face-screaming-in-fearImmigration.  There, I said it.

Surely one of the top ten most inflammatory words in the English language or, indeed, in any language it’s translated to.  Merely to utter the word is to be accused of racism, whatever that is, whatever people think it is.

There are many entire books written on the subject, there are innumerable articles for every perspective.  Personally, I subscribe to the concept of one race, the human race.  As a gardener I’m very well acquainted with familial variations and similarities both of the genus and its variants.  I can only view human beings in the same way.  One genus, one “race”, a word coined specifically to identify the human genus and later adopted for pseudo-scientific and political purposes.  Indeed, with our relatively advanced understanding of genetic science (a word derived, fairly obviously, from the same root as genus), DNA, phenotypes and genotypes, one could say it has now become part of mainstream science.  That’s a shame, giving the word a false importance in the hands of the wrong-minded. Having now entered the realm of establishment science it is thus with us, probably forever.

‘Race’ is actually only about “other”, nothing more.  It’s a word that is used for political and social manipulation and readily adopted by those looking for a way of expressing hatred for their own neighbours.  Do sentient beings *actually believe* that those with a different skin colour, nose, hair, whatever are somehow a sub-species?  Yeah, some do, but the rest of us encourage that to gestate and to mature, every time we buy into the word’s use in this context.

Let’s see if I can find any common ground with my reader.  It is patently true that people, whose appearance separates them out from other people, have genes that demonstrate their geographic origins that we can now identify and whose movement across the globe through history, we can map with significant accuracy.  Genes, we know, adapt through evolution, as a result of the environment in which the organism exists.  Cross-fertilisation, cross-breeding and the processes of evolution themselves cause mutations/variations to occur over time.  Does any serious thinker believe that any one of these variants is any less human than another?  Less humanitarian?  Less intelligent?  If you’re one of those, please don’t read any further as I’d feel tainted by the thought.

There are of course substantial differences in human beings from different regions of the earth, different countries even. Not just in appearance, in perspective, in attitudes, in practices but these are entirely cultural and have nothing to do with genetics, nothing whatsoever.

Ultimately, human beings are tribal and we are tribal for good reason.  Recognising that we are tribal is the beginning of an understanding of difference, of other.  We are referred to as social beings but many animals could be described that way because, for most of them, the genetic drivers are the same: survival.

We associate with our families and are ultimately protective of them.  Survival.  We associate with other families that we come to know, who seem to share common purpose and values.  We form societies based on various concepts (be they behavioural, geographical, political, organised by belief structures) or common interest.  Survival.

We can all think of such structures, from the extended family, to the village.  From the bridge club, to the football team.  From a religious faith, to a political party.  Our life is made up of a series of tribal/familial bonds with others who share similarities, of one kind or another.  We are naturally cautious of other.  Other, historically, has tended to be a portent of doom.  Of invasion, of subjugation, of violence, theft, rape and death.  Our genes are locked into recognition of other and of erecting protective strategies in defence of our tribe, of ourselves.  Luckily, it’s not our inclination to socialise that brings us together, it’s our common defence, of which socialisation is a tool, as it is for almost all animals.  What gives us the edge over those other animals, what offers the possibility of finding ways to overcome our fear of other, without surrendering our common or even personal defence, of thereby being able to harness and exploit other, for the betterment of our race, is our sentience, our ability to rationalise.  As a sentient, rational human being, I know that there is no earthly reason why the colour of my neighbour’s skin, eyes or hair, the length of his nose or the language that he speaks, should, of itself, pose any threat to me or my family.  Were that this was all we had to address but sadly, it’s not.

We rarely exist in one tribe, these days, as once we did.  In the past, everyone in our tribe looked like us, spoke like us, pretty much shared the same cultural views as us.  Naturally, being human, we are an inventive bunch.  We have invented plenty of divisions within each tribe such as class, gender, physical prowess, wealth and so on.  Being competitive creatures we can use this for sport and entertainment but, inevitably, it turns into distinction, identification, separation, other.  We hardly needed any external other to feed our innate s but that external “other” is orders of magnitude more threatening than anything we could create for ourselves.

Today, few societies in the west exist in such an homogeneous tribe but some smaller, constituent parts do, some towns and villages very much do.  Some whole countries do.  If we were for a moment to agree that a more enlightened, sentient acceptance of other is a good and beneficial thing to strive for, then we must agree to consider how *best* this could be achieved.  I would make the suggestion that forcing those communities, those societies to adapt by thrusting “other” upon them rapidly, in substantial numbers and without carefully thinking through of the wide ramifications that will impinge on their established and relatively undisturbed way of life, is perhaps not up there in any definition of “best” that most of us could recognise.

In short, immigration has been botched.  Both the indigenous populations and the immigrants themselves, have been very poorly served by their hapless leaders and by the structures of authority.  The damage that has been done will take decades or generations to put right and no amount of authoritarian reaction or “liberal” heart-bleeding will help.  Communities have been damaged, cohesion has been damaged, the dream of cultural integration has been, potentially, fatally wounded.

