The divided self: "Portrait in Ruby and Blue" (2012) by Daniel Gordon. Image: Daniel Gordon Studio
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The agony and the ecstasy

The creative power of illness.

The first time I experienced severe physical pain, I was 13 years old. It was a new sensation: nauseating, deep and gnawing; centred in my abdomen and the base of my spine, it also radiated down both legs. I lay on the floor of the lounge, one moment curled on my side like a comma, my knees pulled up to my chest; the next on my back; the next on my front with my legs spread as wide as they would go. None of these positions brought relief. I was vaguely aware of shaking and of being unable to talk. My skin, I learned later, was so unnaturally pale that had I not been moving, I might have been taken for dead.

More than a decade of similar episodes followed, until, aged 26, I was diagnosed with endometriosis. I still have the condition today, and sometimes, in the middle of a bad episode, I have longed not to exist. But always after the pain comes the gradual, miraculous release from pain, and with it the sense that my stay in that other strange realm to which illness transports us is by no means over. It seems to me that these periods are vacations, in the truest sense of the word – intermissions, voids, times in which my normal life has in effect been emptied of my presence.

Most people have never seen me suffering: a few (ambulance staff, doctors, night cleaners) have never seen me well. It is as if, since the age of 13, a secret self has existed alongside my everyday self; one for whom, from time to time, the so-called real world, with all its duties and dreary preoccupations, ceases to be. It’s striking how often the notion of the divided self crops up in relation to physical illness. Sometimes the division is literal, as described here by Dorothy Molloy in the title poem of her collection Gethsemane Day:

They’ve taken my liver down to the lab,
left the rest of me here on the bed;
the blood I am sweating rubs off on the sheet,
but I’m still holding on to my head.

Sylvia Plath also presents an account of the self splitting into two while undergoing medical treatment. In December 1952, she found herself in hospital after breaking her leg in a skiing accident. Her response, “In Plaster”, details a struggle between two different selves:

I shall never get out of this! There are two of me now:
This new absolutely white person and the old yellow one,
And the white person is certainly the superior one.

Superior, it transpires, only inasmuch as the plaster self doesn’t need food to sustain it and is “whiter and unbreakable and with no complaints”. But it is the old, yellow self that plays host to this gleaming other. Clearly, we’re in the realms of metaphor: Plath believed that a life lived by a false self or selves was both cowardly and senseless; time and again her poems propound the wisdom of shedding false identities.

Much has been made of the link between creativity and mental illness, but the link between physical illness and the creative life, though less discussed, is just as significant. For some artists, it led directly to a choice of career. Matisse – famous for his intense, saturated colours that seem to blaze with life – initially studied law and had begun work as a court administrator when an attack of appendicitis forced him to take time out. His mother bought him art supplies to keep him occupied during his convalescence and it was only then that he made his first paintings. His subsequent decision to quit law and become a painter was, it is said, the cause of deep disappointment for his father.

Hilary Mantel, a fellow endometriosis sufferer, believes the disease was at least partly responsible for her choice to become a writer, as she explains in an interview at the back of her memoir, Giving Up the Ghost: “A lot of people know they’re going to be writers when they’re children, but I made a conscious decision to become one when I was 22, when, because of my poor health, I saw other career prospects slipping away from me.”

Like Matisse, Mantel read law at university but her studies were interrupted by severe episodes of pain that resulted in a succession of inappropriate medication. She explains, “It was in the nature of educated young women, it was believed, to be hysterical, neurotic, difficult, and out of control, and the object was to get them back under control . . . by giving them drugs which make them indifferent to their mental pain – and, in my case, indifferent to physical pain too.”

Baffled by the symptoms, Mantel’s doctors seem to have resorted to a sort of annihilation of the self. Though the circumstances aren’t usually so extreme, the sensation of surrendered identity is a common reaction to medical intervention – as the bed-ridden speaker in Sylvia Plath’s “Tulips” describes:

I have given my name and my day-clothes up to the nurses
And my history to the an aesthetist and my body to surgeons.
They have propped my head between the pillow and the sheet-cuff

Like an eye between two white lids that will not shut.

