If somebody asked me to think of Italian painting, I would think of Michelangelo’s overwhelming Sistine chapel, Titian’s frolicking nudes, Bronzino’s puzzling pictures, Tintoretto’s huge Crucifixion in the Scuola San Rocco, Botticelli’s magical pictures, the still saints of Bellini, Caravaggio’s brutally real paintings, or Carpaccio’s depiction’s of Venice at its zenith. I wouldn’t think of the frozen paintings of Giorgio Morandi, but I enjoyed the exhibition of his work at the Estorick Collection in hipsterish Islington. As I tour the exhibition, however, I am left with a sense of Morandi fading away—and when you think of the power, colour, and muscle of Italian painting in its golden age I think of Italy itself diminishing.
Morandi was born in 1890, lived through two world wars, and died of lung cancer in 1964. He joined the army in 1915 but had a breakdown and was discharged. Thereafter he lived with his three sisters in Bologna and is buried with them in the family tomb.
Although he painted a series of self-portraits, he painted his last one in 1925 and never thereafter painted a person. Mostly he painted natura morta but more pots than fruit or flowers. He seems to prefer the dead to the living and the motionless to the moving. It is the stillness, the quiet, the peacefulness of his pictures that attracts.
Morandi did many etchings as well as paintings, and they too are beautiful. During the second world war his works became literally darker, and after the war he seemed to do mostly drawings with just a few lines that almost disappeared. The people, flowers, fruit, pots, paint, and colour all departed leaving the faintest traces. Lin and I both liked his final works, his fading away.
Patricia Kopatchinskaja strides onto the stage with Joonas Ahonen, and as soon as he is seated at the piano she launches with no pause into Arnold Schoenberg’s Phantasy for Violin with Piano Accompaniment. Dressed all in black with trousers that are so baggy they seem to be a dress, she is in complete control. It’s like the start of a rock concert. She throws herself backwards and forwards as she plays, going close to Ahonen, a Finnish pianist with a crown of hair on his head, and then far away. Bare feet peep out from the bottom of her dress. Shoenberg’s music is violent and then dreamy. It’s an attack and a caress. The programme says: “The violin writing is very difficult, but in its weird, wild way it is violin music par excellence.” There is no sense that Kopatchinskaja finds the music at all difficult, either to play or to listen to. The whole hall at the Guildhall School of Music and Drama is captured, and when Kopatchinskaja and Ahonen finish the audience whoops.
In 2014, the British Royal Philharmonic Society gave Kopatchinskaja an award and called her an “irresistible force of nature: passionate, challenging and totally original in her approach.” The duo begin to play Anton Webern’s Four Pieces for Violin and Piano. It begins so quietlythat we must strain to hear. The near-silence in the crowded hall has a magic that I would not be able to feel listening at home. Unfortunately there is noise from somebody arriving late and some loud coughs. “We will play it again,” says Kopatchinskaja without anger but disappointed that the experience has been spoilt.
The next morning, I read these words on Kopatchinskaja’s website: “My first teacher was the rain. I listened to the drops. They were the first short, round notes in my childhood imagination. Then came the sun. The notes became longer and more transparent, beginning in the clouds and disappearing into infinity. Wind taught me momentum, the night taught me silence and the suddenness of the morning. I learnt about atmosphere from the smell of the candles in our small Moldovan Orthodox church; the movement and shadows of their flames showed me how to improvise. From language came phrasing, and with that my dreams opened up into the limitlessness of fantasy.” https://en.patriciakopatchinskaja.com/
After the Webern the duo play Beethoven’s Violin Sonata No 7. It’s in C minor, which the programme says is a “dark key…often associated in Beethoven’s music with intense heroic struggle.” Is the music comic or tragic? Somehow the music, written at the beginning of the 19th century, sounds as modern as that by Schoenberg and Webern. That was, I think, Kopatchinskaja’s, intention and message. Her trademark seems to be mixing the old and the new, and she finds more adventure in playing the new. She has written in the Guardian that “all these “B composers” – Bach, Beethoven, Brahms, Bruckner and Bruch – you can sell tickets and fill halls, and audiences will hear immortal works by immortal composers…” but you can’ keep playing the same composers. https://www.theguardian.com/music/2016/feb/05/patricia-kopatchinskaja-changing-minds-festival-schumann-kurtag
She is constantly exploring, and after the break they play Morton Feldman’s Piece for Violin and Piano, which is mostly quiet but then becomes frantic. I fail to recognise that without any pause they are playing Beethoven’s Violin Sonata No 9, the Kreutzer Sonata. The sonata was written for George Bridgetower, a friend of Beethoven’s and a British violinist-composer of African descent. “The original dedication,” says the programme, read: ‘Mulatto sonata, composed for the mulatto Brischdauer [sic], great madman and mulatto composer’, and something of that ‘madness’ can be heard in the volcanic first movement.”
I feel foolish that I have failed to recognise the duo combing two pieces of music written 150 years apart, but Kopatchinskaja has made her point. The applause is tumultuous. People stand. The duo leave and return, and perform an encore that features Kopatchinskaja shouting and striking poses. I can’t even remember if she played her violin. Then she says that they will play one more encore. It will be a premiere, probably a world premiere, and she says: “You must tell me the composer, and we will stay here until you get it right.” They play a short piece, and people start to shout names. She says, “No, no, no.” I shout that she composed it herself. She laughs and says no. Eventually after some 20 to 30 names somebody gets it right: Ligeti. He composed it, Ahonen tells us, when he was 17.
Simply from listening to her music, I had developed the idea that Kopatchinskaja was unusual and forceful, but after watching her perform I’m more convinced. This, I think, is a woman of conviction. I imagine that she cares about the state of the planet, and when I look at her Guardian article the next day I find that I’m right.
She writes about Schumman’s Violin Concerto that it “can be read as an autobiographical testimony or as a tale about how a cruel fate can destroy a despairing soul. Today, might it not also be read as a statement about how global warming will boil our despairing souls and lives to death? Any reading is frightening and it hurts, but the piece has to be played like this. A bleeding bird with cut wings, singing its last song, carved in stone by a blind poet.”
We must, she writes, listen to the music of Galina Ustvolskaja, a Russian composer whose music was banned. “Hers is a brutal primordial music, outside of any tradition, speaking of violence, suffering and some uncertain hope in a far-distant God. Hers were the times of Stalin and the gulags. But are we not, today, happily consuming the products of Bangladeshi and Chinese slave labour, while our governments solemnly lecture their governments about human rights? And are we not employing drones and throwing bombs at many innocent people? Ustvolskaya’s suffering is still right with us, maybe not here but now.
