Friday, 22 May 2020

Dante book and no blog

No recent blogs. Sorry.
I have been writing intensively. "Visions of Heaven. Dante and Divine light in Art".
I am giving priority to finishing the chapters before I have an operation on my back on 2nd June. Spinal stenosis has crunched my mobility. I hope my ability to get about will be restored to a workable degree.
I am more than half way through the last full chapter. Watch this space (if you want to) once the chapter is in draft.

Thursday, 30 April 2020

Covid glossary

A Challenge -  something we have failed at
"The Science" - which of the varied opinions, theories, analyses is most useful politically
Open / Transparent -  anything we can't keep hidden
Ending the Lockdown - planning based on guesswork
Promises - obsolete statements
Flattening the curve - why there is another peak
Press Conference - an opportunity to parade well-rehearsed words that add up to nothing
Media Interview -  ditto
Leadership (BJ) - making a lot of blustering noise that adds up to nothing
Brexit - we are leaving, or not
Care Homes - highly profitable enterprises
Ethnic Minorities -  a group of people against whom we once discriminated and still will when all this is over
Those at risk - those who can be sacrificed.

(Contributions welcomed)

Saturday, 25 April 2020

acronyms and arrogance

During current crisis we are assailed with acronyms. To give one example, an intensive care unit becomes an ICU. Oh yes, we also have PPE.
This is part of a broader and pernicious trend.  I still take Nature on a regular basis, having written a column for a number of years. At one time I could understand about one third of the content, could see what is going on in another third and could not grapple with the other third. Now, the great majority of the articles are closed book to me. Synopses are dominated by acronyms to which I do not have access and the articles themselves by torrents of data translated into graphs of a kind I can't handle.
Given my forthcoming (when?) back operation I have had to learn that CSF = cerebrospinal fluid. If it leaks, I am in trouble.
What is the purpose of acronyms? To economise, but not to a really significant degree. Their main purpose is make the user sound knowledgeable, like an insider and a professional. They are an affectation. They also carry a kind of high-tech air like all the acronyms that plague computer-speak.  How many know what a URL stands for? We may know what it does. But it stands for 'Uniform Source Locator', which is as incomprehensible to me as the acronym. 

I am the founder and sole member (to date) of SAAC. This is the Society for the Abolition of ACronyms. Yes, I know it's not a proper acronym, but that applies to many (most?) these days. There are also many organisations for which bizarre names have been concocted because they provide a good acronym.  

This is loosing battle - like most of mine - but I'm not giving up. 

Sunday, 19 April 2020

virus, science, and more on the scrapheap

'We follow the science'. That or something like it has been the politicians' mantra. But there is no such thing as "the science". There are well-informed. clever people who pursue research, ranging from specialist modellers of probabilities and possibilities to  racing researchers set on the holy grail of a vaccine. We hear that vaccines are not far away. We hear that a vaccine is never going to do the job against this 'clever' virus.  We hear that we will be out of the wood (according to various timescales) or that we will have to live (and die) with the virus for the foreseeable future. We are told that people with antibodies are safe. We hear that we do not know whether we can acquire immunity from a second infection.  With a such a new and unpredictable virus, there are huge uncertainties.  Translating these uncertainties into policies is the politicians' job. When they get things wrong they get the blame (unless their name is Trump). But the scientists should also share the blame. They appear on the media (flattered and self-important) to make ex-cathedra pronouncements based on their particular skill-sets. "The evidence tell us...". Evidence only tells us something there is a theory and/or a set of assumptions. I am concentrating on what is actually happening, listening to the news and hearing the main scientific pronouncements, but the rest seems to me to be media noise. Hooray for Radio 3. Science is hugely powerful and very necessary, but "science' tells us many things. Which of these things do we "follow"? There will be huge winners and losers in this game of scientific snakes-and-ladders.

A footnote on the Sumption survival of the fittest thesis.
State what seems to be unassailable premise: ‘old people are more likely to die that younger ones’. What flows from this,  by a series of steps which have the air of logic, is that if everybody cannot be treated, the old should not be.
But the initial premise has tacit assumptions / biases in it. The ‘old’ are singled out, not infants, pregnant mothers, the disabled, those on social care, those in care homes, those with severe mental problems… The only outcome of the premise is that the old should be left to die.
If I start from the ethical premise that everyone has the same right to a further year (on other unit of time) of life and be given assistance to achieve that goal (unless the quality of life is such as to bring this into question), the outcome is utterly different. At the end of the year, the same equation kicks in. The old will of course on average die more quickly than younger people , but a caring society should not pursue remorseless  if tacit policy to cleanse of society of old people.
Of course, I am biased in this. My birth certificate tells me that I am "old". I would like to think this is fake news, but it seems to be true.