Human beings have big hearts.  Human beings recognise humanity, they recognise their brothers and sisters in different skins and with their many different tongues.  But appearing to take someone’s job, their home, their livelihood, is about as close as it gets to confirming the genetic fear of rape and pillage.  When some of those “other” human beings form themselves into gangs that systematically and purposefully, set about actually targeting and raping the children of their host nation, we have a problem.  When all the structures of authority, designed to protect society against such things collude, through fear of nothing worse than being branded racist, we have a problem.  When “the system” allows such things to carry on year after awful year, with hundreds, even thousands of young girls being raped and abandoned, we have a problem.  When we are no longer allowed to call a spade a spade, we have a problem.  When our elected politicians are hounded and forced from office for having the temerity to speak the truth on such matters, boy do we have a problem.

You might notice that I skipped over the deployment of terrorist atrocities within the host nation.  I chose instead this example of ‘tension’ in our communities, to use a consciously downplayed adjective.  Terrorism, which some would hold as clear-cut, simple and readily condemned, is potentially defensible in the minds of some.  One man’s terrorist is another’s freedom fighter.  However deluded the individual may be, there is always some tortured justification that can be conjured in his own defence.  One woman’s rapist, however, is a rapist to all men and women.  One man’s paedophile is everyone’s paedophile.  There’s no possible room for ambiguity, for justification, for defence.  This is the worst possible crime that any guest could perform in the home of their host.

Most of us get that not all Pakistani Muslim men are rapists and paedophiles.  Most of us also get that such perverted cultural and religious beliefs did nothing to stand in the way of these atrocious crimes.  Not all of us believe that, were similar occurrences to arise again – assuming of course that they’ve stopped – that our government and its institutions would behave any differently.  Personally, I am fully expecting to discover that individuals in positions of authority, did more than turn a blind eye but may also have profited and/or partaken for themselves.  Human beings are as capable of the grossest acts of indecency, wherever they originate, as they are of the most glorious acts of selflessness and humanity.  What protects us, we all know, is our culture.

Culture is formed by society, by the base constituency that inhabits the tribal domain.  We bring our children up, hopefully, steeped in that culture.  We create laws and structures to express what we believe to be acceptable behaviour in that society and we trust one another, for the most part, to be imbued with a greater or lesser degree of similar culture.  Adults do not arrive fully formed into our culture.  They arrive inculcated with their own and the fact that it is not our culture does not make it bad or wrong, as a whole.  It does inevitably mean, however, that it’s different and how great that difference is determines the scale of the challenge. If we believe our culture is reasonably well constructed, reasonably representative of the values and behaviours that we believe to be acceptable, if we believe it takes some eighteen years to fully educate our children in such ways, then we should expect to take a little time to assist those from other cultures to assimilate into ours.

I’m not suggesting that Pakistani society dictates that it’s okay to form gangs and rape young, vulnerable women on an industrial scale.  I do know that they have some pretty strange notions, though.  Stoning a girl to death for being raped, being one such anachronism.  You get the picture.  When an adult male arrives in this country, inculcated with such aberrant notions, it’s going to take some gentle and prolonged absorption in our culture before that prejudice mutates.  One could make such a case for a very long list of cultural differences amongst the populations of the world’s countries.

I, of course, choose the hard case to illustrate my point.  The hard cases are the most difficult to address and are the ones that will sink deeply into the psyche of the host population, proving all the more difficult to erase.  They are the ones it is easy and obvious upon which to gain consensus but there are a plethora of other, sometimes subtle issues, sometimes not so subtle.  This week, a headline appeared suggesting that a young “christian” (read non-muslim) child was placed into the foster care of a devout muslim family.  Pictures of a woman cloaked from head to toe in black garb, rather foreign to the western taste, accompanied the “horror story” which suggested the child will have to learn Arabic and to recite the Kor’an.  I’ve no idea how much truth (or mitigating factors) there is in the story but if there is any truth at all then it is a symptom of an authority that has no understanding of society, whatsoever.  It would provoke the same reaction as an article, featuring pictures of “Strange Fruit”, published in a Mississippi chronicle, alongside the headline “They’re coming for you!”.

Newly arrived immigrants to any country, face a range of challenges which vary in intensity, in direct proportion to the difference in cultures between theirs and their host country.  A black face in a culture which is predominantly black, raises less obvious appearance of “other”.  Some seem to think that’s all it takes to assimilate but ask any black African and he will tell you that the language that immigrant speaks, his dialect, his facial appearance, even his name, all these things label him as “other” and may to a greater or lesser degree colour the extent of the challenge he faces, in his path to integration and acceptance.  Make that a black face in a culture that is predominantly white and the scale of that challenge escalates dramatically.  Hopefully, no one is asking themselves “Why?” but just on the off chance, lets delve a little.  This could get a little hairy.

If I call a fat, black man a “black bastard”, I will be accused of racism.  If I call him a “fat bastard”, I probably won’t.  Go figure?  If I call him a “fat, black bastard”, I think I’m back in the racist camp, why?  If he wore glasses and had red hair (shock horror but it happens) then I could call him a “Fat, four-eyed, ginger bastard” and I’d be ‘okay’ but if I bring the word black back into that list, racist.  Could it be that I’m just being abusive and that as in most forms of abuse the person’s most obvious characteristics are the ones we choose to belittle so as to cause the greatest possible reaction/offence?  Correct.  Abuse is abuse and there is no need for any sub-species of abuse as there is no need for it in human beings.  Racist abuse, fatist abuse, hair abuse, spectacle abuse, it’s all just *abuse*.  It’s all offensive, it’s meant to be and for that reason, it’s just not pleasant or polite.

