A recent piece by Dalrymple in the Telegraph highlights the difficulty of determining the efficacy of breast cancer screening, and in the process, reveals the difficult questions doctors confront on a wide range of issues:

I remember going once into some detail with a patient about the pros and cons of treatment of his condition, and asked what he wanted.

“I don’t know,” he replied. “You’re the doctor. You decide. What would you do?”

A perfectly reasonable question, and a perfectly reasonable attitude. After all, you go to the doctor for advice, not to be presented with a series of conundrums without unequivocal answer.

But what would I have done? I couldn’t answer the question because I didn’t know, never having been in the patient’s shoes. Besides, even if I had been in his shoes from the purely medical point of view, I still wouldn’t have been him.

In the end I advised him to take the treatment, though to this day I am uncertain whether I was treating his condition or my anxiety.

With British public finances under strain, Dalrymple suggests the government consider the fiscal benefits of a change in policy that he has long argued the country already needs: tougher sentences on criminals.

The majority of crime is committed by a small proportion of the population; our prisons are full of recidivists and statistics show that by the age of 39 most criminals stop committing imprisonable crimes.

The implications for a sensible sentencing policy are obvious; and such a policy would decrease rather than increase costs because it is cheaper to imprison someone for five years at a stretch than for five years in ten six-month sentences. The legal aid bill would be much reduced because there would be far fewer cases to defend. Indeed, if one asked on the question of leniency “Cui bono?”, the answer would be the lawyers far more than the criminals.

How optimistic is he about such a policy change? I bet you can guess.

Read it at The Times (subscription required)

In City Journal Dalrymple examines the work of Banksy, a British so-called street artist who has apparently acquired some renown in the art world with his pointed, unauthorized paintings on public property. In one of those instances where criticism is made more powerful by a willingness to recognize non-prevailing virtues, Dalrymple acknowledges Banksy’s talent:

He is highly intelligent and undoubtedly witty. Some of his productions make you smile, and others make you laugh; his implicit criticisms of society can be trenchant, especially if you know the British context. He can sometimes suggest quite a lot with economical means.

There follow several specific examples of what Dalrymple considers succinct, witty works of satirical depth. Nevertheless, these aspects are outweighed by other, more damning characteristics:

Consider the cover of his book Wall and Piece, now in its 37th printing in the United Kingdom alone, which shows one of his most famous images: a young man, his baseball cap worn backward and his mouth masked, in the pose of a thrower of a Molotov cocktail but throwing a bouquet of flowers. The image suggests what is clearly untrue—namely, that such young men are generally peaceful. You wouldn’t survive long on London’s meaner streets if you took this suggestion seriously. Inside the book, by the way, Banksy has characteristically attempted to have his cake and eat it, too, inserting a statement that reads, “Against his better judgement Banksy has asserted his right under the Copyright, Designs and Patents Act, 1988 to be identified as the author of this work.”

….

Despite his wit, Banksy’s sensibility is both conventional and adolescent. Evidence of his conformism is that all his targets are easy and of the sort chosen by the lumpenintelligentsia (which does not, again, mean that they are necessarily unworthy)…

This worldview is that of the eternal adolescent, ever eager to shock the grown-ups with his supposedly contrary views, cleverly and uncompromisingly expressed. Truth comes a distant second to effect.

There are fashions in thought, as there are in dress, that appear bizarre to later generations. Such, surely, will be the fate of the prolonged fashion for psychoanalysis, a procedure still in vogue in countries such as France and Argentina. Never was such an edifice of theory built upon so slight a foundation of fact.

While in Paris recently I bought a brilliant book by an historian, Michel Borch-Jacobsen, Les patients de Freud (Freud’s Patients). In it he traces the fate of thirty-one of the great man’s patients. The result is so damning that I could not help but wonder whether the author’s attitude to Freud determined his evidence more than his evidence determined his attitude to Freud.

I think the latter. Freud emerges from these pages as an unprincipled scoundrel, a serial liar, a man whose egotism extinguished his regard for truth, and a most negligent practitioner, faults that no amount of talent or brilliance (both of which he had) can excuse. Nor does this list exhaust his vices.

Some of his mistakes, it is true, were caused by bad luck. For example, it was bad luck that the first description of a crisis of porphyria provoked by barbiturates was published by Hermann Breslauer, a friend of Freud’s first collaborator, Josef Breuer, only a few weeks after Freud’s patient, Mathilde Schleicher, died of such a crisis provoked by Freud’s prescription of barbiturates.

But Freud repeatedly claimed that his methods had cured patients when he knew perfectly well that they had not. This was a habit he developed early in his career.

