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Views & Reviews Review of the Week

Decline and fall (the speedy way)

BMJ 2009; 339 doi: (Published 12 August 2009) Cite this as: BMJ 2009;339:b3283
  1. Michael Farrell, reader in addiction psychiatry
  1. 1Institute of Psychiatry, King’s College London
  1. michael.farrell{at}

    Images of flashing blue lights in the night sky, derelict houses, vagrants, toothless “meth heads,” scrawny bodies, and multigenerational addicts flicker across the screen. This is a grim and dark world. Following in the speed fuelled footsteps of Jack Kerouac, Louis Theroux drives into buzzing Fresno and drops into some of the down at heel neighbourhoods. Fresno, in central southern California, is the main producer of raisins for the United States and has a large population of migrant agricultural workers. In its current social crisis it bears echoes of John Steinbeck’s Grapes of Wrath.

    Theroux repeats a format he has used in a number of programmes: to observe how the folk on the wrong side of the tracks live. He has a curious and somewhat detached air but also a genuine feeling of empathy—it means that a variety of people …

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