Scribblings and blether and haver

July 2020 reading list

An interesting bunch this month and, for the first time in a while, a book I just could not get along with at all. Here’s the July list.

  • What If? by Randall Munroe
  • Narco Wars by Tom Chandler
  • The Windrush Betrayal by Amelia Gentleman
  • Dopesick by Beth Macy
  • Wind, Sand and Stars by Antoine de Saint-Exupéry
  • Some Kids I Taught and What They Taught Me by Kate Clanchy
  • How to Think Like a Roman Emperor by Donald Robertson
  • The Elements of Eloquence by Mark Forsyth
  • Polio. The Odyssey of Eradication by Thomas Abraham
  • The Obstacle is the Way by Ryan Holiday
  • Hope in Hell by Jonathon Porritt

Comments and Recommendation of the Month

I typed the initial draft of this post in early July, having read the first couple of books on the list and as I neared the end of The Windrush Betrayal by Amelia Gentleman and Dopesick by Beth Macy. At that point, I’d have been astonished if another book could better Gentleman’s effort and I wrote about it back then.° I was listened to the audiobook, read by Gentleman herself, and it was, by turns, leaving me breathless with rage and often close to tears.

I am still prone to shouting at the TV, but I know I am just another madman howling at the moon.

I sometimes wonder what politicians think when they read these books. Do David Cameron, Amber Rudd, Theresa May, feel any sting of shame at all? Most probably not. And, not because I believe they are heartless psychopaths. I try hard not to judge the personal qualities of people on the news and in the media as we can’t really know these people and labelling them as such doesn’t help.

That said, I need to be clear that I am still prone to shouting at the TV, but I know I am just another madman howling at the moon. Yet, as I get older it is impossible to miss the fact that, on a regular basis, the politicians we despised have popped up again in a more human role, having sloughed off the party political skin. Michael Portillo and Ed Balls spring to mind as particularly polarising politicians who have been rehabilitated. No, I suspect Cameron, Rudd and May don’t express any regret because that is, at its heart, how most people behave. We rationalise, we dissemble, we justify and we very rarely admit to ourselves, much less anyone else, that we were mistaken.

Yet Gentleman’s account in The Windrush Betrayal is absolutely damning. The callous behaviour of the politicians, the willingness to de-humanise, is laid bare. At its toxic core, this is, obviously, a book about racism and, importantly, it demonstrates how racism can become systematised. The government machinery, reduced to its heartless efficiencies, exposes the horror of market-driven outsourcing pursuing its sightless, amoral aim. It’s a template for the despots and the malignant. The government created a hostile environment, that could do nothing else but ingrain racist processes. Even worse, they made us all complicit by getting the NHS, GP surgeries, the landlords, and the employers to do the work.

I did read Clanchy as soon as I had heard it won the Orwell Prize° and it is a wonderfully insightful book. It’s more uplifting than The Windrush Betrayal and Clanchy’s background as English teacher, novelist and poet, mean that the literary swirls through it. Which never does any harm, I suspect, when it comes to book prizes. For me, it’s not quite as urgent or as critical as The Windrush Betrayal which I would rate above it.

And, as I mentioned it at the start, I had better follow through and deliver… I could barely muster the strength to finish The Obstacle is the Way which didn’t work for me on any level. I found it superficial and unengaging. I read it shortly after finishing How to Think Like a Roman Emperor — another book following the vogue for Stoic philosophy. In HTTLARE, Robertson weaves in modern psychology and facets of CBT to the story of Marcus Aurelius. I’m happy to recommend it highly if you want to explore that niche.

Late presenting bladder cancer and colour vision

I am red-green colour blind and I’m well aware of my general inability to distinguish red particularly well. In particular, I often miss subtler shades of pink. Apart from a tendency to wear inappropriate shirt and tie combinations it’s hardly life threatening. Or so I thought.

However, it is perhaps rather more than an inconvenience that blood is red. People that are colour-blind may be unable to spot early signs of blood loss. And as any fule kno unexpected blood rings big fat alarm bells for the Big C.

Colour-blind people (the vast majority being men) can’t pick up some of the early signs of disease when it involves spotting colour changes in bodily fluids.

A good example is blood in the urine. I doubt I would miss frank gross haematuria but a red-green colour deficiency makes it easy to miss an elegant pink tinge in my urine. This simple study° from some urologists in Preston took 200 male patients with bladder cancer and assessed them for colour deficiency using an Ishihara°plate test. They found 21 blokes (10.5%) had red-green or ‘complete colour blindness’. The presentation at diagnosis was frank haematuria in 74% of the non-colour blind versus 62% of the colour blind (non-significant).

The study also looked at the histology and the non-colour blind had 69% with superficial disease and the rest had invasive bladder cancer. The colour-blind group had 42% with superficial disease and 58% with less favourable histology. This is statistically significant (p<0.01).

There is sound logic to back up these findings. Colour-blind people (the vast majority being men) can’t pick up some of the early signs of disease when it involves spotting colour changes in bodily fluids. So they are presenting later with more advanced disease. Not good. However, this is a small study — only having 21 cases of bladder cancer in colour-blind men limits how far I would want to rely on the findings.

Colour-blindness is treated as nothing more than an evolutionary oddity; good for teaching the basics of X-linked inheritance° but of no clinical significance. Yet, it might have a little more impact than you think.