Perhaps the most scandalous case is that of Ernst Fleischl von Marxow, a brilliant pathologist and physiologist who became a morphine addict after his thumb became infected during a post-mortem and was afterwards amputated. Freud had read in the Detroit Therapeutic Gazette that cocaine could be safely used to withdraw morphine from an addict, not realising that the Gazette was more promotional literature than medical journal (its editor, George S. Davis, was co-founder of the Parke-Davis pharmaceutical company that manufactured… cocaine).

Freud treated von Marxow with both oral and sub-cutaneous cocaine, and then proclaimed – in print – that it had been a great success, though he knew perfectly well that von Marxow had remained addicted to morphine and became addicted to cocaine. And he never retracted his false claim, far from it.

More shocking still, Freud borrowed money from von Marxow, who was very rich, and then wrote to his own wife, ‘Perhaps he will no longer be here when we shall have to think of repaying him.’ Almost as bad was his response to an article by Albrecht Erelenmayer, who subsequently tried to treat morphine addiction with cocaine and reported failure. Freud replied that Erelenmayer failed because he used sub-cutaneous rather than oral cocaine, though Freud had done the same with von Marxow, and had even said so in print.

Why did Freud, a brilliant man, resort to this unscrupulous behaviour (to put it mildly)? I suspect that it was because he was so desperate for fame, preferably as a result of a dramatic coup, that he disregarded truth and scruple altogether. The story of Freud and von Marxow brings irresistibly to mind that of a certain triple vaccine and its supposed causation of childhood autism.

Copyright 2013 Anthony Daniels.

The hilarious pessimist responds to the whining of the publicly-funded arts brigade:

On 16 May, the sculptor Anish Kapoor was reported to have complained vociferously of the stinginess of British government support for art compared with German. He delivered himself of a somewhat sweeping statement:

In Britain, traditionally – at least since the Enlightenment – we’ve been afraid of anything intellectual, aesthetic, visual.

Let us pass over in charitable silence this thumbnail sketch of our national mental existence since the beginning of the 18th Century. Let us instead remark on the artist’s locus standi to pronounce on such questions: for he is one of those many modern artists who would add considerably to the beauty of the world by desisting from their activities.

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If we must have publicly-funded art, as seems to be inevitable, let us at least have as little and cheap as possible.

At Pajamas Media Dalrymple looks at a recent study on in-flight medical emergencies:

The presence of a physician on board (as there was in nearly half of all flights), or at least of one who came forward to give assistance, made it more likely that an aircraft would be diverted to the nearest airport. Oddly enough, the patient was no more likely to be hospitalized on arrival after assistance by a doctor than when there was no doctor on board, suggesting that doctors on board had either cured their patients by the time of landing, or tended to overestimate the seriousness of the cases. Oddly enough, passengers who were assisted by flight attendants were considerably less likely to cause the aircraft to divert or to be hospitalised on arrival. The authors do not try to explain and make no comment on this.

At the Library of Law and Liberty Dalrymple expounds on the need to guard the boundaries.

Modern man seems unwilling to accept any inherited limits or boundaries, which is to say any that he has not set for himself or that cannot be justified by a valid argument starting from an indubitable Cartesian point that he acknowledges as such. I suspect that this unwillingness is the consequence of the mass rise in self-importance, but that is by the by. Since we live in a social and even physical world composed more of continua rather than of categories, it is not surprising that limits and boundaries tend to dissolve under this intellectual regime: not any given limit or boundary, be it noted, but limits and boundaries as such.

I’m sure we’ve all, in our voyages into the world of electronic discourse, observed the truth of these statements:

It astonishes me how many people take insult for refutation. They think that if they call someone a name – fool, for example, or dupe – they have successfully disposed of his arguments.

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The internet seems to have reinforced the human tendency to resort to the ad hominem.

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The spread of education has done little to raise the tone of argument, or the internet to improve its temper.

Read the whole thing at the Salisbury Review site.

In the New Criterion Dalrymple reviews a recent Paris exhibition of the work of Chinese painter Yue Minjun, whose paintings depict the false, forced smiles of Chinese victims of oppression:

…there is nothing of hilarity or amusement in the laughter he depicts. Rather, his works are full of desperation and terror which are signalled in more than one way. Expressions are uniform, as in the figures in the paintings, only where there is fear or intimidation, by whatever force or for whatever reason. Where there is freedom, there is difference; uniformity implies coercion, whether it be political or other. We should be ill-advised to adopt the complacent view that such uniformity can be produced by, or exist in, only totalitarian regimes; for in our own increasingly over-regulated, fearful, and risk-averse societies, where in many places we fear to say what we think and even have begun to fear to think what we cannot say, the mask of uniformity is beginning to cover our faces. Yue pictures suggest a world in which mental, if not of physical, cloning is being attempted.