And in a certain sense, the promise of the Enlightenment has been triumphantly fulfilled in our modern societies—surely as regards natural evil…We live lives cleaner, more comfortable, and freer from pain than those of any people who have ever existed.

Nor can one say that no moral advance occurred because of the Enlightenment. Just as we are freer from disease, so, too, our mental lives are freer. Of course, dictatorships over thought still exist in the world, but they are on the defensive and have come to seem somehow unnatural. Freedom is now the default setting of human thought. No one can tell us what to think, say, or write, at least not without our consent.

But an uninvited guest has arrived at this banquet of human advancement: evil. Whether men behave better or worse, individually or in the aggregate, than they did before the Enlightenment, is probably a question that we cannot answer approximately, let alone definitively. But what is certain is that moral evil has not only failed to disappear but has taken on a more deliberate, calculated character. Whereas the torturers of Damiens did their evil unself-consciously because it was the natural or preordained thing to do, modern evil is done after intellectual reflection, divorced from any tradition that might guide conduct.

Dalrymple’s latest BMJ contribution is an account of how Graham Greene (temporarily) found the ability to enjoy life thanks to a battle with fever on a trip to Liberia.

No crisis should ever be allowed to slip by without calls for greater public expenditure of doubtful worth, and the Gulf oil spill crisis is no exception to this golden rule of bureaucratic opportunism.

In an editorial in the New England Journal of Medicine for 11 August, titled “Moving Mental Health into the Disaster-Preparedness Spotlight,” Drs Yun, Lurie and Hughes (the latter a lawyer, it seems) write: [‘]Surveillance systems for mental health and substance abuse must be strengthened through broader intellectual investment in a conceptual framework and technical requirements.[‘]

Long experience of bureaucracies has taught me to mistrust language such as this. There is a lot of connotation in it without much denotation: intellectual investments, conceptual frameworks and technical requirements escape from verbiage generators like oil from defective wells, and end up being even more expensive. Personally I am not sure that technical investments, intellectual frameworks and conceptual requirements would not be at least as good, if not better.

In this week’s British Medical Journal, Dalrymple says Henrik Ibsen’s portrayal of syphilis in his 1881 play Ghosts was suprisingly accurate.

It is not a literary masterpiece, perhaps, but it is vivid in its description of the daily struggle to survive and of the compromises people were obliged to make. Dr Lewis does not paint himself as a hero; rather he comes across as something more precious in everyday life: a decent man.

Another funny Second Opinion column at the Monday Books blog dedicated to the book, this one focused on the many excuses his patients used to defend their behavior.

Dalrymple in the Daily Express:

THERE are few accusations more damning in today’s climate of opinion than that of being a killjoy.

To be a killjoy is to be narrow-minded, bigoted, puritanical and authoritarian. No one then wants or dares to prevent what others find enjoyable.

However it remains true that the joy of some should not be the misery of others and there is little doubt that public drunkenness in Britain now reduces the quality of life of millions of its citizens…

The one thing that many environmentalists seem not to care about is the environment. By this I mean its visual appearance. They would happily empty any landscape or any city of beauty so that the planet might survive. Like the village in Vietnam, it has become necessary to destroy the world in order to save it. And, of course, destruction of beauty has the additional advantage of being socially just: for if everyone cannot live in beautiful surroundings, why should anyone do so? Since it is far easier to create ugliness than to create beauty, equality is to be reached by the former rather than by the latter.

What was it that Anna Kavan [author of “Julia and the Bazooka”] liked about heroin? It was the blunting of her own awareness…I have never read a better account of this blunting, deemed desirable by her, than in her short story “Fog.” Told in the first person, it describes how she drives a car under the influence of heroin: “I felt calmly contented and peaceful, and there was no need to rush. The feeling was injected, of course . . . helping me to feel not quite there, as if I was driving the car in my sleep.”