Logger-Eds? Not quite.

The shadow chancellor is no dagger-wielding don.

Those who were there will remember the tension in the room. It was the New Statesman debate at the outset of Labour's arduous leadership election. As Balls interrupted his future leader, Miliband lashed out, "It's just like being back at the Treasury". Balls snapped backk, "Tell us the answer then, Ed, like you always do." The sarcasm hung thick in the air.

Much of the subtext in the final weeks was about how Balls would react to whichever Mili-brother was the victor. If David won, would we see a return to the TB/GBs? A younger Blair vs. Brown? If Mili-Ed won, how would Balls cope with being subservient to a man once his junior when the Treasury was his domain?

As it happened, the younger Miliband won. It was a squeaker. You know the rest. Balls was placed in the Shadow Home Office role, a heavy artillery weapon plonked on Theresa May's lawn. 

It wasn't the role that he wanted. He had too much time on his hands. He longed for the role he was born for. 

The role he had really been running for all the long.

Shadow Chancellor. 

He was publicly loyal, and got on with the job at hand, but few believed he was as happy with his new role as he professed to be.

And then, a twist of fate. Alan Johnson resigned (personal reasons). Balls assumed the role he had always coveted (personal triumph). Once again, Labour's economic policy was in the hands of a giant clunking fist. Johnson had joked of his need for an economic primer. Balls - as anyone who has spent time with the man will attest - has no need for such a rudimentary tome, peppering his conversations with "Ricardian Equivalence" and "Post Neo-Classical Endogenous Growth Theory". Pass the dictionary.

And yet the rumours of Balls-ite plots continued unabated. Yvette Cooper found herself pushed to the fore as Labour's presumptive leader-in-waiting during each one of Ed Miliband's leadership mini-crises. The line went out through the media that this was the work of Balls on behalf of his wife. 

What sexist tosh it was. Yvette Cooper is nothing if not someone who can look after herself. 

The rumours reached a crescendo with what became known as “Lasagne-gate”, where the Balls-Cooper clan reached out to their shadow teams by feeding them. To read the media write ups you'd think this were Labour's latest food-based coup (and they're always food based – always), but nothing came of it besides an opportunity for Balls to refer regularly in public to his 14-hour pulled pork.

The truth and the relationship between the pair of Eds has always been more mundane. 

Last year, around twelve months after that fiesty New Statesman exchange, I was speaking at an event in Parliament. Half way through, Ed Balls appeared at the back of the room, trying to catch the attention of an MP, before disappearing with an almost cartoonish grin on his face. Thirty seconds later, the door at the front of the room swung open. Laughter echoed in the corridor, and in came not only Balls, but Miliband too. Smiling, laughing, joking like friends. But with no cameras about, no need to put on a show.

Since then, this is a side to the “Two Eds” that has been seen more often and more publicly. They're a strong double act in front of both public and press. They seem comfortable in each other's company. They compliment each other. They look, it is possible to say, like a team.

And so it was surprising today to read Rachel Sylvester writing today in the Times that the relationship is strained. There is a “tension” between the two, we are told. There's more “reciprocated mistrust than mutual respect”. 

That's possible, perhaps, but it relies on us believing that both Balls and Miliband are great actors. For the avoidance of doubt, neither man is going to be winning a BAFTA any time soon. 

Similarly, Sylvester states that, “Mr Balls’s hint that the party might support a referendum on Britain’s membership of the EU did not go down well with other Shadow Cabinet ministers.” The reality, again, is boringly mundane. Balls discussed Labour's EU referendum line with Miliband and Shadow Foreign Secretary Douglas Alexander weeks ago. It was, as the parlance goes, “the line”. 

Yet it's not hard to see why these briefings against Balls are coming in. They are no doubt borne out of frustration with the iron grip that the Shadow Chancellor and his team have over public spending commitments. As I wrote back in December:

Nothing that could even notionally impinge on economic policy is put forward without the explicit say-so of the shadow chancellor – a cause for silent frustration for many seeking to make their mark around the shadow cabinet table.

That frustration, it would seem, is rather less silent than it once was. The weapon used for retribution is a blunt and well used implement – Balls-as-Brownite-bruiser with his “bovver boys” and “punishment beatings”. Perhaps this once rang true – heaven knows Balls is no angel – but it's no longer the powerful line of attack it once was. Balls is an operator, sure, but a dagger-wielding don? To what end?

