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Derek Best has contributed to several publications, including Macleans Magazine Canada, and Omni Magazine, USA. He is has also produced many documentary films for Television. For many years, he has been interested in A Course in Miracles, a metaphysical thought system, and maintains the official website for that organization. "ACIM", he says "is central to my personal way of seeing the world." This site is strictly personal however. Derek has an eclectic range of interests, and writes about them here as the mood strikes him.

Sunday, October 29, 2006

Are You Serious?

Someone contributed a comment about my last post which perhaps deserves a post of its own. This is what it said:
I have been reading the Q and A section that you provide, well done. However, in one question you answer by stating that the Gospels are unreliable, yet Helen and the Course are reliable. Are you serious? Please tell me that you don't think that only Helen can be inspired. Please tell me that you think the apostles, who traveled and live with Jesus are not less reliable than the Course. To be honest, even while studying the Course, I still only see the "dialogue" of Jesus as a metaphor. I highly suspect that any actual "dictation" actually took place. The fact that you seem to want to disparage the long standing accounts in favor of your own makes the Course suspect to me... Anonymous. (Empasis added)
Dear Anonymous: First, please let me clear up something. I am the webmaster for the FACIM Question-and-Answer website, but that does not mean that I write the answers, and it does not necessarily mean I agree with them. The metaphysics of the Course takes us into uncharted territory where the likelihood of a perfect consensus is small. In this case however I do agree with the answer. You seem to be experiencing some conflict about this issue. It is as if you very much want to embrace a new idea, but are unwilling to do so because it would violate other dearly held beliefs. I notice the "Tell me it ain't so" structure of your comment.

It may well be that the bible and traditional Christianity are the best path for you. The Course is not for everyone, and it makes no sense to anguish over its perceived inadequacies if another way works better for you. The same underlying message of love is the basis for many different spiritual practices. This is one case where the destination, not the journey, is important.

It is actually quite common to encounter people who have a problem with the credibility of the Course because it attempts to correct (and frequently contradicts) traditional Christian teachings. A lot of the questions on the website are about just this issue, which seems to keep cropping up no matter how often it is discussed. It is important to note that sometimes (not always) this can be a sign that the student is starting to adapt to the new thought system, since no-one defends themself against a threat they do not perceive as real. If a student finds himself defending his established way of thought, it is possible the newer ideas are starting to seem valid to him.

In all compassion, one cannot and should not make light of this confusion. In Judeo-Christian cultures we are raised with a firm and authoritative world-view from our earliest formative years. This is not a matter of lifestyle or taste, like preferring Coke over Pepsi, or classical music over jazz. People can change their tastes in soda or music without a major crisis -- but it is much harder to change fundamental convictions about who we are and where we come from. Imagine if I asked you to change your beliefs about who your parents are. I am sure you would tell me I was crazy, because you "know" what you "know" to be "true". For many people, the fundamentals of Christianity are the unshakeable ingrained kernel of what is "true". It's what they "know". Everything else must be twisted to fit. Not to get too sidetracked -- but with the creationism issue for example, we see the tremendous power of what is "known" overruling all evidence to the contrary.

In our culture and in our very language, the word "gospel" is synonymous with "truth". How can the truth not be inspired? So how can the gospels not be inspired?

Well of course they are inspired. As a matter of fact I was driving on a long highway trip just yesterday and my car radio found a Christian station which was broadcasting a bible reading of Luke: 7, 8, and 9. It was fresh, riveting, relevant, and (for me) deeply moving. It was inspired! But a nagging thought ran through my mind... Was it moving because it was inspired, or was it inspired because it was moving? Don't dismiss that question as pedagogical too quickly. I think we all have favorite works, or poems, or songs, or stories that simply cut through all the layers of crap and reach us on a core level, bringing tears to our eyes or a shudder to our body, with a profound sense of having uncovered the naked soul and brought us face to face with an eternal truth.