All of this simply reflects the unpleasant nature of human discourse by certain people, in certain situations.  It’s no different, and no less unpleasant, than the abuse delivered by a Rangers’ fan at a Celtic fan, by one boxing protagonist at another, it happens all the time in every walk of life.  It is not racism.  It is abuse. It is used by feminists and misogynists, by warring nations and Anti-Fascist “protesters”.  It’s very unpleasant.  It is not a crime.  Abuse could be deemed common assault.  It is certainly not a special category of crime, worthy of the pronoun “hate”.  We are debasing our language.  Let’s keep it simple and unadulterated.

If a bunch of thugs wants to march through the streets, shouting abuse at any particular group within our society, or indeed without, then I would cheerfully see them all rounded up and charged with being thoroughly unpleasant.  For this indiscretion, the penalty would be community service, performing good deeds for the very group they have insulted.  In the process, they might learn a little about their target group and lessen their ignorance.  I would not want to see such things designated as a “hate crime” with all the Orwellian connotations of the term.

If this same group is set upon by a bunch of masked, middle-class gangsters, beating individuals into a coma with placards emblazoned “NO MORE HATE” then please arrest them and have them charged as appropriate with Actual or Grievous Bodily Harm and make the parents pay a substantial fine whilst attending remedial parenting courses.  Folks, there is no rocket science in any of this, there’s just politically and ignorantly motivated hysteria that confuses us into thinking there has been some enormous, evolutionary jump backwards.  None of this is new, aside from the stupid words we use.  It is all evidence of the fact that “progressive societies” are no such thing.

So, back to immigration and to this much misunderstood, grossly over used and abused term “multiculturalism”.  I’ll leave you each to find your preferred definitions online but don’t blame me if you come away none the wiser.  For me, multiculturalism is an anachronism.  I view it as the opposite of integration and thereby an enormous mistake.  It’s very ambiguity is an intentional confusion foist upon the world.  On one reading, it is the goal that each nation should welcome distinctly separate cultures, to be continued and celebrated, amongst and beside diverse immigrant groups within a single host nation.  The easiest way to see it is in the modern American concept of prefixing all Americans with their sub-species as in: ‘African American’, ‘Italian American’, ‘Irish American’, etc.  ‘Native American’, not so much anymore, ‘Jewish American’, never really caught on.  Jews prefer to be called either Jews or Americans. Good for them.  I think the social-engineering consultants picture quaint little festivities, ostensibly exhibiting the supposed culture of each sub-species, whilst dressing in native costume, singing rather silly, ancient folk songs in a language no-one understands whilst stuffing themselves with salmonella-infested replicas of the peasant food of their homeland.

Here’s a thing though.  There are some 200 separate countries around the world.  Each one of them would claim at least one national culture, some of them many more.  Every immigrant came from one of these countries to his chosen (or not) host country, generally to “make a better life” for themselves and/or their children.  Their motivations may be exploitation, may be to escape war or persecution aka security but, in all cases, they see the host country as offering something their previous country does not.  So, I’ve got a radical idea.  If you prefer the culture of your country of origin, stay there.  If you prefer that of your host, move there and integrate with it.  If you yearn for your home culture and hope to return to it someday, do your hosts the courtesy of trying to fit in whilst you remain their guest.

I say this as much to white European and other ‘colonial’ “expats” in the Middle-East and Africa as I say it to Jews, Muslims, brown, black, Asian, African, eastern peoples in Western Europe or America/Canada/wherever.  To everyone equally.  If you want to put on a play or other display of art or culture for the education and enjoyment of your host, please feel free.  But please, try to integrate with your host, don’t ghettoise yourselves, don’t demand separate schooling or places of “worship”, separate structures of law and justice.  If you want to live in a Sharia country, Pakistan and others will provide for you.  If you want French to be the national language, move to France.  If you want your child to spend their life in religious supplication to Mohammed, there are many Muslim countries from which to choose, not all of them completely barbaric.  If you want your neighbour to respect your observation of the Sabbath, Israel is probably the place for you.

If you recognise that such arcane practices are what brought you to your host country in the first place, or even if you don’t but still want to obtain of all the benefits of your host country then, for heaven’s sake, INTEGRATE!

I could fill pages with anecdotes but I’ll let this one suffice.  Thirty years or so ago, I was attending some cocktail function that Barclays Bank had thrown and, presumably, they wanted to sell me something, I don’t recall.  I very much recall though, the Tanzanian guy I met there, the only black face in the room, and with whom I enjoyed ten minutes or so of conversation.  I asked him where he lived, he was clearly well educated and his English was very good and whilst many of his compatriots speak English it’s rare to hear it this anglicised, with someone not actually living here.  I assumed therefor that he lived somewhere in England.  “In the Isle of Man”, he replied.  I was more than surprised, I was actually worried for him.  The Isle of Man was/is, shall we say, not known for its progressive liberal politics and I imagined a black face in the late eighties to be something of a rarity there.  “Um, how do you, err, find it there?”, I enquired, trying desperately to allow lines to be read between.  “It’s wonderful!”, he declared. “I’m something of a celebrity on the island.  Everyone wants to be seen with me, I get invited to all the best functions, it really couldn’t be better!”.  “Are there many black people on the island?”, I asked.  “Oh no”, he countered emphatically, in case I had any lingering doubts, “I’m the only one!”.

