I'm proud to be a member of the "Humourless Left"

Is the Jubilee fawning really what we do better than anyone else? If so, is that something to be proud of?

As we prepare to take down our soggy union jack bunting ahead of the ceremonial handover to St George flags on car roofs, I’m left with questions. Is this really what we do better than anyone else? If so, is that something to be proud of?

Yes, I’m glad of a day off (though it’s unpaid in my case). But I’m also allowed to have a look at what’s happened over the past few days and marvel at the sheer madness of it. Aren’t I? Or must we be shackled to the warble of jubilation, the hearty cheer and the wave of a plastic flag, above every sliver of criticism? Is no mockery allowed?

I fully accept the moniker ‘the humourless left’. Yes, we are the buzzkill, killing your buzz, your fading glow of empire and ‘wasn’t it fun when we were starving people to death and putting people in concentration camps, and now all we do is run call centres’. That’s fine. I am the Humourless Left, left without humour or fun at a time when no-one has any jobs or money while we watch giant golden things belonging to one family. 

But I have just seen, on television, Huw Edwards looking out of a window at the Queen passing by in a coach. He did it, and I saw it. It was as if the BBC were justifying the enormous expense of this four-day royal love-in by that moment. “See, I can see it through the window!” Huw was trying to say. And all I could think of back was “Oh, well good for you, mate.”

There have been similar moments of bafflement right across the weekend. I’ve seen Emma Bunton talking about bunting. I’ve seen Ronnie Corbett provide narration of a room full of people eating their lunch. I’ve seen Stevie Wonder and Will.I.Am wish her majesty a happy birthday, and suffer the tsunami of criticism from the Twitter pedants as a result – like we even know when either of the Queen’s birthdays is meant to be. I’ve seen people talking about boats for what seemed like a lifetime, but which was only really six hours of live TV. Boats! People on boats for six hours.

As ever, the BBC’s rivals have used this occasion as a stick with which to beat Auntie – sometimes fairly, sometimes not. It’ll be interesting to see when the accusations of ‘leftist bias’ return to the corporation after these days in which everything’s been wonderful, and everyone loves the Queen, and everyone everywhere has been just like the perma-grinning mobs on the Mall.

We’ve even seen the biased anti-Tory BBCCCP bring in David Cameron for a couple of hassle-free cosy chats about how much he loves the Queen as much as we plebs do at home, at a time when his ministers are raising fresh questions about their conduct. Give it a week, though, and the usual suspects will be railing about how the Beeb is a hive of pinko nastiness.

Truth is, in the cold light of day and with the right royal hangover receding, you can only broadcast what's there. The Big Society flotilla was a soggy shambles – bring along the little ships from Dunkirk and have done with it. The Queen’s concert was enjoyable enough, though not always for reasons of quality – poor Cheryl Cole (sorry, Cheryl) wailing away into the evening air will live long in the memory, but not for the right reasons.

And of course, there are questions now being raised about the free labour used to steward the billionaires’ fun – obviously by the Humourless Left, who can’t just sit back and anaesthetise their critical faculties for four days, mewling idiots that we are. I dare say there were lovely scenes in communities up and down the country getting together, but that was hardly touched by what we saw on TV – it was the usual Londoncentric celeb-heavy drivel.

It’s just that I feel almost apologetic about pointing this out, like I shouldn’t be doing it. I’m not ruining anyone’s fun, but come off it – if you think we sold ourselves as a nation of anything other than willing subjects prepared to bow and scrape to our betters, I think you’re mistaken.

Jubilee: A royal supporter holds Queen Elizabeth and Union flags as people wait on the Mall for the carriage procession of the Queen’s Diamond Jubilee. Photograph: 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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