Hearing Ustvolskaya’s music changes your life. Nothing after it sounds the same. It’s like being in the middle of an earthquake, on the edge of an abyss, and like a force of nature it can kill. No music before or after makes you feel like that. It goes through you, and it has the same effect on the listeners as on the performers. Every concert-goer should experience her music once in their life. The reaction will be from “never again” to “I want to hear more” to “I have different ears now.” It is a must of our time. I will never stop performing the music of Ustvolskaya.”
Her article ends philosophically: “Can we know about peace if we know nothing about war? Would white make sense without black? Would health be appreciated by someone who’s never been ill? Could beauty be seen in a world of universally polished and shining surfaces? And would such a perfect world allow longing – longing for poetry, composing, for asking, or searching for the things beyond? Or would such a perfectly polished and beautiful world not be rather one-dimensional, and boringly kitsch?”
As I travel home, I feel uplifted. I have heard great music and been in the presence of somebody special. What more could I have asked from a performance?
Listening and watching the consequences of the devastating earthquake in Turkey and Syria, I think back to when I heard a young doctor describe the horrors of the war in Syria. I’ve found the blog I wrote, and it was posted in the BMJ almost exactly ten years ago. https://blogs.bmj.com/bmj/2013/02/04/richard-smith-syria-nows-top-sorrow/
The blog starts by describing the many sorrows facing the young but argues that the war in Syria was then the “top sorrow.” Ten years on that may be briefly be the case because of the earthquake, but until it struck the war, which continues, was largely forgotten, displaced by the pandemic and now the war in Ukraine.
I’ve reminded myself of the war by reading my blog. You might be interested to do the same.
Climate change will soon destroy us. Global poverty is increasing. Non-communicable disease is sweeping the planet. Communicable disease is far from defeated and may re-emerge in new and terrible forms at any moment. Mothers are continuing to die in childbirth. War is now endemic, and nowhere, literally nowhere is safe. The tentacles of the pharmaceutical industry are strangling medicine. Migration of doctors and nurses is undermining already fragile health systems in developing countries. The Health and Social Care Act signals the beginning of the end for the NHS, and the response should be civil disobedience.
Students attending a conference on global health in London on Saturday were presented with a formidable array of sorrows. Would I like to be young now, I wondered. I remembered the young fuzzy haired me who was passionate about the injustice of the world in the ’60s, but we didn’t have quite the array of sorrows confronting students now. Nuclear war followed by nuclear winter was the only sorrow of the 60s that seems not to be on today’s list, but probably it should have been.
“How do you feel about being young now?” I asked several students. They smiled and each said something along the lines of “Excited but scared.” It was, of course, a stupid and unanswerable question: you are young when you are young. I felt guilty that I was glad that I wasn’t young now, but, as the saying goes it’s the job of the young to worry about the world and of the old to worry about the young.
One young doctor from Change.org talked directly about what it was like to be young now. Speaking to the young, he said: we face unprecedented problems, but we also have new tools. To change the world we must first open up, use social networks, self-express, and change values. Next, we should recognise that ordinary people, us, are trusted in a way that governments, CEOs, and authorities are not. We can use that trust to build powerful communities that can create change. He advocated smart targeting. Change.org allows people to create petitions around any topic, and he described examples of where petitions had led to important change. His hero is Molly Catchpole, a young American who organised a protest against the Bank of America introducing charges for people using their bank cards to get cash, built a community of hundreds of thousands who protested, and got the bank to abandon the charge.
(Later when us old timers were offering advice to the students, the young doctor from Change.org told the students not to listen to professors telling them to research and learn, but rather to follow their own instincts. “Good advice,” I thought, “not to follow the advice of a failed generation like mine.”)
But as I listened to the array of sorrows I decided that the biggest sorrow right now, the one that justifies our full attention, is what’s happening in Syria. A specialist registrar in anaesthetics, part of the Syrian diaspora, told us of her first-hand experience in the country. (I’m deliberately not naming her because, although her name was on the programme, I don’t want to add even the tiniest risk to the considerable risks she faces whenever she travels to Syria, which she does regularly.)
The registrar started by showing us pictures of normal Syria, the souk in Damascus, dramatic Roman remains, and a very modern Mediterranean resort. When, she said, people see pictures of countries devastated by war they begin to think that it was always like that—but it wasn’t.
The war within Syria is becoming steadily more brutal, and the people of Syria feel abandoned. Worse, they feel that a proxy war between major powers is being fought in their land. The first time that 50 people were massacred in day it was front page news, now it doesn’t make the news in the West. At least 60 000 people have died, probably many more. Some 700 000 people are refugees, and around 4 million of the population of 20 million are displaced.
Perhaps the most shocking thing for the audience was how health services are being deliberately targeted. “Rebels” are killed while in hospitals. In one case a “rebel” was disconnected from a ventilator and thrown onto the floor. Doctors and nurses thought to be supporting “rebels” are killed, captured, and tortured. Syrian doctors, supported by Syrian doctors living outside Syria, have set up underground field hospitals. But, of course, the government eventually locates and closes them, killing or imprisoning the staff. Some 800 medical staff have now been captured, killed, or tortured.
The registrar described the irritation of the “rebels” that all aid goes to the government and is thus distributed only to government supporters. The aid, she argues, thus becomes a weapon in the war. The charity she works with, Hand in Hand for Syria, has to provide aid to medical staff just to keep them alive. The humanitarian and medical needs of Syrians are huge, and Hand in Hand for Syria has not nearly enough means to meet them.
But, I asked the registrar, isn’t one of the problems in Syria that the “rebels” are a very varied group that has trouble working together and includes some who are very extreme? That’s not really true, she answered. She sees it as an excuse the rest of the world uses as an excuse for not acting. The world could, she believes, stop it tomorrow if they had the will but they don’t. Nor can she see any likelihood of the conflict ending soon.
What can you do? Here’s two easy things. You can sign a petition at change.org calling on Ban Ki-Moon to get members states to do everything possible to stop the crimes against Syria’s children, or you can donate to Hand in Hand for Syria.