That, right there, tells you everything you need to know about tribalism, discrimination, integration, oh and an early version of what we now call ‘virtue signalling’.  “I’m not a racist, look, I have a black guest at my soiree.  I’m so cool, ice wouldn’t melt.”.  Nobody minds one immigrant but at some point there’s a variable number that becomes ‘an army’, ‘an invasion’, ‘a flood’.  One is a celebrity, two is probably just a way of more soirees having a black guest in their number but three?  Maybe three is too many for one small, rather insular island, who can say?  One strange African face was never going to threaten an entire community, especially when that one spoke like them, understood their culture and was so highly prized and sought after.  There comes a point though where one more is one too many or too fast or too much ‘other’.  Numbers are important, speed of arrival of numbers is also important.  Assimilation or integration is crucial.  If we want, as I do, to live in a society that is tolerant of all its members, regardless of colour, ethnicity, origin, indeed effectually blind to such things, then culture is the magic glue that will bind us.  It will dispel fear and ensure faith and unity.  To suggest, to even hint at the concept that separate, disparate and rigidly maintained cultures can exist cohesively as one nation state is, at our current level of evolution, a very dangerous pipe-dream.

The children of immigrants and even more, the grandchildren, these are our future and “good immigrants” (hold that thought) have no other goal for their children than that they should grow up in the culture of the parents’ chosen host, indivisible from the society that surrounds them.  So, what’s a “good immigrant”, then.  Essentially, just as I portrayed them.  They are people who have, either by force of unpleasant circumstance or by choice, migrated to another country which provided them with an opportunity for life, security, safety and prosperity in return for honesty, diligence and respect for the laws and customs, the culture of that host nation.  They don’t have to be perfect, few humans are ever likely to be, and no migrant is likely to be any more perfect than the indigenous population.

No-one is asking that they erase all memory of their country of origin, of the culture of their forefathers.  Tales will be told at home by the old folk, handed down through generations.  Societies and clubs will be formed to celebrate aspects of their culture that are worthy of preservation.  Language and art, history and folklore, all these things are worthy.  Restaurants will add diversity of cuisine, theatre will shine a light on movement and expression. They are all the stuff of humanity, of this incredible species, this genius.

So, what now?  A country like the UK, has stored up many problems for itself that will take many years to resolve, a generation or two at least to put right but if we are to achieve even that, our government and our institutions have to effect radical change.  We have to draw lines.  We have to recognise that we have made many huge and catastrophic mistakes.  We have to do things differently, better.  The recent report by the All Party Parliamentary Group on Social Integration, entitled: INTEGRATION NOT DEMONISATION, is a welcome start but I fear that hapless politicians are never actually going to get this right.  The thrust of the report is still, “We know what’s good for you, stop griping about immigration whilst we tweak things around the edges to make us feel superior about ourselves.”.  The full report is available at

It’s not as if this is a rarity.  There have been many reports and debates in all sorts of government-led forums as well as in and by other interested groups and organisations.  It’s not that there isn’t recognition of a problem, it isn’t that it isn’t talked about but there’s scant sign of anyone willing to stand up and spout home truths.  As we’ve proved, time after time, those that do are politely asked to impale themselves on their sword and never to show their face again in public.

Let’s talk truths.  Around two hundred years ago there were a little over one billion souls on this earth.  One hundred years later there were more than 2 billion.  Today that number is estimated at 7.5 billion and we’re due to hit ten billion in around thirty years time.  Notice how population growth slipped off the public radar in the last forty years?  A very large proportion of those ten billion, will be living in countries with governments and economies much less stable than our own – and with a climate much less temperate.  Whether by virtue of poverty, war or climate change, there is destined to be a large number who are determined to beat a path to our door in search of that “better life” or possibly just an innate desire to survive.  We are an archipelago of a little under seventy million inhabitants and we are quite crowded, as things stand.  If we doubled our population, by taking in another 70 million, we wouldn’t make the teensiest dent in the numbers wanting to come here but we would make the country we know and love, totally uninhabitable in any way that any of us, alive today, could conceive.

What to do?  Well, it’s been four years now since James Lovelock, the Granddaddy of the Environmentalist/Green movement, stunned his faithful by recanting their philosophy.  In January of 2013 he said: “I am an environmentalist and founder member of the Greens but I bow my head in shame at the thought that our original good intentions should have been so misunderstood and misapplied. We never intended a fundamentalist Green movement that rejected all energy sources other than renewable, nor did we expect the Greens to cast aside our priceless ecological heritage because of their failure to understand that the needs of the Earth are not separable from human needs. We need take care that the spinning windmills do not become like the statues on Easter Island, monuments of a failed civilisation.”

He went on in related passages to describe what amounted to “hoards” of peoples from the equatorial south, beating a path to our door, in search of dry land as much as anything.  The environmentalists quickly organised a symposium of the great and the good to debate this revelation and to discuss what could be done, given this new-found wisdom.  Predictably, this being England, discussion focused mainly on, “Where will they go to school? Can the sewers cope? What about the NHS, do we need to build more hospitals?”.  No, you muppets, you missed the point.  What Lovelock was implying is that if you plan on surviving, on continuing to simply exist, then you need to build defences, walls, fortifications, you need to turn these islands into a self-sufficient fortress.  Not a pleasant thought, right?  Of course, we won’t.  It would be frowned upon, don’t you know, as is any act of survival, these days.  “Petty nationalism”, “racism”, “fascism”, “isolationism”, every epithet of “liberal” abuse would be heaped upon any such suggestion – as I risk here.  Well, I hope my Grandchildren don’t have to pay the price for such high-minded idealism but I fear they will.  How merciful that I won’t be around to witness it.