For devout Christians the gospels always have that power. For instance:
Love your enemies, do good to those who hate you.
For devout Muslims it is the Koran that has the same effect:
Do not say, that if the people do good to us, we will do good to them; and if the people oppress us, we will oppress them;
but determine that if people do you good, you will do good to them; and if they oppress you, you will not oppress them.
For Taoists it might be "The Way" of Lao Tse
Respond to anger with virtue. . .
... and so on. Or there need not be any religious association at all. Some people are profoundly inspired by Aristotle, or by Brahms, or by Carvaggio, or John Cage, or Henry Moore, or Maya Angelou. There is a way into any subconscious past any defenses. It is simply more likely to be carved out during formative years ... that's why they are called formative. So to come back to your comment, and your question -- can only Helen (Schucman) be inspired? No of course not. Whoever or whatever has the power to reach you and feel like core truth is inspired, including Helen in my case, and also including the gospels. This is if we accept the definition of "inspired" as being "able to speak the truth to us on a profound level. Since the exact color, flavor, or language can vary, it is obviously the message that matters, not the packaging. The Course clears this up near the beginning with the well-known words:
A universal theology is impossible, but a universal experience is not only possible but necessary
Think of the theology as the packaging or "form", and the experience as the message, or "content", or more simply "truth". To re-phrase this a little: "No matter how it is delivered, the truth must always be the same."

But with respect: what seems to cause you some anxiety is your definition of the word "inspired". If I understand your comment correctly, you feel that "inspired" means the physical source of the message must be directly attributable to Jesus of Nazareth. Thus the new testament would be inspired if the words were handed down directly from the mouth of Jesus (via various scribes, apostles, oral re-tellings, and translations). Helen's words could not be inspired because she obviously never met Jesus of Nazareth and she never knew anyone who did meet him.

In this sense you are technically right, but that rightness comes with some problems. First and foremost: by definition you are saying that the Koran - the words of the prophet Mohammed - is not inspired. Likewise, nor is the Talmud, nor is the Book of Mormon, nor the Bhagavad Gita, nor any other so-called "holy book." To get around this you would have to re-define "inspired" to mean - having come "from God" in some way. Jesus is presented in the gospels as being the son of God, thus he spoke for his Father, thus his words were obviously "inspired", however God also spoke directly to Mohammed, so the Koran is inspired too. He also spoke directly to Moses, so the ten commandments are inspired, and so on... All "holy books" might be said to have originated with God and reached us through some divinely chosen voice or scribe.

But that of course would also allow the Course to be "inspired". I do not see how you can have it both ways.

It does not "prove" the Course was inspired, of course. Helen could have made the whole thing up as you imply. For that matter so could Moses. Those who knew Helen felt her to be completely sincere and without any motivation to do such a thing. Her struggle spoke for itself. But let us assume the worst: let us assume that one day Helen conceived an idea to write a fictitious spiritual book, which would occupy her the rest of her life and for which she would receive no material reward. Suppose she did make it up as she went along. Suppose her local hairdresser told her what to write. Suppose her dog told her what to write. Or suppose, more realistically that she wrote whatever came into her head. Does this mean the words were not "inspired"? As a Christian you surely believe that God is the ultimate author of Heaven and Earth? God could speak to Helen (or Helen's dog) as surely as God could speak to Mohammed or Jesus or Moses ... or Beethoven or Mozart or anyone else with seemingly divinely inspired abilities. Did Mozart hear God? We can never know. If he were here today he would probably say he heard "music" ... but that may be how he heard God. Helen said she heard an "inner dictation," and perhaps that is how she heard God. No, you may say, she heard nothing. It was all an invention. But It is a challenge to understand how we can invent anything without first conceiving it and manifesting it in our minds, and there is no reason to believe we are the sole agent of that process.

Similarly, there is no reason to think that God should take a particular form - such as the spoken word. Do we really think God has a mouth and a larynx, and speaks English? Or do we really believe God is a great piano and came to Mozart in the form of concertos? Are we not in a sense limiting our own creator? This kind of thinking is called anthropomorphization (thinking of "Him" as a being with human or superhuman motives and characteristics). Indeed that is one of the major problems for those coming to the Course from traditional Christianity: they tend to interpret the word "God" in just this way, because that is the concept the Church tends to instill, and they think that what the Course is teaching is that God is still a "father", however not a wrathful vengeful disciplinarian father, but a kind, loving father, who wants us all to go home and be happy together in his nice house. Initially, this kind of metaphor is necessary, to understand the corrections to Christianity the Course would have us learn. But as we move away from the need for comforting human-like entities, and neat divisions of mind into little flow-chart boxes, we reach the deeper levels of pure un-utterable beingness where all form is unmanifest and only love exists. We say God is, and then we cease to speak. "We" has no more meaning.