This feeling is by no means the preserve of female writers. In 2006, in County Donegal, the Nobel laureate Seamus Heaney suffered a stroke that he wrote about in his most tender collection, Human Chain. In conversation with the Observer, he explained, “The trip in the ambulance I always remember because Marie [Heaney’s wife] was in the back with me . . . To me, that was one of the actual beauties of the stroke, that renewal of love in the ambulance. One of the strongest, sweetest memories I have.” In “Chanson d’Aventure”, he describes that same journey: here, the speaker’s sense of powerlessness is powerfully expressed in a series of passive verbs, as he finds himself

Strapped on, wheeled out, forklifted, locked
In position for the drive
Bone-shaken, bumped at speed

Later in the same poem, Heaney finds himself reflecting on the word bell:

. . . the one I tolled in Derry in my turn
As college bellman, the haul of it there still
In the heel of my once capable

Warm hand, hand that I could not feel you lift
And lag in yours throughout that journey
When it lay flop-heavy as a bellpull.

The merging of present and past that Heaney articulates here is another familiar feature of illness. In the midst of severe pain it is difficult to be anywhere except the present, but at times of injury or shock it is common for different time phases to merge.

Disease can open up unique perspectives for the sufferer and a surprising amount of the work that makes up our artistic canon has emerged from it – work that would otherwise never have existed. An obvious example is Paradise Lost, dictated by Milton after he had lost his sight completely.

More poignant still is the story of Mahler’s Ninth Symphony. In middle age, and shortly after the death of his young daughter, Mahler learned that his heart was defective. The first movement of the symphony opens with a tentative, syncopated rhythm that many, including Leonard Bernstein, have suggested echoes the composer’s irregular heartbeat. The motif returns seven times over the course of the movement until, at its climax, it arrives as a sudden intrusion, as Bernstein put it, of “death in the midst of life”. This time it is announced by trombones, underpinned by a booming bass drum and marked in the score mit höchster Gewalt (“with the greatest violence”) – as if death must finally have its say.

My latest poetry collection, The World’s Two Smallest Humans, concludes with an assertion of life – a sequence of poems based on the IVF treatment I received for fertility problems related to endometriosis. The sequence is fictional but the two smallest humans of the title are real enough: there is an extraordinary moment during the IVF process when the embryologist walks into the treatment room with your live embryos attached to the end of a pipette. In she walks, in a little scrub cap and tunic, looking more like a bakery worker than someone who is carrying in her latex-gloved hands the smallest human beings possible. Moments later, those same beings are transferred to the patient’s womb to do their best.

After three operations, my worst pain episodes are few and far between, but they still occur. The most recent happened a few months ago. The two-person ambulance crew that arrived at my cottage door in the dead of night was led by a woman called Jo, for whose professionalism and compassion I shall be eternally grateful.

Philip Larkin said of ambulances, “They come to rest at any kerb:/All streets in time are visited.” According to the poem, a journey in an ambulance signals the end, first of our identity and then our existence: such a trip, the poem concludes, “Brings closer what is left to come,/And dulls to distance all we are.”

That may be true but more often than not it is a temporary truth: Larkin’s poem wilfully disregards the possibility of recovery. In some ancient cultures there is a deity for illness, which strikes me as refreshingly clear sighted. If such a god existed for us today, I would be glad of the chance to offer up a prayer of thanks for the rich crop of art he has nurtured into being.

Julia Copus’s recent collection, “The World’s Two Smallest Humans”, was shortlisted for the T S Eliot Prize and the Costa Book Awards

This article first appeared in the 28 January 2013 issue of the New Statesman, After Chavez

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When it comes to responding to Islamic State, there is no middle ground

If Britain has a declared interest in curtailing Islamic State and stabilising Syria, it is neither honourable nor viable to let others intervene on our behalf.