 

Reference

Katmawi-Sabbagh, S., Haq, A., Jain, S., Subhas, G., & Turnham, H. (2009). Impact of Colour Blindness on Recognition of Haematuria in Bladder Cancer Patients Urologia Internationalis, 83 (3), 289-290 DOI: 10.1159/000241669°

Colourblindness and cricket

WH PonsfordI have been musing on my own personal cricketing failings and I have always suspected that I am handicapped by being colour blind. Think about it. How do you fancy spotting a red ball on a green background with an inability to tell red and green apart? It turns out the medical literature has already considered the issue of colour blind cricketers and is there to back up my plaintive pleas.

There is an expected prevalence of around 8% in the male population for colour-vision deficiency. Of course, an incidence of 8-9% means there is likely to be one colour blind player in every team. Previous studies quoted have suggested rates as low as 4% in first class county cricketers. One study° looked at 293 cricketers from seven cricket clubs in Melbourne. They found that 8.9% had colour-vision deficiencies but only 6.7% played at the highest level within those clubs. However, that reduction in those playing at the highest level is statistically significant.

This could lead one to the conclusion that being colour blind is holding some cricketing men back. This study also looked at some other interesting areas which might prove useful for the village cricket bluffer and will provide ample ammunition to mount a robust defence of any mishaps.

The batting average in those with mild colour-vision deficiencies was 28.3 and those with severe deficiencies was 18.8.

The batting average in those with mild colour-vision deficiencies was 28.3 and those with severe deficiencies was 18.8. (Sadly, the authors report this was not statistically significant but don’t let that stand in the way of your bar-room thesis during the match post-mortem.) It was also noted that those with colour-vision deficiencies rather prefer fielding close to the batter. This might prove a highly useful piece of hard medical evidence for those that find galloping around a boundary rope somewhat wearing. The authors have included some technical explanations which will help beat back any naysayers.

A further hypothesis is that cricketers with abnormal colour vision will have greatest difficulty when fielding in the outfield where the angular size of the ball is small and the ball may often be seen against grass or surrounding foliage. The ball subtends about 12 minutes of arc for a fielder close to the batsman and three to five minutes of arc for a fielder near the boundary. It is known that all observers with abnormal colour vision, even those with a mild deficiency, have difficulty seeing red objects in natural surrounds. For these reasons cricketers with abnormal colour vision should prefer to field close to the batsman. Botham was a brilliant slip fielder…

W.H. Ponsford (pictured) was known to be colour blind but he has the 6th highest average in first class cricket° in the history of the game. He doesn’t always make the lists because he never met the 20,000 run minimum that is often applied. He also scored over 400 twice in first class innings. Only Brian Lara can match that.

Rather amazingly 42% of men in this study did not know they had any colour-vision deficiency. So the next time you shell a dolly at long-off perhaps you ought to toddle down to your GP and do an Ishihara test.° Being colour blind could provide some convenient excuses.

 

Reference
Harris, R., & Cole, B. (2007). Abnormal colour vision is a handicap to playing cricket but not an insurmountable one Clinical and Experimental Optometry, 90 (6), 451-456

The Orwell Prize winner 2020 goes to…

I finished the last hour of Amelia Gentleman’s The Windrush Betrayal this morning as I ran on the western fringes of the Howgills. I was coming off Arant Haw and down towards Seat Knott. It is not very summery at the moment. The baking hot drought days, mid-lockdown, of April and May, are receding in the memory.

It was barely 12°C and I managed with a cotton T-shirt and shorts but there was no lingering. I had to, incongruously, wear a pair of gloves with the scanty running kit, an affectation usually reserved for Premier League footballers, but an essential one as my stiffening blood vessels aren’t letting warmth get to my extremities in quite the way they did. There was a stiff breeze, unusually more easterly, maybe with a hint of south, compared with the usual prevailing westerlies. It’s curious how the wind, something that we wouldn’t normally pay much mind, becomes so startingly evident when out running. The easterly push meant, despite my efforts to lift the pace, that I was engaged in something of a struggle to get up the hills. The playful breezes at house level are rather more persistent higher up and I had to lean in, work hard. I was glad to reach the summit at 606m and turn my back to the wind.

The other problem with the wind is that I can, when it really starts roaring, have difficulties hearing the audiobook but I was still picking it up just fine today. The Windrush Betrayal hasn’t been an easy listen because it is so emotive. It is enraging. A horror story of institutional racism, the hostile environment of May, Cameron and Rudd. The stories of lives devastated had me in tears. I often wonder if some politicians’ cheeks are touched with any blush of shame. I doubt it. Not because I regard them as unfeeling monsters but because it is just not within human nature to admit to mistakes. More likely, they rationalise it, build the fortifications around their own personal story. Gentleman touches on this as she interviews Rudd and she recounts how May expressed personal sorrow, clumsily as ever, but never apologised for the hostile environment policy. That remained inviolate, reasonable; it was simply the unfortunate collateral damage she regretted. (Though, again, Gentleman points out this only came when it became clear public opinion was firmly with the Windrush generation.)

They tell of injustices through gritted teeth, not wanting to let their emotions intrude.

Amelia Gentleman narrates it well and the story includes moments of personal reflection too, where she had doubts and anxieties. These were welcome, there are times when the forced objectivity of journalists feels, well, forced. They tell of injustices through gritted teeth, not wanting to let their emotions intrude. The Orwell Prize rather exemplifies the need for political journalism to have a viewpoint, to have a stance, though it is perfectly possible to over-egg this. Going to far is, perhaps, one of the reasons I found Caroline Criado Perez’s book, Invisible Women, a much harder listen. Her understandable frustration and anger at the demonstrable injustice and bias manages, just at points, to lessen the raw power of the data bias. (In fact, I still have a couple of hours left on that book to finish as I had, unusually, given up on it.)

