The ballad of the poor, young male
BMJ 2004; 330 doi: https://doi.org/10.1136/bmj.330.7481.51 (Published 30 December 2004) Cite this as: BMJ 2004;330:51All rapid responses
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To The Editor, BMJ.
Dr.Spence describes the underside of society to which he is a witness. He describes poor, young males having no choice. This surely means that such a person cannot be blamed for the kind of life they lead or its consequences.
Surely the reality is that, for each of us, choice is extremely limited and this is beginning to be recognised. The emphasis on giving deprived children a better deal I see as hopeful but the viciousness with which people treat some crime, as wrong & depressing.
DSAWTaylor@aol.com
Stephen Taylor, retired GP Walsall.
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Dr. Spence gives a vivid, personal view of the pointless death of so many "poor, young males" [1]. Summarising decades of work alongside the British underclass, Brandon [2] wrote "huge numbers of young people are excluded from the possibility of valued ways of living". What is implicit in Spence's retelling of Elvis' In The Ghetto (and in some rapid responses) is the danger of despair alongside professional duty. But Brandon had himself been a homeless, battered teenage runaway and learned to avoid both a disconnection from the "Other" and an egotistical preoccupation with "macho ways that zap social problems" [2].
After the Government, the second biggest UK provider of social care is the Salvation Army, and there may be lessons to learn from its long-term survival and growth. Perhaps we can only value and give meaning to young people's lives when "inextricably involved in fighting for improvements in social welfare and providing services to meet both spiritual and material needs of those most greatly affected by society's shortfalls" [3]. This involvement, moment by moment, will often appear foolish or costly, but that Army's concept of "salvation" is about "wholeness" [3] - patient and professional, together.
Elvis was not a ghetto child, but Sam Cooke did reflect personal costs (the recent death of his son, his recent arrest by racists for "disturbing the peace") in his universal song A Change Is Gonna Come - written shortly before his own violent, "pointless" death.
"There have been times that I thought
I couldn't last for long
But now I think I'm able to carry on
It's been a long time, but I know
A change is gonna come, oh yes it will" [4].
[1] Spence D. The ballad of the poor, young male. BMJ 2005; 330: 51.
[2] Brandon D. Tao of Survival. Spirituality in Social Care and Counselling. Birmingham: British Association of Social Workers, 2000.
[3] Cochrane B. The paradox of prosperity. In: Social Care and Health: a New Deal? (Ed. Allen I.) London: Policy Studies Institute, 2001: 11-21.
[4] Cooke S. A change is gonna come. Recorded RCA Studio, 1963.
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Thank you for the original article. From some of the responses it's proven illustrative of the predictable dinner-party orators that wax lyrically at the drop of a used syringe on everything other than individual responsibility. All behaviour is excused, as long as there is no beastliness involving children, and you are thought of a 'snob', 'smug' or 'nascent brownshirt' if you think otherwise. The erudite liberal mindset will always find a way of belittling the messenger whilst theorising away the problem. They have infact created the problem. The underclass is their bastard child that, most annoyingly, does not appear to be terribly grateful.
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If you're male and of the middle-class in Britain then watch out, because your life may well be rich, violent, and short. You will leave school at 18 with lots of meaning-less A levels then go to university. This in itself doesn't matter, because the real barrier is your complete lack of any life skills or social skills. You will be incapable of living independently, now you no longer have mummy and daddy pampering you. You won't even have the basic ability to clean, cook, or pay bills. You will never understand how social systems work, and the height of achievement will be to get a letter published on the BMJ website. Your lack of understanding and communications skills means that even when minor problems arise you resort to what you know best; being patronizing and condescending. You may have a girlfriend, but when the baby comes along it's all too apparent that you have no parenting skills and can't cope. Your frustration is expressed through drinking alcohol and abusing prescription drugs and beating the only person who actually loved you .She sticks with you because nobody would believe you could do that and she “must have imagined it”. Your friend prescribes Prozac for her. You seek refuge with your friends but your addictions get the better of you. You start lying and thieving to get drugs so you can relax from the pressures of the job. You get “pharmed out" to a drug conference and end up in a godforsaken hotel with a hundred other men you are not related to but each one of whom could in fact be your twin. You continue to steal and take drugs and end up getting a slap on the wrists from the GMC.You are sent away to a beautiful all expenses paid drug rehabilitation centre. When you are released you go back to your old job with no-one the wiser. Your kind is vilified on the street. At each and every political party conference the leaders stand up and say that they going to get "tough on the causes of crime"—and, not to be too blunt, this means you. Get a job? Sure! But we all know that you're unemployable, because which job advertisement starts with "Seeking a smug, articulate, aggressive, patronizing drunk."
The years roll by, and you continue to drink heavily and beat your wife. One Saturday night a younger version of you, aged 10, sticks a blade in your chest trying to stop his mother being beaten again. One hour later the doctors walk away, having split your chest open but to no avail. "Just another drunk, wife beater," they all think. Thank Christ, anyway, because even though you're only 39, in all likelihood you would have strung yourself up in the next few weeks. Your attacker gets conselling and a ride on the merry-go-round that you've just left. Nobody cares. This scenario is played out 24 hours a day, 365 days a year across the United Kingdom. You had two risk factors that when present together are a fatal combination: "maleness" and "being a smug bastard" You're lucky if your death gets two lines in a local newspaper. You're not even worthy of a song, because your kind are the root of most social evils and your passing is a blessing to most of society.
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... but let´s be more precise: The song, as sung by Elvis, is about 35 years old.
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Dear Editor,
I feel that the author, Des Spence needs to step back and reassess his own standing and whether or not the difference would be any greater should the shoe have been on the other foot!
This hurtful and inaccurate article will remain safely archived away from the eyes of these poor, uneducated and villanous males all of whom are victims of modern greed and neglect by society. The author must fail to recognise that many of these 'boys' had potential just like he did, although lacked a very crucial financial and loving background to nurture inner creativity and ambition.
The charisma and strength of soul displayed by such poor 'boys' that have been forced to reside in youth housing schemes can really make ones own troubles and stresses alarmingly trivial. Drug addictions and violence merely go hand in hand when youthful cries for help are ignored time and time again.
Whilst many of the issues that author has raised do occur i feel the entire article is a thoughtless and sweeping generalisation of events. It exhibits a complete lack of compassion and reinforcement of current attitudes which merely turn a blind eye on this cross section of our society.
I hope subsequent readers of the article are as equally astounded at the author's opinions and moral!
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No advocate?
I had been meaning to respond to Des Spence's personal view weeks ago so was glad when I found it again today. I thought it very moving, realistic and not at all smug. I am astounded at some of the rapid responses!I know that this is an accurate picture of the lives of many of my patients, and there is not much in it I disagree with except: "Nobody cares" and "you never had a single advocate...". My bet is that Dr Spence cares, and I know that as GPs we can (sometimes) act as quite powerful advocates for our powerless patients. Sorry if this makes you choke again Dr Spence!
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