Sunday, 12 April 2020

NHS - Immigration - Virus

The MRI scan of my back was set up by someone of Asian ancestry. The scan was made by someone of (probably) far eastern ancestry. Both the NHS physiotherapists were of Asian ancestry. The local post office is run by a husband and wife of Asian ancestry (who are trying to get me a large bag of rice from the cash and carry since the Co-op is not coping with shelf-strippers). The local store and newsagents is run by a family of Asian ancestry. The 'Indian' restaurant is doing take-aways.. and so on.
They have been pleasant, helpful and professional. They are essential members of our community and are at risk in the frontline.
And yet we read of the Home Office refusing to fast-track or register qualified practitioners and willing workers who do not fit with their hostile immigration rules. An organisation like the Home Office can be collectively racist even if the individual members are not. The net effect of procedures and criteria, with each person / department protecting their own backs, in the face of their political masters and tabloid press, is racist.
This is a time when we can all show our friendship and gratitude to who have chosen to join and participate in our community.

Thursday, 9 April 2020

spinal stenosis

Today an MRI scan on my back to determine what precisely is wrong and what, if anything, can be done about it. The test was conducted at the Manor private hospital in Oxford, which goes against my principles. However the NHS refused a scan and were not too much bothered if I am assigned to the scrap heap. The virus is the (only) thing. Two days ago I tested how far I could walk in Blenheim park. My right leg is only partly functional. I struggled to the pleasure gardens and back, not much more than I mile. 3 months ago this would not have counted as a walk, let alone exercise. By the evening I had difficulty in walking at all. As I said before, it's notable how perspectives can change.

A few years ago I wrote a bit of formatted prose on a neighbour whom I could see in the lane from the window of my study on the first floor. It was printed in the booklet of his funeral service. It has a new resonance for me, now that mobility is a challenge not an assumption.

The Man with Two Sticks

A man frail and tall, not old in counted years,
Shuffles inch by inch from the shadowed lane
With a caring lady who can hardly go so slow.
The radiant sun enters his upturned eyes.
 A quantum of the youthful energy for which he yearns.
Where is the laughing running boy who knew
Nothing of impediments?

“I will get the car” she says, striding up the gentle slope,
Released into normalities of time, space and locomotion.
A low wall is close but separated from him
By a daunting distance of straining effort.
He reaches out for the stony seat with a probing stick,
Turning bit by unwilling bit to crease and settle.
An old lady goes by arthritically. She is envied.

The black car arrives. 
He is folded and loaded. 
To go to somewhere once familiar, once easy,
Now transformed into a theatre. Of impossibilities.

An inch is a foot is a yard is a mile.
A day is a week is a month is a year.
Their will and love annealed in the flame of patient hope.
The channel is swum. Everest is conquered.
“All on your own, yes, all on your own”,
His mother’s reward for infant steps. Long ago. 



Monday, 6 April 2020

on the Judge's scrapheap

The former high court judge and general man of opinions, Lord Jonathan Sumption, wrote a challenging piece in The Times, sent to me by a friend. In attaching it I am probably breaching copyright but I could not find any contact address on the internet I've inserted some comments. He may well be right overall. But his prescription stands a good chance of chucking me on the scrapheap.
Maybe that is also right overall.

Coronavirus lockdown: we are so afraid of death, no one even asks whether this ‘cure’ is actually worse

“The only thing we have to fear is fear itself — nameless, unreasoning, unjustified terror which paralyses needed efforts to convert retreat into advance.” The words are Franklin D Roosevelt’s. His challenge was recession, not disease, but his words have a wider resonance.

Fear is dangerous. It is the enemy of reason. It suppresses balance and judgment. And it is infectious. Roosevelt thought government was doing too little. But today fear is more likely to push governments into doing too much, as democratic politicians run for cover in the face of public panic. Is the coronavirus the latest and most damaging example?

Epidemics are not new. Bubonic plague, smallpox, cholera, typhoid, meningitis, Spanish flu all took a heavy toll in their time. An earlier generation would not have understood the current hysteria over Covid-19, whose symptoms are milder and whose case mortality is lower than any of these.