Personally I think it is highly likely that people like Jesus of Nazareth and probably others have naturally understood this, and have had (if you will pardon the expression) only one foot in this illusion. I feel that the gospels were well-meaning attempts to record the life and circumstances of an extraordinary man... but a man nonetheless. The underlying principles the man represented and the manner in which he taught them are beyond words. There are metaphysical mysteries here we may never understand until we reach our own atonement. Nonetheless it is what he symbolized, not who he was that is the true message. A modern day book inspired by "Jesus" is not in any way connected with the body of a man who lived two thousand years ago. "Jesus" in this sense is not a person but a symbol for a being who lives in the light of God, and thus represents that part of us -- the only true part -- which is eternal love. The book is inspired not by the symbol but by the underlying Love.

We frequently adopt symbols as a means to comprehend the deeper meaning. The early Egyptians believed that the star Sirius was a goddess (Sopdet) and that it was she who caused the flooding of the Nile when she appeared each year. The appearance of the star was merely a symptom of the seasonal rotation of the Earth... It symbolized a larger underlying principle. This was something the Egyptians could not possibly comprehend, but they could certainly comprehend the shining light in the dark sky, and the rising, life-giving waters of the fertile river. They did not actively seek to find or elect a symbol, and in fact were not aware that it was a symbol. They worshipped it as though it were a holy first-cause.

Finally regarding the reliability of those gospels, perhaps it is helpful to review the answer to a previous similar question on the website, which explains it much better than I can:
Since the Gospels were written down approximately 50 years after the historical Jesus' death, there is no certainty that any of the accounts accurately report what the he actually said. In fact, Scripture scholars have established that Jesus probably did not say most of the things that are recorded in the Gospels. The Lord's Prayer, therefore, would not necessarily have come directly from Jesus. It is compatible with the entire teaching of the Bible, both Old and New Testaments, which, as you say, make sin and the world very real. From the perspective of A Course in Miracles, the only explanation for this is that the teaching of the Bible is not the teaching of the Course. They are not similar and can be compared only in contrast, since the Course uses terms found in the Bible but with a different interpretation. You should do whatever you are comfortable with, whatever helps you feel loved and forgiven. If the Bible and Christianity help you achieve that, it would be foolish not to follow that path.
So, dear "Anonymous," I really don't think anyone wants to "disparage" the gospels that you love, as you put it. To do so simply would not be loving, and would be against all principles of the Course, which explicitly states that it will never attack your ego, but it will try to teach how your thought system arose.

Thank you very much for your comment. Perhaps you will write again.

D.

7 Comments:

Anonymous marian said...

A thorough, beautifully-written response. I have a hard time with this kind of question and find myself unable or maybe unwilling to formulate a decent response mostly because I so dislike any feeling of defensiveness in myself.

It's difficult to rise above that reaction and write a well-thought-out answer that is informative but not attacking and that doesn't foster an us vs. them mentality. I think you did it.

5:46 PM  
Blogger Simon said...

Hi Derek. I was directed here (to this post specifically) by Marian (*waves!*) since she thought I may be interested in a snippet of discussion on ACIM. She's foisting the book on me (completely willingly) and I expect to receive it from Amazon directly.

Now, it appears I'll have to bookmark you and hie my way here every now and again once I get right into it to engage in whatever discussion tickles my brain. I'm incredibly engaged by what Marian's mentioned so far and eagerly look forward to going through the process of ACIM.

All best.

12:45 PM  
Anonymous Anonymous said...

I will say your response was thought out, and it is appreciate. However, you makes some assumptions that are incorrect. You assume that I am in conflict, which is not the case. You also assume I am defensive, which you actually become as your response goes further. You state, "it makes no sense to anguish over its perceived inadequacies if another way works better for you." in other words, no sense in questioning, as if the Course is above such questions. Seems a pretty protective stance, dont you think? ANother sense of a touch of arrogance is in your "understanding" and "compassionate" statement that "It is actually quite common to encounter people who have a problem with the credibility of the Course because it attempts to correct (and frequently contradicts) traditional Christian teachings.", as if it necessarily needs the Course's correction. You then state, "The same underlying message of love is the basis for many different spiritual practices." SO if it exists in Christianity already, why does it need correction? That seems like circular semantics.
What I also find a bit distasteful is your attempts to characterize my questions as filled with anxiety. So I must be filled with anxiety and angst if I question the Course?
And speaking of principals of the Course. It states near the beginning of the book that it is not to be taken as a base for another cult. Yet, I read about "Master Teacher" who has some wisdom to awaken the world with his resurrected mind. Not exactly method of operation uncommon to cults.
I do give you credit for posting my writing and responding to it, though the response seems to have defensiveness while trying to have the facade of "compassion".

