Smoking. Photo: Pascal Le Segretain/Getty Images
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Doom-laden ads put healthy people in a panic – but some need to worry a bit more

It's hard to draw the line between inciting fear, and giving a fair warning - as Colin and Mary's story proves.

An advert on a bus shelter caught my eye recently. The gist was: if you’re over 60 and you feel the slightest bit peaky, you’d best get yourself along to the doctor, because illness can be so much more serious at that kind of age. It filled me with gloom. There seems no room for common sense any more; everything must be devolved to a professional. The logic – encourage people to seek help at the first hint of trouble and you’ll catch anything major at an early stage – is seductive yet flawed. Waves of the worried well suck vast amounts of time out of the health service, to the detriment of those with serious disease. Even important diseases can be vague and undifferentiated in the initial phases, making it hard to diagnose them. And then there’s the psychological downside of continually sapping people’s confidence in their own judgement.

Having said that, the folk who devise these awareness-raising campaigns mean well, and there is certainly another side to the coin. The advert put me in mind of Colin and Mary. They were an unusual couple, she in her late seventies, he about 15 years her junior, and they were devoted to each other. They’d never had children, and kept themselves to themselves, rarely bothering with doctors – perhaps in part because Colin was tired of being nagged about his inveterate smoking. It was highly unusual to be asked to visit Mary.

She was sitting in their somewhat dingy lounge when I arrived. And that was the problem, Colin explained: Mary had been “right as rain” the previous day but now he couldn’t get her off the sofa. I asked her various questions, but she denied pain or any other symptoms. She just couldn’t move.

Although this wasn’t typical, I wondered about a stroke – her speech was halting and unclear, and her limbs were markedly stiff – but she firmly declined hospital admission. I set about getting urgent home care for them, and sent off a battery of investigations to try to get to the bottom of it.

Ultimately, the only condition that seemed to explain Mary’s presentation was Parkinson’s disease, in which the area of the brain responsible for executing voluntary movements, the substantia nigra, slowly degenerates. The problem was, Parkinson’s takes years to develop and Mary had succumbed overnight. The only time I’d come across such an acute onset was once, when a drug had caused Parkinson’s-like side effects. But Mary hadn’t been prescribed anything new for ages.

I cross-examined Colin in detail. It turned out his “right as rain” had been hideously misleading. Mary had been becoming ever less mobile for a long time, which they’d been putting down to old age. In the weeks before her final seizing-up, Colin had been having literally to manhandle her across the room. Trying to get her upstairs had involved putting her over his shoulder and shoving with Herculean determination. It was an eye-wateringly scary picture.

Mary soon improved with treatment – there are certain drugs that supplement the neurotransmitter dopamine, which becomes depleted with the degeneration of the substantia nigra. But the whole episode raised an altogether more delicate question: what to do when a patient or their carer seems to lack the kind of common sense that would prompt most people to seek professional help? We had to evaluate carefully Mary’s competence to make decisions about her care, and the degree to which Colin’s disregard for the medical profession might be exerting an undue influence. In the end, we had to move her to a nursing home. Some months later, Colin succumbed at home to a smoking-related cancer, declining all but the minimum help right to the end. His was an almost pathological stoicism, and I can imagine the disdain he would have felt for that bus-shelter advert. That was his right, but the tragedy was that, in the end, Mary had needed protection from his very particular brand of loving care.

This article first appeared in the 27 February 2015 issue of the New Statesman, Russia vs the west

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Why do the words “soup, swoop, loop de loop” come to mind every time I lift a spoon to my lips?

It’s all thanks to Barry and Anita.

A while ago I was lending a friend the keys to our house. We keep spare keys in a ceramic pot I was given years ago by someone who made it while on an art-school pottery course. “That’s er . . . quite challenging,” the friend said of the pot.

“Is it?” I replied. “I’d stopped noticing how ugly it is.”

“Then it’s a grunty,” she said.

“A what?” I asked.

“A grunty. It’s something you have in your house that’s hideous and useless but you’ve stopped noticing it completely, so it’s effectively invisible.”

I was much taken with this idea and realised that as well as “grunties” there are also “gruntyisms”: things you say or do, though the reason why you say or do them has long since been forgotten. For example, every time we drink soup my wife and I say the same thing, uttered in a strange monotone: we say, “Soup, swoop, loop de loop.” How we came to say “soup, swoop, loop de loop” came about like this.

For a married couple, the years between your mid-thirties and your late forties might be seen as the decade of the bad dinner party. You’re no longer looking for a partner, so the hormonal urge to visit crowded bars has receded, but you are still full of energy so you don’t want to stay in at night, either. Instead, you go to dinner parties attended by other couples you don’t necessarily like that much.

One such couple were called Barry and Anita. Every time we ate at their house Barry would make soup, and when serving it he would invariably say, “There we are: soup, swoop, loop de loop.” After the dinner party, as soon as we were in the minicab going home, me and Linda would start drunkenly talking about what an arse Barry was, saying to each other, in a high-pitched, mocking imitation of his voice: “Please do have some more of this delicious soup, swoop, loop de loop.” Then we’d collapse against each other laughing, convincing the Algerian or Bengali taxi driver once again of the impenetrability and corruption of Western society.

Pretty soon whenever we had soup at home, Linda and I would say to each other, “Soup, swoop, loop de loop,” at first still ridiculing Barry, but eventually we forgot why we were saying it and it became part of the private language every couple develop, employed long after we’d gratefully ceased having soupy dinners with Barry and Anita.

In the early Nineties we had an exchange student staying with us for a year, a Maori girl from the Cook Islands in the southern Pacific. When she returned home she took the expression “soup, swoop, loop de loop” with her and spread it among her extended family, until finally the phrase appeared in an anthropological dissertation: “ ‘Soup swoop, loop de loop.’ Shamanistic Incantations in Rarotongan Food Preparation Rituals” – University of Topeka, 2001. 

This article first appeared in the 21 July 2016 issue of the New Statesman, The English Revolt