‘Truth and Reason are part of the Authority they are challenging.’

“Thank you for helping me to remember that.“

“I don’t think I said very much.  I was looking at the little horse “

I had suggested we stopped walking for a moment, ostensibly to look at the little horse (and photograph it, complete with its stumpy legs, as you see in the picture), but actually so that I could write down my precious new idea before I forgot it again.

Something about Reason – that was what I had been saying as we walked together yesterday morning – Authority, and what was happening in today’s world to Truth. There was some new way of putting it together that had come to me suddenly last night when I was in the last stage of consciousness before going to sleep. Too close to sleep to summon the willpower to rouse myself and write it down. In case it evaporated in the night.

Which of course it did.

A few hundred yards back, as our path emerged from the woods, I had started talking about the funny sense you get of some idea that you’ve lost – a feeling, a sort of fleeting glimpse. And the way the more you look to clarify what it was, to try to pin it down and bring it back, the more it retreats. Like some shy animal into a hole. Or like a pea stuck up a child’s nostril in our health centre treatment room years ago (I always think of that one, for some reason) and all you’ve done is drive it further into hiding, until even the elusive sense you had of it has evaporated as well. (I also think of it as the left hemisphere of my brain struggling to pin down and fossilise something that is semi-consciously, shimmeringly, alive in the right. But I’ll come back to that.)

This time, for once, and thanks to her, my idea did come back. But as I whooped and spoke out loud my flash of amazing insight, and then spoke it again, louder, her response was disappointingly low-key. Despite her having been my life-long soul-mate and collaborator, who has had, as I often say, ‘all my best ideas’, this shining new inspiration of mine had struck less of a spark with her than, let me admit it, the little horse.

When we got home I was still delighted with my idea and no less convinced that it would find receptive minds somewhere, so I sat straight down and posted it as one of my rather infrequent tweets. My Twitter profile tells me that I have just passed 300 followers, but my offerings rarely if ever provoke a response. But this one, I felt, would be special, and I took care in highlighting some key words as hashtags, and adding a line of explanation ‒ shrewdly judged, I thought, to hint at both its originality and its importance. Like this:

The above screenshot was taken two days later, and as you can see from the empty icons along the bottom, once again I had failed to make any impression, let alone spark some new kind of viral pandemic.

But I consoled myself with something I learned years ago from reading Edward do Bono – that genuinely new ideas always seem strange, or funny, or off-the-wall, otherwise people would know them already.  So, I told myself, this was all a good sign, my idea really was new. But another time perhaps I might try to spell it out a little more carefully.

Sure enough, another time presented itself lower down the same Twitter feed.  An item by the indefatigable James O’Brian caught my eye. (@mrjamesob ‒ he of the 755.1K followers!) His tweet was about Jacob Rees-Mogg claiming in parliament that Boris Johnson was ‘the most freedom-loving prime minister… for at least 100 years’:

O’Brien commented: ‘He’s going to go nuts when he finds out what’s happened to our freedom of movement’

Aah – the ambiguity of the word ‘Freedom’! Just the kind of cue I needed. So I added my idea, carefully reframed, to the comments underneath:

‘I am thinking that the ‘Freedom’ populists talk about includes freedom from what can seem the terrible Authority of Evidence, Reason, and Truth itself.
I am wondering whether this is an explanation for these people’s otherwise incomprehensible immunity from popular censure.’

It was one of some 250 others, but in spite that, this time there was a response. Within 24 hours it had been flagged as Liked by no less than 21 people, and one of them had passed it on to their followers.

So now I’m going to take this to another stage. I’m going to use this blog to ‘unpack’ the idea that was phrased in the words of my late-night inspiration, as they came back to me the next morning on our walk, and to try to tease out and pin down why it seemed, and still seems, so meaningful to me.

Not just for readers who are kind enough to have got this far, but for me. Because, believe me, I am not writing this stuff straight off. I am using the writing of it, over what is turning out to be the best part of a week, to test out, confirm, and hopefully to explain, why somewhere in this idea I had is lurking a truth which is worth sharing. And here I return to the idea that this is a matter of using words as a left-brain tool to tease out and pin down a richly complex but amorphous conception in the right (see Iain McGilchrist’s masterpiece, The Master and His Emissary, for his definitive account of the divided brain).

It was this process that I discovered three or four decades ago when it dawned on me that my Amstrad personal computer could be used as a revolutionary tool for recording ideas in a new form, a form that was fixed and provisional at the same time, and which then made it easy to progressively hone them.

