by no means perfect

‘The calculators compute them out of their senses. The jesters and buffoons [think Daily Mail and Daily Express] shame them out of every thing grand and elevated. Littleness, in object and in means, to them appears soundness and sobriety. They think there is nothing worth pursuit, but that which they can handle; which they can measure with a two-foot rule; which they can tell upon ten fingers.’

England is embodied in Europe

The great resource of Europe was in England. Not in a sort of England detached from the rest of the world, and amusing herself with the puppet show of a naval power … but in that sort of England, who considered herself as embodied with Europe; in that sort of England, who, sympathetic with the adversity or the happiness of mankind, felt that nothing in human affairs was foreign to her.

The age of chivalry is gone. That of sophisters, economists and calculators has succeeded; and the glory of Europe is extinguished forever.

There are things that are common to all humans

There is a basic core of human nature, which is stable across all cultures, no matter how different they may otherwise be. All humans have fundamentally the same facial expressions for anger, fear, disgust, contempt, sadness and shame. All divide time into past, present and future. All have a primal fear of strangers and snakes. All appear to have a language instinct, which allows them as children to acquire natural language at an extraordinarily rapid rate. Something similar is true for numbers: human infants just twenty weeks old can correctly compute the answers to very simple addition and subtraction tasks. At the group level, all human societies have taboos against rape and murder. All distinguish between members and non-members, and their members rank each other for prestige in different ways. All produce art, enjoy story-telling and worship a god or gods.

Disraeli’s career

Lord Randolph Churchill, father of Winston, once summarized Disraeli’s life as ‘Failure, failure, failure, partial success, renewed failure, ultimate and complete triumph.’

The running of the Spanish and Dutch empires

 ‘In government, tyranny; in religion, bigotry; in trade, monopoly.’

Climate at the Royal Academy Summer Show

The Royal Academy is one of the very best of British institutions. It’s an elitist organisation in that you have to be a distinguished artist to be a Royal Academician, but as it’s the nature of artists to be unstuffy—think Tracey Emin, Grayson Perry, and most of those who are familiar—it’s very unstuffy. Anybody can enter the building, which has become much more interesting with an extension and redesign. There are excellent cafes, restaurants, and shops—and the loos are clean and capacious if you are stuck in Piccadilly and need a pee. The exhibitions are almost always of a high standard and well curated.

Then once a year the Academy holds the world’s largest open exhibition, the Summer Show, https://www.royalacademy.org.uk/exhibition/summer-exhibition-2022 when anybody can submit anything. They have about 15 000 submissions of paintings, drawings, sculptures, architectural models—indeed, anything that could be called art—and about 1500 make it into the show. People might have their first ever drawing selected and find it hung beside a work from a world-famous artist who can sell pictures for hundreds of thousands of pounds. Apart from the Academicians having the right to exhibit something (and why not?), it’s a tremendously democratic institutions—art’s equivalent of the Edinburgh Fringe.

We visited the show last week, and it was crowded. I thought— snobbishly, my wife would say—that lots of the people there would probably go only to the summer show. It was a more diverse audience than at most shows, although David Hockney, an Academician, always packs people in. Many of the works are funny, and with the light-filled rooms, some of the painted bright yellow, the hundreds of pictures and sculptures, and people drinking prosecco as they tour the galleries, the feeling is joyous.

Yet this year’s theme, as was immediately obvious, is climate. What other theme, I thought, could be possible?

The most powerful piece, Cull, won the top prize. It’s a video shown on five screens of giant sequoias crashing to the ground as they are felled to protect local inhabitants. These trees are 2000 years old and 25-stories high. The redwood forests of California are the place where I have felt most intensely the spiritual power of nature. Wildfires are raging across the world burning paradises, and trees are being felled everywhere. We have failed (or I should better say forgotten as many indigenous peoples knew better) as a species to recognise our independence with trees and nature.

Cull. Uta Kögelsberger

I selected several works from the exhibition. They are below. I recommend a visit if you are in London before 21 August.

The British Museum of Decolonised Nature. Studio JZ
Atomic Landscape. Zaxhary Walsh. #preparefordeath
I used to love you. Kevin Knowles
Looking Glass. Gavin Turk
Nicola Hicks. Ringmaster
Scott Brooker. Thanks, Man!

“Persuasion”: an erotic novel full of judgements, most of them sound, but what about slavery?

My friend Beth says that Jane Austen is the most erotic of writers and reading Persuasion I see what she means. There is no flesh, no sweat, and only the most delicate language, and yet we share the longing of Anne Elliot to be reunited with the man she loved eight years ago and rejected. In contrast, after finishing Persuasion I started reading Fleishman Is In Trouble, a book stuffed with fucks and boners, and found myself repelled. I’ve ditched the book after 30 pages, enough, I feel, to give it a chance.

I took many quotes from Persuasion and have included them below with my take on Austen’s message. (I read most of Austen’s novels years ago, and I think I’m right in saying that the clever girls, even if not terribly pretty, get the man, perhaps explaining why bookish girls are so keen on Austen.)

