The Paradox of Progress revisited
The gifted blogger Richard Emerson has recently done me the honour of making me one of the first to be featured in his new podcast ‘Conversations about philosophy, science, mythology, good life, travels, and the big questions!’
In this conversation we revisit my 1995 book The Paradox of Progress together and discuss striking links with Iain McGilchrist’s The Master and His Emissary (2009), and what has turned out to be its magisterial follow-up, The Matter with Things (2021).
This has taken me back to the period of several years in the 90s during which I, a perfectly ordinary NHS GP, was asked to write about the book, give formal lectures and address numerous meetings, including one in The Hague – when the President of the Dutch College of GPs invited me to give the opening keynote of their annnual congress with the wonderful words, ‘Your book puts words to feeling that are felt by many Dutch GPs‘. A third of all the GPs in Holland were in the hall – 1,500 of them – and I remember they all arrived by bicycle or public transport.
With his friendly, informal style, his distinctive Norwegian accent, his wide-ranging erudition, and his insight, Richard Emerson is the ideal intervewer. I found he had picked out perfect extracts from my book to guide our conversation, showing the links with McGilchrist and showing how much we were on the same wavelength as we explored these fascinating and immensely important ideas.
Here is one extract he picked out:
We use the word ‘unbalanced’ to describe an insane mind. Thus the accumulated wisdom embodied in the very language we speak acknowledges the fundamental role of balance in the definition of sanity. So when I say that the common mind of our society is unbalanced, I am making a very serious diagnosis. I am saying that the common mind of society is, to some extent, insane. But that is what I do say.
The Paradox of Progress, Chapter 11 : Good Intentions
I’d love people to hear my conversation with Richard. I think it puts words to feelings that are just as widely shared as they were 25 years ago, and are no less crucially important: Link to the conversation/podcast
My book was reprinted three times by Radcliffe Medical Press, one of their most successful titles ever, but has been out of print since they were taken over many years ago. I have long sought ways to make it available once again. So the other thing that Richard has done for me is to introduce me to Payhip – a simple way to publish a pdf version of a book and make it available for download for a modest charge:
Link to downloadable pdf of The Paradox of Progress
This complements the online version which has been free to read ever since I placed it on my website some twenty years ago. It is complete with a clickable index of ideas in the book, which as far as I know is rarely used, but might help some people:
Mending things
I just mended my grand-daughter’s clarinet.
One of the notes wasn’t sounding and we played around until we’d tracked it down to one of the bottom key covers not closing snugly onto its sound-hole. (Apologies if this isn’t the correct nomenclature, I’m an amateur) When you looked closely you could see a fatal gap remaining under the pad when you pressed its key higher up the instrument. If you held the cover down directly with your finger (we discovered) the note came out perfectly. Lift it off again and it stopped. You could play a little trill like that. And we did.
The diagnosis was clear – the ‘close that cover’ message wasn’t making it through the intricate arrangement of shiny levers.
There was a concert imminent and phone calls were being made to try to find a spare clarinet. People were unhappy.
Now I have something of a reputation for this sort of thing which I cherish. Ever since, many years ago, when I did some trivial mending job – putting a wheel back on a toy car or something – and its little owner went toddling around the house holding it up to people and explaining ‘Gran’pa fix it‘.
Life doesn’t get much sweeter than that.
But now that treasured reputation was on the line – musical instruments being on a different level of delicacy and complexity from model cars. The best I could come up with was to suggest weakly that the pad might be dry (did that happen with clarinets?) perhaps we could make it plumper by moistening it with something? The young owner mentioned the special grease she used for the cork-lined joints of the instrument, and that sounded the sort of thing. I duly smeared some of that about with a wooden toothpick.
Absolutely useless.
So I put the instrument down while we attended to other things. Until stubborn curiosity drew me back for another look. And this time, as I pressed the keys idly up and down, I saw something new – one of the pivots seemed to be slightly sloppy. It looked, it seemed to me, like wear in that joint. Did that happen with clarinets? Were they supposed to be oiled?
Not sure, but it never had been.
Perhaps that was it?
One way or another, it was looking like a professional job.
