Intended for healthcare professionals

Analysis Christmas 2009: Years Like This

Journal of another plague year

BMJ 2009; 339 doi: (Published 11 December 2009) Cite this as: BMJ 2009;339:b5033
  1. Mark Petticrew, chair in public health evaluation1,
  2. David Morrison, director2
  1. 1London School of Hygiene and Tropical Medicine, London WC1E 7HT
  2. 2West of Scotland Cancer Surveillance Unit, Section of Public Health and Health Policy, University of Glasgow, Glasgow G12 8RZ
  1. Correspondence to: M Petticrew mark.petticrew{at}

    Mark Petticrew and David Morrison uncover Daniel Defoe’s account of the “remarkable occurrences during the great economic, health, and climactic visitations of 2009” and his difficulties in getting his ideas published

    Recent years have seen a catalogue of plagues and sundry other contagions. Hard on the scaly heels of avian flu follows global warming, swine flu, obesity, and now the economic plague. This litany of woes has affect’d me deeply, as these few entries from my diary this past year shew.

    5th April

    Rose early to enjoy reading the latest bill of mortality of estate agents in the Parish of St Giles, which show’d again a monthly increase. The Bankers, too, have this past year been struck low, and it transpires that their understanding of the term “Bank” has left much to be desired; they have been sinking our shillings in miscellaneous crackpot schemes in the Colonies that few understand, and fewer profit from: to wit, hedge funds, subprime mortgages, Ponzi schemes, plans to build golden stairways to the moon, and God knows how many other feeble minded schemes.

    Fearful of my own savings, I visited my bank in the Strand this morning, only to find to my dismay the building lock’d up with a large “X” marked roughly upon the door. I rapped loudly, and Mr Madoff put his head out the window. When I demanded to withdraw my savings he tossed me a florin, saying insolently, “This is what is left, Defoe, use it wisely. Remember, past performance is no guarantee of future results—as I told you when you invested, the value of your savings can plummet, as well as fall briskly,” and with that he slamm’d the window with a hollow laugh. On close examination I discovered the coin to be but a poor fake, bearing the head not of our beloved monarch but of one Fred the Shred, who some claim help’d land us up to our necks in the financial privy in the first place.

    12th May

    Walked deep in thought to the tavern. Much talk there of the change in the climate and the dire consequences for the publik health. However the country’s best brains are at work to identify remedies, and I am heartened to read in a broadsheet that the fashion world has come up with a solution: viz, new “flood length trousers” which keep the wearer’s hems out of the rising waters.[1] We need no longer live in fear of flooding when the fashion industry is working so assiduously on our behalf.

    (Mem: To payment to tailor for reduction of trousers to knee length: 5 shillings)

    6th June

    Up betimes and stroll’d down the Strand, only to be assail’d by the dismal sight of formerly prosperous bankers and estate agents begging for alms. At Aldgate I was approach’d by one in rags outside the coffee house, who seiz’d me by the elbow and hoarsely ask’d for the price of a skinny venturi decaff soya latte with cream, an extra shot, and coffee on the side. Not to drink, mind, but simply and intransitively “To go.” It would be a harder heart than mine that could turn down such a low wretch and I toss’d him a florin, which he bit to test its soundness. Would that the bankers had always been so careful.

    7th June

    Read in the broadsheet that a banker has choked to death on a counterfeit florin in St Giles.[2]

    3rd July

    Remembering that a previous plague—to wit, the foot and the mouth—was combat’d by burning all our cattle, and that we had to wipe our feet when visiting our country estates, I am seiz’d with a plan: viz, that all avian and porcine visitors to the country should wipe their feet upon entering and that all those already here should be incinerated forthwith. In this latter endeavour I intend to enlist the help of Britain’s many Fried Pullet and Braised Offal emporia. Three tallow candles did I exhaust, as many quills, and a night’s sleep dismiss, in the fever’d exposition of my proposal. I dispatched my opus—extending to ten quires of copperplate manuscript—upon the tea clipper Sea Difficile bound for the English colonies in America, for consideration by their most highly esteem’d New England Medical Intelligencer. My fortunes assured, I retired in high spirits to my local tavern, the Winter Swallow, to partake of a majestic supper, before which I was entreated by the victualler, “Goeth ye large? ‘Tis but a Ha’penny more.”

