You don’t have to be an amnesiac to read The Spectator but it helps. Or so it seems for one of its former columnists, the medical correspondent Theodore Dalrymple has been writing the same thing over and over again for the last two decades. I have almost completed the task of reading his entire oeuvre and despite my reservations I had quite a good time doing it. For Dalrymple is witty and frequently cruel and his prose is little short of sublime. And it’s dressed up as satire so what the hell?
I’ve always thought psychiatrists were a peculiar breed and Dalrymple is more peculiar than most. I’ve never encountered a psychiatrist who despises his patients as much as he does. His ‘Dispatches From the Front Line of the NHS were first published in The Spectator in the early ’90s and were reproduced in book form: two slim volumes entitled If Symptoms Persist and If Symptoms Still Persist.
Although he worked in separate institutions, each designed to serve very different sections of society: a psychiatric hospital and a prison he fails to acknowledge this and often conflates the two. In neither collection of biographical vignettes does he refer to a single case of bona fide mental illness. Illnesses that often necessitate admissions to psychiatric hospitals such as bipolar affective disorder or schizophrenia are notable for their absence. He also avoids making explicit his own medical specialisms: he was a consultant psychiatrist in the hospital and a general practitioner in the prison.
So what is his agenda? It is tempting to dismiss him as a ruthless, relentless, one-man right wing propaganda merchant. Yet the man himself, in recordings made for the internet, comes across as charming, kindly and avuncular. His soft voice and gentle manner lead one to believe that he’d make quite a good confidante. So you confide in him and the next day he is sharing your deepest, darkest secrets with the entire readership of The Spectator.
His patients are portrayed as cardboard cut-outs, devoid of any redeeming features. With a nod and a wink Dalrymple is telling his readership ‘They’re not like you and I. They’re not as human as you and I. In fact, they’re barely human.’ He was that tour guide in Bedlam.
There is a war going on, if Dalrymple is to be believed, between doctor and patient. He takes great delight in denying his patients medication. He also takes pleasure in forcing medications upon them, (‘I got my revenge. I had her injected in the buttock’- If Symptoms Still Persist). And if, despite his ministrations, the patients failed to recover then it was their fault, not his. It couldn’t possibly be that Dalrymple was an ineffectual doctor.
According to Dalrymple all of his patients are members of the so-called ‘underclass’. Are these people poor because they are mentally ill or mentally ill because they are poor? It is a question Dalrymple declines to address. And anyway 99.9% of his patients are malingerers. (Does that not sound statistically unlikely?)
I feel compelled to ask if the good doctor was born with a jaundiced eye. I get the feeling he probably was. Are sour old cynics (like me) born or are they made? And why do such people choose psychiatry as their medical specialism and then express astonishment when their patients turn out to be mentally ill? His former patients have my deepest sympathy.