But again I couldn’t resist one more look, and suddenly the penny dropped – that glorious eureka! moment: A little silver rod projecting from the mechanism, which I had noticed earlier and assumed was meant to be like that, was in fact the axle of the faulty key which had become detached from its socket. So the whole bearing wobbled slightly when you worked the key. I pressed on the end of the little rod with my finger and sure enough it started to move. Not the whole way in, but that was OK because I could now see a tiny screw slot across its end. All I needed, I announced to the company, was a suitable screwdriver to finish the job.
While my wife was searching in her handbag for the little glasses-repair kit she always carries (!) our young musician remembered that her equipment did indeed include a tiny screwdriver, for which she had never found a use. Exactly what I needed, this enabled me to screw the little axle securely home, completely abolishing the fatal floppiness.
And lo, the clarinet was sounded, and a torrent of melodious arpeggios poured into the grateful air.
Emboldened by a similar success with a drain plug in our bathroom sink (not to mention the hall clock triumph which I described in an earlier post) I recently volunteered my lack of expertise for the new Repair Café at our Community Centre.
Arriving with a few tools on the inaugural morning I was so conscious of the presumptuousness of what I was doing that I very nearly turned away and went back home.
But I did go in, and the first person in the queue happened to be a former patient of mine who greeted me like a old friend. And before I had time to demur, he and his broken item – his Father’s old mantelpiece clock – had been allotted to me.
The clock had three problems – it hadn’t run for 25 years, two pieces of wooden molding had become unglued from its case, and it needed a thorough clean.
I told him I had absolutely no expertise with clocks and he urged me to go ahead anyway – it was broken and there was nothing to lose. So I freed up the nuts that held the movement in place and eased it out.
It appeared to be fully wound, and as I gently prodded the balance wheel it oscillated a few times before slowing and stopping. It seemed to me that somewhere the mechanism was sticking. So I told him I did have a cheap and cheerful fix which had worked with a clock at home, and again he told me to go ahead.
So I gave it one judicious blast of WD40.
And that was that. It worked. I prodded the balance wheel again (this, I suspect, is again not a technical term) and this time it didn’t stop. I set the hands and it was still showing the right time when he left.
Dismantling the face, cleaning it, and replacing the fiddly-little screws that held it in place was the second and by far the longest job. And then it came to mending the wooden case.
It was obviously a simple gluing job, but I didn’t want to send him home with everything swathed in tape while it set. So I used a tip I once found on the web: we didn’t seem to have any PVA glue, so I mixed up some Araldite (epoxy resin) which we did have, and put a good blob of that in the middle of each piece of loose moulding. Then, and this is the clever bit, I put superglue in several different places on the same joints, and then pressed the pieces together until the superglue held. Handled gently, this would give time for the epoxy resin to develop its tremendous strength. Bingo!
Well. To say he was delighted is putting it very mildly. He wrote the most fulsome and heartwarming letter of appreciation anyone received that day.
Our Member of Parliament turned up at the next Repair Café the following month. Recognising me as a retired doctor and a persistent correspondent about issues very far removed from the mending of clocks he expressed surprise to see me there as one of the repairers.
But I pointed out that I had been a GP – a generalist – and that the mending of people in general practice had meant that doing things for the first time, using that amazing thing, educated common sense, had been the daily currency of that job. Or words to that effect. And that was why I had loved it so much.
I opened my book The Paradox of Progress with an anecdote about mending a dislocated kneecap (for the first and only time in my career) on a house call in the middle of one night, to make a similar point. It is here for anyone who is interested.
GP Obstetrics in ‘the good old days’. Reminiscences of good and bad after half a century.
We talk about the good old days – but they weren’t always good.
Way back in 1972, one of the things which attracted me to coming to work here in Alton was the availability of a local GP maternity unit where I would be able to look after my mothers when they had their babies.
Brexit: We are all more susceptible to persuasion than we like to think.
I was a young doctor. I had it in my power to help this guy. So I did.
He was a drug rep. Sitting opposite me in my consulting room. Half a century – most of a lifetime – ago. He had been waiting outside for much of my morning surgery, as reps used to in those days, hoping I would see him before I started on my paperwork and visits. As usual it had worked – me being too soft-hearted to say no and send away a fellow human being with a wasted morning. ‘There but for the grace of God’, and so on… Read more…
Generally Speaking 