Views & Reviews Between the Lines

Nothing but wickedness

BMJ 2012; 344 doi: (Published 23 April 2012) Cite this as: BMJ 2012;344:e2884
  1. Theodore Dalrymple, writer and retired doctor

Dr Samuel Johnson had many illnesses, and even more ascribed to him by writers, but he had a strong constitution and lived to what was, for the time, an old age—75. He was interested in physic and was willing to experiment on himself. On his deathbed, frustrated by the inability of his doctors to relieve the gross oedema of his legs, he cut deeply into his own flesh.

Johnson, whom Voltaire (wrongly) called a superstitious dog, believed that science would help to relieve mankind of much misery, but not of misery as such. Living at a time when poverty meant not an income lower than 60% of the median income but having little to eat and rags to wear, it was perhaps prescient of him to realise that, notwithstanding the horrors of poverty that he never underestimated, material progress would not mean full and final happiness.

A religious man, or perhaps (better) a man striving to keep his religious belief intact, one of his preoccupations was the problem of how an infinitely wise, powerful, knowing, and benevolent God could permit such suffering in the world. Among the great causes of suffering, of course, were disease and illness. When Johnson was writing his great Rambler, Idler, and Adventurer essays, half of all children in London died before their fifth birthday, and the city was so unhealthy that its population grew only because of migration from the countryside. The search for good health is not a cause of mass migration.

In one of his lay sermons, Johnson tackled the question of how much suffering was attributable to God’s will. He wrote:

In making an estimate, therefore, of the miseries that arise from the disorders of the body, we must consider how many diseases proceed from our own laziness, intemperance, or negligence; how many the vices or follies of our ancestors have transmitted to us; and beware of imputing to God, the consequences of luxury, riot, and debauchery. There are, indeed, distempers which no caution can secure us from, and which appear to be more immediately the strokes of heaven; but these are not of the most painful or lingering kind; they are for the most part acute and violent, and quickly terminate, either in recovery or death; and it is always to be remembered, that nothing but wickedness makes death an evil.

The last sentence makes sense, of course, only if there is a future state of being whose felicities are handed out according to our desert in this life; and perhaps pedantically inclined philosophers might say that otherwise it is not death itself that is an evil, but only the truncation of existence that might have been more prolonged and is foregone by the intervention of death.

Be that as it may, I confess that whenever I read the first sentence of the part of the sermon that I have quoted, I think of the mass public drunkenness that foolish or perhaps corrupt governments have assiduously encouraged, promoted, and benefited from in these islands. What better illustration of Johnson’s point could there be than that, at the last count known to me, 70% of attendances at casualty departments between midnight and 5 am are attributable in one way or another to drunkenness.


Cite this as: BMJ 2012;344:e2884