7:47 PM  
Anonymous Don said...

I'm not much of an expert on the "Course in Miracles" in fact I'm not too sure where its coming from either, I'm still trying to learn and decide for myself. But I agree with "Marian" that Derek's response was well thought out and patient. I do think "anonymous" you should do more basic research. It seems to me all the questions you raise have been answered time and again on the Course website and aren't really valid points. To be honest I can't help feeling most of the rest of your objection is just personal attack, not real objection. I don't know why this is. Excuse me for saying this but I really sense a lot of fear in your thoughts and I guess the thing to do is to wish you peace, although I suspect that will just piss you off. BTW the stuff about cults and the master-teacher, I've heard of him too but as far as I know he has no official connection with the course, heis just an individual who has created a following for himself using the course as a basis. So he might be a cultist, I don't know, but I don't see it as relevant. Wasn't Jim Jones an ordained christian minister? Does that make christianity a cult? Of course not, he was just one man gone wrong.
I have a question for Derek. What do you mean when you say we are "not the sole agent of that process" ?

best wishes, Don.

12:56 PM  
Anonymous Brian said...

Just my two cents worth: I think anonymous comments would have a lot more credibility if they were not anonymous.

Brian.

5:59 PM  
Anonymous Derek said...

Marian:
Thanks for the encouragement

Simon:
Welcome, and look forward to further communication with you.

Anonymous:
Good grief, have a cup of tea and relax will you!

Don:
Good question. Broadly speaking we may have created the brain but not the mind. The former exists within the latter, not the other way around. Our mind though, is co-creator with God, of Whom it is a part. For more detail please email me OK?

Brian: I'll see your two cents and raise you two :-)

3:44 PM  
Anonymous marian said...

Derek old friend, I know you're still alive because the Q&A service is still functioning. Just checking in to make sure you are actually just not having time to post -- as opposed to having a good reason not to. And to wish you a forgiving 2007. xoxom.

10:25 AM  

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Thursday, October 12, 2006

A bed, a bath, and no bugs.


I don't like to do this too much but two different friends have asked me for copies of a blog entry from 3 years ago, before I came to the US. Ostensibly it is about Bloomsbury and medical treatment, but it might have subtexts -- I can't decide. Since recently I have been very busy with no time to write here - I am repeating that old page with the promise to myself I will post some fresh stuff soon. This post is rather timely because another blogger whose page I read, has been working through some difficult problems lately, and her struggles with the palpable pain of time slowly passing -- put me in mind of Virginia Woolf. I sent her a Woolf quote - which is a dangerous thing to do since so many Woolf quotes dally with the notion of suicide.

Ms. Woolf was one of the most famous literary residents of Bloomsbury. She might aptly be called the patron saint of bloggers, with her statement

If you do not tell the truth about yourself you cannot tell it about other people.

Most quotations herein are from T.S Eliot’s, The Love Song of J Alfred Prufrock, except where otherwise noted. Eliot was an American who took up British residence (and citizenship) and also lived in Bloomsbury, as did so many literary figures of the nineteenth and twentieth centuries. He was awarded the Nobel prize for literature.

Streets that follow like a tedious argument
Of insidious intent
To lead you to ask an overwhelming question.
Oh do not ask “what is it”
Let us go and make our visit…