Tackling immigration?  The ideal placement of deck-chairs on a well-known and long-since-submerged, ocean-going liner, spring to mind.




By luck and good fortune, I am not the parent of little Charlie Gard whose blessed little soul deserved a better break than he got, a much better break.  I said things about the NHS when this story broke, all of which I adhere to but having studied many of the court documents and judgments in the matter, there is much I would like to add.

His parents, Chris Gard and Connie Yates, have suffered more in the past year than most parents will know in a lifetime.  They are to be commended for the love and dedication they have shown to their son.  Tales of the exhaustive effort they have both put in to his care, to their research and their fight for the justice they believe Charlie deserves, are beyond the understanding of most of us.

Would that any of us had ever tested our parents in this way or been so tested by their child, they could not have done one jot more and that is absolutely as it should be.  Charlie is a part of each of them.  He shares their Chromosomes, their DNA, their “soul” if you will.  He is of them, they are him.  We are all born with certain nature-driven forces and one of those is survival, another is the protection of our children which, with the longer view, amounts to the same thing, the protection of self, of genetic reproduction.  Charlie is as much a part of them as each of their limbs but almost as crucial a part as their very heart.

That said, and whilst I pay them my very highest respect, I do believe that they were ill-advised, poorly guided and therefore, ultimately, wrong to continue the fight as long as they have.  I’m sorry if I offend anyone, that’s not my intention.  We live in a world where amazing things are possible with the benefit of modern science and medicine.  We have become, in the eyes of our ancestors, very nearly immortal.  We have conquered diseases that have laid waste to millions in history and today those things hold virtually no fear for us whatsoever.  That’s an amazing achievement.  It leads us though into a sense that everything can be cured, can be fixed, if only we can find the right doctor, the right drug, the right treatment.

When Aysha King’s parents “abducted” their own child from the NHS hospital in Southampton that intended to treat his post-operative brain tumour with whole brain radiation, I applauded them and damned the doctors – and I do so again today.  The parents had done their research.  They had read widely.  They had discovered that there were more advanced treatments, Proton Beam Radiation in this case, that had an at least equal chance of success but more significantly, a greatly reduced potential for damage to the healthy brain tissue.  The doctors were outraged and the hospital, through the auspices of the Courts, turned the parents literally into fugitives from the law, made Aysha a hostage to fortune and denied him access to privately funded treatment in another country.  The parents were ultimately successful, as was the treatment.  There are no long term guarantees but Aysha is now a five year old happily back at school with his friends this past year or so.  It’s possible this outcome could have been achieved “the NHS way”, it’s possible not.  The point is that Aysha was as healthy and whole as any little boy could be, post the surgical removal of his brain tumour.  Proton Beam therapy had a virtually zero chance of making this situation worse, whilst attempting to kill residual cancer cells to prevent their regrowth.  Whole brain radiation *without question* kills healthy brain cells.  The noticeable extent/effect of this is unknowable on one so young but the outcomes range from fine to dire.

If this was my child, I’d have done exactly the same thing but I wouldn’t have been so nice about it.  The key issues that influence my judgment in this are:

  1. The parents’ rights over the child – in the absence of any good reason to the contrary – are paramount.  They are the child.  The child is them.  If they have weird religious beliefs, if they have less than normal intelligence, if they appear to be acting irrationally in some way, perhaps suggesting mental health issues, then there is a question which the Courts may choose to examine but in all normal circumstances, they should be respected entirely.
  2. The parents were not withdrawing the child from treatment, they wanted an alternative treatment, a better, safer treatment which the NHS could not provide in the UK – though they could have paid for it in another country.
  3. Aysha was perfectly able to be transported to the appropriate place for treatment.
  4. There was no cost to the NHS who had already declined to fund it, the parents had determined to fund it themselves – which they did with help from donations after the event.
  5. Aysha had suffered no permanent damage thus far that affected his quality of life.  Given the successful outcome of the treatment, he had every possibility of living at least a substantially extended and happy life and possibly (I hope) a very full and lengthy one too.

The same cannot be said for poor little Charlie.  When the condition was eventually diagnosed in October last year, there may have been the faintest glimmer of hope.  Vanishingly small, by January such hope was gone.  It was at this point that skilled and intelligent medics would have assisted Charlie’s parents to take the right decision, a decision that was in everyone’s best interests.

By this time however, just as in the Aysha King case, relationships between doctors and parents had started to deteriorate.  Trust had been broken, lost.  I have seen such circumstances more times in my life than I care to remember.  I’ve experienced it myself, I’ve experienced it with loved ones – children, wives, mother, friends.

Trust between a patient, or parents, and the medical team treating them is paramount to ensuring the very best care and when it’s lost, it takes a very special effort to regain.  The arrogance of many in the medical profession is not limited to the NHS but it is certainly exacerbated within the statism of that organisation.  Heroes of modern medicine like the American, Atul Gawende and our very own Henry Marsh are such wonderful human beings precisely because they recognise this character in their profession but more importantly, in themselves.  It’s a very rare thing in my experience.  Doctors are much better at disguising it these days where once upon a time they didn’t even bother.