Even before the brutal terrorist attacks in Paris, British foreign policy was approaching a crossroads. Now it is time, in the words of Barack Obama, addressing his fellow leaders at the G20 Summit in Turkey on 16 November, “to step up with the resources that this fight demands”, or stand down.

The jihadist threat metastasises, and international order continues to unravel at an alarming rate. A Russian civilian charter plane is blown out of the sky over the Sinai Peninsula in Egypt, killing 224 people, most of them returning from holiday, and the various offshoots of Islamic State bare their teeth in a succession of brutal attacks in France, Lebanon, Tunisia, Turkey and further afield. Our enemies are emboldened and our friends want to know to what extent we stand with them. The UK can no longer afford to postpone decisions that it has evaded since the Commons vote of August 2013, in which the government was defeated over the question of joining US-led air strikes against President Bashar al-Assad’s regime following a chemical weapons attack on Syrian civilians. MPs’ continued introspection is on the verge of becoming both irresponsible and morally questionable. There is no fence left to sit on.

On Sunday night, two days after the Paris attacks, the French – with US support – launched a series of bombing raids against Islamic State targets in Raqqa. With much more to come, the choice facing this country may not be easier but it is certainly clearer. Britain must determine whether it wants to be a viable and genuine partner in the fight against Islamic State, and in the long-term efforts to bring an end to the assorted evils of the Syrian civil war; or whether we are content to sit on the sidelines and cheer on former team-mates without getting our knees dirty. We can join our two most important allies – France and the United States, at the head of a coalition involving a number of Arab and other European states – in confronting a threat that potentially is as grave to us as it is to France, and certainly more dangerous than it is to the US. Alternatively, we can gamble that others will do the work for us, keep our borders tighter than ever, double down on surveillance (because that will certainly be one of the prices to pay) and hope that the Channel and the security services keep us comparatively safe. There is no fantasy middle ground, where we can shirk our share of the burden on the security front while leading the rest of the world in some sort of diplomatic breakthrough in Syria; or win a reprieve from the jihadists for staying out of Syria (yet hit them in Iraq), through our benevolence in opening the door to tens of thousands of refugees, or by distancing ourselves from the ills of Western foreign policy.

That the international community – or what is left of it – has not got its act together on Syria over the past three years has afforded Britain some space to indulge its scruples. Nonetheless, even before the Paris attacks, the matter was coming to the boil again. A vote on the expansion of air operations against Islamic State has been mooted since the start of this year, but was put on the back burner because of the May general election. The government has treated parliament with caution since its much-discussed defeat in the House in summer 2013. The existing policy – of supporting coalition air strikes against Islamic State in Iraq but not Syria – is itself an outgrowth of an awkward compromise between David Cameron and Ed Miliband, an attempt to reverse some of the damage done by the 2013 vote in parliament.

The Conservatives have waited to see where the ground lies in a Jeremy Corbyn-led Labour Party before attempting to take the issue back before the Commons. Labour pleaded for more time when Corbyn was elected, but there is no sign that the Labour leader is willing to shift in his hostility to any form of intervention. More significantly, he has now ruled out Labour holding a free vote on the matter.

If anything, the coalition of Little Englanders, anti-interventionists and anti-Americans in the House of Commons seems to have dug its trenches deeper. This leaves the Prime Minister with few options. One is to use the Royal Prerogative to announce that an ally has been attacked, and that we will stand with her in joining attacks against Islamic State in Syria. The moment for this has probably already passed, though the prerogative might still be invoked if Isis scores a direct hit against the UK. Yet even then, there would be problems with this line. A striking aspect of the killing of 30 Britons in the June attacks in Sousse, Tunisia, is just how little domestic political impact it seems to have made.

Another option for Cameron is to try to make one final effort to win a parliamentary majority, but this is something that Tory whips are not confident of achieving. The most likely scenario is that he will be forced to accept a further loss of the UK’s leverage and its standing among allies. Co-operation will certainly come on the intelligence front but this is nothing new. Meanwhile, the government will be forced to dress up its position in as much grand diplomatic verbiage as possible, to obfuscate the reality of the UK’s diminishing influence.