As I was running down, I thought how disappointed I would be if Gentleman’s book doesn’t win the Orwell Prize. A little unfair as I have yet to read any of the other five on the list beyond Gentleman and Perez. I thought, if they can best these two then they really will be worth the effort. My timing is impeccable, as it turns out, as it spurred me to check the site and the Prize was being announced today. Not long to wait to find out. As it happens Amelia Gentleman didn’t win — it has gone to Kate Clanchy for Some Kids I Taught and What They Taught Me. An unanimous decision according to Stephanie Flanders. I have it on my Kindle and plan to start immediately.

June 2020 reading list

Well it was a much better month than May and I found my groove again. There are some real gems here that would have me enthusing in any given month. I’ll try to tackle them individually with posts in the coming weeks. Here’s the June list.

  • Don’t Be Evil by Rana Faroohar
  • You Talking to Me by Sam Leith
  • Parliament Ltd by Martin Williams
  • Our Final Warning by Mark Lynas
  • How to Survive a Plague by David France
  • The NHS at 70: A Living History by Ellen Welch
  • The COVID-19 Catastrophe by Richard Horton
  • Humankind: A Hopeful History by Rutger Bregman
  • You Are Not Human by Simon Lancaster
  • The Art of Statistics by David Spiegelhalter
  • The Candy Machine by Tom Feiling
  • Unpopular Essays by Bertrand Russell

Recommendation of the Month

Don’t Be Evil is a good run through of the problems at Google and Facebook. You Talking to Me hops through the formal discipline of rhetoric, something that I’m not very familiar with at all but I enjoyed. Parliament Ltd is damning of many politicians and the whole parliamentary process. There is a lot to be cross about but, weirdly, I found Williams’ scathing tone about politicians slightly irritated me. It’s clear he has a very low opinion but I wasn’t always sure it was entirely fair to daub all politicians with this particular brush at all times.

Our Final Warning is a bleak read but not to be ducked. How to Survive a Plague is a fairly long book but uplifting despite the desperately long list of victims. One of the big players at the time of the HIV epidemic was none other than Anthony Fauci. He doesn’t always come out of it well. The NHS at 70 is rather short and somewhat superficial. The COVID-19 Catastrophe by Horton is brutally honest, again relatively brief, but packs a punch.

You Are Not Human was excellent and made me think deeply about metaphor and how we use it, unthinkingly, all the time. Humankind is very good as well and this book, plus Utopia for Realists, make Bregman one to keep close. The Art of Statistics does a manful job of tackling some complicated stats. It’s not my first rodeo when it comes to looking at these but my head was swimming at times. The Candy Machine is another book covering the horrors of the ‘War on Drugs’.

My favourite book this month was Unpopular Essays by Bertrand Russell. I picked it up because of a recommendation in Bregman’s book. For some reason, the life and works of Russell have passed me by. I could barely have told you who he was, much less anything about his books. It was wonderful to read these essays from a different period but be entertained and stimulated. And knowing there is much to read of Russell’s yet is always a lovely feeling — reminiscent of that thrill when you find an author you love and there is a long backlist to work through. I’m not certain I’ll be delving into all his past academic works but there are plenty of essay collections to enjoy.

A note

I’m keeping it simple and focused on the writing but I have added a few tags for some themes.

Email if you want to get in touch: euan@euanlawson.com

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January 2020 reading list

Nothing too complicated about this. Here are the books I’ve got through in January 2020. As usual there is a mix of audiobooks, ebooks, and good old fashioned hardcopy.

I’ve provided some links above when I’ve written something about them. I don’t use Amazon or affiliate links so click away with impunity. These span some seriously varied genres so it is hard to nominate a favourite. As a general rule, the ones I write about are usually the ones that have had most impact. The book I’ve found myself recommending the most and talking about has been Narconomics. I was shocked by Catch and Kill and I loved reading Tilman again after many years away from him. I think I would read a shopping list if it was written in Chang’s wonderfully accessible style and Bliss’s book was instructive in showing how science can be written with a wonderfully human, sidelong gaze.

Narconomics by Tom Wainwright

Narconomics has been on my reading list for a long time now and I’m sorry I didn’t get to it sooner. It’s a sharp analysis, informed and informative, and I took a tremendous amount away from it. It reinforced some important points around the global drug market. Wainwright covers in some detail° the expense and largely futile policing of the drugs trade. In an early example, he takes us through the economics of destroying large amounts of the coca crop and how this has almost no impact on the final price for the consumer. Until then the policy of destroying the source of the drug seems to be entirely logical yet Wainwright dismantles it so comprehensively you are left wondering how you ever believed it in the first place.

The concept of the hard drugs market as being relatively inelastic is an important one. Reductions in supply don’t necessarily shift demand. Attacking the supply-side of the industry has very little impact, particularly in early links of the chain. Interestingly, one of the biggest changes in heroin use, in one case study, was the large-scale adoption of heroin assisted treatment in Switzerland. In effect, it reduced the market, but it also took out the low-level dealers with dramatic reductions in overall usage.

It is also worth reiterating an important point about the drugs debate. It is important to acknowledge the difference between decriminalisation and legalisation. The countries where drugs are used (UK, USA etc) are keen to lay the blame for the problem on the supply side with Johnny Foreigner. We need to be mindful that a half-baked decriminalisation could result in unintended consequences. It will not necessarily have the same effect as full legalisation and regulation. The murders, the deaths, and all the misery inflicted through the organised crime networks that supply the drugs may continue depending on the exact nature of the changes. Decriminalisation may work for the drug-consuming rich nations while entrenching violence and poverty in the drug producing and transit countries.

