Chronic boredom is like the dull itch of a pair of Seventies school trousers

Nicholas Lezard's "Down and Out" column.

I have been suffering lately from something very like boredom. “Only boring people are bored,” runs the tiresome mantra, delivered by those tiresome people who consider life to be a glorious cycle of song and a medley of extemporanea. (For those who are unfamiliar with the lines, from Dorothy Parker, they continue: “And love is a thing that can never go wrong;/And I am Marie of Romania.” I do not quote these lines in the main body of my piece because, for once, love for me is not going wrong, touch wood.)

It is the kind of boredom that is actually more like the flu, in that it seems to be caused not by anything visible, but everything you do becomes imbued by suffering. I remember Vyvyan the punk in The Young Ones staggering around, smashing himself in the head with his own cricket bat in an attempt to relieve the tedium.

“Bored, bored, BORED,” Vyvyan would say, in time to the clouts to his own brains. It felt like that – everything was boring. Eating toast was boring. Being on a train was boring. Or perhaps not so much boring as mildly unpleasant, like wearing an itchy suit. (Note to younger readers: it was, until around the late Seventies, the rule for formal wear of whatever kind – whether it was a business, dinner, or school suit – to be made of a material that afforded the wearer the continual sensation of active discomfort, especially about the legs. To feel mildly pleased, or even neutral, about putting on a pair of trousers was considered to be unmanly, disgraceful and effete.)

Things on the horizon weren’t looking any better because the Beloved was going off to see her sister in Durham and I was to be left alone for a few days. Cohabitation has proved to be a delight, with the really rather counterintuitive side effect that the longer we stay together at a stretch, the more affectionate we are with each other, which is hell for other people – but nuts to them. Left to my own devices, though, I rediscover the fundamental meaninglessness of the universe, and plumping up the pillows as I retire to bed on my own becomes a terrifyingly lonely act, like the mysteriously ageing astronaut eating his solitary meals in silence towards the end of 2001.

How strange it is that men are in two horribly conflicted states of mind when it comes to this kind of thing! Those friends of mine who are married and parents would love to come out for a drink but find themselves prisoners in their own home. Do they like it, deep down, or do they chafe, as if wearing vintage trousers? The other day Martin Rowson, the rather wonderful cartoonist, discovered that all his immediate family members had scattered to various corners of the globe, and rather than potter around his house on his own, he came down to the Hovel, bearing gifts.

That was fun and he declared the Beloved THE BEST PERSON EVER (his caps) because she told him how she had been rude to Toby Young without even knowing who he was. (It was a conversation about musical education and he really should have thought twice before engaging with the B on the subject. But then these days poor Toby should think twice before saying anything. I wonder, sometimes, if he has had some kind of accident, which would account in some way for his increasing nuttiness.)

In the end, I found the perfect cure for my boredom: a game of cricket. Playing, not watching. It seems that Vyvyan was on the right lines all along. I have not done this for a couple of years and feared great rustiness, which would lead to some kind of terrible accident with the ball. It’s jolly hard, you know, and some of those people can really whack it. But the whole business of playing, the state of mild alertness you have to maintain on the field, the banter of one’s teammates, the play of the summer sun on the clouds, the trees, and even the picturesque sheep in the next field, put one in a state of something approaching bliss.

It was heaven and even the visiting American, who admittedly spent half the afternoon asleep, declared himself charmed, if baffled. (But not as baffled as the elderly Englishwoman a few feet away. “Why are they moving?” she would ask. “Is he the only one allowed to wear a hat?”) So that was all fine, until I got back and foolishly decided, for reasons that escape me, to check my bank balance. Any emotion I had vanished and was replaced by fear. That was bad. I don’t like the fear. I prefer the boredom.

Dorothy Parker (left) famously wrote that "only boring people are bored". Photo: Getty

Nicholas Lezard is a literary critic for the Guardian and also writes for the Independent. He writes the Down and Out in London column for the New Statesman.

This article first appeared in the 26 August 2013 issue of the New Statesman, How the dream died

Flickr/Michael Coghlan
Show Hide image

Why does the medical establishment fail to take women in pain seriously?

Women with mesh implants have been suffering for years. And it's not the only time they have been ignored. 

Claire Cooper’s voice wavered as she told the BBC interviewer that she had thought of suicide, after her mesh implant left her in life-long debilitating pain. “I lost my womb for no reason”, she said, describing the hysterectomy to which she resorted in a desperate attempt to end her pain. She is not alone, but for years she was denied the knowledge that she was just one in a large group of patients whose mesh implants had terribly malfunctioned.

Trans-vaginal mesh is a kind of permanent “tape” inserted into the body to treat stress urinary incontinence and to prevent pelvic organ prolapse, both of which can occur following childbirth. But for some patients, this is a solution in name only. For years now, these patients – predominantly women – have been experiencing intense pain due to the implant shifting, and scraping their insides. But they struggled to be taken seriously.

