Anthony Daniels

Twice in my career, in very remote places, I encountered lunatics who had been chained for many years to the wall or to posts in the ground. The reasons why they were so enchained had been lost in the sands of time, but their keepers were convinced that they were far too dangerous to be released. By now they were certainly mad, but whether they were mad because they had been tied up, or tied up because they had been mad, it was impossible to say. And in one of the institutions — a prison — I found prisoners who had been acquitted or whose release had been ordered by a judge ten years before, but who did not have enough money to pay their gaolers to release them.

It is an old-established truth, a truism in fact, that money does not buy you happiness — though, as the late Professor Joad pointed out, it does allow you to be miserable in comfort. Yet the great majority of people, knowing this, nevertheless devote their energies to increasing their wealth, which suggests that happiness is not actually their ultimate goal. In fact, most people don’t have an ultimate goal. The authors of this book, father and son, seek to persuade us that we should devote more of our energies to things that are done for their own sake, that are good in themselves, rather than spend our lives on the treadmill of getting and spending, which is ultimately no more satisfying than the work of prisoners who are forced to dig holes only to fill them again.

Few men are prepared to die for the right of others to say what they strongly disagree with; and most people’s faith in multiparty democracy is at best a lukewarm recognition that the alternative is much worse. Secretly most men would like their ideas (which they naturally believe to be correct) to rule absolutely and forever. Of this company is James Gilligan. He is a professor of psychiatry at New York University and would like to see the Republican Party in the United States disappear from the face of the earth. His argument for this consummation so devoutly to be wished is as follows: the death rate from homicide and suicide in the United States goes up when there is a Republican president and down when there is a Democratic president.

The quasi-religious zeal with which certain popularising neuroscientists claim that man is no different, essentially, from the animals, and that consciousness is but an epiphenomenon, strikes me as distinctly odd. The popularisers seem to take a sado-masochistic delight in it, in the way that some people get a thrill from envisaging the end of the world. They also seem to imply that we now understand almost everything about ourselves, apart from a few odd details to be filled in by ever-more-sophisticated scanners. In other words, man has finally come to understand himself. Here is an addition to the fast-growing genre of books that claim scientific authority for the idea that we are, at base, not much different from the bacteria.

There was a time when detailed case histories, including direct quotations from patients’ accounts of their own experiences, formed a significant part of the medical literature. There was a time when detailed case histories, including direct quotations from patients’ accounts of their own experiences, formed a significant part of the medical literature. French doctors of the 19th century were particularly adept at writing such case histories; the lucidity of their prose, as of their thought, was exemplary. Indeed, French medical prose of the 19th century was often as good as that of Flaubert. But the extended case history has gone out of medical fashion, as being too anecdotal and therefore unscientific.

The habit of dividing the past into centuries or decades might be historiographically suspect, but by now it seems unavoidable. And it is possible that, because we now expect decades to have flavours of their own, they end up actually having them. We change our behaviour when the year ends in 0. Can there be anyone who has never used ‘The Twenties,’ ‘The Thirties,’ ‘The Fifties’ or ‘The Sixties’ as historical shorthand, expecting his interlocutor to know exactly what he means by it? By comparison with the Sixties, the flavour of the Seventies is indistinct and muted.

When I was a young doctor working in what was still Rhodesia, I read a book by a nun who was also a political economist. She demonstrated that land reform was not only a requirement of social justice but would lead to greatly increased agricultural output, since African peasant farmers cultivated their land more intensively than commercial farmers. Her argument was positively Euclidean in its precision and I accepted it in its entirety. The only thing that she omitted to mention, and that did not occur to me at the time, was that the land reform would have to be carried out by men; and not just men in general, but by particular men, with all their passions, weaknesses and prejudices. Political geometry is non-Euclidean.

It is questionable whether psychiatry as a whole does, or has done throughout its history, more good than harm. Certainly there are some patients who benefit from its ministrations; but there are many others who have been harmed by the wrongful administration of noxious drugs or other therapies. A less tangible, but nevertheless potentially serious, harm is that it persuades people with the difficulties in living that are inseparable from human existence that they are ill, and therefore disguises from them that the best remedy, if one there be, lies in their own hands. Indeed, psychiatry seems to have persuaded whole societies that all forms of mental distress are illnesses, for which there is a technical medical solution.

The epidemic of Aids among heterosexuals of which we were once warned by public health officials is now almost as forgotten as the global freezing of which the environmentalists in the 1970s also warned us. Only in Africa has Aids spread through the general population, reducing the already low life expectancies of several countries still further. The African exception has long puzzled doctors. Why should Africa be the exception? Various theories have been put forward, from general malnutrition to the prevalence of other sexually transmitted diseases that facilitate the entry of the virus into the body and the polio immunisation experiments conducted in the 1950s in the Congo.

Globalisation is not as new as we sometimes like to think. Within a mere five years of the publication in 1798 of Jenner’s tract about vaccination, Dr Francisco Xavier de Balmis set sail to the Spanish colony of New Spain (Mexico) with a view to introducing vaccination there. Having done so successfully, he sailed on to the Philippines, Macau and Canton with the same aim in view. Vaccination arrived about the same time in Java by way of Mauritius. No modern consumer product has spread more rapidly. Vaccination, however, was late in reaching Japan. This was not because there was no need for it: on the contrary, it has been estimated that about a fifth of Japanese children died of smallpox before the age of five.

Medical advance has been startling in the past half-century. To give only one example, more or less at random: if the techniques of resuscitation and trauma surgery that were available in 1960 were still in use today, our homicide rate would be three to five times higher than it is (and it is two or three times higher than it was in 1960 nonetheless). Atul Gawande is a surgeon at one of the world’s greatest surgical centres, the Brigham and Women’s Hospital in Boston. As such, he is committed to medicine’s noblest ideal, the dedication of science to the cure of disease. It seems almost unfair that he should also be a gifted writer with an ability to tell medical anecdotes whose dénouement the reader awaits with suspense.

The desire to wage war as if it were keyhole surgery is, after a certain fashion, a laudable one. It indicates that a government can no longer afford to treat its own population, if not that of the enemy, as mere cannon fodder. Each soldier killed is ten, a hundred, votes lost. But the new-found tenderness towards the lives of soldiers has two inconveniences. The first is that keyhole-surgery war is a chimera, and what is impossible cannot be desirable. The second is that the decline of what one might call the cannon-fodder spirit makes the prosecution of long-drawn out wars and military occupations very difficult. Keyhole surgery is limited not only in space but in time.

When Slobodan Milosevic died, more than four years into his trial for war crimes, newspapers around the world said that he had cheated justice. It would have been more accurate to say that he had cheated injustice. Had he lived, the judges would have been faced with an unpleasant dilemma: either to find him not guilty, thus casting a lurid light upon the past activities of their employers, the powers that had brought the tribunal into being in the first place, or to find him guilty and to sentence him to a long prison term on evidence that would not have justified a fine for illegal parking.

Hubris is followed by nemesis, and the idea that the English-speaking peoples (that is, those who speak English as their native language) exert an economic, political, moral and cultural hegemony in the world strikes me as distinctly hubristic. Whether it is true, or if true desirable, is another question. Andrew Roberts’ history is rather old-fashioned, and none the worse for that, in that it is mainly a narrative of political and military events: a tale of kings (or presidents and prime ministers) and wars. Social, intellectual, cultural and economic history are included only insofar as they impact upon high politics and the balance of power.