But if Sylvester is right (which, for further avoidance of doubt, I don't think she is), then would it really be so bad if a leader and his key economic spokesperson were at loggerheads? Blair and Brown may have loathed each other, but the “creative tension” that threatened to crack the walls between Number 10 and Number 11 was responsible for a (perhaps never to be repeated) triplicate of election wins. By contrast, the current PM and his Chancellor are bosom-buddies, with Osborne preferring the role of Mandelsonian strategist to the position of economic Stakanovite. A part-time chancellor propping up a “chillaxed” PM.

Sometimes a little creative tension goes a long way.

Mark Ferguson is the editor of LabourList

Best of buds? Eds Miliband and Balls. Photo: Getty Images
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The surprising truth about ingrowing toenails (and other medical myths)

Medicine is littered with myths. For years we doled out antibiotics for minor infections, thinking we were speeding recovery.

From time to time, I remove patients’ ingrowing toenails. This is done to help – the condition can be intractably painful – but it would be barbaric were it not for anaesthesia. A toe or finger can be rendered completely numb by a ring block – local anaesthetic injected either side of the base of the digit, knocking out the nerves that supply sensation.

The local anaesthetic I use for most surgical procedures is ready-mixed with adrenalin, which constricts the arteries and thereby reduces bleeding in the surgical field, but ever since medical school I’ve had it drummed into me that using adrenalin is a complete no-no when it comes to ring blocks. The adrenalin cuts off the blood supply to the end of the digit (so the story goes), resulting in tissue death and gangrene.

So, before performing any ring block, my practice nurse and I go through an elaborate double-check procedure to ensure that the injection I’m about to use is “plain” local anaesthetic with no adrenalin. This same ritual is observed in hospitals and doctors’ surgeries around the world.

So, imagine my surprise to learn recently that this is a myth. The idea dates back at least a century, to when doctors frequently found digits turning gangrenous after ring blocks. The obvious conclusion – that artery-constricting adrenalin was responsible – dictates practice to this day. In recent years, however, the dogma has been questioned. The effect of adrenalin is partial and short-lived; could it really be causing such catastrophic outcomes?

Retrospective studies of digital gangrene after ring block identified that adrenalin was actually used in less than half of the cases. Rather, other factors, including the drastic measures employed to try to prevent infection in the pre-antibiotic era, seem likely to have been the culprits. Emboldened by these findings, surgeons in America undertook cautious trials to investigate using adrenalin in ring blocks. They found that it caused no tissue damage, and made surgery technically easier.

Those trials date back 15 years yet they’ve only just filtered through, which illustrates how long it takes for new thinking to become disseminated. So far, a few doctors, mainly those in the field of plastic surgery, have changed their practice, but most of us continue to eschew adrenalin.

Medicine is littered with such myths. For years we doled out antibiotics for minor infections, thinking we were speeding recovery. Until the mid-1970s, breast cancer was routinely treated with radical mastectomy, a disfiguring operation that removed huge quantities of tissue, in the belief that this produced the greatest chance of cure. These days, we know that conservative surgery is at least as effective, and causes far less psychological trauma. Seizures can happen in young children with feverish illnesses, so for decades we placed great emphasis on keeping the patient’s temperature down. We now know that controlling fever makes no difference: the fits are caused by other chemicals released during an infection.

Myths arise when something appears to make sense according to the best understanding we have at the time. In all cases, practice has run far ahead of objective, repeatable science. It is only years after a myth has taken hold that scientific evaluation shows us to have charged off down a blind alley.

Myths are powerful and hard to uproot, even once the science is established. I operated on a toenail just the other week and still baulked at using adrenalin – partly my own superstition, and partly to save my practice nurse from a heart attack. What would it have been like as a pioneering surgeon in the 1970s, treating breast cancer with a simple lumpectomy while most of your colleagues believed you were being reckless with your patients’ future health? Decades of dire warnings create a hefty weight to overturn.

Only once a good proportion of the medical herd has changed course do most of us feel confident to follow suit. 

This article first appeared in the 20 April 2017 issue of the New Statesman, May's gamble

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