TOPSHOT – A Turkish soldier walks among destroyed buildings in Hatay, on February 12, 2023, after a 7.8-magnitude earthquake struck the country’s south-east. – The death toll from a massive earthquake that hit Turkey and Syria climbed to more than 20,000 on February 9, 2023, as hopes faded of finding survivors stuck under rubble in freezing weather. (Photo by Yasin AKGUL / AFP)
This blog was posted in the Guardian in 2008, the earliest days of blogging. https://www.theguardian.com/commentisfree/2008/may/11/thenakedtruthI was reminded of it yesterday when, as I often do, I was advocating that boards meet once a year with everybody naked. Although I’m the chair of four boards and have been of others, I’ve never had the courage to practice what I preach.
“For a top politician you can’t continue in power when you are seen naked,” wrote political analyst Ooi Kee Beng in China Daily in January. He was writing about the former health minister of Malaysia, Chua Soi Lek, who had to resign after featuring in two sex videos which were available on the internet. I don’t want my politicians featuring in sex videos (although I don’t especially mind if no deception is involved) but I’m strongly in favour of naked politicians. Indeed, I’d go as far as to suggest that all politicians give at least one naked press conference before they can be elected and that one session of prime minister’s questions each year should be held with everybody in the room naked, including the policemen.
The besetting sins of politicians are pomposity, horribly overrating their own talent and importance, taking themselves too seriously, oversimplifying complex problems, patronising us and being slippery with the truth. Nakedness is an antidote to all of these. If Robert Mugabe had to stand naked before the people of Zimbabwe and justify his actions he’d be gone in seconds.
Some of the most miserable afternoons of my life were spent sitting in the finance and general purposes committee of the British Medical Association (BMA). The BMA is run by small-time politicians – arguably the worst kind – and the pomposity sucked the air from the room. People took positions based not on what made intellectual or even business sense but rather on accumulating credit for future debates or doing others down for the fun of it. “If only,” I’d sit there thinking, “these people were naked then they wouldn’t be able to keep this up. Reality would intrude. These middle-aged men with their paunches, hairy chests, flabby legs, small penises, and droopy balls (me included) wouldn’t be able to sustain the bullshit.”
It seems unlikely that the finance and general purposes committee of the BMA will ever decide to get naked, but I’ve fantasised about the next best thing. I was the editor of the British Medical Journal – which was why I was at those dreadful meetings – and by tradition I’m having my portrait painted. My portrait might be hung on the walls of the debating chamber among those of long-dead doctors, most of them weighed down with gowns, medals, honours, sad expressions, and diplomas. I’d like to be there -painted ideally (but unaffordably) by Lucian Freud – stark bollock naked with my bits dangling. That would keep them honest.
But nakedness in politicians could do much more than revolutionise BMA committees: it could abolish tyranny. “Nazis,” observes Frederic Raphael in his book Fame and Fortune, “were the only people who always had to be dressed … To be a superman you have to be dressed … Hitler could never be Hitler when he was naked.” I agree.
Could Hitler have ranted at the Nuremberg rallies naked? Of course he couldn’t. The ancient Greek historian Herodotus concurs: “Among the barbarians it is reckoned a deep disgrace, even to a man, to be seen naked.” He doesn’t actually suggest that non-barbarians can cope with being naked, but I take that as read. Shakespeare is also on my side: “And thus I clothe my naked villainy/With old odd ends, stol’n forth of holy writ;/And seem a saint, when most I play the devil.” Strip the politicians naked and we would see their villainy.
One question naturally arises: “When we choose to have our politicians naked will young women do better than old men?” Well they might, and that would be no bad thing. We’d no longer need positive discrimination. But my bet is that it won’t be the beauty of your body that counts but rather how comfortable you are in your nakedness. I can see Tony Benn stark naked but for his pipe talking quite comfortably. Aneurin Bevan too I can easily imagine naked, but Margaret Thatcher and George Bush no. Maybe nakedness would shift us all to the left – again no bad thing.
But I rest my case on one of the last century’s great insults – Winston Churchill calling Gandhi a “half- naked fakir.” Wasn’t Gandhi the greatest politician of the 20th century, and, come to that, didn’t Churchill (no political slouch himself) receive colleagues while in the bath?
An increasing proportion of people in countries like Britain are recognising that the way we live is environmentally unsustainable. Most people hope, however, that a combination of a political response (albeit belated), science, and technology can allow us to live in a manner not that different from how we live now. Indeed, with the rapid rise in renewable energy and lots of talk of achieving net-zero, not least in the NHS, many people simply assume that we will achieve a low-carbon version of our current lives. Many health professionals think that a net-zero health service will allow the continuation of much of the complex, specialist care currently available. Dougald Hine, the former BBC journalist, student of the environmental crisis, and co-author of the Dark Mountain Manifesto, https://dark-mountain.net/about/manifesto/ is not one of those who think that life as we know it can continue, as he makes clear in his new book At Work in the Ruins.
Published in 2009, the Dark Mountain Manifesto has eight propositions. The first is “We live in a time of social, economic and ecological unravelling. All around us are signs that our whole way of living is already passing into history. We will face this reality honestly and learn how to live with it.” The first sentence of the proposition feels even more true 14 years later, particularly after the pandemic; the third sentence asks us to do something hard that most have not yet managed. The propositions become steadily more positive and end with: “The end of the world as we know it is not the end of the world full stop. Together, we will find the hope beyond hope, the paths which lead to the unknown world ahead of us.”
For the billion people in the world who go to bed hungry every night and the billions living in poverty and suffering injustice the world as it is doesn’t seem that good anyway. Perhaps we can find paths to something better. Hine does not think that the big path, the path of politics, science, and technology, will work. Rather we will have to find new paths (the plural is crucial), and we are likely to be prompted to find those paths not through a sudden understanding of the unsustainability of our lives but through collapse. Paradoxically (and also illustrating his wide reading), Hine quotes Milton and Rose Friedman, the parents of monetarism, to illustrate his point: “We do not influence the course of events by persuading people that we are right when we make what they regard as radical proposals. Rather, we exert influence by keeping options available when something has to be done at a time of crisis.”
The phrase “climate change” runs throughout Hine’s book, but he is writing about much more. In a thought experiment he imagines the Intergovernmental Panel on Climate Change suddenly announcing that it had made a terrible mistake—greenhouse gases were not going to warm the planet to uninhabitable temperatures. Would we think that then everything was fine? We couldn’t. We’d still have our depleted soil, air filled with toxins, a largely deforested planet, mass extinctions of our fellow creatures, and poisoned oceans.
The American essayist and archdruid John Michael Greer distinguishes between a problem and a predicament. A problem can be fixed. It goes away. A predicament, in contrast, has no solution. You have to live with it and can do a better or worse job. What we are living through is a predicament not a problem to be fixed.
