Ancient and modern

The Royal College of Physicians has suggested that doctors should learn to talk to patients about death. But talk about what, precisely? The medical diagnosis? Matters spiritual? Philosophical? In a play about his fate, Prometheus, the mythical champion of mankind, said that he had benefited mortals by preventing them from foreseeing their death. Asked how, he replied ‘I lodged blind hopes in them’. This reflected a school of medical thought which took the view that offering the patient encouragement could prevent them ‘giving up on themselves’ and actually keep them alive. Not everyone took that approach. In a world where anyone could become a doctor (we hear of 18-year-olds starting to practise), it was vital to maintain one’s reputation.

World Mental Health day raised again the issue of suicide, still regarded as happening only among those ‘whose balance of mind is disturbed’. Not necessarily, Romans would have argued. For Romans the manner of one’s death was as important as that of one’s life. As Seneca said, ‘Like a story, the important thing about life is how it is played out. It does not matter where you stop. Stop wherever you want to, but just attach a good ending.’ On his deathbed the emperor Augustus invited those gathered round him to applaud him for acting well his part in life’s comedy. The key was to face death like a man, or a woman. Lucretia won everlasting fame when she committed suicide after Sextus Tarquinius raped her.

Financial constraints combined with a shortage of staff have brought the NHS to a situation so desperate that it is proposing that doctors treat patients, not one by one, but in groups of 15 or more. It is good to see the NHS finally catching up with the cutting-edge thinking of the ancient Babylonians. Let the great Greek historian Herodotus (c. 490-c. 425 bc) explain... Herodotus travelled throughout the Near East as part of his mission to discover the deep origins of the conflict between Persians and Greeks that led to the famous Persian wars (490-479 bc). But he was also fascinated by human behaviour and assiduously recorded the customs of those peoples with whom he came into contact.

Hardly a day goes by without someone making excitable predictions about human progress and how, thanks to AI, we are all going to become algorithms served by robots. The ancients took a different view. All ancient man had available to him was what nature in its raw state offered. Only fire (e.g. cookery, metal-work) or man’s ingenuity (e.g. papyrus, concrete, the arch) could significantly alter it. But men could still fantasise about flying to the moon, or imagine a world in which ‘Every stream ran with wine; fish came to the house, baked themselves, and served themselves up at table; rivers of soup, swirling with meat chunks, flowed by the dining couches; thrushes, served with milk cakes, flew down men’s gullets.

Given that we use only 2 per cent of the rain that falls on these islands, one would not think it an insuperable job to secure our water supplies during the longest dry spells. If the Romans could do it with their technology, surely we can with ours. Since communities in the ancient world could survive only if they had supplies of fresh water available in the first place — rivers, wells and cisterns — aqueducts were not strictly necessary for human survival. Many places never had one (e.g. London). It was the baths, the Romans’ leisure centres, that created the demand. According to a late survey, Rome had 154 public lavatories, 46 brothels, 1,352 water points — and 856 bath buildings.

Everyone talks about the importance of ‘charisma’ in a politician. But while it may take one a long way with the voters, it does not necessarily cut much mustard in parliament unless bolstered by other strengths. The Romans provided a useful checklist. Boris, still popular in the country but now, despite high office, in self-exile after failing to win over colleagues to his Brexit views, might care to contemplate them. Top priority were amici, political allies among the great and good. These would automatically include those joined by blood, marriage or other associations, but needed to spread much further into networks of relationships incorporating men from a wide range of political, legal and social backgrounds.

The UK obesity crisis is again in the headlines, and ‘life-style’ is the culprit. The ancients may have come up with a different analysis. Our word ‘diet’ derives from the ancient Greek diaita, which meant ‘way of living’ and, medically, a prescribed way of life, or regimen, especially in relation to diet for the ill. But whatever deficiencies are evident in the normal diet of the ancients, a tendency to promote obesity was not among them. Sugar was unknown (honey was the only sweetener), and fats too would have been enjoyed only on special occasions.

Matthew Parris feels that he has become a genuine Remainiac, and kindly readers, fearing for his mental health, have been springing to his aid. The Roman elite, who felt the same sense of disempowerment after the republic collapsed and Augustus became the first Roman emperor in 27bc, might have a solution. The point about Augustus was that he did not call himself ‘emperor’ but princeps (‘first citizen’) or Caesar (as the later emperors did); and he maintained the trappings of the republican system (senators, consuls, etc). But he was now the final source of all authority. Any popular control over laws and appointment of officials was gone. So Romans began to wonder how they should live under a system that allowed them no political say.

Alfie Evans was seven months old when he went to hospital with seizures. When more than a year later doctors said that nothing more could be done for him, his parents took the hospital to court. They lost a number of cases on the issue, and when the courts ruled he could not be moved abroad, public outrage ensued. The ancient view on such events was very different. In 1931 a well (dated to c. 150 bc) was excavated in Athens and found to be a mass grave into which some 450 babies had been discarded. Recent analysis shows that one third had died from bacterial meningitis, an infection of the brain caused by cutting the umbilical cord with an unsterile object. Others presumably died from common conditions that were often fatal in babies, e.g. diarrhoea.