From a flea's teeshirt

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7072.1654 (Published 21 December 1996) Cite this as: BMJ 1996;313:1654

Ruth Holland, our reviews editor, died in the Watford train crash in August. Readers may find it hard to appreciate the extent of her contribution to the journal as most of her efforts went on improving the work of others. In her tribute to her, Trisha Greenhalgh wrote: “As is the lot of the humble and skilful editor, much of her best prose was grafted on to otherwise mediocre articles and credited to other people.” And Tony Smith, another of her Soundings authors wrote: “She persuaded me that my submissions were really good when they were adequate and that they were adequate when they were below par. And then she improved them.”1

Yet Ruth also wrote wonderful pieces for the journal, which were all her own: book reviews mainly, but also forwards to collections of articles and even a 22 stanza poem commemorating the 50th anniversary of the BMA's centenary meeting in 1932.

Next year, we will publish a collection of her pieces written for the “BMJ” and elsewhere. Meanwhile, we reprint here some of the edited highlights. If there is a bias in this selection then it is towards passages where she was writing about writing; these found Ruth at her wittiest and most instructive.

It must be one of Nature's jokes that those most eager to talk about themselves are the ones with the least interesting things to tell. Nothing brings on the yawns more quickly than earnest self-revelation, and there's a lot of it about these days, when we're all being urged to dig into the unconscious, bare the soul and generally let it all hang out. Most people's souls, like their bodies, are best kept decently covered, and the managers interviewed here all come across as irredeemably dull dogs. I shouldn't care, either, to spend much time in the company of their wives, who seem a bigger collection of drips than you'd find on a wet Monday morning in Worcester (the Midlands are sodden and unking—my own research supports this). I don't know why this should be so. Maybe it's the effect of going to all those seminars and filling in questionnaires, while others are out doing more interesting and useful things, like fiddling their expense accounts, playing golf with the boss, jumping into bed with the milkman (this is usually for wives only), or simply getting on with their work.

There's much emphasis throughout the book on making the right “time and energy investments.” The authors seem intelligent and thoughtful men, and they must have done a lot of hard work, but it makes you wonder—in a world shivering under a darkening nuclear shadow, where tyranny stalks unchecked, murder rules OK, and famine, sword, and fire not only don't crouch for employment but put in overtime every week—whether so much effort and diligence need be spent on finding out why some well paid well fed people aren't as happy as they might be. “Plateauing” is a luxury not many can afford and most people are too busy trying to stay alive to think about “exploration of oneself and exploration of the occupational world.”

But maybe that's neither here nor there. The book's here and I've read it. Time now to make an energy investment in something else. [From a review of Must Success Cost So Much? by Paul Evans and Fernando Bartolome2]

Discarding as so much obsolete stock any thought of the resurrection of the body and life everlasting, samsara, the transmigration of souls, Elysium, Valhalla, Tir-nan-Ogh, or simply somewhere over the rainbow, our technological age has come up with the practical solution that what's good enough for halibut fillets and spermatozoa is good enough for the human body—in other words, bung it in the freezer.

When you come to kick the bucket you can now—if you wish and can afford it—make sure it's full ofice and get yourself and your nearest and dearest preserved until the onward march of science has found a way to get you going again. The undiscovered country from whose bourn no traveller returns is at the end of an Awayday ticket….

