Holey private: dreams of health for loadsamoney. Photo: BBC
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Theatres of the absurd: the unadulterated horror of Harley Street

Six months of treatment for cancer? A mere £30,000 at London's most exclusive clinics.

Inside Harley Street
BBC2

Don’t be misled by the outwardly jaunty tone: in her new films about Harley Street (Mondays, 9pm), the documentary-maker Vanessa Engle has opened a vein of unadulterated horror. How desperate people are, and how deluded. I suppose we all know that human beings will cough up almost any amount of cash in pursuit of hope. But it’s surprising and rather devastating to find that they also write vast cheques in exchange for hugs, handshakes and empty blandishments. “You look great!” trills a plastic surgeon to her seventysomething-year-old patient as she arrives at her consulting room post-facelift, looking like something out of a Channel 4 drama about domestic violence. Beneath her gaze, the patient, bruised and battered, blooms like a flower. It seems not to occur to her that the doctor is merely praising her own (very expensive) handiwork.

Engle (Jews, Women, Welcome to the World of Weight Loss) has a satirical eye and is known for asking her interviewees blunt questions (“What’s your worst fear? That he might die from cancer?”). But what I like best about her technique is her swift, minimalist way with folly. So deftly does she lay it out – she is the surgeon here – that we’ve no option but to fall into line in the matter of judgement. Will a hair transplant change a young man’s life? It seems unlikely, and perhaps his mother is weeping because she already knows that it won’t. Will a husband appreciate, or even notice, his wife’s umpteenth cosmetic procedure? Well, anything for a quiet life; but no. Is it really possible to believe that, as a doctor, you were put on the earth to perform liposuction on sad young women? Definitely not, for all that you might well have a carefully prepared line about making people “feel” better.

Engle’s series is in three parts. The first film focuses on those who visit Harley Street because they are sick and the doctors who treat them. The second (airs 20 April) is about plastic surgery (I watched a preview because once I’d seen the first film I couldn’t bear not to). The third is about complementary therapies (ditto). The last two films are, I think, better than the first, and you should certainly try to catch them; I can’t remember a bit of observational TV that made me feel more disapprovingly Protestant, feminist and, above all, rationalist. But the first film had its moments, too. I do see that if you have cancer, and enough money, you might want to opt out of the NHS. Then again, if the highly qualified professional I was paying hundreds of quid an hour addressed my mother with the words “Hello, Mum!” I think my fear would temporarily shade into indignation. Equally mystifying was the young woman who wanted to be treated for breast cancer by the same clinic that had cared for her father. She wanted, she said, to share the same cancer “journey”. This dear dad, by the way, had since died.

The sums involved made your eyes pop. Six months of treatment for cancer? A mere £30,000. I tried to unpick the complicated mathematics of risk, faith and profit, but it was tricky. All the doctors involved confessed to having private insurance. Then again, the leading urologist Professor Roger Kirby admitted that the NHS had the same equipment as his clinic; the difference is that he offers a more personalised service (for instance: making the effort to learn the Norwegian word for “cured” while treating a patient from Oslo). How did they feel about working in the private sector? Not too conflicted, I would say. Only one, Professor Justin Stebbing, who runs a cancer research unit in the NHS alongside his Harley Street practice, said it sat “badly” with him.

And how did the patients feel about handing over their credit cards? Pretty good. One woman, pterodactyl-like behind glasses as big as television screens, had no idea how much her medical bills came to. “This is like asking Cameron how much a bottle of milk is,” she said, en route to her Bentley. Still, in the matter of serious illness (as opposed to the chap who rings his private GP at 2am and demands to have his blood pressure checked on returning from the casino), pity usually trumps politics, or so I find. Save your outrage for the next two films, which are Engle at her very best – and that’s really saying something.

Rachel Cooke trained as a reporter on The Sunday Times. She is now a writer at The Observer. In the 2006 British Press Awards, she was named Interviewer of the Year.

This article first appeared in the 17 April 2015 issue of the New Statesman, The Election Special

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The West can never hope to understand Islamic State

Graeme Wood's The Way of the Strangers: Encounters with the Islamic State reminds us of something that ought to be obvious: Islamic State is very Islamic.

The venue for the declaration of the “Islamic State” had been carefully chosen. The Great Mosque of al-Nuri in Mosul was a fitting location for the restoration of a “caliphate” pledged to the destruction of its enemies. It was built in 1172 by Nur al-Din al-Zengi, a warrior famed for his victories over the Crusaders. When Abu Bakr al-Baghdadi ascended the pulpit in July 2014 and proclaimed his followers to be “the backbone of the camp of faith and the spearhead of its trench”, he was consciously following in Nur al-Din’s footsteps. The message could not have been clearer. The Crusaders were back and needed defeating.