But before I get to the quotes and messages. I have to note the mentions of the “West Indies,” two words that immediately male me think “slavery.” Austen published Persuasion in 1817, 10 years after the first law to begin to stop slavery. She must have been aware of the passionate debate around slavery, and she must have known as well that the economy of the West Indies was based on slavery and that many Britsih institutions ad people had been enriched by their investments in the West Indies. The British navy had defended British slaving ships for years, but after the 1807 act it seized slave ships.

Captain Wentworth, the object of Anne’s desire, had been “sent off to the West Indies,” commanding a naval ship. He had gone to sea after being rejected by Anne some eight years before, and so it seems after the 1807 Act. Does it add to his nobility that he was fighting against slavery? Did Austen intend that? What follows suggests not.

Later we learn that Mrs Croft, who always and unusually sailed with her husband, “was never in the West Indies.” The admirable Admiral Croft is untainted by any link with slavery.

But the dead husband of Mrs Smith, an impoverished invalid but noble woman who bears her suffering with great fortitude, had “property in the West Indies.” This would surely have been a plantation worked by slaves, and at the end of the book when everything is being neatly tied up Captain Wentworth, now married to Anne, manages to put “her in the way of recovering her husband’s property in the West Indies, by writing for her, acting for her, and seeing her through all the petty difficulties of the case with the activity and exertion of a fearless man and a determined friend, fully requited the services which she had rendered, or ever meant to render, to his wife.” Slavers, in contrast to slaves, were compensated when their slaves were “freed,” and we must suspect that Captain Wentworth helped Mrs Smith profit from slavery.

As we are always led to think well of Captain Wenwtworth and Mrs Smith, I can only suppose that slavery was not in Austen’s mind when she wrote of the West Indies.

And now the quotes and messages from Persuasion:

Brains in a woman are essential for a discriminating man

“A strong mind, with sweetness of manner.”

The discomfort of meeting again somebody you have loved and lost can be exquisite

It was agitation, pain, pleasure, a something between delight and misery.

She had distinguished every word, was struck, gratified, confused, and beginning to breathe very quick, and feel an hundred things in a moment.

A woman never forgets a man she has loved and lost (and nor does a man

We certainly do not forget you as soon as you forget us. It is, perhaps, our fate rather than our merit. We cannot help ourselves. We live at home, quiet, confined, and our feelings prey upon us. You are forced on exertion. You have always a profession, pursuits, business of some sort or other, to take you back into the world immediately, and continual occupation and change soon weaken impressions.”

A man does not recover from such a devotion of the heart to such a woman. He ought not; he does not.

Good manners are everything and will overcome ugliness (at least for a woman)

“There is hardly any personal defect,” replied Anne, “which an agreeable manner might not gradually reconcile one to.”

Beyond our circle we are nothing

She must now submit to feel that another lesson, in the art of knowing our own nothingness beyond our own circle, was become necessary for her.

Death has value

The real circumstances of this pathetic piece of family history were, that the Musgroves had had the ill fortune of a very troublesome, hopeless son; and the good fortune to lose him before he reached his twentieth year; that he had been sent to sea because he was stupid and unmanageable on shore.

Generosity is good, vanity bad

The origin of one all selfish vanity, of the other all generous attachment.

The right kind of character and spirit will allow you to cope with being ill

A submissive spirit might be patient, a strong understanding would supply resolution, but here was something more; here was that elasticity of mind, that disposition to be comforted, that power of turning readily from evil to good, and of finding employment which carried her out of herself, which was from nature alone. It was the choicest gift of Heaven;

The bad are very bad

Mr Elliot is a man without heart or conscience; a designing, wary, cold-blooded being, who thinks only of himself; whom for his own interest or ease, would be guilty of any cruelty, or any treachery, that could be perpetrated without risk of his general character. He has no feeling for others. Those whom he has been the chief cause of leading into ruin, he can neglect and desert without the smallest compunction.

Beware of books

I will not allow books to prove anything.

Autumn is the season for those who have taste

That season [autumn] of peculiar and inexhaustible influence on the mind of taste and tenderness.

Hypocrisy is everywhere, even in a generous heroine with exquisite manners

Like many other great moralists and preachers, she had been eloquent on a point in which her own conduct would ill bear examination.

Jane Austen would, I think, have approved of me because I never look in a mirror

As I read Jane Austen’s Persuasion I try to see myself in her beautifully-drawn world. As I’m low on “manners,” I don’t think that I’d get by in the Bath drawing rooms and country homes of her novels. Lacking the refinement to be even a butler or footman, I’d have been more comfortable as the gardener or even the man who looked after the pigs—and such people don’t feature in her novels.

But then I read about Admiral Croft and saw that Austen might have approved of me. Croft is an old, weather-beaten sea dog, who has fought in many battles, including Trafalgar. Sir Walter, Anne’s father and the shallowest and vainest of men, “declared that the Admiral was the most handsome sailor he had ever met, and went so far as to say that if his man could have fixed his hair, he would not be ashamed to be seen with him everywhere.” I doubt that the Admiral’s hair was as unruly as mine, and I’m sure that Sir Walter would be ashamed to be seen with me whatever I did to my hair.