The move towards cannabis legalisation continues. Wainwright also explores this using economic principles and the often complex, not always intuitive, impact it can have on drug markets. There is a fascinating opportunity with legal cannabis production to ensure it is socially just. Handing over the industry and the profits to corporate regimes would be a mistake – try this article in The Correspondent° for more on empowering people through Big Marijuana.

Catch and Kill by Ronan Farrow

Harvey Weinstein is appearing on television regularly as his trial continues. He looks broken and frail, a shell of a man, but I find it easy to harden my heart and watch, with grim satisfaction, some semblance of the justice process playing out. Before reading this, I understood the gist of the story but I hadn’t read exhaustive accounts in the mainstream media. In Catch and Kill°, Farrow lays it all down for inspection.

In some ways, the pictures of Weinstein now remind me of a few hard men I met when doing prison medicine. Only they weren’t hard men any more. They were weakened, spent, and preyed upon. They had meted out some violence in their time and were now, in their turn, feeling the threat. The difference is that Weinstein is facing appropriate legal actions and not some extra-judicial beating. And perhaps my biggest emotion when seeing Weinstein looking so elderly is one of regret. It has taken too many years and too many victims to get to this stage.

Catch and Kill portrays Weinstein as a predator and a man who deserves to face the full weight of the justice system pressing down on him. The book grimly details Weinstein’s modus operandi and Farrow’s dogged, if not plain obsessive, pursuit of the story. Farrow’s descriptions of the establishment, “the great white predators”°, closing ranks is enough to make you retch. Farrow also records in the book how he was trailed and investigated by a shadowy Israeli security company, a “private Mossad”, employed by Weinstein. NBC do not come out of it well. Actually, very few do. Perhaps only the women who went through it and the ones who were able to steel themselves to resist, to tell their story. And, Farrow as well, he certainly went through the wringer.

One small point, but it needs to be mentioned. I listened to the audiobooks and I have no idea what the producers were thinking of in letting Farrow do the accents. You will read many reviews commenting on it. The only thing I can say is that they did, as the book went on, grate less and less, and the story is too compelling, too astonishing, to even consider sacking it. Don’t let it stop you reading this important book.

The Ascent of Nanda Devi by HW Tilman

There are few figures in the 20th century with as remarkable a story as HW Tilman.° He will be well known to anybody who has spent time working through any of the rich literature we enjoy on mountains and exploration. Inevitably, it won’t be long before your attention is drawn to the books of Tilman and his co-explorer Eric Shipton.° They are a justly famous pairing, though less celebrated beyond adventurer circles, whether armchair or active. I was going to write ‘sadly’ there, but given the style in which they went about their lives, there seems little to regret.

I remember, with great excitement, when the seven collected mountaineering exploration books by Tillman were published in the 1990s. The larger volume still sits on my bookshelf but the very size of it does somewhat restrict its use. As handsome a volume as it is, it’s not easy carting around 900-odd pages worth of hardback book.

I was delighted to discover that the Tilman (and Shipton) books have now been made available as individual volumes and also as e-books. So, I was able to enjoy The Ascent of Nanda Devi (1937) on my Kindle. I can scarcely add to the fine words that have been written about Tilman. He has a thoroughly laconic style, much imitated by would-be literary mountaineers, and famous enough in the 1950s to have helped inspire the parody, The Ascent of Rum Doodle

On the front of the new book it states: “I believe we so far forgot ourselves to shake hands on it” quoting Tilman’s self-parodying line on reaching the summit. It’s a delight.

January Debrief — The Political Doctor

My Debrief for the January 2020 issue is available on the BJGP website.° It was an odd one to write and it already feels like a long time ago. The lag with monthly publication always leaves me slightly disorientated when articles are published. I’m working ahead and, suddenly, something written many weeks in the past bobs back up. This one was particularly unusual as I wrote it in the feverish week before the general election and it was published a couple of weeks after.

I was determined to write something political but I didn’t want, with this particular article, to be overtly partisan. Not that I have a problem with that. I don’t think you’d have to dig too far back into my writings to determine where my loyalties lie but I figured the timing was critical here. I hesitate to invoke the imagery of a party to characterise the election campaign but further comment in the BJGP might have been about as welcome as being offered the previous night’s leftover cold kebab while nursing a brutal hangover. All that said, there has been an interesting reaction to it and it seems to have struck a note with a few people.

For those of the left-leaning persuasion, it’s tremendously easy to lurch into apathy, if not outright despair. Personally, I plan to find ways to dig in and get more involved. The responses I’ve had suggest I’m certainly not alone. Get in touch if you want to talk about it.

On Immunity: An Innoculation by Eula Bliss

This is a sensitive exploration of immunity and vaccines that occasionally digresses and certainly doesn’t follow the main thoroughfares of the scientific highways. It’s more like a version that takes the scenic road, meandering through the countryside, ending up at the same destination, but offering a very different experience for the traveller.

Reading the reviews on Amazon is an uncomfortable experience as it serves a very pointed reminder that the anti-vax sentiment is very much alive and kicking. One review stuck with me, suggesting that Bliss didn’t quote any papers or research, though the reviewer may well have been an anti-vaxxer who simply didn’t like Bliss’ viewpoint. Actually, I think On Immunity is very rich in scientific detail, it’s just wearing it in a very different style. Bliss couldn’t have written a book° like this without the depth of research she has done, it’s a rich vein amongst many other layers, not all of them familiar to those of us whose time is spent reading a certain type of dry academic article.

