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Galliano’s fashionable beliefs: Laurie Penny on an act of hypocrisy

The problem with racism and sexism in fashion goes far beyond one slurring fantasist.

The fashion industry is a vacuous sausage factory that minces down the bodies of vulnerable young people, tosses in handfuls of unexamined prejudice and squeezes out glistening parcels of expensive self-hatred. There is also, as Hunter S Thompson might have said, a negative side.

This week, after an alleged anti-Semitic verbal assault by the Dior designer John Galliano in a Paris bar, an earlier video emerged of him ranting about Jews and women. "I love Hitler. People like you would be dead today," he tells two horrified women. "Your mothers, your forefathers, would be fucking gassed and fucking dead."

Fashion people everywhere rushed to check their hair before joining the chorus of dismay, almost as if racism and sexism were not the stock-in-trade of their industry. In fact, it is an open secret in high fashion that black and minority ethnic faces - alongside women whose ribs cannot be counted through their rattan tops, or "fat mummies" in the phraseology of Chanel's Karl Lagerfeld - are not welcome. The few working black models accuse fashion houses of declining to hire them on the basis of skin tone - model agencies recently suggested that perhaps consumers just don't like looking at black people.

Diversity in fashion is going backwards. The recent fashion week in New York, one of the most multicultural places on the planet, featured 85 per cent white models, a proportion that has hardly changed in a decade. Recent high-profile campaigns have showcased white models in blackface, and when real black models do make it on to the pages of magazines, the airbrushing invariably lightens their colouring and straightens their hair into more marketable, Caucasian styles. Then we wonder why anxious teenagers across the world are using dangerous toxins to bleach the blackness out of their skin.

Frock horror

What should shock is not just the substance of Galliano's comments, but the fact that it took a man being caught on camera explicitly saying that he loves Hitler for the fashion industry to acknowledge a teeny problem with racism. The rabid misogyny of Galliano's outburst has hardly been commented on because, while most people now acknowledge that anti-Semitism isn't very nice, the jury is still out on institutional sexism.

The misogyny of fashion culture, however, exceeds its apparent conviction that any woman with the temerity to do more than silently starve herself is abhorrent. Silent complicity surrounds the rapes and sexual assaults that are routine in the industry. When the designer Anand Jon was last year found guilty on 16 counts of rape and sexual battery of models as young as 14, the only surprise expressed by fashion insiders was that his victims had dared to come forward at all.

The pearl-clutching piety of the response to Galliano's ugly outburst is a primer in tasteful hypocrisy. High-profile fashion colleagues eventually expressed discomfort with his viewpoint, if that's an appropriate term for the sort of drooling monologue normally delivered by a park-bench pervert with two hands down his pants. The problem with racism and sexism in fashion, however, goes far beyond one slurring fantasist.

Laurie Penny is a contributing editor to the New Statesman. She is the author of five books, most recently Unspeakable Things .

This article first appeared in the 07 March 2011 issue of the New Statesman, The great property swindle

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Want to know how you really behave as a doctor? Watch yourself on video

There is nothing quite like watching oneself at work to spur development – and videos can help us understand patients, too.

One of the most useful tools I have as a GP trainer is my video camera. Periodically, and always with patients’ permission, I place it in the corner of my registrar’s room. We then look through their consultations together during a tutorial.

There is nothing quite like watching oneself at work to spur development. One of my trainees – a lovely guy called Nick – was appalled to find that he wheeled his chair closer and closer to the patient as he narrowed down the diagnosis with a series of questions. It was entirely unconscious, but somewhat intimidating, and he never repeated it once he’d seen the recording. Whether it’s spending half the consultation staring at the computer screen, or slipping into baffling technospeak, or parroting “OK” after every comment a patient makes, we all have unhelpful mannerisms of which we are blithely unaware.

Videos are a great way of understanding how patients communicate, too. Another registrar, Anthony, had spent several years as a rheumatologist before switching to general practice, so when consulted by Yvette he felt on familiar ground. She began by saying she thought she had carpal tunnel syndrome. Anthony confirmed the diagnosis with some clinical tests, then went on to establish the impact it was having on Yvette’s life. Her sleep was disturbed every night, and she was no longer able to pick up and carry her young children. Her desperation for a swift cure came across loud and clear.

The consultation then ran into difficulty. There are three things that can help CTS: wrist splints, steroid injections and surgery to release the nerve. Splints are usually the preferred first option because they carry no risk of complications, and are inexpensive to the NHS. We watched as Anthony tried to explain this. Yvette kept raising objections, and even though Anthony did his best to address her concerns, it was clear she remained unconvinced.

The problem for Anthony, as for many doctors, is that much medical training still reflects an era when patients relied heavily on professionals for health information. Today, most will have consulted with Dr Google before presenting to their GP. Sometimes this will have stoked unfounded fears – pretty much any symptom just might be an indication of cancer – and our task then is to put things in proper context. But frequently, as with Yvette, patients have not only worked out what is wrong, they also have firm ideas what to do about it.

We played the video through again, and I highlighted the numerous subtle cues that Yvette had offered. Like many patients, she was reticent about stating outright what she wanted, but the information was there in what she did and didn’t say, and in how she responded to Anthony’s suggestions. By the time we’d finished analysing their exchanges, Anthony could see that Yvette had already decided against splints as being too cumbersome and taking too long to work. For her, a steroid injection was the quickest and surest way to obtain relief.

Competing considerations must be weighed in any “shared” decision between a doctor and patient. Autonomy – the ability for a patient to determine their own care – is of prime importance, but it isn’t unrestricted. The balance between doing good and doing harm, of which doctors sometimes have a far clearer appreciation, has to be factored in. Then there are questions of equity and fairness: within a finite NHS budget, doctors have a duty to prioritise the most cost-effective treatments. For the NHS and for Yvette, going straight for surgery wouldn’t have been right – nor did she want it – but a steroid injection is both low-cost and low-risk, and Anthony could see he’d missed the chance to maximise her autonomy.

The lessons he learned from the video had a powerful impact on him, and from that day on he became much more adept at achieving truly shared decisions with his patients.

This article first appeared in the 01 October 2015 issue of the New Statesman, The Tory tide