It's like the kind of scene they were always having in old Hollywood films, where the hero tells the plain girl to take off her glasses (in modern films he doesn't even need to ask her to take off her clothes). She obeys. He gazes into her, presumably myopic, eyes and says, “Why, but you're beautiful!” In the appendices of the book Professor Sheskin suddenly takes off her sociologist's specs and shows her face. She describes why she started investigating this subject and what it was like to do it; how she was sometimes nervous or embarrassed, sometimes amused—particularly when the interviewees started giving her good advice on how to get a man—and how she had qualms about “using” people who had taken her into their confidence and whom she had grown to like. She comes across as honest and sensitive and shrewd; she also, it appears from her acknowledgements, has a lot of friends and likes mint juleps. So what is a nice girl like this doing trudging through the barren wastes of research and documentation? From one or two remarks in her book I suspect that this is what she has sometimes wondered herself. I hope by now she has downed a couple more juleps and said “To hell with it”; that she can be found, like the government official in Daudet's story, stretched out beneath the trees, chewing violets and writing poetry; and that she has forgotten the cold fantasies of those who put all their money on the future—which after all is no better than living in the past. In spite of what the cryonics enthusiasts say, “Eat, drink and be merry, for tomorrow we die” seems a better bet—and Ken Dodd has the right idea when all wild hair and stupendous teeth, he announces to his audience with a flourish of his tickling stick that “The good old days are here now—while you're warm and walking.” [From a review of Cryonics: a Sociology of Death and Bereavement by Arlene Sheskin3]

Brutal cutting would have improved his text much more than slapping on a garish colour supplement style full of unfortunate blobs of imagery like: “the iceberg over the African continent spreads its perils far and wide”; Smellie had opened the floodgates of pelvic mensuration”; and someone with “large hands to boot.” This straining after impact leads him to dramatising the undramatic (“Somewhere in the Bahama Islands there once lived a small community of people and spirochaetes …the people and their spirochaetes had learned to live in symbiosis”) and then into the Department of Fatuous Information of the “London's Leicester Square” school of writing, which presumes absolute ignorance in its reader and explains everything: “the male pelvis is not concerned with childbirth”; “it is fortunate indeed that the obstetrician has no need to sex the pelves of his or her patients as…they are all female.” After this it's only a short step to sweeping statements— “We know that Greek women loved their children”; “All Australian eco-wen enjoyed their sex life”—and finally to the last desperate trick of a writer trying to keep your attention.

Which is the single sentence paragraph.

Which makes what you're saying sound very significant.

Like: “The rape of the land had begun.”

Or “To Hippocrates the womb was the egg.”

But I've lost you, haven't I? You're wondering what Australia eco-wen are, with their universally enjoyable sex lives. They're aborigines. Why call them eco-wen? Because Mr Gebbie is very careful of the sensibilities of those of us who are not male, not European, not industrialised, or simply not around any more. [From a review of Reproductive Anthropology—Descent Through Woman by Donald A M Gebbie4]

I talk of him as a friend, but I never knew him, nor am I in his profession. I make no apologies for this, since in literature time and distance mean nothing; you can meet the dead just as happily as the living, and they will take you into their confidence, tell you their jokes, give you the benefit of their opinions and experience, and ask for nothing in return but your eye on the book. What's more, as the times become so barbarous that the Goths and Vandals are at the gates trying to get out you could have more chance of finding civilised companions in print than in the flesh and all-too-frequently-spilled blood. Of course, the personality that comes over on the page might not be the same as the everyday one—Milton, for instance, according to his latest biographer, was a rather jolly soul, which you'd hardly gather from Paradise Lost or Areopagitica—but I suspect that in Asher's case they are not so very dissimilar. He was, according to those who knew him, a delightful companion; a happy family man; a skilled musician and craftsman; witty, playful, and eccentric; “a pastmaster of the unexpected”; a fellow, in fact, of infinite jest, of most excellent fancy; and that is how he wrote. Even his most serious and weighty articles sparkle with sequins—his own aphorisms, imaginary dialogue, fantasies, quotations—and he had that knack of being always entertaining, which Shaw described as having your pockets stuffed with sausages and keeping a red hot poker in the fire….