Sir Walter needs mirrors everywhere in which to admire himself, and the Admiral has them removed when he rents Sir Walter’s house. It was here that I came to see a parallel between me and the Admiral. My wife accuses me of never looking in a mirror, and she’s right. (Similarly I can never listen to myself on the radio or in a podcast or watch myself on television.) My wife thinks that if I did look in a mirror I would not allow myself to go around looking as I do.

This is what the Admiral says about Sir Walter and then himself: “A very good man, and very much the gentleman I am sure: but I should think, Miss Elliot,” (looking with serious reflection), “I should think he must be rather a dressy man for his time of life. Such a number of looking-glasses! oh Lord! there was no getting away from one’s self. So I got Sophy to lend me a hand, and we soon shifted their quarters; and now I am quite snug, with my little shaving glass in one corner, and another great thing that I never go near.”

I doubt that the Admiral dresses as badly as me, and Sophy may have had more success managing the Admiral than my wife has had with me, but Austen clearly deplores vanity—and it’s that deploring that might have led her to see a little virtue in me.

I regularly walk past the house in Winchester where Austen died, and next time I do I will doff my hat (not that I ever wear a hat, even when it’s raining or snowing.)

Advice on living from the greatest English poet of love and sex

A fellow of All Souls, Katherine Rundell has a passion for the poetry of John Donne that is almost sexual, which is appropriate as he is not only the great English poet of love but also of sex. ‘Love’s mysteries in souls do grow/ But yet the body is his book.’ “Donne,” says Rundell in Super-Infinite: The Transformations of John Donne, “wrote sex as the great insistence on life, the salute, the bodily semaphore for the human living infinite.” Rundell has slaked her lust for Donne by exploring every part of his thinly-documented life and revelling in his poetry: “He wrote poems that take all your sustained focus to untangle them. The pleasure of reading a Donne poem is akin to that of cracking a locked safe, and he meant it to be so.” It seems unlikely that Rundell has ever cracked a safe, but only the frigid and impotent will fail to share her passion for Donne’s poetry by the time they have finished this luxuriant book.

I know Donne as poet, lover, and cleric and have wondered how it was that “a man of the church” could write such erotic poetry, but Rundell makes clear that he was much more: “Sometime religious outsider and social disaster, sometime celebrity preacher and establishment darling, John Donne was incapable of being just one thing. He reimagined and reinvented himself, over and over: he was a poet, lover, essayist, lawyer, pirate, recusant, preacher, satirist, politician, courtier, chaplain to the King, dean of the finest cathedral in London. It’s traditional to imagine two Donnes – Jack Donne, the youthful rake, and Dr Donne, the older, wiser priest, a split Donne himself imagined in a letter to a friend – but he was infinitely more various and unpredictable than that.” Rundell explores all those Donnes.

Born a Catholic, Donne saw his brother tortured and executed for his faith. Donne became a Protestant, and he became dean of St Paul’s more because he needed the money than because of the ardour of his faith. But he was a great preacher. Crowds came to see him, and he preached for kings. “Sermons,” explains Rundell, “were heard hungrily: they had breaking news in them, politics, entertainment, theatre; people gossiped about them and picked over in the week that followed.” The distance between preacher and poet is, I now understand, small, as both are masters of words and stories. “Poetry could be made,” writes Rundell, “to function as entertainment, news, flirtation, insinuation, slander, religious contemplation, invoice, in-joke, thank-you note, apology, profound meditation of love, scurrilous sex dream.”

Donne was also a great writer of letters, and most of his poems were incorporated into his letters as offerings to his friends. His poems were gathered together after his death, and there may still be poems to be found. A letter for Donne was “akin to an extension of the living person, and should not exist without its parent….‘Sir, more than kisses, letters mingle souls,/ for, thus friends absent speak.’

Gathering words, sayings, knowledge, and thoughts in his Commonplace book, as was a custom then, Donne delighted in language and “accounts for the first recorded use in the Oxford English Dictionary of around 340 words in the English language. Apprehensible, beauteousness, bystander, criminalist, emancipation, enripen, fecundate, horridness, imbrothelled, jig.”

Life was far from easy for Donne with death of family members, including his children, all around him. “There was a constant running through his life and work: he remained steadfast in his belief that we, humans, are at once a catastrophe and a miracle….He believed us unique in our capacity to ruin ourselves: ‘Nothing but man, of all envenomed things,/Doth work upon itself with inborn sting’. Donne was “often hopeless, often despairing, and yet still he insisted at the very end: it is an astonishment to be alive, and it behoves you to be astonished.” I think often of the Jewish prayer that advises keeping a note in one pocket saying “you are nothing but dust and ashes” and another in the opposite pockets saying “The world was created just for you.”Donne,” writes Rundell, “suggests that you look at the world with both more awe and more scepticism: that you weep for it and that you gasp for it.”

Rundell ends her book with Donne’s most famous words:

“No man is an island, entire of itself; every man is a piece of the continent, a part of the main; if a clod be washed away by the sea, Europe is the less, as well as if a promontory were, as well as if a manor of thy friend’s or of thine own were; any man’s death diminishes me, because I am involved in mankind, and therefore never send to know for whom the bell tolls; it tolls for thee.”