The mesh implants has become this month's surgical scandal, after affected women decided to sue. But it should really have been the focus of so much attention three years ago, when former Scottish Health Secretary Alex Neil called for a suspension of mesh procedures by NHS Scotland and an inquiry into their risks and benefits. Or six years ago, in 2011, when the US Food and Drug Administration revealed that the mesh was unsafe. Or at any point when it became public knowledge that people were becoming disabled and dying as a result of their surgery.

When Cooper complained about the pain, a GP told her she was imagining it. Likewise, the interim report requested by the Scottish government found the medical establishment had not believed some of the recipients who experienced adverse effects. 

This is not a rare phenomenon when it comes to women's health. Their health problems are repeatedly deprioritised, until they are labelled “hysterical” for calling for them to be addressed. As Joe Fassler documented for The Atlantic, when his wife's medical problem was undiagnosed for hours, he began to detect a certain sexism in the way she was treated:

“Why”, I kept asking myself, when reading his piece, “are they assuming that she doesn’t know how much pain she’s feeling? Why is the expectation that she’s frenzied for no real reason? Does this happen to a lot of women?”

This is not just a journalist's account. The legal study The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain found that women report more severe levels of pain, more frequent incidences of pain, and pain of longer duration than men, but are nonetheless treated for pain less aggressively. 

An extreme example is “Yentl Syndrome”. This is the fact that half of US women are likely to experience cardiovascular disease and exhibit different symptoms to men, because male symptoms are taught as ungendered, many women die following misdiagnosis. More often than should be acceptable, female pain is treated as irrelevant or counterfeit.

In another significant case, when the news broke that the most common hormonal birth control pill is heavily linked to a lower quality of life, many uterus-owning users were unsurprised. After all, they had been observing these symptoms for years. Social media movements, such as #MyPillStory, had long been born of the frustration that medical experts weren’t doing enough to examine or counter the negative side effects. Even after randomised trials were conducted and statements were released, nothing was officially changed.

Men could of course shoulder the burden of birth control pills - there has been research over the years into one. But too many men are unwilling to swallow the side effects. A Cosmopolitan survey found that 63 per cent of men would not consider using a form of birth control that could result in acne or weight gain. That’s 2 per cent more than the number who said that they would reject the option of having an annual testicular injection. So if we’re taking men who are afraid of much lesser symptoms than those experienced by women seriously, why is it that women are continually overlooked by health professionals? 

These double standards mean that while men are treated with kid gloves, women’s reactions to drugs are used to alter recommended dosages post-hoc. Medical trials are intended to unearth any potential issues prior to prescription, before the dangers arise. But the disproportionate lack of focus on women’s health issues has historically extended to medical testing.

In the US, from 1977 to 1993, there was a ban on “premenopausal female[s] capable of becoming pregnant” participating in medical trials. This was only overturned when Congress passed the National Institutes of Health (NIH) Revitalisation Act, which required all government funded gender-neutral clinical trials to feature female test subjects. However, it was not until 2014 that the National Institutes of Health decreed that both male and female animals must be used in preclinical studies.

Women’s exclusion from clinical studies has traditionally occurred for a number of reasons. A major problem has been the wrongful assumption that biologically women aren’t all that different from men, except for menstruation. Yet this does not take into account different hormone cycles, and recent studies have revealed that this is demonstrably untrue. In reality, sex is a factor in one’s biological response to both illness and treatment, but this is not as dependent on the menstrual cycle as previously imagined.

Even with evidence of their suffering, women are often ignored. The UK Medicines and Healthcare Regulatory Agency (MHRA) released data for 2012-2017 that shows that 1,049 incidents had occurred as a result of mesh surgery, but said that this did not necessarily provide evidence that any device should be discontinued.

Yes, this may be true. Utilitarian thinking dictates that we look at the overall picture to decide whether the implants do more harm than good. However, when so many people are negatively impacted by the mesh, it prompts the question: Why are alternatives not being looked into more urgently?

The inquiry into the mesh scandal is two years past its deadline, and its chairperson recently stepped down. If this isn’t evidence that the massive medical negligence case is being neglected then what is?

Once again, the biggest maker of the problematic implants is Johnson&Johnson, who have previously been in trouble for their faulty artificial hips and – along with the NHS – are currently being sued by over 800 mesh implant recipients. A leaked email from the company suggested that the company was already aware of the damage that the implants were causing (Johnson&Johnson said the email was taken out of context).

In the case of the mesh implants slicing through vaginas “like a cheese-wire”, whether or not the manufacturers were aware of the dangers posed by their product seems almost irrelevant. Individual doctors have been dealing with complaints of chronic or debilitating pain following mesh insertions for some time. Many of them just have not reported the issues that they have seen to the MHRA’s Yellow Card scheme for identifying flawed medical devices.

Shona Robison, the Scottish Cabinet Secretary for Health and Sport, asked why the mesh recipients had been forced to campaign for their distress to be acknowledged and investigated. I would like to second her question. The mesh problem seems to be symptomatic of a larger issue in medical care – the assumption that women should be able to handle unnecessary amounts of pain without kicking up a fuss. It's time that the medical establishment started listening instead. 

 

Anjuli R. K. Shere is a 2016/17 Wellcome Scholar and science intern at the New Statesman

0800 7318496