Hine is interested in how we got to where we live now, which he calls simply “modernity.” Which, he says, “is born out of devastation: the destruction of the fabric of the living world and the destruction of the weave of culture.” Did we simply burn too many fossil fuels, or does our predicament have earlier and deeper roots? The Dark Mountain Manifesto has a succinct answer: “We believe that the roots of these crises lie in the stories we have been telling ourselves. We intend to challenge the stories which underpin our civilisation: the myth of progress, the myth of human centrality, and the myth of our separation from ‘nature’. These myths are more dangerous for the fact that we have forgotten they are myths.”
Somebody who saw early the mistakes we were making was Ivan Illich, a critic of industrial society. I heard him speak when I was a medical student, and his impact on me has lasted a lifetime with greater relevance with each year that passes. https://wordpress.com/post/richardswsmith.wordpress.com/6685 Illich observed that the advantages of the institutions of industrial society were quickly cancelled and followed by an unhealthy dependence. Cars are sold to us as freedom (when did you ever see a traffic jam in an ad for a car?) but have killed millions, made streets unsafe, polluted our air, and been an important driver of the climate crisis. Illich also noted that schooling breeds ignorance, hospitals make people sick, and prisons train criminals. (Illich wrote a lot about our relationship to death, arguing that “A society’s image of death reveals the level of independence of its people, their personal relatedness, self-reliance, and aliveness.” https://richardswsmith.wordpress.com/2020/08/10/the-history-of-natural-death-is-the-history-of-medicalisation-of-the-struggle-against-death-ivan-illich-1976 Hine also writes a lot about death, and I will discuss that in another blog.)
Illich wasn’t alone in recognising where industrialisation would take us. Hine quotes a woman remembering the words of her grandmother of the Guarani people, indigenous people from South America: “the house the European man built on the back of indigenous peoples would eventually fall, and we’d better take cover when it happened.”
At Work in the Ruins has two powerful images that capture the fragility of modernity. One is the fish tank. Keeping cold water fish alive in a tank is a complex business: the water must be cleaned and changed, the electric filter maintained, and a chemistry kit used to test a dozen indicators. (As I read this, I thought of an intensive care unit.) A common consequence is dead fish, but a river or lake does it all “for free and with ease.” We live in a fish tank.
The other is the contrast between Israeli and Palestinian hens. The Israeli hen “cannot survive, grow, or produce eggs without special shots, a special mixture of food, a special mixture of food” and much technology. In contrast the Palestinian hen has adapted to the harsh environment over thousands of years. It doesn’t need the technology to keep producing eggs, although it seems likely that it produces fewer. But when the technology collapses the Israeli hen will die and the Palestinian hen survive. We are like the Israeli hens. (As far as I can tell, Hine is not making a political point by contrasting Israeli and Palestinian hens.)
Modernity depends on science and technology, and there would have been no industrialisation without science. Science, although we tend to see it as a saviour (particularly after the pandemic), has led us to a planetary crisis. Hine is not anti-science, but he does describe it as “an ideology posing as a method.” He thinks that “the status accorded to science is mostly a sham.” Although, he says, scientists hold each other to standards of integrity that few other groups can match, they are useful when they contribute to the growth of GDP but when their findings start to call the aims (or even the viability) of modernity into question “their voices carry little more authority in the summit rooms than those of the protestors at the gates.” I think that most scientists would agree with Hine: science cannot tell us what to do; it can never be a substitute for values and judgement.
How should we respond to our predicament? The first step is to recognise it, and that is a hard step to take. Hine argues for the centrality of stories and tells the story of the sociologist Kari Norgaard studying a Norwegian coastal community badly affected by climate change: the snow comes two months late, the ski resort struggles, and people fall through the ice that used to be solid and safe. Yet life goes on as if climate change wasn’t happening. “In some sense,” observes Norgaard, “not wanting to know was connected to not knowing how to know.” Or from Sir William Davenant in the 17th century, “Since Knowledge is but Sorrow’s spy/It is not safe to know.”
It is hard to accept that your world is ending unless you can envisage a future, a way forward. The favoured route forward is what Hine calls “the main path,” which is built largely around the concept of green growth: we can be green and rich and preserve most of what we have. Major financial institutions like the World Bank and International Monetary Fund (if not some Tory MPs) accept that unfettered growth, which has been bult largely around fossil fuels, will destroy us, but there is much more argument around green growth. https://www.bmj.com/content/bmj/378/bmj.o2326.full.pdf Hine quotes the economists Jason Hickel and Giorgos Kallis, who describe green growth as a fantasy born out of desperation: “It is not politically acceptable to question economic growth, therefore green growth must be true, since the alternative is disaster.” There is probably more agreement than disagreement that the route to successful green growth is not clear and depends on technology not yet developed.
The alternative to green growth for Hine is not disaster but rather recognition of our predicament and a search for not one main path but multiple paths. He encourages us to “surrender yes—but surrender to the mystery not the certainty.” We must also recognise the centrality of relationships: “we matter because we matter to each other. You are the fruit of all the relationships that constitute and arise from what makes you who you are.” The Lancet Commission on the Value of Death, which I cochaired, recognised this centrality of relationships and might be described, although we didn’t think this at the time, as a search for a minor path in that we advocated a rebalancing of death and dying moving it away from the health care system towards families and the community. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02314-X/fulltext We quoted Carlo Rovelli, the quantum physicist, who says that relationships are fundamental to the Universe and all life: we only exist in relation to others and “reality is made up of relations rather than objects”.
Hine ends his rich book, which like a poetic or religious text deserves multiple readings, with four kinds of work that we must undertake to find paths in our predicament. This work can be done by many, concentrating perhaps on what areas of life you know best. No one can do it alone.
The first step is to decide what to salvage from the ruins of modernity. This is serious work, but I have spent just a few minutes to imagine how I might start the conversation. As a beginning I would take from the health world, the role of healer, the capacity to do a caesarean section, a few anaesthetics, morphine, and some vaccines and drugs with high benefit to safety ratios. Most of modern medicine I would discard, but some of it I would mourn, which is the second kind of work that Hine suggests. We might also take stories of open-heart surgery, intensive care, and the like with the idea that these activities might return in some future time when we have learned to practice them in harmony with the world.
The third kind of work is noticing the things in our ways of living than were never as good as we thought they were. The first things that come my mind are cars and most chemotherapy for cancer. The fourth kind of work is “to look for the dropped threads, the moments earlier in the story that have something to tell us.” I think of the wisdom of traditional healers, particularly birth attendants, and cultural ways of dying and thinking about death.