“We, slapdash chaotic humanity,” concludes Rundell paraphrasing Donne’s advice for living, “persistently underestimate our effect on other people: it is our necessary lie, but he refused to tell it. In a world so harsh and beautiful, it is from each other that we must find purpose, else there is none to be had.”

Other quotes I took from the book:

Man: catastrophe and miracle

Joy and squalor: both Donne’s life and work tell that it is fundamentally impossible to have one without taking up the other. You could try, but you would be so coated in the unacknowledged fear of being forced to look, that what purchase could you get on the world? Donne saw, analysed, lived alongside, even saluted corruption and death.

What good is perfection to humans? It’s a dead thing. The urgent, the bold, the witty, the sharp: all better than perfection.

Advice for living

 Be thine own palace,or the world’s thy jail.’

Writing and language

The word most used across his poetry, apart from ‘and’ and ‘the’, is ‘love’.

Donne’s [Commonplace] book must surely have had: angels, women, faith, stars, jealousy, gold, desire, dread, death.

Commonplacing was a way to assess material for those new connections: bricks made ready for the unruly palaces he would build.

It is necessary to shake language until it will express our own distinctive hesitations, peculiarities, our own uncertain and never-quite-successful yearning towards beauty.

Language, his poetry tells us, is a set, not of rules, but of possibilities.

‘Language, thou art too narrow, and too weak

To ease us now; great sorrow cannot speak.’


Foxes and goats, all beasts change when they please:

Shall women, more hot, wily, wild then these,

Be bound to one man?

But he who loveliness within

Hath found, all outward loathes,

For he who colour loves and skin,

Loves but their oldest clothes.

‘I am a little world made cunningly

Of elements and an angelic sprite.’

Illness, death, and life

To be ill, then, is to journey closer to the reality of death, to be closer to the ear of God in order to importune him. And the closer to death, the more clearly you see the richness of living.

What he sees in the doctors who attends him when he is dying:

‘I see he fears, and I fear with him; I overtake him, I overrun him, in his fear, and I go the faster, because he makes his pace slow; I fear the more, because he disguises his fear, and I see it with the more sharpness, because he would not have me see it.’

He knew that readers give special weight to the words of those who are at the edge of life.

‘We study health, and we deliberate upon our meats, and drink, and air, and exercises; and we hew, and we polish every stone, that goes to that building; and so our health is a long and regular work. But in a minute a cannon batters all, overthrows all, demolishes all; a sickness unprevented for all our diligence, unsuspected for all our curiosity; nay, undeserved if we consider only disorder, summons us, seizes us, possesses us, destroys us in an instant.’

When Donne wrote about suicide there was urgent pain: but when he wrote about death in itself, there is great serious joy, and occasional rampant glee.

‘I am afraid that Death will play with me so long, as he will forget to kill me, and suffer me to live in a languishing and useless age.’


‘There shall be no cloud nor sun, no darkness nor dazzling, but one equal light; no noise nor silence, but one equal music; no fears nor hopes, but one equal possession; no foes nor friends, but an equal communion and identity; no ends nor beginnings; but one equal eternity.’

Flattery as an art form

‘All that I mean in using this boldness, of putting myself into your Lordship’s presence by this rag of paper is to tell your Lordship that I lie in a corner, as a clod of clay, attending what kind of vessel it shall please you to make of Your Lordship’s humblest and thankfullest and devotedest servant.’

Marvellous writing from Bertrand Russell to console you amid the idiocy and emptiness of the Tory leadership election and life’s many other woes

But while the trivial pleasures of culture have their place as a relief from the trivial worries of practical life, the more important merits of contemplation are in relation to the greater evils of life, death and pain and cruelty, and the blind march of nations into unnecessary disaster.

For those to whom dogmatic religion can no longer bring comfort, there is need of some substitute, if life is not to become dusty and harsh and filled with trivial self-assertion. The world at present is full of angry self-centred groups, each incapable of viewing human life as a whole, each willing to destroy civilisation rather than yield an inch. To this narrowness no amount of technical instruction will provide an antidote.

The antidote, in so far as it is a matter of individual psychology, is to be found in history, biology, astronomy, and all those studies which, without destroying self-respect, enable the individual to see himself in his proper perspective.

What is needed is not this or that specific piece of information, but such knowledge as inspires a conception of the ends of human life as a whole: art and history, acquaintance with the lives of heroic individuals, and some understanding of the strangely accidental and ephemeral position of man in the cosmos—all this touched with an emotion of pride in what is distinctively human, the power to see and to know, to feel magnanimously and to think with understanding. It is from large perceptions combined with impersonal emotion that wisdom most readily springs.

This comes from the end of Russell’s essay “Useless” knowledge, which begins with these wonderful three sentences: “Francis Bacon, a man who rose to eminence by betraying his friends, asserted, no doubt as one of the ripe lessons of experience, that ‘knowledge is power’. But this is not true of all knowledge. Sir Thomas Browne wished to know what song the sirens sang, but if he had ascertained this it would not have enabled him to rise from being a magistrate to being High Sheriff of his county.” (I must confess that I have broken one paragraph into four to make the passage a little easier to read for the modern reader used to short paragraphs.)