The thing is, you see, I can’t decide if I am a cynic or an incurable romantic. There is no possibility that I am anything in between… except possibly a nihilist. I could happily inhabit the Left Bank or the Montmartre district of Paris. I could smoke Gitanes and argue the Myth of Sisyphus over café au lait… If only it weren’t for all those infernal French people ;-) But I’m doing the next best thing… I’ve spent the last week in Bloomsbury, mostly in the care of the National Hospital for Neurology in Queen Square. Queen Square is like Evelyn Waugh’s secret garden, “not overlooked by any window.” No one knows it is there. Cab drivers drop you off a block away because they can’t find it or can’t get in. It is approachable from the south only by a pair of tiny narrow streets, one of which is one-way in the wrong direction. From the West only a pedestrian alley gets you in, as is also the case from the North. From the East is the most feasible approach Start from High Holborn, walk down Lambs Conduit Street and turn left on Great Ormond Street. To come in that way unveils a pageant of grand old Victorian red-brick hospitals with intriguing names like The Hospital For Sick Children, and the Royal Homeopathic Hospital (presumably a little of what you don’t fancy does you good). What do you suppose the emergency ward is like in the Royal Homeopathic Hospital? If a man is brought in with multiple gunshot wounds what do you suppose they do? Put very very dilute lead-extract drops under his tongue?

Anyway, Great Ormond street terminates in Queen Square, and suddenly there you are in this perfect little hidden Victorian enclave, about three hundred meters square, with a lovely little manicured park and gardens in the center, surrounded by very Londonish black iron railings. All around the square facing inward are high echoing, six storey cool stone and redbrick buildings, with a multitude of terraces, cornices, reliefs, stained glass, ledges, steps, brass signs, black railings and plaques commemorating where Duke this or Princess that or Lady so-and-so dedicated a new something, always in the name of her majesty goodness-gracious Queen Victoria herself. The little street that runs around it is just wide enough for two hansom-cabs to pass. Unfortunately cars are parked on both sides, leaving a strip of road just wide enough for a slender cyclist to navigate. This does not deter the delivery trucks (sorry – “lorries”) that pick their painful way between the parked cars around the right-angles of the square with only millimeters of clearance on either side, often getting stuck until the owners of the offending vehicles return hours later to move them.

The reigning monarch of the square is the National Hospital for Neurology and Neurosurgery, which occupies buildings on both sides of the quadrangle and generates a steady stream of pedestrian traffic from one side to the other, cutting through the peaceful little park with its mysterious statue of “Humphrey” the cat, and its numerous daffodil flowerbeds and bench seats. The whole scene is a delightful enclave of pregnant peace, humming and echoing with the hushed sounds of the city, nearby but unseen… a world of its own.

In the light airs of summer you might think you have stumbled on the lost valley of Shangrila. Time has no meaning here. The mighty rumblings of London do not enter. This is a little wormhole in the fabric of the British universe, immune from the present day. In the dark dreary winter the London fogs descend under their own density into the square and sit there, transforming the geometry into the limitless. You can almost feel the languid tedious gazes of scores of patients from the hospital windows as time hangs heavy like the yellow-gray curtain of mist outside.

And indeed there will be time
For the yellow smoke that slides along the street
Rubbing its back upon the window panes…

If you have to have a neurological disorder and if you have to get treatment or diagnosis somewhere in the world, this is probably the place to come. I have not been to all the famous venues, such as Johns Hopkins or Mayo, nonetheless intuition tells me they would lack the grand style of this institution. My cumulative man-years of experience in American hospitals have taught me to expect extreme efficiency, modernity, processity, systemity, automity, dispassionity, and the kind of mediocrity which comes from being subjected to all the aboveity. The National Hospital for Neurology (NHN) has the incomparable advantage of being British, which means it avoids being efficient at all costs. This results in a delightful staff-to-patient ratio about three times higher than in the US. It also means that rather than shuttle you in and out of an outpatient facility in a single day, to save money, or several days in a row, to save money, with all the associated travel and trauma, they are inclined to provide the patient with a nice little bed to sleep in, a nice little bathroom to shower in, a TV to watch, and three free meals a day. Oh yes – did I mention the numerous free cups of tea and coffee from the trolley which comes around? Cookies too! With so much idle time on one’s hands, the clatter of the tea-trolley becomes a welcome Pavlovian signal of distraction to the resident patients.

For I have known them all already, known them all;
Have known the evenings, mornings, afternoons,
I have measured out my life with coffee spoons…

All this while reclining in splendor in the bosom of Bloomsbury, drinking in the curving colonnades of Georgian townhouses, with the grand old British Museum, and the University of London for neighbors, not to mention the ghosts of the English literati reposing all around: E.M. Forster, Virginia Woolf, T.S.Eliot, Dylan Thomas, Oscar Wilde, Aldous Huxley, John Maynard Keynes, Bertrand Russell, G. E. Moore, A. N Whitehead… Oy Vey! All those agnostics! This is a high rent district sure enough. It exudes antique grace and charm from every pore of every brick of every townhouse. There is more charm and history in a single beech tree on Great Russell street than in most North American cities.