Back in the mid-seventies, at the end of that incredible summer of ’76, my wife was in hospital preparing for the birth of our first son, Marc.  We had a close friend who was a midwife, originally from the Bronx in NYC but living close by.  As was very much the feeling back then, my wife wanted to try to go through labour without the use of drugs. On the one hand she wanted to experience the entire process in full command of her senses and on the other, she was concerned (as many were at the time and many are today) with the effect of those drugs on the ‘fragile’, soon to be born foetus.  She had made me swear that, no matter what happened, unless she was in physical danger, I was not to allow her to cave in to temptation nor to allow anyone to administer drugs, unless she specifically requested them.

Sharon, our midwife, was on another call and we had to wait for her to attend.  In the meantime a succession of nurses determined to make Paula’s time as difficult as possible.  She had explained her choice to them, calmly and rationally as they looked, one to the other as if she were quite mad.  I even recall one of them making that circular motion with the forefinger beside one temple that is often used to signal someone who’s gone a bit “doolally”.  I had explained it too, but constant efforts were made not only to encourage Paula to relent but to demean her and me, for her decision.

The labour, though prolonged was not at all problematic (says the husband) from a medical perspective.  I think the comment that got to me wasn’t the nurse’s “What’s the matter, love, won’t the meanie (me)let you take the drugs?  Don’t you worry about him, we can give it to you now, all you have to do is say the word.”.  No, it was later when the arrogant little prick of a doctor said to her, as if we weren’t even present let alone three feet away, “Come on nurse, these two seem to know more about it than we do, let’s leave them to it” and promptly left the room, never to be seen again.  I kid you not.  All this simply because of Paula’s determination to give birth, drug-free.  That may sound worrying but we both knew that Sharon wasn’t far away and we were just glad to see the back of them.  This had been a day we had both looked forward to for so long and for the last two hours they seemed to have had no other objective but to make the whole process a misery.  Sharon arrived, she was a diminutive, beautiful angel of a thing with her movie-style Bronx accent, her humour, her compassion and her professional skill.

Marc Alexander, all ten pounds of him and a future PhD (yes, I’m proud) emerged crying into the beautiful September dawn and I was speechless with delight, with awe and wonder.  We hugged, we laughed, we cried, we danced, the four of us, alone in our little cell with not a doctor or nurse in sight.  It was one of the most incredible days of my life.  I would have fought a wounded tiger to save that child.  I would have picked a fight with every member of the hospital staff if I thought it necessary to defend my wife and child.  I do understand why Charlie’s parents felt the need to fight for him and why they felt as if they ended up fighting the entire world.

My tale is one but many of such tales I can tell but this one relates most closely to what Charlie’s parents had to face, albeit in comparatively benign circumstances.  Alone in a foreign world that operates in a foreign language, dependent on those with far more knowledge than you, when you and your loved ones are at their most vulnerable, ever….that’s hard, and we usually feel we have to yield, even when we don’t agree or we’re simply not sure or uncomfortable about what’s being said and done.

For those of us who question, who don’t accept that any individual has all the answers in any situation, life can become difficult.  I learned early on and I practiced this in the tale I related above, that it pays to smile, to be polite, to ask nicely, to always appear open to persuasion, to never appear absolute.  In most walks of life, it comes naturally to most of us but I’m describing something closer to grovelling.  In situations like this, it comes hard and it grates but usually it makes things easier and often achieves success, though not during Marc’s entrance into the world, it must be said.  The question is, why do we feel the need to have to put on such aires and graces?  “Do you think that….?” “Could it be…..?”  “Might it not be….?”  It’s to counter arrogance.  That simple.  It’s demeaning and disgraceful that I should feel I have to do this but if you ever needed evidence, it’s there in every NHS building: “We have a policy of zero tolerance to abuse!  You will be summarily executed if you disagree with any member of the staff”.  Well, ok, I added that last part but the implications are clear.  As a member of NHS staff, I can say, do or not do anything I like but don’t you dare react to the persistent prodding of my finger in your chest, for if you do, there’ll be hell to pay.

It’s all pervasive this sense of entitlement, of superiority, of higher knowledge.  I don’t get it from my window cleaner, I don’t get it from my taxi driver, I don’t even get it from my highly paid private doctors, so where on earth does it come from, why is it there and what do we have to do to get rid of it?  Well, it all comes down to the fact that the healthcare we receive in the NHS is “free” and we should be grateful for what we’re given.  You’ll rarely heard the words said out aloud but it’s there for all to see.

You disagree?  Many do, this indoctrination is seventy years old and backed up by centuries of cultural superiority.  It is ingrained in the British psyche and has become as deep and blind a faith as any that theistic religion has to offer.  Let me put it to you this way:  If Charlie Gard was being treated in a good private hospital and the parents had asked for him to be referred to another doctor, in another hospital, in another country, neither the hospital nor the doctors would have had a moment’s hesitation in picking up the phone and making the arrangements – all at the expense of Charlie’s parents, naturally.  The very last thing that would have crossed their minds would be to contact the lawyers and start Court proceedings.

It’s not the medicine, you understand.  Most doctors working in private practice earn their ‘basic’ living from the NHS and most of the nurses are moonlighting via the agency or were trained and practiced in the NHS – some continue to exhibit many of those tendencies in private practice.  It’s the institution, the institutionalisation of mind.  The NHS is the first Nanny of the Nanny State.  Doctor knows best, sit there patiently [sic] and be a good boy.  We might talk to you when we think we have something you might understand, impoverished, uneducated wretch that you are.