Time present and time past are both perhaps present in time future. In Islamic State’s propaganda, they certainly are. Sayings attributed to Muhammad that foretold how the armies of Islam would defeat the armies of the Cross serve their ideologues as a hall of mirrors. What happened in the Crusades is happening now; and what happens now foreshadows what is to come.

The Parisian concert-goers murdered at the Bataclan theatre in 2015 were as much Crusaders as those defeated by Nur al-Din in the 12th century – and those slaughters prefigure a final slaughter at the end of days. When the propagandists of Islamic State named their English-language magazine Dabiq, they were alluding to a small town in Syria that – so they proclaim – will at last bring the Crusades to an end. Every issue is headed with the same exultant vaunt. “The spark has been lit here in Iraq, and its heat will continue to intensify – by Allah’s permission – until it burns the Crusader armies in Dabiq.”

How much does Islamic State actually believe this stuff? The assumption that it is a proxy for other concerns – born of US foreign policy, or social deprivation, or Islamophobia – comes naturally to commentators in the West. Partly this is because their instincts are often secular and liberal; partly it reflects a proper concern not to tar mainstream Islam with the brush of terrorism.

Unsurprisingly, the first detailed attempt to take Islamic State at its word ruffled a lot of feathers. Graeme Wood’s article “What Isis really wants” ran in the Atlantic two years ago and turned on its head the reassuring notion that the organisation’s motivation was anything that Western policy­makers could readily comprehend.

“The reality is,” Wood wrote, “that the Islamic State is Islamic. Very Islamic.” The strain of the religion that it was channelling derived “from coherent and even learned interpretations of Islam” and was fixated on two distinct moments of time: the age of Muhammad and the end of days long promised in Muslim apocalyptic writings. Members of Islamic State, citing the Quran and sayings attributed to the Prophet in their support, believe themselves charged by God with expediting the end of days. It is their mandate utterly to annihilate kufr: disbelief. The world must be washed in blood, so that the divine purpose may be fulfilled. The options for negotiating this around a table at Geneva are, to put it mildly, limited.

In The Way of the Strangers, Wood continues his journey into the mindset of Islamic State’s enthusiasts. As he did in the Atlantic, he scorns “the belief that when a jihadist tells you he wants to kill you and billions of others to bring about the end of the world, he is just speaking for effect”. Although not a report from the “caliphate”, it still comes from front lines: the restaurants of Melbourne, the suburbs of Dallas, the cafés of Ilford. Wood’s concern is less with the circumstances in Syria and Iraq that gave birth to Islamic State than with those cocooned inside stable and prosperous societies who have travelled to join it. What persuades them to abandon the relative comforts of the West for a war zone? How can they possibly justify acts of grotesque violence? Is killing, for them, something
incidental, or a source of deep fulfilment?

These are questions that sociologists, psychologists and security experts have all sought to answer. Wood, by asking Islamic State’s sympathisers to explain their motivation, demonstrates how Western society has become woefully unqualified to recognise the ecstatic highs that can derive from apocalyptic certitude. “The notion that religious belief is a minor factor in the rise of the Islamic State,” he observes, “is belied by a crushing weight of evidence that religion matters deeply to the vast majority of those who have travelled to fight.”

Anyone who has studied the literature of the First Crusade will recognise the sentiment. The conviction, popular since at least the Enlightenment, that crusading was to be explained in terms of almost anything except religion has increasingly been put
to bed. Crusaders may indeed have travelled to Syria out of a lust for adventure, or loot, or prospects denied to them at home; but that even such worldly motivations were saturated in apocalyptic expectations is a perspective now widely accepted. “Men went on the First Crusade,” as Marcus Bull put it, “for reasons that were overwhelmingly ideological.”

The irony is glaring. The young men who travel from western Europe to fight in Syria for Islamic State – and thereby to gain paradise for themselves – are following in the footsteps less of Nur al-Din than of the foes they are pledged to destroy: the Crusaders.

Jonathan Riley-Smith, who revolutionised the study of the Crusades as a penitential movement, once wrote an essay titled “Crusading as an Act of Love”. Wood, in his attempt to understand the sanguinary idealism of Islamic State sympathisers, frequently echoes its phrasing. In Alexandria, taken under the wing of Islamists and pressed to convert, he recognises in their importunities an urgent longing to spare him hellfire, to win him paradise. “Their conversion efforts could still be described, for all their intolerance and hate, as a mission of love.”

Later, in Norway, he meets with a white-haired Islamist to whom the signs of the impending Day of Judgement are so palpable that he almost sobs with frustration at Wood’s failure to open his eyes to them. “To Abu Aisha, my stubbornness would have been funny if it were not tragic. He looked ready to grab me with both hands to try to shake me awake. Were these signs – to say nothing of the perfection of the Quran, and the example of the Prophet – not enough to rouse me from the hypnosis of kufr?”

