Ted Hughes's "Last letter": the response

A month on from our publication of Ted Hughes's lost poem, and the critics are divided.

In an article in this month's New York Review of Books, the poet and academic Mark Ford has written about the recent publication in the New Statesman of Ted Hughes's previously unpublished poem "Last letter", which describes Hughes's movements and thoughts in the three days leading up to the suicide of his first wife, Sylvia Plath.

Ford suggests in the piece that the emotional power of the poem is "closer to that of an uncontrolled diary entry than of a speech by King Lear or Macbeth." He gives a comprehensive overview of the literary excitement and debate caused since the poem appeared in the New Statesman in early October, looking in particular at Daniel Huws' arguments that the events of those three days as described by Hughes in "Last letter" are factually inaccurate. Ford seems to accept that Huws is correct on several of these points - namely that Hughes probably didn't really sleep in his and Plath's "wedding bed" with Susan Alliston as asserted in the poem - but points out that "if the poem does indeed take "liberties" with the truth, these liberties seemed designed to intensify ... Hughes's coruscating sense of his own guilt." Michael Rosen, however, writing in the New Statesman, points out that there is something slightly suspect in Hughes's continual use of repetition and alliteration in the poem. As Rosen puts it, "on one level, this is the cohesion of poetry. On another, it feels like a special pleading: if I say something twice, you will be more convinced."

In the NYRB article, Ford also refers to Al Avarez's article in the Guardian, published in the wake of the poem's appearence, in which the critic and friend of Hughes judged that "the poem is a confession: he is a guy in the witness box pleading guilty. It's very strong stuff, but it ain't finished." Ford concludes his piece in a similar spirit, suggesting that the real value of "Last letter" comes from the portrait it gives of the poet's visceral emotion rather than its literary merit: "Hughes wrote "Last letter" because he needed to, rather than because he thought he could make a good poem out of this impossible material."

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Scientists have finally said it: alcohol causes cancer

Enough of "linked" and "attributable": a new paper concludes that alcohol directly causes seven types of cancer.

I don't blame you if you switch off completely at the words "causes cancer". If you pay attention to certain publications, everything from sunbeds, to fish, to not getting enough sun, can all cause cancer. But this time, it's worth listening.

The journal Addiction has published a paper that makes a simple, yet startling, claim: 

"Evidence can support the judgement that alcohol causes cancer of the oropharynx [part of the throat], larynx, oesophagus, liver, colon, rectum and [female] breast"

So what's especially significant about this? 

First, scientists, unlike journalists, are very wary of the word "causes". It's hard to ever prove that one action directly led to another, rather than that both happened to occur within the same scenario. And yet Jennie Connor, author of the paper and professor in the Preventive and Social Medicine department at the University of Otago, New Zealand, has taken the leap.

Second, alcohol not only causes cancer of one kind – the evidence supports the claim that it causes cancer at seven different sites in our bodies. There was weaker evidence that it may also cause skin, prostate and pancreatic cancer, while the link between mouth cancers and alcohol consumption was the strongest. 

What did we know about alcohol and cancer before?

Many, many studies have "linked" cancer to alcohol, or argued that some cases may be "attributable" to alcohol consumption. 

This paper loooks back over a decade's worth of research into alcohol and cancer, and Connor concludes that all this evidence, taken together, proves that alcohol "increases the incidence of [cancer] in the population".

However, as Connor notes in her paper, "alcohol’s causal role is perceived to be more complex than tobacco's", partly because we still don't know exactly how alcohol causes cancer at these sites. Yet she argues that the evidence alone is enough to prove the cause, even if we don't know exactly how the "biologial mechanisms" work. 

Does this mean that drinking = cancer, then?

No. A causal link doesn't mean one thing always leads to the other. Also, cancer in these seven sites was shown to have what's called a "dose-response" relationship, which means the more you drink, the more you increase your chances of cancer.

On the bright side, scientists have also found that if you stop drinking altogether, you can reduce your chances back down again.

Are moderate drinkers off the hook?

Nope. Rather devastatingly, Connor notes that moderate drinkers bear a "considerable" portion of the cancer risk, and that targeting only heavy drinkers with alcohol risk reduction campaigns would have "limited" impact. 

What does this mean for public health? 

This is the tricky bit. In the paper, Connor points out that, given what we know about lung cancer and tobacco, the general advice is simply not to smoke. Now, a strong link proven over years of research may suggest the same about drinking, an activity society views as a bit risky but generally harmless.

Yet in 2012, it's estimated that alcohol-attributable cancers killed half a million people, which made up 5.8 per cent of cancer deaths worldwide. As we better understand the links between the two, it's possible that this proportion may turn out to be a lot higher. 

As she was doing the research, Connor commented:

"We've grown up with thinking cancer is very mysterious, we don't know what causes it and it's frightening, so to think that something as ordinary as drinking is associated with cancer I think is quite difficult."

What do we do now?

Drink less. The one semi-silver lining in the study is that the quantity of alcohol you consume has a real bearing on your risk of developing these cancers. 

On a wider scale, it looks like we need to recalibrate society's perspective on drinking. Drug campaigners have long pointed out that alcohol, while legal, is one of the most toxic and harmful drugs available  an argument that this study will bolster.

In January, England's chief medical officer Sally Davies introduced some of the strictest guidelines on alcohol consumption in the world, and later shocked a parliamentary hearing by saying that drinking could cause breast cancer.

"I would like people to take their choice knowing the issues," she told the hearing, "And do as I do when I reach for my glass of wine and think... do I want to raise my risk of breast cancer?"

Now, it's beginning to look like she was ahead of the curve. 

Barbara Speed is a technology and digital culture writer at the New Statesman and a staff writer at CityMetric.