Here are just a selection of passages I highlighted:

“Having virtually invented a paid profession and being almost exclusively available to the rich, doctors were suspect to the working class.”

“When he taught me [Bliss’s father] to drive, he gave me this advice from his own father: you are responsible not just for the car you are driving, but also for the car ahead of you and the car behind you. Learning to drive all three cars was daunting, and inspired an occasional paralysis that plagues driving to this day.”

“As early as 1840, I learned, a doctor observed that vaccinating only part of a population against smallpox could arrest an epidemic in full.”

“The concept of a “risk group,” Susan Sontag writes, “revives the archaic idea of a tainted community that illness has judged.””

“Killing germs, rather than washing them away, reminded him of the Crusades, when an abbot who was asked how to tell the faithful from the heretics replied, “Kill them all—God will know his own.””

“But risk perception may not be about quantifiable risk so much as it is about immeasurable fear.”

“Our fears are informed by history and economics, by social power and stigma, by myths and nightmares.”

“Intuitive toxicology is the term that Slovic uses for the way most people assess the risk of chemicals.”

“But most people prefer to think of substances as either safe or dangerous, regardless of the dose.”

“But the use of natural as a synonym for good is almost certainly a product of our profound alienation from the natural world.”

“But vaccines are of that liminal place between humans and nature—a mowed field, Berry might suggest, edged by woods. Vaccination is a kind of domestication of a wild thing, in that it involves our ability to harness a virus and break it like a horse, but its action depends on the natural response of the body to the effects of that once-wild thing.”

““Probably the worst thing that ever happened to malaria in poor nations,” Rosenberg writes, “was its eradication in rich ones.””

“It spelled “munity,” from the Latin munis for service or duty. “Munity is what you are really writing about,” a colleague would say to me.”

“The debate over vaccination tends to be described with what the philosopher of science Donna Haraway would call “troubling dualisms.” These dualisms pit science against nature, public against private, truth against imagination, self against other, thought against emotion, and man against woman.”

“That croup, the kind that was frequently fatal in a short time, was caused by diphtheria and has virtually disappeared in this country since the introduction of the diphtheria vaccine in the 1930s. My son had viral croup, once distinguished from diphtheria by the French with the term faux-croup. While diphtheria kills as many as 20 percent of the children who contract it, faux-croup is rarely fatal.”

“The wise practice of waiting and watching is hard to sell, in part because it looks a lot like doing nothing.”

“The purpose of heroic medicine was not so much to heal the patient as it was to produce some measurable, and ideally dramatic, effect for which the patient could be billed.”

“Childbed fever, as puerperal sepsis was called, was spread by doctors who did not wash their hands between exams. But doctors blamed it on tight petticoats, fretting, and bad morals.”

“Autonomy is usually imagined as the alternative to paternalism. But in what is sometimes called the “restaurant model” of medicine, the paternalism of doctors has been replaced by the consumerism of patients.”

“And the doctor, who was a father in the paternalistic model, is now a waiter.”

““Where there is trust, paternalism is unnecessary,” the philosopher Mark Sagoff writes. “Where there is no trust, it is unconscionable.” And so we are caught in a double bind.”

“measles has killed more children than any other disease in history”

“Until the results of a small study are duplicated by a larger study, they are little more than a suggestion for further research.”

“Immunity is a shared space—a garden we tend together.”

Bad Samaritans by Ha-Joon Chang

I’ve read a number of books about economics in the past year or so. They have, undeniably, been written by economists who would self-identify as left wing and who are, on various levels, putting forward arguments to refute neoliberalism.

In a recent Debrief column for the BJGP° I wrote that doctors did, often, regard themselves as being beyond politics. Economics has also tried to pull off this sleight of hand. Economic is no more apolitical than medicine. The notion that the free market is currently unrestricted in some pure form, outside the interference of politics, doesn’t stand up to any reasonable scrutiny. We don’t let industries pollute indiscriminately and we have abolished child labour – both are fundamentally political decisions, made by society, for the greater good and the boundaries of the free market are always set in one place or another.

I’ve read the Chang books slightly out of order and I’ve just read Bad Samaritans.° This one puts forward his myth-busting approach to economics, so well exemplified in 23 Things They Don’t Tell You About Capitalism° and puts it in the context of the developing nations which is Chang’s main interest. I find Chang to be lucid and compelling. We castigate developing countries who dare to suggest economic policies that we ourselves used to nurture our own infant industries°, and we strong-arm them into accepting a free market approach that will continue to enrich us more than anyone. It’s hard to shake a lurking outrage, if not shame, when our hypocrisy is so grimly exposed.

Strava update for 2019

Here, apropos of not all that much, are my Strava stats for 2019. I’m fairly diligent about recording all my activity on Strava and I find it a convenient way to monitor how much exercise I’m getting. I’m no longer indulging in the social media side of it at all. Over the past 5-6 years I’ve hit around 250-270 hours each year and that’s evenly spread over the months. I’m almost tediously regular. I rarely have single activities that are particularly long but I am super consistent. And, no matter how hectic life gets I can almost always get something in. Measuring it keeps me honest and if I have to have a lighter week or two, or I have a quiet month, I just try to lift it back again a little.

This works for me incredibly well. I don’t go through any binges of exercise and I simply have no prolonged periods without any exercise. I no longer have to go through that pain of trying to get back into running when I’ve laid off for a few months. Doing half as much, on a consistent basis, month upon month, is something most people could manage. It’s surprising how little will work if you can just keep doing it, week in week out, building the habit, accumulating the benefits.

