Dalrymple’s September 14th BMJ column (subscription required) is a comment on the novel Moon Tiger by Penelope Lively. The two most interesting items therein are his statement that he once almost died…
It is common wisdom that your life passes before your eyes like a video as you die, but I am not sure how this can be verified. My life certainly did not appear before me in this fashion on the only occasion I was ill enough to be thought close to death; but I was still a young man who perhaps did not really believe that he was dying. Alternatively, I wanted to protect myself from seeing the expense of spirit in the waste of shame that so many lives can be made to seem.
…and this commentary on informality:
Because [Moon Tiger] was written a quarter of a century ago, there is one humiliation that the nurses [of the novel] do not inflict upon their patient. Although when her visitors arrive they will say in front of her that, “it’s one of her bad days, you never know, with her,” they still never call her by her first name. They always address her respectfully as Miss Hampton. Nowadays it would be by the first name or, worse, a diminutive of the first name.We are told, and even taught, that this informality is friendly and patients like it. But an acquaintance of mine became Mr Smith rather than Bill the moment he crossed over from being an NHS patient to being a private patient, which suggests that modes of address still mean something even today. Unsolicited informality is therefore an expression not of friendliness, but of power and a desire to keep people in their place.