The Good Samaritans

J P W Mallalieu at Stoke Mandeville Hospital in 1956 argues foreigners have every right to use the NHS: after all, they built it.

Early this year, a friend of mine had his appendix removed in Moscow and was presented with a bill for £100. He protested that a Russian taken ill in Britain could have the operation free. He was not believed and had to pay. But when, some weeks later, he was about to come home, his £100 was returned to him—in blocked roubles. The Russians had been making inquiries, had caught up with at least one of the facts of British life and had decided that for one individual Briton, at least, there should after all be reciprocity.

When the National Health Service was launched the proposal that it should be as freely available to foreigners as it was to Britons was strongly and understandably criticised. But Nye Bevan persisted. He reminded the House of Commons that for centuries the Catholic Church had freely given treatment in its monasteries to all who asked for it, no matter from what country they came and he insisted that Britain should set an example to the rest of the world by reasserting the principle that in healing there should be no bounds. The fact that only one country, Sweden, which has plans to give free treatment to Britons taken ill there, has followed our example and that a country like Russia, so far from following the example, did not seem even to have heard of it, has tended to revive the criticisms made eight years ago. The critics find it hard that when, as a nation, we are barely keeping our heads above financial water, foreigners should get cheap teeth and spectacles at our expense or have their babies or operations in hospital beds which are badly needed for British patients. It was with this criticism in mind that I have just visited one of the more famous hospitals in the National Health Service.

Stoke Mandeville was built early in the war by the Ministry of Pensions to handle air raid and service casualties. It is now under the Royal Buckinghamshire and Associated Hospitals Management Committee. It is a general hospital catering like others for the normal ills of mankind and is able to provide a better than average service, partly because its buildings are relatively modern. But its service is not confined to the people of Buckinghamshire. I found that the general surgery wards, while I was there, were full of patients from Northampton. In a month's time they may well be full of patients from Oxford and, later on, from Reading. For the hospitals in those towns are so overloaded that there is a long waiting list for all but emergency cases. So Stoke Mandeville breaks down the boundaries, at least, of county and helps to take the load off its neighbours.

Further, the research which it is carrying on into, for example, rheumatism, under Dr A G S Hill, and the experience it has acquired in such things as plastic surgery, under Professor Pomfret Kilner, are attracting patients to its specialised services from all over the country. It is, I suppose, possible that some people in the neighbourhood of Aylesbury, who occasionally have to wait for treatment rather longer than they might otherwise have to do, resent the intrusion of such "foreigners" from other parts of the country—though I did not hear such resentment expressed. But I have heard resentment about a far more spectacular breach of boundaries which has followed the development of the Stoke Mandeville Spinal Injuries Department.

Years ago many people who suffered spinal injuries were abandoned. They were left to rot in bed, developing horrible bed sores, without hope for themselves and knowing that they were a burden to others, until they died. Stoke Mandeville, more perhaps than any other hospital in the world, has begun to change this. Paralysed men and women come there unable to do anything for themselves. By special machines and by special exercises they are taught to make other muscles do the work previously done by muscles which the paralysis has wasted. I saw a racing cyclist, whose legs no longer had feeling in them, managing to keep his leg muscles from atrophy by means of a specially designed bed cycle which he worked with his hands. I saw men in wheel chairs developing new strengths by practising archery, or playing table tennis, basket ball and even polo. Above all, these patients, who would once have been considered, and would have considered themselves, as rejects from society, are being taught that they can have a new and fully useful life. They are taught new jobs so that a steeplechase jockey, for example, who broke his back, eventually left the hospital having qualified as a chartered accountant; and he is now practising as such.

Despite the seriousness of the complaints with which it has to deal there is an atmosphere of gaiety in the Department; and in that atmosphere men and women who felt that they would never walk again are wheedled, cajoled and bullied by staff and fellow patients into taking their first, effortful steps. Inevitably, the successes here achieved are attracting patients not only from all over this country but also from all over the world. While I was there, I talked with a Frenchman, a Portuguese, a Turkish lady and a little Cypriot boy. In the hospital as a whole there were 16 foreign patients—a small number out of the total of 390—yet a number which may well seem exasperatingly large to some helpless Briton waiting for his turn. When I saw the treatment being given there to paraplegics and thought of my own god-child who is on the waiting list for a bed, I myself began to wonder whether in this, at any rate, charity could not begin at home and still be both Christian and Socialist.

And yet . . . it was impossible not to be moved by the sight of that black-eyed paralysed Cypriot boy, slowly regaining the power of movement in the same hospital where a British soldier was recovering from the wounds he had received in Cyprus; or by the sight of the boy's mother working in the wards, so that she could be near her son and help to repay the hospital for its care. It was impossible not to realise that but for the work of 122 foreigners, who now help as nurses, porters, cooks and maintenance staff at Stoke Mandeville, the general work of the hospital could not be carried on. Above all, it was impossible not to realise that, but for the work of a foreigner, the paraplegics in the hospital and, indeed, throughout the world would not have the hope which they feel today.