Around 200 hours is running and most of the rest is made up of weight training. I’ve done a minsicule amount of cycling in the past year. That is, on reflection, the one thing I’d like to do more of in 2020. I do go up hills for most of my exercise and my elevation stats reflect that. However, I’d add that I don’t go up them very quickly. The main benefit is that it probably helps with my leg strength and I think it makes me less injury prone. I also get to enjoy a nice view…

December 2019 reading list

Here are the books I’ve got through in December 2019. There are certainly more than usual as there are several shorter volumes here. And, I had some leave as well so I hared through a few more then.

I’ve provided some links above when I’ve written something about them. I don’t use Amazon or affiliate links so click away with impunity.

Darkness Visible: A Memoir of Madness by William Styron

This is only a short book but it is a harrowing tale of one man’s plunge into the abyss of depression. I picked it up via a comment in Christopher Hitchen’s autobiography. Styron spends quite a bit of time emphasising just how utterly inexpressible depression is as a disorder. How the language doesn’t exist and the words just don’t match up to the horror. Styron himself is quick to point out that an individual experience is just that, unique and idiosyncratic, but I’m certain there will be some deep resonances for many people in this slender volume.

I should add that the doctors don’t fare well yet Styron is admirably restrained, even generous, in his descriptions. Styron is right to highlight the complexity of predisposing factors and triggering events but the iatrogenesis of the benzo prescribing is very ugly and I blush to read of it. Some of the medical perspective is of its time as Styron’s depression, so starkly painted in Darkness Visible°, affected him in the 1980s. Much of it remains frighteningly pertinent.

Some selected quotes:

“The most honest authorities face up squarely to the fact that serious depression is not readily treatable.”

“Frighteningly, the layman-sufferer from major depression, taking a peek into some of the many books currently on the market, will find much in the way of theory and symptomatology and very little that legitimately suggests the possibility of quick rescue.”

“The intense and sometimes comically strident factionalism that exists in present-day psychiatry—the schism between the believers in psychotherapy and the adherents of pharmacology—resembles the medical quarrels of the eighteenth century (to bleed or not to bleed) and almost defines in itself the inexplicable nature of depression and the difficulty of its treatment.”

“This is to say more specifically that instead of pleasure—certainly instead of the pleasure I should be having in this sumptuous showcase of bright genius—I was feeling in my mind a sensation close to, but indescribably different from, actual pain.”

“Nonetheless, for over seventy-five years the word has slithered innocuously through the language like a slug, leaving little trace of its intrinsic malevolence and preventing, by its very insipidity, a general awareness of the horrible intensity of the disease when out of control.”

“Bloody and bowed by the outrages of life, most human beings still stagger on down the road, unscathed by real depression. To discover why some people plunge into the downward spiral of depression, one must search beyond the manifest crisis—and then still fail to come up with anything beyond wise conjecture.”

“I used alcohol as the magical conduit to fantasy and euphoria, and to the enhancement of the imagination.”

“Alcohol was an invaluable senior partner of my intellect, besides being a friend whose ministrations I sought daily—sought also, I now see, as a means to calm the anxiety and incipient dread that I had hidden away for so long somewhere in the dungeons of my spirit.”

“I couldn’t rid my mind of the line of Baudelaire’s, dredged up from the distant past, that for several days had been skittering around at the edge of my consciousness: I couldn’t rid my mind of the line of Baudelaire’s, dredged up from the distant past, that for several days had been skittering around at the edge of my consciousness: “I have felt the wind of the wing of madness.””

“But never let it be doubted that depression, in its extreme form, is madness.”

“The madness of depression is, generally speaking, the antithesis of violence. It is a storm indeed, but a storm of murk.”

“Over two years before my siege, an insouciant doctor had prescribed Ativan as a bedtime aid, telling me airily that I could take it as casually as aspirin. The Physicians’ Desk Reference, the pharmacological bible, reveals that the medicine I had been ingesting was (a) three times the normally prescribed strength, (b) not advisable as a medication for more than a month or so, and (c) to be used with special caution by people of my age.”

“Then, after dinner, sitting in the living room, I experienced a curious inner convulsion that I can describe only as despair beyond despair. It came out of the cold night; I did not think such anguish possible.”

“Much evidence has accumulated recently that indicts Halcion (whose chemical name is triazolam) as a causative factor in producing suicidal obsession and other aberrations of thought in susceptible individuals. Because of such reactions Halcion has been categorically banned in the Netherlands, and it should be at least more carefully monitored here.”

“While my own carelessness was at fault in ingesting such an overdose, I ascribe such carelessness to the bland assurance given me several years before, when I began to take Ativan at the behest of the breezy doctor who told me that I could, without harm, take as many of the pills as I wished.”

“More or less the same can be said for Art Therapy, which is organized infantilism.”

“It is of great importance that those who are suffering a siege, perhaps for the first time, be told—be convinced, rather—that the illness will run its course and that they will pull through.”

“A tough job, this; calling “Chin up!” from the safety of the shore to a drowning person is tantamount to insult, but it has been shown over and over again that if the encouragement is dogged enough—and the support equally committed and passionate—the endangered one can nearly always be saved.”

“To most of those who have experienced it, the horror of depression is so overwhelming as to be quite beyond expression, hence the frustrated sense of inadequacy found in the work of even the greatest artists.”