How will the world be when humans are gone? 12 practical answers

It feels not long until humans will be gone, perhaps in less than a hundred years. The Earth has spent well over 99% of its existence without any humans, but now that we have made a mess of the planet we find ourselves wondering how the damaged Earth will be when we are gone. There are two starkly contrasting theories, which I’ll summarise below, but the adventurous Cal Flyn has tried to answer the question by visiting 12 places where humans have already gone after leaving a mess and written an excellent and in the end uplifting book about the experience, Islands of Abandonment: Life in the Post-Human Landscape.

The well-known Gaia hypothesis (named after the Greek good of the Earth) is that living organisms interact with their inorganic surroundings on Earth to form a self-regulating system that maintains and perpetuates the conditions for life on the planet. It seems to have little evidence to support it and is falling out of favour. The contrary Medea hypothesis (named after the Greek mother who killed her children) is that multicellular life is suicidal. There have been some eight mass extinctions and man-made climate change is the latest. One, which still has some way to run.

These are the 12 places that Flyn visited and something about what she found.:

  • The Five Sisters, West Lothian, Scotland are high hills of gravel left from 19th century oil extraction from shale. Abandoned by humans, the sisters have become asylums for wildlife threatened elsewhere: “Hares and badgers, red grouse, skylarks, ringlet butterflies and elephant hawkmoths, ten-spotted ladybirds. Among the flora was a diverse array of orchids – the vanishingly rare Young’s helleborine, a delicate, many-headed flower in pale greens and pinks, found in only ten locations in Britain (all post-industrial); the early purple orchid in ragged mauve; the greater butterfly orchid, with its winged petals – and a genetically distinct birch woodland that had established naturally at the base of the tiny bing at Mid Breich.”
  • The Buffer, the demilitarized zone in Cyprus left from the war in 1974. Scientists have recorded “358 species of plants, 100 species of birds, 20 reptiles and amphibians and 18 mammals.” The demilitarized zone between the two Koreas hosts “the Asiatic black bear, the Korean water deer, the rare long-tailed goral and the diminutive leopard cat,” all of which are rare in human-occupied Korea.
  • Chernobyl, Ukraine, abandoned after the nuclear meltdown in 1986. After the area was sealed off “animals reappeared: lynx, boar, deer, elk, beavers, eagle owls – and on, and on.” A decade after the accident “every animal population in the zone had at least doubled in number. By 2010, the wolves had increased sevenfold. In 2014, brown bears were spotted in Chernobyl for the first time in a century.”
  • Blight, abandoned houses in Detroit, Michigan, United States. Blightbusters turn scrappy vegetation into lawn. “Mow any type of vegetation three times, and it will turn into grass.”
  • Paterson, New Jersey, an abandoned industrial landscape where the river caught on fire and spewed poison into the sea. Fyn meets Wheeler, who says “My goal is to find old factories, junked cars, discarded oil tankers and drowned boats … the underbelly of our highways, the dirty bottom of our sewage system … the forgotten zone.” Fyn finds something “sublime”: “In an urban environment, entering an abandoned space is the nearest thing we have to stepping off the map. It offers anonymity, the succour of green space – without the order, the omnipresence of man, so implicit in the park or garden. An urban ruin might offer an effect upon the mind akin to slipping into the dark forest, or scaling a rugged peak, that same wild element, and we might seek it out for similar reasons.”
  • Arthur Kill, Staten Island, where the Passaic River has poured poison into the sea. The place has become a bird sanctuary: “In 1980, egrets were discovered nesting there, and since then it has become a haven for water fowl – glossy ibises, black-crowned night herons, cormorants have all taken up residence in this shabby palace.”  Pollution-tolerant species begin to flourish: “bluefish, weakfish, blackfish, catfish, dogfish.” Crabs proliferate but cannot be eaten. Killifish have evolved to become resistant to pollution.
  • Zone Rouge, Verdun, site of a major battle in the First World War that poisoned the land and has been fenced off. Almost 20% of the soil is arsenic, and there are many heavy metals left in the soil, making this a good place for metallophytes, metal-loving plants that grow in soils rich in metals and have flowers of different colours depending on the metal in the soil.
  • Amani, Tanzania, an almost abandoned botanical garden planted by German colonialists in 1902 in an area of virgin and unusual tropical forest. Imported species battle with the locals as grey squirrels battle with red squirrels in Britain. A study found that in Amani “thirty-eight exotic plant species had become naturalised, while sixteen had escaped their designated plots and were running rampant through old-growth forest.” The battle continues.
  • Swona, Scotland, occupied for thousands of years this small island was finally abandoned in 1974, leaving cows behind to look after themselves. They have survived becoming feral and of great scientific interest. How far and how fast can domesticated animals dedomesticate?
  • Salton Sea, California. The Colorado river flooded a huge area in 1905, creating at first a sea with seaside entertainment but then as the sea dried an area of sludge and industrial ruin. “This was a sick ecosystem heaping sickness upon sickness in a cycle of destruction, an environment spinning dangerously out of control.” Flyn visits Slab City, a postindustrial slum but also “the last free space in America” where criminals, the homeless, lost, and dispossessed live a “free life.”