This is not all the work that must be done, and the search is not for one main path but for multiple paths, some of which will be dead ends. Hine finishes his book with a story of how “in the best of worlds we stand near the beginning of a process that will take a thousand years, because that is how long it will be before old growth forests have returned, how long it takes for the mother trees to grow back.”
The Taliban banning women from education and even from aid work is hard to understand from a Western point of view, but I’ve understood more from reading Palace Walk by Naguib Mahfouz, the only Arab writer to win the Nobel Prize for literature.
Set in the old part of Cairo during the First World War, the novel, the first in The Cairo Trilogy, is built around the family of al-Sayyid Ahmad Abd al-Jawad, a well to do merchant. He has a wife, Amina, three sons (one by a previous wife), and two daughters. The wife never leaves the house except to go occasionally with her husband to see her mother. She hasn’t been anywhere except to see her mother for twenty years. The daughters similarly must stay in the house, and none of the women must be seen by a man outside the family. There is nothing unusual about this arrangement. Everybody accepts it, although they push at the edges—the younger daughter allowing herself to be glimpsed through the shutters. But the wife feels “sincerely dutiful to him [her husband], as though he were a god whose decree could only be received with submission, love, and loyalty.”
Yasin, the older son, something of a fool, says bluntly: “What more does any woman want than a home of her own and sexual gratification? Nothing! Women are just another kind of domestic animal and must be treated like one.” But his wife has power, albeit through her father, and leaves the house and divorces him after he drunkenly tries to rape a maid.
More surprising and shocking is what seems to Western eyes the hypocrisy at the centre of al-Sayyid Ahmad Abd al-Jawad’s life. At home he is a humourless, unsmiling, pious tyrant. Everybody is terrified of him but also they love him. “I’m a man. I’m the one who commands and forbids. I will not accept any criticism of my behavior. All I ask of you is to obey me. Don’t force me to discipline you.” His family are appendages to him: “No daughter of mine will marry a man until I am satisfied that his primary motive for marrying her is a sincere desire to be related to me…me…me…me…‘ The only way to live with such a man is to lie: “Lying was not considered contemptible or shameful in this household. Living in their father’s shadow, none of them would have been able to enjoy any peace without the protection of a lie.”
Al-Sayyid Ahmad Abd al-Jawad is also lying—or at least never reveals some truths. Outside his home he is completely different. He is smiling, generous, hospitable, and a lover of music with a wonderful sense of humour. Every night he goes out with his friends to drink wine and carouse with a succession of courtesans. He comes back every night drunk after midnight. His wife must wait up to help him undress. She doesn’t mind.
“Thus he was able to conduct his amorous adventures with a delight free of regret and a serenity unblemished by ill will. In other words, he had successfully balanced the animal within him that was voracious for pleasure with the man in him that looked up to higher principles….Just as he had reconciled the opposing forces of sensuality and ethics, he was also able to merge piety and debauchery successfully into a unity free of any hint of either sin or repression.” For him adultery was not a sin: “Men are all like this or ought to be.” But Mahfouz recognises the emptiness of his love-making: “Despite his great number of amorous adventures, out of all the different varieties of love, al-Sayyid Ahmad had experienced only lust.”
As I read about the drinking of al-Sayyid Ahmad Abd al-Jawad and his friends, I thought back on when I attended a medical meeting in Egypt and heard a boring talk on liver disease. The elderly Egyptian doctor giving the talk made the point that there was no alcohol-related liver disease in Egypt because people didn’t drink alcohol. “Don’t you believe it,” said Roger Williams, Britain’s leading hepatologist, who was sitting next to me, I’ve got a ward full of them back in London.”
Palace Walk tells mainly of family life with its ups and downs, but towards the end the novel describes the Egyptian Revolution against the English, who ruled Egypt as a Protectorate (classic Orwellian language, and an international equivalent of a protection racket.) One of al-Sayyid Ahmad Abd al-Jawad’s son becomes active in the revolution, more active than his father would have allowed if he’d known its extent, but survived when many didn’t. The Taliban now must feel like the Egyptians then: “A people ruled by foreigners has no life.” The revolution spread across Egypt: “Demonstrations in different provinces, the battles between the English and the revolutionaries, the massacres, the martyrs, the nationalist funerals with processions with tens of coffins at a time, and the capital city with its students, workers, and attorneys on strike, where transportation was limited to carts. He remarked heatedly, “Is this really a revolution? Let them kill as many as their savagery dictates. Death only invigorates us.”
Death probably also invigorates the Taliban, and reading this novel gave me not only a better understanding of Arab life and the history of Egypt but also of the attitudes of the Taliban that otherwise seem impossible to understand.
I took many quotes from the book:
Men
He could not imagine that the world of the emotions had infiltrated the atmosphere of his home, which he vigilantly strove to keep one of stern purity and immaculate innocence.
“No man has ever seen either of my daughters since they stopped going to school when they were little girls.”
He convinced himself that if he forgave her and yielded to the appeal of affection, which he longed to do, then his prestige, honor, personal standards, and set of values would all be compromised. He would lose control of his family, and the bonds holding it together would dissolve. He could not lead them unless he did so with firmness and rigor. In short, if he forgave her, he would no longer be Ahmad Abd al-Jawad but some other person he could never agree to become.
The closer this woman got to his heart, the farther she was removed from his respect.
Women
She discovered that jealousy was no different from the other difficulties troubling her life. To accept them was an inevitable and binding decree.
{She must] conform with the atmosphere of the household that did not allow human emotions their rightful place and where the affections of the heart were hidden behind veils of self-denial and hypocrisy.
Love/lust
The way love can disregard fears, however, is an age-old wonder. No fear is able to spoil love’s development or keep it from dreaming of its appointed hour.
Thus he had shot off in pursuit of all the varieties of love and passion, like a wild bull. Whenever desire called, he answered, deliriously and enthusiastically. No woman was anything more than a body to him.
‘Love has penetrated my heart….It won’t be long till I’m taken to Tokar Prison’?
Love is like health. It is taken lightly when present and cherished when it departs.
Marriage
Marriage’s external appearance was beguiling, tempting enough to die for, but inside it was so staid and sedate that a person might become indifferent or disgusted. It was like a trick chocolate presented on April Fools’ Day with garlic stuffed inside the sweet coating.
Education
The Shawkats were an old family, although not much was left of their former glory, except their name, especially since the family fortune had been divided up over the years by inheritance. The fact that they shunned modern education had not helped either.