Already, speaking at the G20 Summit, the Prime Minister emphasised the need to show MPs a “whole plan for the future of Syria, the future of the region, because it is perfectly right to say that a few extra bombs and missiles won’t transform the situation”. In principle, it is hard to argue with this. But no such plan will emerge in the short term. The insistence that Assad must go may be right but it is the equivalent of ordering the bill at a restaurant before you have taken your seat. In practice, it means subcontracting out British national security to allies (such as the US, France and Australia) who are growing tired of our inability to pull our weight, and false friends or enemies (such as Russia and Iran), who have their own interests in Syria which do not necessarily converge with our own.

One feature of the 2013 Syria vote was the government’s failure to do the required groundwork in building a parliamentary consensus. Whips have spent the summer scouting the ground but to no avail. “The Labour Party is a different organisation to that which we faced before the summer,” Philip Hammond, the Foreign Secretary, has said. It is ironic, then, that the Prime Minister has faced strongest criticism from the Labour benches. “Everyone wants to see nations planning for increased stability in the region beyond the military defeat of the extremists,” says John Woodcock, the chairman of the Parliamentary Labour Party defence committee, “but after two years of pussy-footing around, this just smacks of David Cameron playing for time when he should be showing leadership.”

The real story is not the distance between the two front benches but the divisions within both parties. There are as many as 30 Conservative MPs said to be willing to rebel if parliament is asked to vote for joining the coalition against Islamic State in Syria. It seems that the scale of the Paris attacks has not changed their position. A larger split in the Labour ranks also seems likely. Even before Paris, there were rumoured to be roughly 50 MPs ready to defy their leader on this question.


At first, in the wake of last week’s attacks, it seemed as if the Prime Minister might force the issue. To this end, he began the G20 in Turkey with a bilateral meeting with President Putin. His carefully chosen words before and after that discussion, in which he was much more emollient about Moscow’s role, showed the extent to which he was prepared to adapt to the changing situation. Cameron hoped that if he could show progress in building an international coalition on the diplomatic front, that might just give him enough to get over the line in a parliamentary vote.

This new approach has not had the desired effect. At the time of writing, the government believes it is too risky to call another vote in the short term. It calculates another defeat would hugely diminish Britain’s standing in the world. In truth, the government was already swimming upstream. On 29 October, the Conservative-
dominated Commons foreign affairs select committee, chaired by Crispin Blunt, released a report on the extension of British military operations into Syria, in anticipation of government bringing forward a parliamentary vote on the question. The report recommended that Britain should avoid further involvement unless a series of questions could be answered about exit strategy and long-term goals. The bar was set deliberately high, to guard against any further involvement (even the limited option of joining the existing coalition undertaking air strikes against IS in Syria).

The most flimsy of the five objections to further intervention in the report was that it will somehow diminish the UK’s leverage as an impartial arbiter and potential peacemaker. This is based on an absurd overestimation of the UK as some sort of soft-power saviour, valued by all parties for its impartiality in Middle Eastern affairs. Britain cannot hope to have any influence on policy if it is always last to sign up while others put their lives on the line. As so often in the past, what masquerades as tough-minded “realpolitik” is nothing of the sort. It is just another post-facto rationale for inaction.

Although it is sometimes said that Britain has yet to recover from the consequences of the invasion of Iraq, the committee report had a retro, 1990s feel. Many of the objections raised to burden-sharing in Syria were the same as those raised against humanitarian intervention in the Balkans two decades ago, when Blunt was working as special adviser to Michael Rifkind as defence and foreign secretary, and the UK was at the forefront of non-intervention. Likewise, two of the committee’s Labour members, Ann Clwyd and Mike Gapes, were veterans of the other side of that debate, and strong supporters of the Nato intervention in Kosovo in 1999. They expressed their dissent from the report’s conclusions but were voted down by their Conservative and SNP fellow committee members. “Non-intervention also has consequences,” said Gapes when he broke rank. “We should not be washing our hands and saying, ‘It’s too difficult.’”