To the professional journalists Asher was clearly one of the boys, and though he implied that writing was only a hobby, his approach to it was not that of the dilettante but the hard bitten weariness of the pro: “I have often thought while trying to write an article, ‘Why am I doing this tedious and unrewarding thing?’” “Writing is done more by toil than gift. Is it worth it? I don't really think it is.” He wrote and rewrote, scratching out words, reinserting phrases from separate scraps of paper, and throwing screwed up pages into the wastepaper basket in true Grub Street fashion. (Odd irrelevant notes crept in—the handwritten draft of an article on “The body as a machine” bears a reminder to be at the Essoldo, King's Road, at 4.30.) He worked long and hard “because I am incapable of producing anything worth reading except by a laborious process,” and the superbly polished results are proof again, if any were needed, of the truth of C E Montague's maxim: Easy reading, hard writing. [From the introduction to A Sense of Asher: A New Miscellany5]

Having a prejudice against big books (probably the result of long years' toiling on the BMJ, where anything worth saying is supposed to be capable of being printed on a flea's teeshirt) I don't read them much, but I'mobviously no great loss to the publishing trade as they sell in tens of thousands, and they seem to be getting bigger and bigger—I saw a man on the train the other day take from his briefcase what I took to be a litre carton of orange juice and start reading it.

I'd always assumed that such portly volumes were thrilling adventure stories, stuffed with lust, death, rape, brutality, and all the other things that make the world go round, but if this one is anything to go by they're quite the opposite. To read it is rather like listening to the conversation of an elderly aunt who has complete and indiscriminate recall of her whole life and tells you exactly what she said to Cousin Ernest in Mr Johnson's living room on the night of 20 January 1935 when Hester had come down from Weybridge and had missed her connection at Waterloo, and…. The only defence against such a verbal battery is to nod and smile at suitable intervals and let your mind wander. Or, with a book, to skip. This one had me skipping like St Vitus at his fizziest. [From a review of Strong Medicine by Arthur Hailey6]

Much of its charm lies in the quirkiness which sometimes produces parables that make a serious point, sometimes funny stories or light verse; and sometimes is simply out to lunch. In fact, I suppose what it comes nearest to is the kind of chat you might pick up in the hospital canteen if you ever had time and inclination to go there. Introduced 50 years ago by Stephen Taylor, later Lord Taylor of Harlow, with the idea of showing how British medicine was coping with the second world war, the column when it first started was called “In England—now,” which the more dog eared among us, who went to school when they taught you English literature rather than comparative video studies, will recognise as a quotation from Robert Browning. The Lancet, however, or perhaps its typesetters, soon got tired of the Browning version and dropped the dash. A clanger rather than a dash is what they would have dropped if they'd stuck with the title they first thought of—an unimpeachable source claims that, presumably with RAMC despatches from the front in mind, it was originally scheduled to go out as “French Letter.” [From a review of In England Now: Fifty Years of Peripatetic Correspondence in the Lancet, edited by G A C Binnie, R L Sadler, W O Thompson, D M D White, and D W Sharp7]

Lord Walton, bless him, tells you everything you never wanted to know about the rise and rise of a lad from Spennymoor to the heights of the medical trade (professor of neurology, president of the BMA (twice), chairman of the GMC, warden of Green College, etc etc), not failing to mention that his mother's mother was well cared for by a companion called Mabel, that he spent much time in the church choir hoping for a glimpse of his future wife's knees as she swung round on the organ stool, that his elder daughter was a wakeful baby, that Dulwich has a splendid picture gallery and Lichtenstein lovely mountain scenery, that Holland is flat, and that in 1963 he and Betty (of the knees) while house hunting in Newcastle found that several “were attractive but had significant disadvantages, even including some in Elmfield and in Graham Park Road.”

I suppose the auditory equivalent of the mind's eye is the mind's ear, and I was surprised to hear persistently in this organ while reading Walton's autobiography the voice of the late Noel Coward singing “Mad Dogs and Englishmen.” Why? I stopped reading to listen to the words: “It seems such a shame when the English claim the earth/That they give rise to such hilarity and mirth.” In this case to puzzlement as well because curiously, although Walton tells you absolutely everything, by the end of the book you really know nothing about him except that he has a colossal memory. If he has hidden depths—or, indeed, hidden shallows—they remain hidden. The undoubted distinction of his career also unfortunately gets obscured in the fog of total recall. [From a review of The Spice of Life: From Northumbria to World Neurology by John Walton (Lord Walton of Detchant)8]


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