Fyn, although she has learned about the Medea hypothesis, read the apocalyptic Book of Revelation in the Bible, studied the ecological crisis, and visited these abandoned and poisoned places refuses “to accept the inevitability of a fallen world, a ruinous future….Everywhere I have looked, everywhere I have been – places bent and broken, despoiled and desolate, polluted and poisoned – I have found new life springing from the wreckage of the old, life all the stranger and more valuable for its resilience.”

A prescription from Kerala for transforming medicine

M R Rajagopal (know to all as Raj) is an internationally renowned Indian anaesthetist and palliative care physician who is one of the founders of a system of palliative care in Kerala that is admired the world over. The Lancet Commission on the Value of Death (of which Raj and I were members) said that societies everywhere could learn from the Kerala innovation, which is a system led by the community with health professionals as supporters rather than leaders. Raj has now published his readable, insightful—and at times funny—autobiography, Walk with the Weary: Lessons in humanity in healthcare, which is both a severe critique of modern healthcare and a prescription for transformation.1

Learn from your patients, they will teach you the most important lessons

Walk with the Weary is built mostly around stories of encounters with patients, and Raj has learnt a great deal from his patients. They have taught him most of what is in his book, and he is generous in attributing credit to them.

“Over the years, I have learnt from many patients and their families that I should not be afraid to ask for help. I should learn to accept rejection with equanimity, and support with gratitude.” But perhaps the person who taught him the most was not a patient but a cousin. The cousin lived close and was dying of a rare cancer that caused him great pain. Raj, a medical student at the time, heard him screaming but visited him only once before he died. Raj didn’t know how to help and felt powerless and scared. He writes: “I carry that guilt to this day. I could not relieve his pain, but at least I could have held his hand and sat near him for a few minutes.”

Do not turn away when something needs to be done and do not fear to fail

What Raj learnt from his cousin was consolidated by what he learnt from Gandhi: “Gandhi…shaped my palliative care work and my life, not by his words, but through his life. He taught me not to turn away when something needed to be done and I had the power to try. He taught me that it was acceptable to fail; but unacceptable not to try. I admired his tenacity of purpose, how he clung on to the idea of freedom for India and did not let go of it.”

Medicine should be primarily concerned with responding to suffering not treating disease

The main lesson in the book is that medicine should be primarily about responding to suffering and pain. Instead, it is concerned mostly with disease and diagnosis. Raj tells multiple stories of patients with untreated pain. When he was a young doctor he encountered Shekhar, a young man in severe pain from a condition his doctors declared untreatable. Raj went to help him with a nerve block but was told by his superior: “We have enough work in the operating theatres. We cannot afford to have you start working in the wards,” Raj “watched as the last sign of hope drained from Shekhar’s face.”

Vishnu had pain from multiple sources and asked Raj if he would help him die. Raj said that was not possible but that he would do all he could to treat his pain and told him that he would “walk with him on his difficult journey” as far as he could. Later Vishnu had a heart attack, was admitted to intensive care and given a pacemaker. He suffered greatly and said to his wife: “This is agony. They cannot understand my suffering, you can. Please help me.” She said to the doctors. “You don’t know the suffering that he has already been through. If it is time for him, please let him go.” They ignored her, and Vishnu died suffering.

“This kind of disease focused treatment,” concludes Raj, “has become the order of the day. It ignores human suffering and concentrates on a beating heart, ventilated lungs or a functional kidney even when a cure is not possible.” Elsewhere in the book he writes: “Nobody articulates it in so many words, but the lesson passed on to us is that our job is to diagnose and to cure. We have nothing to do with human suffering. Suffering is inevitable.”

The message to respond to suffering rather than disease is hammered home throughout the book, and Raj warns that if doctors continue to concentrate on disease rather than suffering then the backlash cannot be long in coming. “We need to teach healthcare professionals and students,” writes Raj, “that their primary duty of care (as officially defined in India) is to “…mitigate suffering. It is to cure sometimes, relieve often and comfort always… There exists no exception to this rule.”

There is also the problem, emphasises Raj, that healthcare concerned with treating disease is expensive, often bankrupting patients and their families in health systems that are not funded by the government. In India some 55 million people a year are plunged into poverty by the costs of healthcare, destroying health for those people and their families. And across the world it is many more millions who have the health of them and their families destroyed.

Treat the patient not the disease, which means knowing the patient

Despite the words in the Indian definition, doctors feel awkward with the suffering, as the physician Eric J Cassell observed in a famous article in the New England Journal of Medicine in 1982.2 It’s persons not bodies who suffer, wrote Cassell, and he emphasised, as does Raj, that responding to suffering means recognising the whole person.

Raj tells the story of a 42-year-old professor with severe pain from cancer of the tongue. Raj successfully treated his pain with a nerve block, and when the man asked when he should come back Raj told him he needn’t be seen again until the pain came back. That night the professor killed himself. Raj learnt from the professor’s cousin that nobody had discussed the prognosis with the professor and he felt that he was being abandoned to suffer and die. Raj had treated the pain but not the person: “The man gave up his life to teach me a vital lesson. He taught me that doctors should be more than body mechanics—that they also have the tremendous and awesome responsibility of recognising, acknowledging and honouring the human beings that entrust their lives to them.”