Polling figures have shown majority public support for air strikes against IS since the spate of gruesome public executions that began last year, but nothing seems to change the calculus of the rump of anti-interventionist MPs.

All this promises an uncertain future for British foreign policy. On 6 November, the Defence Secretary, Michael Fallon, suggested that the UK’s existing position, of joining the coalition in Iraq but stopping at the borders of Syria, is “morally indefensible”. The killing of Mohammed Emwazi, aka “Jihadi John”, by a US predator drone on 12 November demonstrates what he meant. Emwazi was a Briton who was responsible for the beheading of British and American citizens, as well as countless Syrians. While the UK government was closely involved in that operation – and has previously used the justification of “self-defence” to “take out” targets in Syria – such are the restrictions placed upon it that we are forced to ask our allies to conduct potentially lethal operations (which are in our core national interests) on our behalf. The very act of “self-defence” is subcontracted out once again.

How long can this last when Islamic State poses a much greater threat to the UK than it does to the US? There is an issue of responsibility, too, with hundreds of British citizens fighting for and with Islamic State who clearly pose a grave danger to other states.


The very notion that Britain should play an expansive international role is under attack from a pincer movement from both the left and the right. There are two forms of “Little Englanderism” that have made a resurgence in recent years. On the left, this is apparent in the outgrowth of a world-view that sees no role for the military, and holds that the UK is more often than not on the wrong side in matters of international security, whether its opponent is Russia, Iran, the IRA or Islamic State. The second, and arguably just as influential, is the Little Englanderism of the right, which encompasses a rump of Tory backbenchers and Ukip. This is a form of neo-mercantilism, a foreign policy based on trade deals and the free movement of goods that regards multilateralism, international institutions and any foreign military intervention with great suspicion, as a costly distraction from the business of filling our pockets.

The time is ripe for long-term, hard-headed and unsentimental thinking about Britain’s global role. The country is not served well by the impression of British “decline” and “retreat” that has gained ground in recent times; and it is no safer for it, either. Given how quickly the security and foreign policy environment is changing, the publication of the Strategic Defence and Security Review in the coming week, alongside an update of the National Security Strategy, is likely to raise more questions than it answers. The officials responsible for its drafting do not have an easy brief, and news forecasting is a thankless task. Strategic vision and leadership must come from our elected politicians.

For all the talk of British decline, we are still one of the five wealthiest nations in the world. What we do matters, particularly at moments when our friends are under attack. However, until a new broad consensus emerges between the mainstream Labour and Conservative positions on foreign policy, the Little England coalition will continue to have the casting vote.

Syria continues to bleed profusely and the blood seeps deeper into different countries. There will be no political solution to the civil war there for the foreseeable future; to pretend that there is a hidden diplomatic solution is to wish to turn the clock back to 2011, when that might have been possible. Nor is the security situation any easier to deal with. A few hours before the attacks in Paris began, President Obama gave an interview in which he argued that he had successfully “contained” Islamic State. For the wider Middle East and Europe, that is simply not the case. Now, France will escalate its campaign, and the US will do more. Russia already has troops on the ground and will most likely send reinforcements.

The war in Syria is becoming more complicated and even more dangerous. The best that can be hoped for is that the Syrian ulcer can be cauterised. This will be achieved through the blunting of Islamic State, simultaneous pressure on Assad, and the creation of more safe places for Syrians. All roads are littered with difficulties and dangers. Yet, in the face of this ugly reality, is Britain to signal its intention to do less as every other major actor – friend and foe alike – does more? If we have a declared national interest in curtailing Islamic State and stabilising Syria – both because of the growing terrorist threat and because of the huge flow of refugees – then it is neither honourable nor viable to let others take care of it on our behalf.

John Bew is an NS contributing writer. His new book, “Realpolitik: a History”, is newly published by Oxford University Press

This article first appeared in the 19 November 2015 issue of the New Statesman, The age of terror