Come, we shall find a room with a bed, a bath, and no bugs, in Bloomsbury.
Poet: Dylan Thomas, resident of Bloomsbury, spoken to his wife.

London has a reputation as a stimulating city, but those who judge it so, and who care about such things are usually travelers – or those trying to entice travelers. Areas steeped in history like Bloomsbury are part of the city’s international charm. If I were wealthy and I chose to live in London I would take up residence here myself. At night I would haunt the streets of Soho and Covent Garden – a stones throw away. By day I would stroll the dappled tree-lined squares of Bloomsbury.

Thank God most visitors and travelers never get to see the rest of London. I know it well because I was born there, and I can tell you, once you get beyond a fairly small area, most of it is an immensely depressing and dingy place. North London, which I know best, is fine as far as Hampstead. But North of the Heath is like a different planet. Once you get up into the desolate tracts of Golders Green, Finchley, Hendon, Cricklewood or Kilburn, it is one vast drab wasteland of endless streets with endless rows of maisonettes, and tawdry little high streets packed with curry joints, fish and chip shops, betting shops, Tesco supermarkets, dirty little pubs, and dark apartment buildings. There are enclaves of quaintness to be sure but on the whole the national character of the architecture and the mindset is soggily stuck in what Sir Terence Conran calls the “Georgabethan” style. The charm, history and character of the city is unknown and irrelevant in these minions. Here it is just double-decker buses, death and taxes. The hopelessness is written on the faces of the inhabitants. In the animated film of “Yellow Submarine,” Eleanor Rigby is set in a bleak brown forbidding world of British pre-war terraced houses and crumbling businesses. That just about sums it up. In that context, the well-known lyric: “Look at all the lonely people” seems to be a comment on the alienating nature of that urban landscape. I would rather live in Bakersfield, and that’s saying something.

So we recline in splendor here in Bloomsbury, this little community of diverse humans from diverse walks of life, thrown together by little twists of neurological fate – a little myelin missing here, a little substantia nigra eroded there, all people with obscure and difficult disorders, some life-threatening, some not, some more debilitating, some less, but all with two things in common: First, we all need periodic treatment and evaluation to keep us functional, second – we are all to some extent guinea-pigs. In the world of neurology there are very few cures. It’s a good gig being a neurologist: there are few happy endings -- your patients don’t really expect one, but they keep coming back anyway. You keep measuring, testing, trying new dosages and discussing the latest miracle drugs which, it turns out, aren’t. A neurologist is not so much a doctor in the sense that he solves medical problems, but more of a highly professional mechanic, fiddling with a machine he does not understand and cannot fix, but he knows more about it than you do, and he can keep tweaking it for optimum performance, given the circumstances. Neurology is a highly intellectual pursuit, with little hardcore empirical evidence of anything. Often the only valid confirmation of a diagnosis is an autopsy: a procedure which most patients would wish to forego. Good neurologists are highly intuitive puzzle solvers, wielding a battery of tests which only vaguely indicate the problem, and only slightly narrow the possibilities. Conclusions from tests are usually an intersection of matrices rather than smoking guns. Ultimately their best diagnostic tool is their own intellect and insight, combined with a certain amount of trial and error.

Here in Bloomsbury is accumulated an enviable clique of these intellectual giants. The hospital has a distinguished reputation as a center of excellence for teaching and study, as well as being a headquarters for neurological clinical studies. If you are a patient with condition “X” and you want to participate in a clinical study you read about in the papers, you can certainly apply, but you will quickly find there are five thousand applicants for ten positions, and your odds are slim. But if you are a patient of one of the intellectual giants at NHN, guess what…? It is they who conduct many of the studies, and they frequently select participants from among their own patients. The reason is simple … publish or perish! There is enormous competition among the “consultants” as they are called, to attain celebrity status. Preferably international celebrity status. The more studies they can run, the more they can publish the results in Lancet, or Journal of Neurology, or New England Journal of Medicine. The more they can intellectually dissect the complex field of neurological disorders into categories and subcategories, the more papers and monographs they can publish, claiming ownership of some allegedly new variant of a condition, to be quoted in future by other consultants. I think I am unlikely to enjoy that honor. If you see any publications citing Best, et al, please let me know. You will make my day.