What has changed? For one thing, we have become much more risk-averse. We no longer accept the wheel of fortune. We take security for granted. We do not tolerate avoidable tragedies. Fear stops us thinking about the more remote costs of the measures necessary to avoid them, measures that may pitch us into even greater misfortunes of a different kind.

As someone who (statistically at least) is nearer the bottom on the wheel or fortune than many, I am reluctant to acquiesce to dying conveniently. 

We have also acquired an irrational horror of death. Today death is the great obscenity, inevitable but somehow unnatural. In the midst of life, our ancestors lived with death, an ever-present fact that they understood and accommodated. They experienced the death of friends and family, young and old, generally at home. Today it is hidden away in hospitals and care homes: out of sight and out of mind, unmentionable until it strikes.

I think the idea that death was in effect domesticated in earlier eras is oddly romantic. The Boccaccio account of the bubonic plague that I posted here does not suggest that the ravages of disease were comfortably 'accommodated'. Death was what it always has been. Essentially nasty.

We know too little about Covid-19. We do not know its true case mortality because of the uncertainties about the total number infected. We do not know how many of those who have died would have died anyway — possibly a bit later — from other underlying conditions (“comorbidities”, in doctor-speak).

What is clear is that Covid-19 is not the Black Death. It is dangerous for those with serious existing medical conditions, especially if they are old. For others, the symptoms are mild in the overwhelming majority of cases.

The prime minister, the health secretary and the Prince of Wales — all of whom have caught it and are fine — represent the normal pattern. The much publicised but extremely rare deaths of fit young people are tragic but they are outliers.

Yet governments have adopted, with public support, the most extreme and indiscriminate measures.

We have subjected most of the population, young or old, vulnerable or fit, to house imprisonment for an indefinite period.

We have set about abolishing human sociability in ways that lead to unimaginable distress.

We have given the police powers that, even if they respect the limits, will create an authoritarian pattern of life utterly inconsistent with our traditions.

We have resorted to law, which requires exact definition, and banished common sense, which requires judgment.

These things represent an interference with our lives and our personal autonomy that is intolerable in a free society. To say that they are necessary for larger social ends, however valuable those ends may be, is to treat human beings as objects, mere instruments of policy.

And that is before we even get to the economic impact. We have put hundreds of thousands out of a job and into universal credit.

Recent research suggests that we are already pushing a fifth of small businesses into bankruptcy, many of which will have taken a lifetime of honest toil to build. The proportion is forecast to rise to a third after three months of lockdown.

Generations to come are being saddled with high levels of public and private debt. These things kill, too. If all this is the price of saving human life, we have to ask whether it is worth paying.

The truth is that in public policy there are no absolute values, not even the preservation of life. There are only pros and cons. Do we not allow cars, among the most lethal weapons ever devised, although we know for certain that every year thousands will be killed or maimed by them? We do this because we judge that it is a price worth paying to get about in speed and comfort. Every one of us who drives is a tacit party to that Faustian bargain.

The inability of people ('society') to understand  risk is one of the great anomalies in human behaviour. Does anyone ever educate children about what risk is and how it can be handled? I've been on boards where we have conducted risk assessments. Little was really understood, and the fact that the risks were all neatly tabulated on some sheets of paper seemed to neutralise them, courtesy of  a managerial exercise,

A similar calculation about the coronavirus might justify a very short period of lockdown and business closures, if it helped the critical care capacity of the NHS to catch up. It may even be that tough social distancing measures would be acceptable as applied only to vulnerable categories.

But as soon as the scientists start talking about a month or even three or six months, we are entering a realm of sinister fantasy in which the cure has taken over as the biggest threat to our society. Lockdowns are at best only a way of buying time anyway. Viruses don’t just go away. Ultimately, we will emerge from this crisis when we acquire some collective (or “herd”) immunity. That is how epidemics burn themselves out.

In the absence of a vaccine, it will happen, but only when a sufficient proportion of the population is exposed to the disease.

As someone who is 'vulnerable' by dint of age, I am reluctant gamble on my resistance to further the march of 'herd immunity'.  I feel I still have much to do. As always, I think my next book is to be the really good one. I am happy to accept personal restrictions, until such time as the 'absence of a vaccine' is rectified. 

I am not a scientist. Most of you are not scientists. But we can all read the scientific literature, which is immaculately clear but has obvious limitations. Scientists can help us assess the clinical consequences of different ways to contain the coronavirus. But they are no more qualified than the rest of us to say whether they are worth turning our world upside down and inflicting serious long-term damage. All of us have a responsibility to maintain a sense of proportion, especially when so many are losing theirs.