    The Inn’s recent refurbishment with sturdy oak furniture, reinforced against obesity,[3] will be viewed by future generations as prescient and of much comfort and benefit to our expanding populace. Doctors of physik today are wont to say that corpulence, like plagues before it, is borne of an “obesogenic miasma.” Such an observation is self evident, and any man may test its veracity. I, myself, found recently that after partaking of frequent long walks in the Highgate countryside I had need to entreat my tailor to take in the waistband of my breeches. The only rational explanation must be that the fresh and vital air of Hampstead Heath is unpolluted by the “portly odours” of the City.

    1st September

    Scarcely had the Difficile docked in New England than her sister ship, C Shanty, return’d to London bearing missives from the referees of the Intelligencer. These discharged upon my Paper such bile that I was sorely tempted to dispatch a quicke response on the first schooner at dawn. The referees’ comments moreover were accompanied by an insolent memorandum to the effect that they receive many epistles such as mine, and that unfortunately they can only print a sparse 10 per cent of them, etcetera. I replied by return, saying that their gross inefficiency is not my concern, and further drew their attention to the fact that I receive many such rejection letters, but unfortunately I, too, can only accept 10 per cent of them.

    2nd September, post meridian

    With renewed spirit, I consider’d the views of my New World critics and set down to draft again my Manuscript. Deftly, I filleted the piece to one twelfth its original length while introducing a fanciful Conclusion—to wit, that the swine flu might be attenuated through variolation of the sort that has been used to curb the Small Pox in Asia since the first Millennium. My revision includes many clear messages for policymakers, practitioners, quacksilvers, mountebanks, poultrykeepers, pill merchants, and sundry other busybodies, as required. To avoid any delay by His Majesty’s Royal Mail—I admit, a most unlikely eventuality—I dispatch my footman, Lance, to Camden Lock, where a prestigious journal— yet one of somewhat less standing than the Intelligencer— has its offices.

    3rd September, ante meridian

    I find this morning that my latest modest proposal too has been rejected by the onion-eyed hedge pigs[4] who run this penny dreadful, and I repair to The Polar Bear and Wellingtons to mull over the sundry Global catastrophes which befall us and, more pressingly, to consider whether they afford me any opportunity for publication. I dash off a short missive of appeal for reconsideration of my paper.

    20th December

    Christmas draws nigh, and since my last intervention, nothing but silence from the sots at the Journal, who no doubt are in their festive cups instead of inking the printing presses. I repair to The Pig and Tamiflu for a small cordial and to consider my few remaining options.

    21st December, ante meridian

    A great anxiousness afflicts me after a night of diabolical fever and I fear that I am finally succumbing to that most dreaded distemper, the swine pestilence, or, as it is now widely known, “the pink death.” From my sick bed I draft my obituary, in which, with sincerest modesty, I detail my glorious achievements, laudations and major contributions to the World. I enclose a small woodcut likeness of my visage, seal the whole with wax, and dispatch it to a local but respectable journal—though a modest one of considerable less Impackt, again—the Provincial Medical and Surgical Journal.

    21st December, post meridian

    Feeling much the better. Perchance the increasingly unseasonal meteorological conditions, in which the temperature of London has reached 80 degrees Fahrenheit in the shade, accounted for my feverishness; for it seems I am to be spared. While taking afternoon tea, a messenger from the Provincial Medical and Surgical Journal is shewn into my study, bearing a dainty folded vellum notelet. Its message can barely be deciphered having, it appears, been impressed by a very worn India rubber stamp and not written out, proper. “Thank you for taking the time to consider our Journal for your Obituary,” its single sentence begins, “But we feel there would be insufficient interest among our readers for your artickle.”

    23rd December

    I console myself by spending my last 12 shillings in The Sty in Quarantine; and thankfully after downing the first two pints of port, much of the rest of the evening, and indeed this sorry year, remains a blur. (I have a discomfiting memory of a semi-naked man lying in Russell Square fountain holding a half empty port bottle, and singing “Deck the halls” or a version thereof).

    24th December

    Mem: To purchase of tincture of willow bark: 2 shillings; Laundry of sundry items of wet and soil’d clothing: 6 shillings; To postage of numerous letters of apology to residents of Russell Square: £0-12-6.

    1. Fox I. The right trousers. Guardian 2009 May 12.

    2. Green M. Squire Haggard’s journal. Prion Books, 2000.

    3. Mitchell D. Congratulations, you flobby slob, now you’re a sex symbol. Observer 2009 Aug 9.

    4. Elizabethan curse generator.


    Cite this as: BMJ 2009;339:b5033


    • Contributors and sources: MP wrote the first draft and both authors then wrote subsequent drafts and contributed to and approved the final version.

    • Competing interests: None declared.

    • Provenance and peer review: Not commissioned;

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