You impune their intelligence, their position, their character when you suggest, with all the palliative, cringing words at your disposal,  that there might just possibly be another way?

Another tale, it occurred a few years after the first, late seventies now.  Paula called me at work to tell me she was in extreme pain, she’d done something to her back.  She assured me she’d be fine and she’d just take some painkillers and lie down.  When I got home I discovered that she had taken to crawling on all fours as she found it that painful to stand, let alone walk.  I determined to take her to the doctor first thing in the morning, completely forgetting that it was the Easter weekend and, naturally, because no one ever gets sick outside of office hours, the surgery would be closed.  When I called I discovered that Paula’s doctor was actually pulling a shift at the local cottage hospital over the holiday and I spoke to to him there, on the phone.  He said I should bring Paula to him as he couldn’t leave the hospital and advised me that no ambulance would be available, because it was Easter, don’t you know, and this wasn’t an emergency.  I explained that we lived in a cottage that had no vehicular access and that half of the path, of some two hundred yards to the road, was up a very steep incline.  He left it to me to figure out the where’s and whyfores but he was there “if she wants to see me”.  It was obvious to me that Paula was walking nowhere and after scratching my head I remembered I had a sack barrow at home – you know, the kind of vertical trolley used in marketplaces and warehouses to move packages and, well, sacks around.

I explained the plan to Paula.  I warned that once I started up the hill I’d have to keep going and that was going to mean me taking a potentially very frightening run at the thing, to gather momentum, you understand.  She looked terrified but her existing pain was worse than her fear so she agreed.  It was painful, but she managed to bring herself upright at the front door, stand on the rung at the bottom and lean backwards when I said, ‘when’.  Thankfully, she probably weighed no more than eight stone, a teensy bit less than me at the time.  I figured, “You can do this, Robin, you can do this!”.  We set off. When I was about twenty or thirty yards from the start of the incline I wound up my pace until I was literally running, full pelt.  I wish I had been in front, so I could have seen what I was certain would be a look of abject fear on Paula’s face!  The momentum, of course, was nowhere near enough but somehow my legs and arms found hidden resources from where, I do not know, but we made it to the top of the slope and I collapsed, breathless and in considerable pain, at the roadside.

At the hospital we didn’t have to wait too long to see the doctor.  His name escapes me but, I promise, I would happily publish if it comes to mind.  He and Paula went into a room for the examination whilst I, as was more than customary at the time, sat outside.  After ten minutes the doctor came out, Paula propelling herself behind in the wheelchair she’d now been supplied with.

The doctor turned to go back into his office, with no intention whatsoever of addressing me.  “What’s the verdict, doctor?” I enquired, politely.  “I’ve told your wife”, he responded in that matter of fact voice that intones “as if it was any of your business”, “She’s slipped a disk.  There’s nothing can be done except rest.  She needs to go to bed for at least six months and do nothing strenuous for at least ten years.”  You’ll think I’m making this up, I promise you, every word may not be 100% accurate but the absolute sense and the approximate wording I have related, is precisely what he said.

Meaning it as a genuine enquiry, and in the most decorous and delicate tones, I requested his opinion as to “What do you think of the benefits of Paula being seen by an Osteopath, doctor?”.  His face reddened, instantly as if I had pressed a button that flushed blood from a bucket into his veins.  His brow furrowed, his jaw tightened and in a low voice, but leaving no room for doubt, he determined, “If she see’s an Osteopath, that’s the last she sees of me!  I’ll have nothing more to do with her”.

Now I’m not proud of this but I was young, in love with the mother of my child and in my late twenties, by which time I had come across all sorts of people in life, from angels to pompous gits like him.  “You know what, doctor” looking him straight in the eye from a very short distance, “that’s absolutely fine with me.  You can fuck right off because over my dead body will you ever come near my wife again!”.  I grabbed Paula’s wheelchair handles and pushed her straight out of the hospital without a backward glance.  It was a small hospital, very small.  I became aware that I had shouted rather louder than I intended as, in one of those movie moments, everyone around seemed to have paused in mid air, stopped whatever they were saying or doing and had fixed their gaze on us, mouths mostly agape, as I pushed doggedly forward with my own gaze fixed firmly on the door to the outside world.

It just so happens that one of our customers was an Osteopath.  It also happens that he is widely regarded, by his peers, as the best Osteopath in the whole world, that has ever lived or is ever likely to.  He’s quite special.  He is in his seventies today, still in practice, still training others who flock to be trained by him and still available to me and my family on the odd occasion I have need.  Stuart saw Paula once, in the day or so that followed.  She may have had one or two subsequent consultations.  She was immediately able to walk.  Within a week she was back at work and has, more or less, never looked back.  I say that, perhaps more glibly than I should, as we haven’t been together in twenty-five years but let’s put it this way, she didn’t go to bed rest at all, let alone for six months and she was being her normal hyperactive self within the week.  Best prognosis a doctor ever said to me and he was spot on, she never did see him again.

What does all this have to do with our young Charlie?  It’s the epitomy of the arrogance I am trying to describe.  I am also trying to contrast it with the incredibly high esteem in which I hold those doctors and practitioners whose feet, frankly, I’m not fit to wash. None of them would ever display the traits I am writing of, any more than they would eat their own flesh.