Doctors and modern medicine
The truth was that she did not like the idea of sending for a doctor. She had never had a doctor before, not merely because her health had been good but also because she had always succeeded in treating whatever ailed her with her own special medicine. She did not believe in modern medicine and associated it with major catastrophes and serious events.
Revolution and independence
The upheaval had been necessary to relieve the pressure in the nation’s breast and in his own.
Observations
At times a person may create an imaginary problem to escape from an actual problem he finds difficult to resolve.
A person who has forgotten his sorrows can be forced to confront them
Sayings
“For the sake of the rose, the thorns are watered.”
Henry Miller, the witty and now dead neurologist from Newcastle, said that one of the great challenges for 21st century medical historians would be to explain the obsession with psychoanalysis in the 2oth century. How did a junk science take over American psychiatry and bewitch intellectuals? Seamus O’Mahony doesn’t specifically set out to answer that question in his wonderfully readable and funny book The Guru, the Bagman, and the Sceptic: a story of science, sex and psychoanalysis, but he provides some answers. The book is also filled with delicious and often crazy stories: psychoanalysts and their patients may have been self-deceiving but they were rarely boring.
His book is built around the intertwined stories of three men. One of them, Sigmund Freud, the guru, is one of the best-known figures of the 20th century or any century. Ernest Jones, the bagman and disciple, translator, and biographer (or hagiographer) of Freud, a “pschoanalytic capo,” is far from a household name but is well known in psychoanalytic and literary circles. In contrast, the surgeon, Wilfred Trotter, the person whom O’Mahony admires, is largely forgotten despite saving the life of George V and treating Freud.
Jones, a lower-middle class, clever, and energetic boy from Swansea, qualified in medicine and met Trotter at University College Hospital. Jones called Trotter “my best friend—and apart from Freud—the man who mattered most in my life.” Trotter, a gifted and deeply humane surgeon and “a philosopher in a profession where there are none,” was pathologically shy, and Jones was his only close male friend. Although largely forgotten, Trotter was the first to refer to the “herd instinct” in his best-selling book Instincts of the Herd in Peace and War published in 1916.
Jones, whom O’Mahony describes as a “fixer, seducer and opportunist,” was in 1906 charged with gross indecency in relation to three teenage girls in the Edward Street School for Mentally Defective Children. Although probably guilty, he got off but needed a career other than a traditional medical one. It was Trotter, a wide and great reader, who introduced him to Freud, and psychoanalysis proved a natural home for Jones. Trotter, in contrast, had a distinguished surgical career and was revered by those who worked with him. They were unlikely friends, and O’Mahony notes the big difference between them: Jones “admitted that he was ‘not overliberally endowed by nature’ with scepticism,” while in Trotter it was “all-embracing.” Jones swallowed psychoanalysis whole, while Trotter saw through it.
One thing that Freud, Jones, and Trotter had in common were that they were all fine writers. Freud was more writer than scientist or doctor. He was, write O’Mahony, “indifferent to the outcome of therapy; his patients and their problems were simply the raw material for his ideas and his writing – he didn’t really care whether they got better or not, and this indifference has persisted within psychoanalysis to this day.” Freud’s fame flourishes because of his writing and thinking not because of his science or contribution to medicine, but many of his ideas were not original—for example, Arthur Schopenhauer conceived of the unconscious decades before Freud.
Freud was capable of behaving unethically. O’Mahony tells the story of how in a patient with psychosis and a “hyperlibidinal state” he recommended ovarian radiation ‘in order to expedite the menopause’. He gave “ex cathedra advice to carry out a futile and potentially dangerous procedure on a patient he had never seen, with a condition in which he had no expertise.”
One reason that psychoanalysis became so popular is that after the First World War it was adopted wholesale by many intellectuals and the highly influential Bloomsbury Group. “Psychoanalysis was as influential in Cambridge in the 1920s as communism in the 1930s; if religion was the opium of the masses, psychoanalysis was the opium of the intellectuals.” Even people like Archie Cochrane, who later promoted the importance of evidence and inspired the Cochrane Collaboration, were swept up by the enthusiasm: like many others he went to Vienna to be analysed.
Virgina Woolf was the only prominent Bloomsberry unconvinced by Freud, whom she described as “a screwed up shrunk very old man, with a monkey’s light eyes.” Despite her scepticism, she and her husband published Freud’s work, which didn’t stop her satirising the great man’s work: “I glance at the proof and read how Mr A.B. threw a bottle of red ink in the sheets of his marriage bed to excuse his impotence to the housemaid, but threw it in the wrong place, which unhinged his wife’s mind – and to this day she throws claret on the dinner table. We could all go on like that for hours; and yet these Germans think it proves something – besides their own gull-like imbecility.”
Another reason for the success of psychoanalysis was that it was a great business. With minimal training, you treated the rich for up to three guineas an hour three times a week for years. Freud despite not caring what happened to his patients could charge more. Eight patients could provide a rich living. Jones had houses in London, the English and Welsh countryside, and the French Riviera.
Jacques Lacan, the French neo-Freudian, reached the business peak. He saw patients for 10 minutes without reducing his fee, meaning he could see 80 patients a day. He would see his tailor, pedicurist and barber while analysing patients. “He died a multimillionaire, leaving a legacy of discarded lovers, several patients who died by their own hand, and a dozen or more psychoanalytic societies and associations, each claiming to be the true heir to his progressive and revolutionary ideas.”
Dozens of characters alive and dead feature in the book, including in addition to the main characters George V, Malinowski, Princess Alice of Greece, the mother of the Duke of Edinburgh, Boris Johnson, Napoleon, Jomo Kenyatta, R D Laing, Nijinski, Clement and Lucien Freud, James and Lucia Joyce, and dozens of others, but my favourite was Princess Marie Bonaparte, who embodies the craziness of psychoanalysis and its obsession with sex.
She was the great-grandniece of Napoleon and had inherited a fortune. Freud treated her in 1925 for “frigidity,” which she defined as the inability to achieve orgasm in the missionary position. She was ‘in search of the penis and orgiastic normality’. Her frigidity did not stop her having multiple lovers. It was to her that Freud asked the famous question: “What does a woman want?”