For the hospital's Spinal Injuries Department was founded and is still supervised by a 55-year-old German Jew who escaped from Hitler; and among his assistants are another German, Dr Michailis, and a Czech, Dr Melzak. Their skill, persistence and imagination have helped to create something of immeasurable value for a hitherto abandoned section of British people. I cannot believe that British people will want to deny to foreigners a share in something which foreigners have helped to create. But I hope we shall continue to go beyond quid pro quo's and accept into our care, as Stoke Mandeville has accepted into its care, with equal warmth both the British soldier shot by Cypriots, and the Cypriot boy paralysed by a cruel misfortune almost before his life had begun.

The entrance to the Spinal Injuries Unit at Stoke Mandeville Hospital. Photo: Getty.

J P W Mallalieu (1908-1980) was a Labour MP and New Statesman Westminster columnist.

Photo: Getty
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Essayism is ultimately about how literature can make a difference

Brian Dillon’s study of the essay is a beautiful and elegiac volume – having read it, I re-read it.

It is somewhat unseemly for a critic to confess that their immediate reaction to a book is one of unremitting envy. But Brian Dillon’s study of the essay is so careful and precise in its reading of a constellation of authors – Derrida and Barthes, Didion and Sontag, Browne and Burton, Woolf and Carlos Williams, Cioran and Perec – that my overall feeling was jealousy.

Dillon is a writer on art and culture and a tutor at the Royal College of Art, and the author of an award-winning memoir from 2005, In The Dark Room, about losing both his parents in his youth. A remarkable meditation on memory, it shares with his other work – an examination of hypochondria, Tormented Hope, and his writing on the cultural significance of ruins – a wide and nimble range of reference as well as a sense of personal grief and literary anomie.

 In Essayism, Dillon deals, with a kind of weary shrug, with the etymology of “essay”. But more than just sauntering through “attempt”, “try” and “test”, he digs much deeper: from essayer he goes to examen, the needle of a scale, an image of control. The essay is both a proposition and the judge of it. What truly comes across in this book is that the essay may well be a sally against the subject, but what is tried, in the final reckoning, are the authors themselves. And, of course, found wanting, in both senses of the word. The essay, in Dillon’s account, is both erotic and absent, lapidary and profuse, and is at its best when always concerned with its own realisation of its inherent sense of failure. Before this discussion of etymology, though, comes a bravura cadenza of topics, placed to make us realise the essay is never about what it claims to be at all.

The close readings of various essayists are counterpointed by chapters headed “On Consolation”. This is some of Dillon’s most autobiographical writing to date. In Essayism he both excoriates and exorcises, using the essay as a flail and a balm. In other
essayists he finds mirrors of his own joys and despairs, particularly in a wonderful piece about Cyril Connolly, which deserves commendation simply for not mentioning the pram in the hall.

Essaysism resists defining its subject. As the critic David Shields has said, you don’t have a drawer labelled “non-socks”; and “non-fiction” is a singularly slippery notion. Dillon’s “essays” range from aphorism to such glorious sprawls as Robert Burton’s 17th-century treatise The Anatomy of Melancholy. Some are journalistic, others are philosophic. To an extent, it is the very fluidity that Dillon admires; but above all he claims to admire style, and he is exceptionally good at defining the styles he likes. He reads more into the placing of a comma in a piece by Elizabeth Hardwick than most critics might find in the whole of her work.

This neatness, as it were, typifies the book. It is about noticing, and scrutinising, and reflecting. He has a keen ear for when a sentence has a word that is somehow out of key – “porcupine”, “broccoli” – yet possesses a strange beauty.

The book shifts into a higher gear when Dillon writes about his own depression. There is never a moment where he asks the reader to feel sorry for him. There is a steeliness in his descriptions of the nebulous haze that anti-depressants led him into; a stoic willingness to face one’s own sadness. Books, and the tiny curlicues of beauty he notes in them, were a kind of redemptive force for Dillon, far more so than Prozac. That at one point he found consolation in the pages of the NME is remarkable.

His account of depression is reflected in thinking about the essay. Is it something composed of fragments and shards? Is it a coolly organised progression? Is it about confession? Is it about concealment? The book’s excellence lies in the way these paradoxes are held suspended.

It seems churlish to mention omissions, but I do so because I would like to read what Brian Dillon would have to say about figures such as William Hazlitt, Richard Steele, Matthew Arnold or Iain Sinclair (perhaps our most essayistic novelist). And Dillon’s assertion about the absence of a literature of sickness is unjustifiable if one considers Thomas Mann, Knut Hamsun, Céline. His canon is, as all are, arbitrary: they are the pieces of writing that mattered to him when they mattered most.

The book, ultimately, is about how literature can make a difference. It is a beautiful and elegiac volume. I can give no greater compliment than to say that having read it, I re-read it. 

Essayism
Brian Dillon
Fitzcarraldo Editions, 228pp, £10.99

This article first appeared in the 20 July 2017 issue of the New Statesman, The new world disorder