I think of an ophthalmologist I saw who described me to my GP as “this pleasant, retired GP.” I was tempted to write to him saying that I was none of those things. He was interested in my eyes not me.

The book includes a powerful quote from Harvey Chochinov, a Canadian psychiatrist from Winnipeg and founder of dignity therapy: “Treating a patient’s severe arthritis and not knowing their core identity as a musician; providing care to a woman with metastatic breast cancer and not knowing she is the sole carer for two young children; attempting to support a dying patient and not knowing he or she is devoutly religious—each of these scenarios is equivalent to attempting to operate in the dark.”

Listening is better than talking

Warrier, an elderly man with cancer, came to see Raj with pain that he was able to successfully treat. Warrier asked Raj if he could see him every week, which was difficult as he was extremely busy. But Raj did see him, and Warrier thanked him for the solace that his words gave him. “My words? What words?” writes Raj, “I hardly spoke. And then it dawned on me—it wasn’t my words, it was my ears that he needed. He wanted to unburden his mind and I was willing to listen whenever I could.”

Most doctors, active people who are pressed for time and who like to fix things, are better at talking than listening. Listening seems horribly passive. I’ve been telling myself for 65 years to talk less and listen more, and I’ve made little progress—as my wife regularly confirms.

Nobody should die alone and everybody in the world should have access to palliative care and pain relief

Raj is best known internationally for the work he has done in Kerala to create a community-based system of palliative care. He developed this with Suresh Kumar, a younger anaesthetist, and Asok Kumar, who ran a printing press, often helped friends in need, and became India’s first palliative care volunteer. “It was through Asok’s compassionate lens,” writes Raj, “that I was clearly able to see the skewed singular focus of the medical system on diseases; how appallingly little it focussed on the human being and how utterly lopsided its obsession with diagnosis was.”

At that time there was little or no palliative care in India, and Raj learnt from a British palliative care nurse and attending a course in Oxford. But while in Britain he observed deficiencies in the system in high income countries: “To me, there seemed to be too many old patients lying alone on their beds in the UK hospices. True, a nurse would appear at the push of a button but once their immediate needs had been attended to, they would be alone again.” (I think of the seven-year-old son of an Indian friend who moved to the suburbs of London and couldn’t understand why there were no people in the street.)

The model of palliative care in Britain is medical, built around health professionals. There weren’t enough interested health professionals available in India, and the Kerala model is based on communities and volunteers: “A major reason behind the success of the palliative care movement that evolved in Kerala was community participation. Compassionate people accepted the responsibility of supporting the less fortunate around them. They helped people in multiple ways—acting as links between the patients and the medical system, offering weekly or more frequent visits, and sometimes arranging financial support.”

The people in Kerala feel that the programme belongs to them, and the community offers financial support as well as volunteering. Importantly the programme extends beyond the “traditional, restrictive definitions of palliative care. Instead, we have consistently done our best to take care of any person in significant suffering, be it physical pain or breathlessness; grief, anxiety, guilt or depression; social issues, whether financial hardships, or relationship matters and sexuality related or even spiritual pain.”

The vision of the founders of the Kerala scheme is to integrate palliative care into healthcare for all of India and beyond.

But things are far from perfect in Kerala, particularly with the availability of morphine—perhaps the drug that is most associated with relieving suffering. Anxiety about drug addiction restricts access to opiates across much of the world, although we have the paradox of opioids killing hundreds of thousands in the US while others die without access to any pain relief. Access to the morphine is “abysmally low” in Kerala with per capita consumption being around 1.67 mg compared with 241 mg in the UK. In the rest of India it’s even lower at 0.11mg.

Global efforts to improve access to palliative care

Raj has been active not just in India, but globally working with the World Health Organisation and the Lancet to increase access to palliative care. The WHO adopted a resolution in 2014 to incorporate palliative care into routine healthcare with all health and care workers being able to care for the suffering and dying—rather than palliative care being a specialty. But currently 80% of the world does not have access to basic pain relief.

Towards the end of the book Raj imagines a woman a few centuries from now researching “modern medicine.” “Would she not ask herself—how could they be so senseless to invest so much time, energy, and money in research on “conquering” diseases, but not focus on channelling that knowledge so as to provide relief to those in suffering?”

If you’d like to hear Raj talking you can watch this video: https://www.youtube.com/watch?v=uVc5ElxIMbM

The magical return of forests and lawns from abandoned land

Despite having an A-level in biology, I had never heard of Succession, the process by which bare ground may transmute into forest, until I read about it in Cal Flyn’s book Islands of Abandonment: Life in the Post-Human Landscape. She writes that Succession is “as central to the field as evolution is now to general biology.” She also describes how “mow any type of vegetation three times, and it will turn into grass… Succession in reverse.” I find all this very ulifting.

The theory of Succession was developed by the American botanist Frederic Clements, and Flyn summarises it: “a ploughed field, left to go fallow, will over time pass through a number of intermediate stages – ‘seres’ – as the age of the weedy annual passes into the era of the shrub, and then the kingdom of the fast-growing softwood trees, before finally, over a period of many years, the process climaxes in an established hardwood forest, which remains in place until the land should be disturbed again.”