You can see how these consultants view themselves by watching them do their rounds. Once a week they swoop through the wards to inspect their charges, like princes obliged to hobnob with villagers. While everyone else wears white or standard medical garb, the consultants swagger around in tailored suits, accompanied by a fawning bevy of wannabe students, younger doctors, distinguished international visitors, and miscellaneous scribblers who write down everything frantically. The nurses naturally buy into the whole “prince” mentality and dart around like worker ants, fetching and carrying at the prince’s beck and call, preparing patients for inspection with all the dehumanizing haste and flurry of runway models behind the scenes at a fashion show. God forbid that some record or chart should be unavailable or lost at the precise moment a great prince requests it. The poor nurse responsible for it gets a slightly disdainful “never mind,” which is probably the career equivalent of a kiss on the cheek from Al Capone. As far as the patients are concerned, the princes speak about them in a very loud British accent, charged with supreme confidence, as if they were not even there, unless of course it is necessary to ask them a question. Once the answer is obtained however, the patient is immediately excluded from the process again.

You have to remember every patient is a puzzle to be solved. He or she is a piece of meat to be prodded, poked, tested and adjusted, this way and that, until some acceptable result is obtained. What tends to happen is that the patient is completely excluded from the diagnostic process until it is complete. It is much like the way Holmes always treated Watson, keeping him in the dark until the very end, when all was revealed. So the NHN will send you upstairs and down for test after test, without sharing the results at all. You sit on your little bed, eat the three meals a day and chat with your shipmates. Every so often the porter arrives to wheel someone off to the dank catacombs of the castle for some other hideous unimaginable procedure. When he returns he is none the wiser. He knows what was done to him but he knows not why. He sits in ignorance contemplating his fate. He reads the British papers. He watches the “telly.” He drinks more tea. Perhaps like me, he writes a journal…

And when I am formulated, sprawling on a pin,
When I am pinned and wriggling on the wall,
Then how should I begin
To spit out all the butt-ends of my days and ways?

Sooner or later though, the consultants come up with an answer, or a best guess. Then the patient gets a slightly different kind of visit, in which he is told what is wrong with him, and what kind of treatment he is going to get. At that point he may be released to the care of his family doctor (or “GP” in England) or he may be set up with visits to a hospital in his hometown, or – he may win the lottery – like me – and be placed on the list of “regular” patients at party central – the NHN itself! That is precisely my situation… every so often I need an intravenous infusion of rather rare and expensive drugs. There’s a faint – very faint – possibility of an adverse reaction, so they prefer to administer the drugs themselves. Thus I get to enjoy the Bloomsbury hospitality for a few days. However the main reason they want to keep me coming back is because the condition needs constant monitoring and evaluation. As a result, I get to enjoy five precious golden minutes with the prince, my consultant, one afternoon during my treatment.

You have to know how to manage this royalty. I have found the best method is to do all my own medical research on the internet, where all the latest advances can quickly be found, then to print out the papers on the topics which concern me, and which may be of benefit to me. Then when the consultant breezes through with his entourage of drones, and draws the curtains around my little bed in a single authoritative swoosh, I hit him with requests for state-of-the-art progress in all the areas I have researched. If there is some new technique or drug he has not heard of he is likely to say – “There is no applicable research on that yet.” At that moment I present him with the printout and say “Actually, there is… Let me give you this information for your review and …” (here you look directly at the poor worker drone who is scribbling notes) … “we can make a note to review it at our next meeting, yes?” The drone looks at the prince, who says “Yes,” (what else can he say without losing face?”) and the drone licks his pencil and writes this down. Then I cement this by saying “Let’s see … what date will that be…?” The consultant is then obliged to figure out the next time we will meet and say the date, and so the poor drone is obliged to write it in the notes, because the prince hath spake it.