That was when I was still deeply immersed in the life and work of a family doctor, with a stable list of patients whom I knew extremely well, in many cases over decades and several generations. Out of this experience, which in the modern world was already almost unique, I began to draw what I called ‘notes and jottings’, setting down things that struck me as surprising during my daily consultations. Surprise, I already knew from my reading De Bono, was another of his signals that something you’ve noticed conflicts with your existing picture of the world, and therefore that you should be paying it attention (because your existing ideas might be wrong)..

For years I worked like this on what I called my ‘project’. Just for fun, just out of private curiosity. But gradually I began to believe I had something worth contributing, so that my humble collection of thoughts developed until it was accepted for publication as my book, The Paradox of Progress. And after that, for me, the rest was history.

Although that digression does have some relevance to what I am getting at, it was mainly about the method I’m going to use. So, back to the short sentence I started with and let me try to work out why I found it so meaningful:

“Truth and Reason are part of the Authority they are challenging’.

First I should recall that as I went to sleep that night my preoccupation was still with the mystery I had been addressing here just a few days earlier: why almost half of America voted to give Donald Trump a second term, in spite of his record in his first. And I knew from the appreciative comments I was receiving, and indeed from the hit count on the blog ‒ by far the highest since the travelogue I posted here four years ago from our Golden Wedding trip up the west coast of North America – that I did seem to be able to contribute usefully on this subject.

So, that was the context, let’s start by asking who I was thinking of when I said ‘they’?

Easy – I meant the populists, specifically Trump. From the outset he set out to challenge authority, and his followers loved him for it. Because that picked up on a deep-seated, human resentment of authority. Which we can all understand because, to a greater of lesser extent, we share that feeling.

We hate our lives being constrained by rules, originally from our parents ‒ however much we loved and needed them ‒ later at school – then in adult life, both at the workplace and outside it ‒ e.g. speed limits on roads or the latest footling regulations on the use of garden pesticides.

And there is a tension in all of us between on the one hand our realisation that these constraints on our freedom are essential in a civilised society ‒ we know we can’t all choose which side of the road to drive on, or the voltage of our electricity supply ‒ and on the other hand our human desire for autonomy and freedom of action ‒ for the dignity and challenge of basing our actions on our own decisions.

It is that freedom that is at the heart of Americans’ understanding of what it means to be a citizen of their ‘sweet land of liberty’.  Perhaps my two formative years at High School in Washington DC ‒- mentioned in another earlier post – has made that assumption second nature to me as well.

This kind of resentment of authority is more acute when such constraints on our freedom come from a source which we perceive to be alien. Which is why so many British resented ‘Brussels’, however generously we have been represented in the decisions taken there, and why the Westerner we met in the canyon in Capitol Reef National Park so bitterly resented being prevented from exercising his dogs in that fragile environment by distant ‘Washington!’.

But I also meant authority as a concept, in the way that Shakespeare personifies Love in his song, Who is Sylvia? – ‘Love doth to her eyes repair/To help him of his blindness/And, being helped, inhabits there’.

Which is why I spelled Authority with a capital A.

Trump attacked Authority in all these senses. He didn’t just rail against the Washington ‘swamp’. He didn’t just tell his followers, as Michael Gove told his in the UK, that they had ‘had enough of experts’. He didn’t just sack officials who failed to echo his every, self-contradictory whim. All of that is obvious, all of that has been rehearsed endlessly by critics. With zero effect on his followers.

The deeper idea that struck me as I went to sleep that night was that Trump went much further ‒ he attacked the very concept of Authority by attacking the foundations upon which legitimate Authority rested. His cheerful and absolute disregard for Reason and for Truth (which I also capitalised in my sentence) made him wildly popular with great swathes of supporters precisely because, as I suddenly realised, Truth and Reason were themselves aspects of the overbearing authority which had, step by ratchet-step throughout the modern era, progressively constrained their freedom of action, and even freedom of thought.

Here again, I have my own reasons for understanding this. My freedom of action as a doctor was progressively subjected to more and more constraints as my career went by. That was the background story to my forty years as a doctor. And that, and my attempt to resolve the resulting conflicts, was largely the subject of the book I wrote as I approached retirement.

On the instant I qualified as a doctor the way I was perceived by society changed. This was symbolised by my moving from the highest risk category for car insurance (as a medical student) to the lowest.

As my years as a junior hospital doctor progressed, I acquired steadily more freedom of action, but the ultimate clinical responsibility always rested with the consultant who headed the team–my ‘chief’. It was the chief who, at least in theory, faced the music when something went wrong.

And eventually, when I became a GP with my own list of patients, I took on that mantle of responsibility myself. I had nobody over me and nobody under me ‒ one of the many things I loved about the role. I also loved, although it was as daunting as it was stimulating, what now seems the extraordinary privilege of ‘clinical freedom’.

Clinical freedom did have its boundaries, which were policed with notorious severity by the General Medical Council. But that august body mainly concerned itself with drugs, sex, alcohol, and criminality. Freedom to treat our patients in whatever way we judged best remained to all intents and purposes absolute.