Flynn visited Estonia, where a great deal of farmland, Stalin’s collective farms, has been abandoned and reverted to forest, which covered only 21% of the country in 1920 but 54% 90 years later. Around 90% of the forest has been “naturally regenerated.”

Abandoned farmland has also become forest in the former Soviet Union. A 2015 study estimated that there had been at least 10 million hectares of forest regrowth in eastern Europe and European Russia. but by then only 14% of the abandoned farmland had reverted to forest. If and when the rest reverts the “collapse of the Soviet Union [will create] the biggest man-made carbon sink in history.”

“Overall,” concludes Flyn, “more than two-thirds of the world’s forest is now considered ‘naturally regenerated’. This is Christ-like rebirth, Lazarus-like revival, on land we had left for dead.”

How might the NHS die?

I posted this log in the BMJ in 2016, but I could have written it today. https://blogs.bmj.com/bmj/2016/02/16/richard-smith-how-might-the-nhs-die/ The NHS might be closer to its death than it was in 2016, but it will probably “muddle through,” as it has for decades.

“The NHS is under tremendous pressure,” I tell a novelist friend.

“Could it die?” he asks.

“I suppose it could.”

“How would that happen?”

How would it happen? That’s a hard question. I didn’t have a convincing answer, but it’s a question worth examining.

I trotted out to my novelist friend my usual reference by the world’s wittiest health economist, Uwe Reinhardt, that all health systems will eventually be the same: the rich will, as they do now, buy what they want where they want; the middle classes will have to buy insurance; and the poor will be left with a low quality rump service. It’s the health system most of the world has right now.

But how might we get there? “Death,” famously “hath a thousand doors,” but there are three groups that might precipitate the death of the NHS: patients, doctors, and politicians.

The worry of supporters of the NHS has long been that the middle classes would bail out—as they do with education. If they went, there would not be sufficient political and financial support to maintain the current NHS. The poor would be left with the rump service, which would inevitably deteriorate without the sharp elbows and funds of the middle classes. But why would the middle classes go? They’d go because of extreme dissatisfaction with the NHS: increasing difficulty in seeing GPs, long waits for hospital treatment; and, most important of all, a sense that the NHS could no longer offer world class care. The inability to offer the best could come about simply because inflation in the costs of care always runs ahead of general inflation. It may be a race that will inevitably be lost with a service funded from taxation. Data released last week showed that satisfaction with the NHS dropped by a significant 5% in 2015—but 60% are still “very or quite satisfied.”

The middle classes could desert only if there was somewhere to desert to. At the moment the private sector couldn’t begin to offer the extent and range of care needed. In particular there is almost no non-NHS private practice, but most GPs are independent (private) practitioners—and they could decide to abandon NHS contracts and go it alone. They are currently threatening mass resignation. Mass desertion by GPs could potentially happen fast, and there are plenty of global hospital chains that could provide hospital care. It might even be that a company could spot a business opportunity and increase private healthcare capacity. Construction of hospitals might take time, but perhaps many would become available if the NHS was collapsing. Social care and some mental health care are already provided by the private sector. Insurance companies would also be needed, but both local and overseas companies already exist.

The doctors, particularly consultants and GPs, are the other group that could bring about the death of the NHS. Nurses, the biggest group of NHS employees, probably lack the muscle, and managers are unlikely to take the lead, although some of them might enjoy the challenge of setting up the new system—and undoubtedly nurses, managers, and the other professions within the NHS would be needed in a private system.

General practitioners could, as I’ve said, switch to providing services for non-NHS patients, and a body of them are already calling for charges to patients. Consultants are the most powerful group, and many of them currently work at least some of the time in the private sector. A professor of surgery once told me that surgeons innovated in the private rather than public sector because it was so much easier. There have long been mutterings about consultants forming chambers, like barristers, and selling their services to the highest bidders.

I write this on the day that the government has imposed a new contract on junior doctors, and negotiations are also underway for a new consultant contract. Perhaps the consultants could become so alienated, so resentful of heavy handed government that they could desert in large numbers. Again there has to be somewhere to desert to.

Politicians are the final group who have the power to kill the NHS, and some people have long been convinced that that is what right wing politicians want. The Daily Mail, the newspaper with the most influence over politicians, is so persistent in its attacks on the NHS that it’s easy to think it wants to kill it. But politicians are well aware that despite lots of grumbling there continues to be huge public support for the NHS. The current Secretary of State for Health has taken a big gamble in imposing a contract on junior doctors, but a move that seemed to signal the end of the NHS would be far riskier.

Current politicians are unlikely to make any move that might kill the NHS unless they see that much of the public has lost confidence in the NHS. But as recent experiences in Britain and current experience in the US show the unexpected can happen very quickly in politics. Nigel Farage may be “Donald Trump lite,” but he has expressed doubts about the NHS. Perhaps a more strident and effective politician could arise on the right and kill the NHS.

Having been born four years after the launch of the NHS, I hope that it will “see me out.” I’ve never used a private system and hope never to have to, but as I think about the possible death of the NHS I reflect on the First World War. Historians still argue—and always will argue—about how it started, and the death of the NHS might be equally complicated, arising from deep forces, like countries arming themselves, and a particular incident, like the assassination in Sarajevo.