Wood does not, as Shiraz Maher did in his recent study Salafi-Jihadism, attempt to provide a scholarly survey of the intellectual underpinnings of Islamic State; but as an articulation of the visceral quality of the movement’s appeal and the sheer colour and excitement with which, for true believers, it succeeds in endowing the world, his book is unrivalled. When he compares its utopianism to that of the kibbutzim movement, the analogy is drawn not to cause offence but to shed light on why so many people from across the world might choose to embrace such an austere form of communal living. When he listens to British enthusiasts of Islamic State, he recognises in their descriptions of it a projection of “their idealised roseate vision of Britain”. Most suggestively, by immersing himself in the feverish but spectacular visions bred of his interviewees’ apocalypticism, he cannot help but occasionally feel “the rip tide of belief”.

The Way of the Strangers, though, is no apologetic. The time that Wood spends with Islamic State sympathisers, no matter how smart or well mannered he may find some of them, does not lead him to extenuate the menace of their beliefs. One chapter in particular – a profile of an American convert to Islam whose intelligence, learning and charisma enabled him to emerge as the principal ideologue behind Dabiq – is worthy of Joseph Conrad.

Elsewhere, however, Wood deploys a lighter touch. In a field where there has admittedly been little competition, his book ranks as the funniest yet written on Islamic State. As in many a British sitcom, the comedy mostly emerges from the disequilibrium between the scale of his characters’ pretensions and ambitions and the banality of their day-to-day lives. “He can be – to use a term he’d surely hate – a ham.” So the British Islamist Anjem Choudary is summarised and dismissed.

Most entertaining is Wood’s portrait of Musa Cerantonio, whose status as Australia’s highest-profile Islamic State sympathiser is balanced by his enthusiasm for Monty Python and Stephen Fry. His longing to leave for the “caliphate” and his repeated failure to progress beyond the Melbourne suburb where he lives with his mother create an air of dark comedy. Visiting Cerantonio, Wood finds their conversation about Islamic State ideology constantly being intruded on by domestic demands. “His mother was about ten feet away during the first part of the conversation, but once she lost interest in the magazines she walked off to another part of the house. Musa, meanwhile, was discussing theoretically the Islamic views on immolation as a method of execution.”

The scene is as terrifying as it is comic. Were Cerantonio merely a solitary eccentric, he would hardly merit the attention but, as The Way of the Strangers makes amply clear, his views are shared by large numbers of Muslims across the world. Just as Protestant radicals, during the 16th-century Reformation, scorned the traditions of the Catholic Church and sought a return to the age of the Apostles, so today do admirers of Islamic State dread that the wellsprings of God’s final revelation to mankind have been poisoned. What, then, are they to do?

That their enthusiasm for, say, slavery or the discriminatory taxation of religious minorities causes such offence to contemporary morality only confirms to them that there is a desperately pressing task of purification to perform. As Wood observes, “These practices may be rejected by mainstream Muslim scholars today, but for most of Islamic history, it barely occurred to Muslims to doubt that their religion permitted them.” Verses in the Quran, sayings of the Prophet, the example of the early caliphate: all can be used to justify them. Why, then, should Islamic State not reintroduce them, in the cause of making Islam great again?

Perhaps the most dispiriting section of Wood’s book describes his attempt to find an answer to this question by consulting eminent Muslim intellectuals in the US. Scholars whose understanding of Islam derives from a long chain of teachers (and who have framed documents on their walls to prove it) angrily condemn Islamic State for ignoring centuries’ worth of legal rulings. It is a valid point – but only if one accepts, as Islamic State does not, that scholarship can legitimately be used to supplement the Quran and the sayings of Muhammad.

When Wood asks Hamza Yusuf, an eminent Berkeley Sufi, to demonstrate the group’s errors by relying only on the texts revealed to the Prophet, he struggles to do so: “Yusuf could not point to an instance where the Islamic State was flat-out, verifiably wrong.” This does not mean that it is right but it does suggest – despite what most Muslims desperately and understandably want to believe – that it is no less authentically Islamic than any other manifestation of Islam. The achievement of Wood’s gripping, sobering and revelatory book is to open our eyes to what the implications of that for all of us may be.

Tom Holland’s books include “In the Shadow of the Sword: the Battle for Global Empire and the End of the Ancient World” (Abacus)

The Way of the Strangers: Encounters with the Islamic State by Graeme Wood is published by Allen Lane (317pp, £20​)

This article first appeared in the 19 January 2017 issue of the New Statesman, The Trump era