The Princess’s great theory was that frigidity was caused by an excessive distance between the clitoris and vagina. She measured the distance in 243 Parisian women, correlated it with the women’s ability to achieve orgasm, and published her results in a Belgian medical journal. There were, she concluded, “two types of female frigidity: libidinal frigidity, where sexual desire is simply absent, and vaginal frigidity, where desire is present, but there is too great a distance between the clitoris and the vagina.” The former needed psychoanalysis and the latter surgery. She teamed up with the famous gynaecologist Josef Halban, and they experimented on ‘fresh’ corpses to develop a surgical technique for reducing the clitorido-vaginal distance. The Princess told Freud that she experienced ‘orgasmic pleasure’ when handling a scalpel. She and Halban developed a procedure they called ‘the Narjani-Halban Klithorikathesis,’ which the princess had twice.
The treatment didn’t seem to work, and the American doctor Ruth Mack Brunswick taught her an auto-erotic technique, “telling her that she was prouder of her masturbation than of ‘ten doctoral degrees’.” The Princess became the lover of her next psychoanalyst, just avoided starting an incestuous relationship with her son as a cure, and then, as so many of the patients did, became a psychoanalyst herself.
The Princess was the one who got Freud, his family, papers, antique figurines out of Vienna and away from the Nazis. “Her imperious manner and high connections opened many doors; Nazi officials were impressed and slightly intimidated.” Catherine Deneuve played the princess in a television film in which she “bares her soul (and her breasts) to Freud,” who “tells her – somewhat regretfully – that he is an old man, and moreover, a petit-bourgeois.”
The Guru, the Bagman, and the Sceptic is filled with similar characters, leaving the reader wondering how anybody could have taken (or, indeed still take) psychoanalysis seriously. O’Mahoney sums it up: “Psychoanalysis was the banner behind which marched a raggle-taggle army of failed neurologists, curious intellectuals, psychopaths, sexual opportunists, cultural entrepreneurs, eccentric aristocrats, and bored rich dilettantes. It was the making of many of them… Psychoanalysis was the solution to the pressing problem of what to do with their lives.”
This review was published in the Journal of Epidemiology and Community Health in 2003. You have to scroll to the fourth page of the PDF to read my piece, but you might enjoy the other pieces as well. https://jech.bmj.com/content/jech/57/12/927.full.pdf
The closest I ever came to a religious experience was listening to Ivan Illich. A charismatic and passionate man surrounded by the fossils of the academic hierarchy in Edinburgh, he argued that “the major threat to health in the world is modern medicine.” This was 1974. He convinced me, not least because I felt that what I saw on the wards of the Royal Infirmary of Edinburgh was more for the benefit of doctors than patients. I dropped out of medical school that day. Three days later I dropped back in again, unsure what else to do. Now I’m the editor of the BMJ, which is ironic. Having deserted medicine, I’ve become a pillar of the British medical establishment (yes I am, like it or not).
I devoured both Medical Nemesis and Limits to Medicine, and now I’ve reread the latter—for the first time in 25 years. The power of the book is undiminished, and its prescience seems remarkable. What was a radical polemic in 1974 is in some sense mainstream in 2002. Medicine does seem to have over-reached itself and some reigning in will benefit not only patients but also doctors.
Health, argues Illich, is the capacity to cope with the human reality of death, pain, and sickness. Technology can help, but modern medicine has gone too far—launching into a godlike battle to eradicate death, pain, and sickness. In doing so, it turns people into consumers or objects, destroying their capacity for health.
Illich sees three levels of iatrogenesis. Clinical iatrogenesis is the injury done to patients by ineffective, toxic, and unsafe treatments. The book has extensive footnotes that draw from a far wider range of sources than most medical books. Illich is equally at home with the New England Journal of Medicine and medieval German texts, making him a formidable opponent for the contemporary doctor who might dispute his conclusions. Evidence based medicine is described in these pages, 20 years before the term was coined. Illich also points out that 7% of patients suffer injuries while hospitalised. Yet only in the past few years and in a few countries have doctors begun to take patient safety seriously.
Social iatrogenesis results from the medicalisation of life. More and more of life’s problems are seen as amenable to medical intervention. Pharmaceutical companies develop expensive treatments for non-diseases. Healthcare consumes an ever growing proportion of the budget. In 1975 the United States spent $95 billion on health care, 8.4% of its gross national product—up, Illich noted, from 4.5% in 1962. In 2001 it was $1424 billion, 14% of GNP. Predictions published this month suggest will be 2815 billion, 17% of GNP by 2011. Can this be sensible?
Worse than all of this for Illich is cultural iatrogenesis, the destruction of traditional ways of dealing with and making sense of death, pain, and sickness. “A society’s image of death,” argues Illich, “reveals the level of independence of its people, their personal relatedness, self reliance, and aliveness.” For Illich ours is a morbid society, where “through the medicalisation of death, health care has become a monolithic world religion…Society, acting through the medical system, decides when and after what indignities and mutilations he [the patient] shall die…Health, or the autonomous power to cope, has been expropriated down to the last breath.” Dying has become the ultimate form of consumer resistance.
Illich’s book is more polemic than analysis and should be read as such. The rhetoric is intoxicating, and I can see why Illich captured my soul all those years ago. Illich was a Catholic priest before he became a critic of industrial society, and the story he tells reeks of “the fall of man.” Romantically, Illich seems to hanker after “the noble savage,” and most readers of his book will never have known such a person and may be sceptical that he has ever existed. Much of life before modern medicine looked nasty, brutish, and short, and have not most people offered the choice opted for the comforts of modern medicine?
It’s the ultimate book reviewer’s cliché to say that every doctor and medical student should read this book, but those who haven’t have missed something important. When sick I want to be cared for by doctors who every day doubt the value and wisdom of what they do—and this book will help make such doctors.
An abbreviate version of this review has been published in the BMJ (2002; 324: 923).
The composers we like must say something about us, and a composer who resonates with me is Shostakovich. I particularly like his 15 string quartets, which are said to be a personal diary and are all about death. I once heard all 15 played over three days, with the 15th, which has six movements all adagio, played by candlelight. I’ve been listening to Radio 3’s Building a Library discuss which is the best version of the 8th quartet. https://www.bbc.co.uk/programmes/m001h567 There are 99 recordings of the quartet, and Emily MacGregor, a music academic, selected and described the different versions.
The quartet, which has five movements, was written in three days. It was a bad time in Shostakovich’s life (were there good times?). After Stalin had condemned his opera Lady Macbeth of Mtensk, he was being pressured to join communist party; his identity was being challenged. His wife and mother had recently died, and he had developed a rare form of polio that would eventually kill him. A friend said that he saw the work as his epitaph and was planning to kill himself.