It made for a heady time when being trusted brought out the best in us a great deal of the time. But it also left too wide the door for bad practice and, crucially, for ignorance of what was an ever increasing cascade of scientific advances.

The end of those days can be traced with some accuracy to an editorial in the British Medical Journal of Saturday 29 October 1983. Headed The end of clinical freedom Its opening paragraph summarises what was a pivotal moment in medical history:

Clinical freedom is dead, and no one need regret its passing. Clinical freedom was the right‒some seemed to believe the divine right‒of doctors to do whatever in their opinion was best for their patients. In the days when investigation was non-existent and treatment as harmless as it was ineffective the doctor’s opinion was all that there was, but now opinion is not good enough. If we do not have the resources to do all that is technically possible then medical care must be limited to what is of proved value, and the medical profession will have to set opinion aside.

From then on, the changes were relentless. The god of Clinical Freedom was dead, only to be replaced by the god of Evidence Based Medicine. For the first time, government ‒ specifically Margaret Thatcher’s government in 1990, a year which my generation of GPs remembered for ever after as ‘when the darkness came’ ‒ saw its opportunity, as paymasters of the National Health Service, to call in what had been, ever since 1948, the independent contractor status of GPs. So began the imposition of more and more external rules and constraints on our practice. This, I have to say, was with the enthusiastic support of our Royal College, the academic body of British general practice, which saw nothing in the trend but progress.

And, writing this now, another new thought strikes me. For the first time I have an uncomfortable realisation that the success of my book, for success it undoubtedly was, may have been because it struck ‒ surely not, heaven help me, like Trump! ‒ a populist chord with fellow GPs.

It also struck a chord amongst people from outside medicine who happened to come across it. Perhaps that was populism as well? One of them, for example, wrote from a ballet school in Switzerland to thank me for it, saying it was ‘just the same for them’. Quite recently a farmer in the North of England emailed me out of the blue to say the same.

So, this ‘paradox of progress’ that I tried to analyse in the context of NHS general practice, seemed to pervade more generally. Throughout contemporary society there seemed to be a perception that making things better was making them worse.

Perhaps my own sense of impotence in the face of the terrible authority of our increasingly systematised world was lurking somewhere in the background to my supposed flash of inspiration into the mystery of Donald Trump?

Perhaps it was like this: Many of us feel trapped by the inescapable Authority of Logic and Reason which underlies Progress ‒ what Trump did, which accounts for his astonishing immunity from censure by half of a vast and superbly educated nation, was simply to throw Logic and Reason out of the window.

He had bought a large map representing the sea,
   Without the least vestige of land:
And the crew were much pleased when they found it to be
   A map they could all understand.

“What’s the good of Mercator’s North Poles and Equators,
   Tropics, Zones, and Meridian Lines?”
So the Bellman would cry: and the crew would reply
   “They are merely conventional signs!“

Extract from The Hunting of the Snark Lewis Carrol 1832-98

And can’t you just see the attraction! What do you do when some clever clogs ‘fact-checker’ keeps some tedious count and says your hero has just passed 20,000 lies on the public record? You say, ‘I don’t believe they were lies – that’s just another opinion, there are alternative facts which say the opposite.’    On with the party!

Just the same with the size of the crowd at his inauguration. Just the same with Covid-19 when it manifestly didn’t ‘vanish like magic’. Just the same with the ‘hoax’ of climate change. Just the same with dozens of wild claims over the last four surreal years.

But Trump’s truly radical innovation, I think I now see, is to take things one stage beyond this: He says ‘what the heck do numbers matter ‒ they are just numbers ‒ they are ‘merely conventional signs’. What is this stuff called ‘truth’ which you keep throwing at me? What is this thing called ‘reason’? It is time to cast ourselves free from the shackles of these outdated concepts which have enslaved us for so long! Time to see this monster ‘science’ for what it is –a conspiracy against our heritage of freedom, which preachifies of nothing but encumbrances to our rights to frontier lives, to the drilling of oilwells, to the driving of giant cars, to the building of private armouries of guns. Americans were born free. Born to think freely, like birds up in the air. Yet everywhere their consciences have been chained by this foul imposter ‘evidence’! 

And once a leader convinces people that their chains are mere illusion, and gives them permission to ignore such outmoded constraints, to think without the shackles of reason, and to believe everything they want to believe is true, the people are wildly grateful. Wey hey, let the good times roll! It is the coming of a new Messiah.

Of course such a leader can do no wrong, for in this new New World, wrong is meaningless and has nothing to do with the case.

Perhaps it is time to return to the little horse, and leave further consideration of this for another day…

25 November 2020