The Gentle Art of Tramping by Stephen Graham

It may be approaching the centenary since its publication but this small hardback book from 1926 is a treat. One shouldn’t place aesthetics over content when it comes to a book but Bloomsbury have got the package just right. The woodcut style cover and the heft of the hardback amplify the wonderfully rebellious nature of the content. It is, quietly, subversive and if you are ever struck with a smouldering desire to get outdoors then Graham will rekindle your fire.

Here are selected quotes from The Gentle Art of Tramping°:

“The tramp is a friend of society; he is a seeker, he pays his way if he can. One includes in the category ‘tramp’ all true Bohemians, pilgrims, explorers afoot, walking tourists and the like. Tramping is a way of approach, to Nature, to your fellow man, to a nation, to a foreign nation, to beauty, to life itself. And it is an art, because you do not get into the spirit of it directly — you leave your back door and make for the distant hill. There is much to learn, there are illusions to be overcome. There are prejudices and habits to be shaken off.”

“From day to day you keep your log, your daybook of the soul, and you may think at first that is a mere record of travel and facts; but something else will be entering into it — poetry — the new poetry of your life, and it will be evident to a seeing eye that you are gradually becoming an artist in life.”

“Of all tramping the most delightful is in the mountains; the most trying is along great highways.

“Mountain walking is really much less tiring because: first of all, there is no dust, then there is more contrast and mental distraction, and last, not least, one’s feet hit the earth at varying angles, employing more muscles.”

“The freedom of speech and action and judgement it gives you will breed that boldness of bearing which, after all, is better than mere good manners.”

“The less you carry the more you will see, the less you spend the more your will experience.”

“The best companions are those who make you freest. They teach you the art of life by their readiness to accommodate themselves.”

“For tramping is the grammar of living. Few people learn the grammar — but it is worthwhile.”

On Tthe Trespassers’ Walk: “It takes you the most extraordinary way, and shows what an enormous amount of the face of the earth is kept away from the feet of ordinary humanity by the fact of ‘private property.’

“The world is large enough, or is only too small, as takes your fancy or speaks your experience. But blue sky by day and fretted vault of heaven by night gives you the foil of the infinite, making your petty exploit a brave adventure.”

“Life is a like a road; you hurry, and the end of it is grave.”

“Lord Chesterfield’s Letters to his Son and Arnold Bennett’s How to Live on Twenty-four Hours a Day are of little value to us. We will not read in our baths, nor memorise French verbs while we fry. Or we will, if we like, but not upon the compulsion of filling time.”

“Tramping is straying from the obvious. Even the crookedest road is sometimes too straight. You learn that it is artificial, that originally it was not made for mere tramping. Roads were made for armies and then for slaves and labourers, and for ‘transport’. Few have been made for pleasure.

“After a long tramp it is nice to see a book which has been clothed with pencillings. It records in a way the spiritual life of the adventure, and will recall it to you when in later years you turn over the page again.”

“It is well to take a book that you do not quite understand, one that you have nibbled at but have found difficult.”

“So also man’s life. We think of it in length of years. But that in a way is an error. Life is not length of time, but breadth of human experience.”

“Self-expression is life.”

“A thought recorded, one that is your own, written down the day when it occurred, is a mental snapshot, and is at least as valuable at the photographs you may take on your journey.”

“Yesterday’s thought is worth considering again, if only as the stepping-stone of your dead self.”

“The personal diary, however, that daybook of the soul, is not meant for other gaze.”

“It is in description tht the keeper of a diary becomes artist. All description is art, and in describing an event, an action or a being, you enter to some extent into the joy of art.”

“You are more than the mere secretary of life, patiently taking down from dictation, more than life’s mere scribe; you become its singer, the expressor of the glory of it.”

“No farmer objects to your walking alongside his corn fields or across his pastures. It is people who enclose but do not farm who have most prejudice against strangers.”

“It will soon strike you when tramping that the word infinite does not always mean the same: there are grades in infinity and measures of the immeasurable.”

Understanding colour blindness

I was talking about colour blindness again today. As I said, it’s a topic that I’m prone to going off on. I’d been drafting some rough ideas and a few paragraphs for the book° on the train down to London and I had been thinking about how other people perceive colour blindness.

And, interestingly, this was the turn the conversation took. The two people I was speaking to are intelligent and perceptive yet it was just incredibly challenging for them to get a handle on what it’s like to be colour blind. I showed them the picture in the last blogpost — and, of course, they both saw the number and I was able to explain what I saw. Just a mess of red-brown-green blobs. (I almost feel like I need a new word for this kind of shade as to me, it’s just a single colour with varying shades.) I also pulled up one of the early chapter drafts, provisionally titled Everyday annoying shit and was able to point out some of the problems colour blindness can cause.

It would be good in the book to make it a guide for people to try to get a feel for how it is to be colour blind. Mostly, it doesn’t feel like anything of course but the world does just stump us in some funny little ways. With 1 in 12 men affected, there are very few people out there who don’t know others who are colour blind. One often sees, in any description of colour blindness, photographs that have been altered to take out red hues or green hues. Pictures of market stalls of fruit seem very popular for this. I’ve no idea if these work, they don’t for me, for obvious reasons, but they seem to lack a reality and an essential quality that tells you about the lived experience. If I can capture a little of that I’ll be happy.

Purple skies and pink elephants

I do love talking about colour blindness. You can’t be in conversation with me too long before I’ll raise the topic and I suspect most of my work colleagues know about it. They are very generous about making accommodations when we are in presentations, or standard setting sessions, or just looking at documents. Yet, it’s also apparent some of them don’t necessarily understand it particularly well.