Notes on the Borodin Quartet’s 1962 recording of the quartet say: “The Borodin Quartet played this work to the composer at his Moscow home, hoping for his criticisms. But Shostakovich, overwhelmed by this beautiful realisation of his most personal feelings, buried his head in his hands and wept. When they had finished playing, the four musicians quietly packed up their instruments and stole out of the room.”
Shostakovich scholars debate endlessly the possible meanings of this quartet, much of his music, and Shostakovich’s life. The quartet, which has been described as “overlaid by mirrors,” is dedicated to victims to victims of fascism and war, but did he mean the millions who had died in the Second World War or himself or both? The music is filled with quotes and references, most of them to Shostakovich’s own works but also to Richard Strauss’s Metamorphosen, a lament for the downfall of the Nazis ( a piece that despite it’s appalling connections I much like.)
Shostakovich’s 8th Quartet was first played by the Beethoven Quartet, which premiered most of his quartets, in Leningrad in 1960, and the record I’m listing to now was released 19 days later. I find their sound in the first largo movement lovely, mournful, and surorisingly modern. This first movement and the whole quartet is filled with the sound made in German notation by DSCH, Shostakovich’s name. The Borodin Quartet, which worked closely with Shostakovitch, released the second version in 1962. Theirs is a thinner sound than that of the Beethoven Quartet, and the leader said: “We try to delve, seek out the spiritual storminess, get closer to the truth.” But where does the truth lie? Nobody really knows. The 2019 version by the Pavel Haas Quartet from Prague is deep, delicate, slow, and hovering. Their version is intelligently shaped.
The second allegro molto movement is aggressive, and the 1975 version by the Fitzwilliam Quartet, is fast, abrasive, and shattering. You hear the sounds of war, cries of alarm and terror. The piece plunges and gallops. Played fortissimo you may hear a train rattling past, perhaps taking soldiers to war, the injured home, or people to the gas chambers. The French Danel Quartet version shrieks and grinds, creating a frantic, edgy atmosphere. They also bring out well the Klezmer feel. The Emerson Quartet play the piece in 1998 version with a strong pulse and leave it hanging by a thread.
The third allegretto movement is a demonic dance, and in the version by the Eder Quartet the violin depicts witches dancing, perhaps with goblins. You hear the witches stamping on a grave and just a touch of Vienna. The Hagen Quartet is both more menacing and more delicate. They tiptoe and slide, creating tension and uneasiness. The 1996 recording of the Rosamonde Quartet is brittle and hard, moving from chunky to gossamer, creating a mood that is sad and elegiac. The Pavel Haas Quartet provides a twanging descent into the fantastical. They play with mutes creating a sound that is creepy and macabre.
MacGregor listened to but excluded versions from the Brodsky, Novus, and Jerusalem Quartets. It was the Brodsky Quartet I heard play all 15 quartets.
The fourth largo movement is the heart of the work. You hear repeated quavers, an aircraft drone, and a knocking that may either be the KGB knocking on the door or bombs being dropped. I hear it very much as an insistent, malignant knocking on the door. The external world is intruding into the internal world. The 2015 recording by the Carducci Quartet is heavy and slow, while that by the Kronos Quartet is rapping and fast, making the knocking sound more like gunfire. The movement includes a quotation from the Russian revolutionary song Tormented by Harsh Captivity, which was played at Lenin’s funeral. The music is tantalising: you see political truth for a moment but then it’s gone. The Fitzwilliam Quartet 1975 version is brooding and sombre, evoking dying. Rather than revolution you hear failure. The version by the Hagen Quartet is delicate, filled with remorse.
The final movement, which is also largo, sounds glacial. There is much to resolve. The piece may be resolved musically, but the enigma remains. McGregor selected three final versions. The Fitzwillian she found understated and lyrical, steadily building, but her final choice was between the Borodin and Pavel Haas quartets, both of which made it sound new—because it was new when the Borodin recorded and because the Pavel Haas version is fresh and alive. The Borodin provide a glimmer of optimism, a green shoot, but her final choice was for the Pavel Haas Quartet version, which is wonderfully self-contained, haunting and dark.
I always enjoy playing, or should I say dancing, Farmer’s in His Den, but I’m too inhibited to play it with just adults. You need children, and luckily we have two available, our granddaughters Betty (5) and Thirza (3). They enjoy it too, but they like to improvise on the theme.
Four of us are playing. In addition to the girls there is Lin (unknown age) and me (70). The first challenge is who is going to be the farmer. Is that the best role, wonder the girls, or is it better to be the dog—or even the bone?
Betty is the first farmer. Three of us link hands and dance round her.
“The farmer’s in his den, the farmer’s in his den, ee-ay-alio, the farmer’s in his den.”
We change direction: “The farmer’s wants a wife, the farmer wants a wife, ee-ay-alio, the farmer’s wants a wife.”
We pause. Betty is uncertain but eventually says “Granny.”
Now Thirza and I must dance round two people, not easy. We improvise.
“The wife wants a dog…”
“We’ll have to skip that and go straight to bone,” says Lin.
“The wife wants a bone, the wife wants a bone, ee-ay-alio, the wife wants a bone.”
As I dance, I wonder why the wife would want a bone. Soup, I imagine.
We stop. “Thirza,” says Granny.
“I don’t want to be the bone.”
“Well, Betty then.” Betty rises to the challenge of being both farmer and bone.
“We all pick the bone, we all pick the bone, ee-ay-alio, we all pick the bone.”
Betty squeals with delight as we pick at her.
“I want to be the bone,” says Thirza.
“Who will be the farmer?” I ask.
“Granny,” says Betty.
“It would be more logical,” says Lin, ever practical, “to go from farmer to dog then bone.”
“I don’t want to be the dog,” says Betty.
We play several versions with the girls arguing over who will be what. Then Betty suggests a variant. “Let’s play Space Alien is in his den, and the dog wants space cheese.”
“Space cheese?” Lin and I query together. This is a new one on us.
Off we go. “The space alien is in his den, the space alien is in his den, ee-ay-alio, the space alien is in his den.”
We skip over the problem with the scanning and progress to: “We all pick the space cheese, we all pick the space cheese, ee-ay-alio, we all pick the space cheese.”
Developing the game still further, Betty, with Thirza following, takes off all her clothes except her pants. Lin and I don’t follow.
The game or dance descends into chaos, but one conclusion is that being the bone or the space cheese is the best role. My unvoiced conclusion is that I prefer the traditional game or dance, preferably with at least six people.
Richard Smith's non-medical blogs 