‎ ‘In their secret being, dignity and hopelessness clasp, to emerge vacantly, as inscrutable amnesia, or, sometimes, as an unknown actor or actress, a weeping or a laughing clown. Tears and laughter in such conditions are true, yet unrelated often to the experienced primeval instincts. There is an obvious emotional numbness, but it is often a mask or disguise, assumed, that precludes questioning. One becomes aware of all the defence mechanisms, the pathetic remains, of human dignity. To the stranger they appear odd, aloof, unfriendly and unapproachable. To the initiated, their eccentric behaviour merely demonstrates, in many guises, their own pent-up emotions and disappointments.’ (Hanna Greally, Birds’ Nest Soup)



Dr Grene: ‘For the first time I have noticed the effrontery, I think that is the word, the effrontery of my profession. The come-around-the-back-of-the-house of it, the deviousness.’ (The Secret Scripture)

Contemplating the idea of writing about her child’s cancer, the Mother, in Lorrie Moore’s story ‘People Like That…’, says to her husband ‘This is irony at its most gaudy and careless. This is a Hieronymus Bosch of facts and figures and blood and graphs. This is a nightmare of narrative slop. This cannot be designed. This cannot even be noted in preparation for a design –‘

Reading Philip Roth’s American Pastoral, from which:

“the overwhelming spell that we continue to cast on one another, right down to the end, with the body’s surface, which turns out to be … about as serious a thing as there is in life. The body, from which one cannot strip oneself however one tries, from which one is not to be freed this side of death.”


“[Jerry:] The operating room turns you into somebody who’s never wrong. Much like writing’. [Nathan:] ‘Writing turns you into someone who’s always wrong. The illusion that you may get it right someday is the perversity that draws you on. As pathological phenomena go, it doesn’t completely wreck your life.'”

David Spodick in an editorial in the American Heart Journal in 1971:
Physicians cure little or nothing. We alter physiology, arrest inflammation, and remove tissue, but with the exception of some infections and some deficiency states there are few if any cures in terms of restitutio ad integrum.
(Quoted in Petr Skrabanek’s The Death of Humane Medicine)

As a young doctor, Sassall “had no patience with anything except emergencies or serious illness… He dealt only with crises in which he was the central character: or to put another way, in which the patient was simplified by the degree of his physical dependence on the doctor. He was also simplified himself, because the chosen pace of his life made it impossible and unnecessary for him to examine his own motives.”

As he matured as a doctor, Sassall exchanged that obsession with the “life-and-death emergency for the intimation that the patient should be treated as a total personality, that illness is frequently a form of expression rather than a surrender to natural hazards.”

From Follies & Fallacies in Medicine by James McCormick, Peter Skrabanek:

“The aim of our book is to reach inquisitive minds, particular those who are still young and uncorrupted by dogma. We offer no solutions to the problems we raise because we do not pretend to know of any. Both of us have been thought to suffer from scepticaemia* but are happy to regard this affliction, paradoxically, as a health promoting state. Should we succeed in infecting others we will be well content.

*Scepticaemia: An uncommon generalised disorder of low infectivity. Medical school education is likely to confer life-long immunity.”

(Thank for reminding me, Colman.)

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