It’s good to have things in the notes because then if they don’t get done I can refer the consultant to his own notes, which is embarrassing, and usually results in them getting done the next time. It’s all silly games and politics I know, and I don’t really want to belittle the skills or abilities of these neurologists: they are among the best in the world. Unfortunately in the world of medicine, the relationship between doctor and patient has become far from simple and direct, particularly in the specialty fields. The only way to break through the iron rule of isolationism, protectionism, and bureaucracy among specialists is to apply a little left-handed politics… all the while shrugging affably and trying hard to act like you are just a dumb layman

Advise the prince, no doubt an easy tool,
Deferential, glad to be of use,
Politic, cautious, and meticulous...

At least the British system makes this possible. Now that I am living in the US again, I see what tends to happen is – after the initial diagnosis all treatment is administered by nurses only, and on an outpatient basis. They just follow a written regimen. The specialist rarely if ever visits the outpatient clinics, and the infernal American medical insurance companies make it as difficult as humanly possible for you to get to see your specialist again. You must first see a primary care physician, who if you’re lucky will then write you another referral, so you can book another appointment with the specialist – probably months later. There is simply no opportunity for regular exchange of information with the princes, and regular review and evaluation. The American scourge of cost-saving efficiency renders the prince remote and unapproachable, leaving the poor patient to fend for himself, with his future dictated by royal covenants from a distant palace, rendered by faceless nurses... who, unlike their British counterparts, do not serve me tea, and think my fears are cause for silent snickering behind the curve of the great desk at the end of the room that marks the intractable boundary between their world and mine.

Should I, after tea and cakes and ices,
Have the strength to force the moment to its crisis?
But though I wept and fasted, wept and prayed,
Though I have seen my head (grown slightly bald) brought in upon a platter,
I am no prophet – and here’s no great matter,
I have seen the moment of my greatness flicker,
And I have seen the eternal Footman hold my coat and snicker,
And in short, I was afraid…

London, 2004.

Footnote: In July 2005, in Russell Square in the heart of Bloomsbury, a terrorist bomb blasted a London bus into twisted metal, killing and wounding many people. Buses still ply the square, and daffodils still grow -- but quo vadis Virginia? I fear we both are lost forever.

9 Comments:

Anonymous marian said...

Thanks for that. I'm humbled by what a good writer you are! Good lord.

As for cynics, they ARE incurable romantics -- two sides of the same coin, don't you think? Each a defense against the other?

7:16 PM  
Anonymous derek said...

I had not really thought about cynics being mirror images of romantics. Maybe that's why every time this youthful handsome energetic young lad looks in the mrror he sees a tired worn-out ugly old geezer... D.

6:52 PM  
Anonymous marian said...

Darling, I won't have you insulting yourself...

8:22 PM  
Anonymous Angela said...

I spent a lot of time in London in 2001 through 2003, and you capture perfectly the joys and delights of one of the great cities of the world. Thank you. You make me want to go back again. If you don't mind me saying, it seems obvious that is where your heart belongs too, and I wonder why you choose to be in the US?

12:47 AM  
Anonymous Tom Beal said...

I read your post twice with interest and pleasure. It seems you have a real feeling for your subject. Do you know about the book called "Snapshots Of Bloomsbury"? You can look it up on Amazon.

12:57 PM  
Anonymous Walter said...

Nice post. Can't decide if you are pro-medical establishment or anti. What do you think of the very different attitude of the two health-systems (Brit & U.S.) toward money? Also, when will you write more stuff on ACIM?

5:10 PM  
Anonymous Anonymous said...

Hi Derek,

I stumbled upon your blog coming over from the ACIM website. I just wanted to thank you and tell you how much I enjoy your writing.

Best wishes,

Bruce

6:55 PM  
Blogger Derek said...

Walter:
You might be interested in a very detailed article on this topic in the British Medical Journal:
click here to read
Thanks for your comment.
Derek.

1:57 AM  
Anonymous Anonymous said...

I have been reading the Q and A section that you provide, well done. However, in one questio you answer by stating that the Gospels are unreliable, yet Helen and the Course are reliable. Are you serious? Please tell me that you dont think that only Helen can be inspired. Please tell me that you think the apostles, who travelled and live with Jesus are not less reliable than the Course. To be honest, even while studying the Course, I still only see the "dialouge" of Jesus as a metaphor. I highly suspect that any actual "dictation" actually took place. The fact that yo seem to want to disparage the long standing accounts in favor of your own makes the Course suspect to me. I doubt this post will eve make it to yor blog, but at least you will see it.

11:31 PM  

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