Posts Tagged ‘The Spectator’

Contextualising…

November 20, 2010

‘New Consultant’

This is not an article. This is a temper tantrum.

Nobby (the war veteran/ the former commando) said, ‘Oh bugger Dalrymple, he talks a lot of nonsense. When was he born? It sounds like he just missed national service. Pity. it would have done him a lot of good. The army would have shown him what vulgarity was.’

And besides, remember which nation vomited forth Le Corbusier.

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Oppressed by the Underclass

October 24, 2010

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.

Found in the Bowels of the BMJ

September 28, 2010

Finally, I have discovered someone else who is not star struck by Theordore Dalrymple/Anthony Daniels:

If Symptoms Persist

Theodore Dalrymple Andre Deutsch, pounds sterling8.99, pp 150 ISBN 0 233 98898 X

Writing under a pseudonym in his weekly column in the Spectator, Theodore Dalrymple presents a picture of a lawless world. Dr Dalrymple works at a hospital, and he makes regular prison visits. His life is threatened, and within the space of a week his car is broken into for the third time in a year, his secretary’s mother is attacked, and one of his patients is robbed and beaten in two separate incidents. Responsibility for this anarchy is placed squarely on both the courts and the police, who are either stupid, lazy, or interested only in clearing their cells.

Inhabiting Dalrymple’s world are an edentulous people, unable to read (with the exception of benefits pamphlets) and sometimes called Jason, who use words like “yoof” (for youth). His patients carry knives, and they tell stories of robberies, burglaries, and vandalism. Their tattoos determine their relationship with the world and proclaim a message which is either unambiguous (“Fuck Off”; “Made in England”; a swastika) or subtle (the Old Borstalians’ blue spot on the cheek). They are a whingeing breed “maintained if not created by the welfare state and whose every word is uttered with the dying fall of complaint.” Even in prison the standard British burglar, malevolent and self righteous, lives the life of Riley, endlessly replaying the violent parts of videos.

The environment matches its inhabitants. A community centre’s garden is barren because its clients urinate on the plants. Residence in a tower block is possible only if tenants are calmed with Valium. Housing officers and social workers are the targets for attack and manipulation. One man requested a transfer to a three bedroomed flat because his existing accommodation was too small for himself and his 40 ferrets.

Felons blame either drink or drugs. Young women, blessed with many nippers (sic)—who are mostly cared for by someone else—and deserted by their violent cohabitees, become pregnant in an attempt either to force their men to return or to have another person to give them love. Overdoses and threats of self harm have an added value, causing bad debts to be cancelled and those who have been disconnected from services to be reconnected.

A selection of Dalrymple’s articles is now available in a book, and the whole could be read as an exercise in satire, with invective and wit being used to dramatise the vice inherent in contemporary urban society. Some hint as to whether or not Dalrymple is a psychiatrist can be deduced from the following. (Of a patient frequently the victim of burglary): “It was fortunate…that she was too poor to have valuable possessions”; (speaking of giving evidence in court): “It gives me great pleasure to cook the goose of some of my more obnoxious patients”; (of a man tormented by hallucinations whose origins he believed lay in an intestinal worm): “No doubt advances in parasitology will soon result in a compact disc worm.” A last example is worth a thousand words, and in it he mocks in trenchant tabloidese: “Single mother victim of bag snatcher outside social security.”

Coming from a doctor’s pen it all has a certain shock value. But there is something sinister about a physician presenting in this way people to whom he has a duty of care. It is both exploitative and unremitting in its harshness. It is a perfect paranoid position: reason surrounded by feckless scrounging, short-termism, and greed. But is it not all a fabrication that panders to those who have the responsibility to change things from being what they are but choose not to do so? And do his patients know what he thinks of them?—PAUL BOWDEN, consultant forensic psychiatrist, Maudsley Hospital, London

http://www.bmj.com/content/310/6988/1207.1


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