Henry Miller died a few months before I started medical school in Newcastle in 1976. At the time of his death he was VC of the university having been Dean of Medicine and Professor of Neurology. By today’s standards he was a larger than life figure. I like reading what he said about medical education, although with hindsight I think he was wrong about many if not most things. But there was a freshness and sense of spirited independence of mind in his writing that we not longer see in those who run our universities (with some notable exceptions such as Louise Richardson). In the time of COVID we should remember the costs of conformity and patronage.
It would be naive to express surprise at the equanimity with which successive governments have regarded the deteriorating hospital service, since it is in the nature of governments to ignore inconvenient situations until they become scandalous enough to excite powerful public pressure. Nor, perhaps, should one expect patients to be more demanding: their uncomplaining stoicism springs from ignorance and fear rather than fortitude; they are mostly grateful for what they receive and do not know how far it falls short of what is possible. It is less easy to forgive ourselves…..Indeed election as president of a college, a vice chancellor, or a member of the University Grants committee usually spells an inevitable preoccupation with the politically practicable, and insidious identification with central authority, and a change of role from informed critic to uncomfortable apologist.
Originally published in the Lancet, 1966,2, 647-54. (This version from ‘Remembering Henry’, edited by Stephen Lock and Heather Windle).
“I hope the lesson will really be that we can’t afford as a society to create the fire brigade once the house is on fire. We need that fire brigade ready all the time hoping that it never has to be deployed.”
Peter Piot 1
No just in time here. It’s in the statistical tails that dragons lurk and reputations are shattered. Chimes with a quote from Stewart Brand that I posted a short while back.
Education is intellectual infrastructure. So is science. They have very high yield, but delayed payback. Hasty societies that can’t span those delays will lose out over time to societies that can. On the other hand, cultures too hidebound to allow education to advance at infrastructural pace also lose out.
As with HIV, “an epidemic reveals the fault lines in society. The big one this epidemic has revealed is how we treat the elderly. We often park them in pre-mortuary type institutions and give a bit of money and hope it is OK”.
When the tide goes out you see who is not wearing bathing costumes…
Terrific post in the Monday Note from Jean-Louis Gassée. He writes:
This week’s note was sparked by a conversation with a learned engineer friend. He cut through my lamentation that our country lacks the will to send astronauts to the Moon again. ‘It’s not about will, it’s about our changed estimate for the cost of human lives!’.
Jean-Louis then expands on this with details of the various space flight-related accidents, before moving on — as befits a Frenchman— to the legendary 2CV, and the change in safety trade-offs between then and now in car design. Then there is the matter of covid-19, and the calculus advanced societies took the in the not so distant past.
Worth a read in full, and not just for the new acronym (to me, anyway) SWAG (scientific wild-ass guess).
There is lots about covid-19 that I do not understand — the biology and all that. But the NHS and government’s responses are something else. I find it hard not to assume that every statement has an ulterior motive: they are, it seems, strangers to the truth. Here is Bruce Schneier (the security guru as the Economist once called him).
“My problem with contact tracing apps is that they have absolutely no value,” Bruce Schneier, a privacy expert and fellow at the Berkman Klein Center for Internet & Society at Harvard University, told BuzzFeed News. “I’m not even talking about the privacy concerns, I mean the efficacy. Does anybody think this will do something useful? … This is just something governments want to do for the hell of it. To me, it’s just techies doing techie things because they don’t know what else to do.”
I haven’t blogged about this because I thought it was obvious. But from the tweets and emails I have received, it seems not.
It has nothing to do with privacy concerns. The idea that contact tracing can be done with an app, and not human health professionals is just plain dumb.
Testing, testing and more testing, please.
But, as R.H. Tawney once observed, shifts to collective provision are only realised after demonstrations that ‘high individual incomes will not purchase the mass of mankind immunity from cholera, typhus and ignorance’: many elements of the coming future ought to be favourable to the left, though only if they are shaped politically, and if blame – always elusive in the UK’s diffuse system of responsibility – is correctly apportioned.