Medicine is a science but much more than that, it is an art. The Art of medicine.  Anyone with intelligence, aptitude and application can learn the science of medicine.  If you can write text books to describe it, then almost anyone could learn it.  Learning medicine is one thing, learning to be a doctor is quite another.  Much as some would like, one cannot divorce the patient from the condition and treat only the condition.  One must also treat the patient and to do that we have to communicate with them, we have to learn and understand a little about them, we have to get them on side because, quite literally, we are in this together – the patient and the doctor.  When that patient is a small, totally inarticulate, barely sentient child, the parent combines with the child in any definition of “the patient”.  It is therefore the parents with whom that skilled communication is now required and to whom it must be directed, in the clear knowledge that it is they, not the doctors, that have life-threatening decisions to make.  The doctors are there to inform, educate, advise, to guide, to coax.  In some cases, especially like this one, to use every psychological tool in their toolkit to bring the parents to a conclusion which, whilst inevitable to the doctors, is quite simply the last thing, literally the last thing, that any parent can bring themselves to.  In short there are times when to allow life to end, even to assist it indirectly, is “the right thing” to do.

When Charlie was diagnosed in October, was not the right time.  If, and I say this in full knowledge of the pressures of time and resource that exist within the NHS, some bright doctor had dedicated the time to Charlie and applied every effort to the research required, they may have come up with the potential treatment we’ve all heard so much about, at an earlier stage.  The Court documents show that Charlie’s doctors did indeed go to great lengths to consult widely and internationally.  All credit to them.  But.  As someone with long experience of such matters, that is: of what some people consider to be speed, application, diligence, devotion on the one hand and what I consider to fit that description on the other, there is a yawning chasm of difference.  In a different environment, with different people, given a different ethos, it’s just possible more could have been done.  I say all this, in the full knowledge that the only treatment available may have had little or no effect.  I make the point simply that looking into something is not what matters, it’s the vision, the speed, the diligence of that research – knowing there’s a steam train coming down the track – that makes the difference.  Do I think Charlie’s doctors at GOSH (Great Ormond Street Hospital) could have done more in this regard?  Probably not, not in that environment, with that ethos.  I don’t blame them one iota for that.  I think, given the limitations of a free-at-point-of-use, socialised,State healthcare-system, they did probably more than can reasonably be expected of them.

As I understand it though, there came a point in January, at least by March, when it was clear that a) Charlie’s condition had progressed beyond repair (brain damage) and b) No magic treatment was coming down the line to reverse that, or even to halt the progression of the disease.  At that point, Charlie became quite frankly, irrelevant.  The challenge for the doctor’s, the hospital, the “authorities” in general was to treat the parents.  To treat them with all the care and compassion possible, yes, but to treat them psychologically to bring them to the right place for them to be able to take that last, that impossible decision.  They alone now needed the full professional resources of a caring compassionate health service but as I understand it, the trust had gone.  That fragile but essential gift shared by doctor and patient, it was gone.  I cannot know how, what events or misunderstandings brought that about but I can say this with complete certainty.  It was that loss of trust that brought this whole sorry sage to the Courts, time after time.  It was that breach that caused Charlie’s parents so much agony – not to mention all those involved in Charlie’s care and let’s not forget how harrowing this must have been for both sets of lawyers and for the judge – as they fought tooth and nail to protect their offspring, convinced that GOSH was no longer working in their shared best interests.

Where trust is lost, where there is a breakdown in this precious bond, there is responsibility to apportion.  I don’t say ‘blame’ but responsibility.  If nothing else, a need to go back over the proceedings in exquisite detail, to learn the lessons, to make plans to avoid the same thing occurring in the future.  There’s a need to adopt some humility.  To ask themselves, each one of those involved, what contribution they may have made and how they can be better ‘next time’.

I can’t tell Charlie’s parents what they should or should not have done.  I know without hesitation what I would have done and I believe it would have been the best thing his parents could have done.  I would, in January, have accepted the futility of the fight, found a way to come to terms with my loss and asked the hospital to switch off the apparatus that was sustaining Charlie’s physical functions.  I say this without a scintilla of blame for Chris Gard and Connie Yates.  I’m saying what I would have done and what I wish they had done.

As for the legal process, having read extensively, I stand proud to live in a country that can demonstrate such a rigorous, compassionate, fair and cautious judicial approach to such a complex and emotional situation.  I have only praise for the judge, whose written judgments read as if they had been considered and the issues dissected by Solomon himself.  I have linked both the first judgment, gosh-v-yates-and-gard-20170411-1, dating back to the hearing in April, and the second gosh-v-gard-24072017 on 24th July.  I would like to commend the lawyers on all sides, especially those who worked pro-bono for Chris and Connie.  It’s an obligation for me to point out that without them, these parents would have had no recourse to legal aid and thus would have had to rely on their own representations.  I am not angling for taxpayers funds to be used in situations like this, any more than they already have been.  I was particularly struck by the Great Ormond Street Hospital position statement at High Court on 24 July 2017 prepared by Katie Gollop, QC on behalf of GOSH, which is deeply thoughtful and considerate, in all the circumstances.

There is no good way to end an item like this, other than to say that we all do the very best that we believe we can in this world, Charlie’s parents, lawyers, judges, doctors, nurses, all of us.  Sometimes all of that cannot save each and every precious life on this planet and we all have to be realistic about that.  In the wider context of life on Earth, we are all very small, very fleeting and very, very insignificant.  Our thoughts must be with Connie and Chris.

RIP Charlie Gard 28th July 2017