I have written a couple of articles on Blokeology: there’s one on late presenting bladder cancer° and another on colour blind cricketers.° And in Episode 053 I spoke to Kathryn Albany-Ward who runs the Colour Blind Awareness website.° Over the early months of 2020 I’m going to turn my attentions to a short book on colour blindness. As well as covering some of the basic science I’m going to touch on some of the interesting wrinkles around this common condition. With 8% of men affected it’s not that niche. It’s much less common in women — just 0.5% of them are affected — but we all know plenty of people who are colour blind. It is another matter whether they know it themselves of course. Doubtless I will discuss that.

At the moment I’m just planning a slim volume. I have an outline and it may come in with as little as 20-25,000 words but I may digress and it could be more like 35-40,000. That would be satisfying as it will feel more like a complete, if trim, book. So, that’s the aim and I’m getting my 2020 plan in early. I’ll post updates, and perhaps some excerpts, in due course. The working title is, as you might have guessed, Purple Skies and Pink Elephants, though that’s likely to change. It stems from my direct experience: it’s a standing joke that I refuse to accept the existence of the colour purple and pinks look very grey to me. I always thought elephants were pink. I was shocked to find out that’s not true.

The image is an example of an Ishihara plate. My daughter tells me that she can see the number 74. I can’t see anything, it’s just a blend of dots with no discernible pattern at all. She tells me the numbers are in green and the surrounding dots are varying shades of dark red and browns. I look at it and I’m not honestly sure I know what colour most of the dots are at all. I think I can tell some of the light greens with confidence but after that I’m stumped. They could be dark green, red, brown, orange… who knows?

The pleasure of unexpected snow

It was, completely unexpectedly, and rather joyfully, snowy today. I stumbled out of bed in the half-light and was surprised to see snow nestling, Dickensian style, on the skylight window. Maybe I just hadn’t really been paying attention to the forecast.

It wasn’t freezing outside and underneath it was rather muddy but the dogs were ecstatic to be out, frolicking around, and it was the puppy’s first experience of snow. Both dogs ended up with mutiple globes of snow dangling from the back of their legs.

 

This is the track that takes you up to Winder from Howgill Lane. Dead ahead is the the Nab, not much more than a flank with a pseudo-summit that leads up to Arant Haw. I trudged up Winder today. No running for me as my right knee is unhappy with life, aching like hell and with some tenderness on the medial joint line that has sprung up out of the blue. I didn’t tweak it and it didn’t even start hurting during a run. It all just kicked off a few hours after a gentle run on the flat. Odd. I’m hoping it’s trivial and it just needs a few days to calm down. In that regard, the snow is entirely welcome as walking doesn’t feel like such as drag when you are in the snow and any real running isn’t an option in any case.

 

The odd half light of snow is so hard to capture. I almost always prefer black and white in any case (it’s a colour blindness thing°). The view is south east from the summit of Winder — the trig point is just out of shot on the left — and the Frostrow Fells are the first line of lower hills with Dentdale sitting just in behind.

 

And, of course, this is the wider summit view. Behind the trig point is one of those 360° observation points that maps out the horizon and allows you to spot and identify all the surrounding hills and landmarks.

The winter days are more or less at their shortest now and the dark mornings have been pressing in. The December solstice is in a few days. I also have in mind the sinusoidal curve of day length — there isn’t much change at this time of year and it will be a few weeks before the length of the days starts to shift significantly and we feel the difference. Yet, it’s always a good time when we pass through the solstice and a weekend morning with snow is a welcome bonus.

Men Explain Things to Me by Rebecca Solnit

This is a slim volume, made up of seven essays, by Solnit. The first, and most well known, is the 2008 titular essay that, while not using the term itself, helped inspire the recognition of ‘mansplaining’. The key passage, summing up the concern, is here:

“Yes, people of both genders pop up at events to hold forth on irrelevant things and conspiracy theories, but the out-and-out confrontational confidence of the totally ignorant is, in my experience, gendered. Men explain things to me, and other women, whether or not they know what they are talking about. Some men.”

It’s never going to be comfortable, as a man, reading these essays but Solnit’s feminism is inclusive. Solnit talks about that term ‘mansplaining’ and how she is not super-keen on it, with suggestions of an inherent male flaw, rather than recognising it is an inappropriate behaviour. Near the end, in the essay Pandora’s Box and the Volunteer Police Force she says:

“I think the future of something we may no longer call feminism must include a deeper inquiry into men. Feminism sought and seeks to change the whole human world; many men are on board with the project, but how it benefits men, and in what ways the status quo damages men as well, could bear more thought.”

I’m wholeheartedly on board with this but one is always treading a fine line. There is an ever-present risk that flagging problems for men in culture looks like it is, again, ignoring women. And this is a recurring theme in Solnit’s essays – the invisible women (the title, of course, of Caroline Criado-Perez’s book on the gender data gap). Yet, if men engage in a discussion about feminism, we have to be hyper-aware of the risk of falling into the trap of explaining, of mansplaining. This doesn’t have to be a major problem, most of the time we just need to do a bit more listening, and a little less talking. Which is almost certainly good advice for life generally.

I don’t believe we (men, I mean) so should be in the slightest bit concerned about feminism. Certainly not the movement Solnit advocates. A couple of her quotes to illustrate:

“Feminism is an endeavour to change something very old, widespread, and deeply rooted in many, perhaps most, cultures around the world, innumerable institutions, and most households on Earth — and in our minds, where it all begins and ends.”

“Like racism, misogyny can never be adequately addressed by its victims alone. The men who get it understand that feminism is not a scheme to deprive men but a campaign to liberate us all.”