Treat with extreme caution

Homoeopathic medicine is founded on a bogus philosophy. Its continued use is a drain on NHS resource

Two years ago, a loose coalition of like-minded scientists wrote an open letter to chief executives of the National Health Service Trusts. The signatories simply stated that homoeopathy and other alternative therapies were unproven, and that the NHS should reserve its funds for treatments that had been shown to work. The letter marked an extraordinary downturn in the fortunes of homoeopathy in the UK over the following year, because the overwhelming majority of trusts either stopped sending patients to the four homoeopathic hospitals, or introduced measures to strictly limit referrals.

Consequently, the future of these hospitals is now in doubt. The Tunbridge Wells Homoeopathic Hospital is set to close next year and the Royal London Homoeopathic Hospital is likely to follow in its wake. Homoeo paths are now so worried about the collapse of their flagship hospitals that they are organising a march to deliver a petition to Downing Street on 22 June. Local campaign groups are being formed and patients are being urged to sign the petition.

Homoeopaths believe that the medical Establishment is crushing a valuable healing tradition that dates back more than two centuries and that still has much to offer patients. Homoeopaths are certainly passionate about the benefits of their treatment, but are their claims valid, or are they misguidedly promoting a bogus philosophy?

This is a question that I have been considering for the past two years, ever since I began co-authoring a book on the subject of alternative medicine with Professor Edzard Ernst. He was one of the signatories of the letter to the NHS trusts and is the world's first professor of complementary medicine. Before I present our conclusion, it is worth remembering why homoeo pathy has always existed beyond the borders of mainstream medicine.

Homoeopathy relies on two key principles, namely that like cures like, and that smaller doses deliver more powerful effects. In other words, if onions cause our eyes to stream, then a homoeopathic pill made from onion juice might be a potential cure for the eye irritation caused by hay fever. Crucially, the onion juice would need to be diluted repeatedly to produce the pill that can be administered to the patient, as homoeopaths believe that less is more.

Initially, this sounds attractive, and not dissimilar to the principle of vaccination, whereby a small amount of virus can be used to protect patients from viral infection. However, doctors use the principle of like cures like very selectively, whereas homoeopaths use it universally. Moreover, a vaccination always contains a measurable amount of active ingredient, whereas homoeopathic remedies are usually so dilute that they contain no active ingredient whatsoever.

A pill that contains no medicine is unlikely to be effective, but millions of patients swear by this treatment. From a scientific point of view, the obvious explanation is that any perceived benefit is purely a result of the placebo effect, because it is well established that any patient who believes in a remedy is likely to experience some improvement in their condition due to the psychological impact. Homoeopaths disagree, and claim that a "memory" of the homoeopathic ingredient has a profound physiological effect on the patient. So the key question is straightforward: is homoeopathy more than just a placebo treatment?

Fortunately, medical researchers have conducted more than 200 clinical trials to investigate the impact of homoeopathy on a whole range of conditions. Typically, one group of patients is given homoeopathic remedies and another group is given a known placebo, such as a sugar pill. Researchers then examine whether or not the homoeopathic group improves on average more than the placebo group. The overall conclusion from all this research is that homoeopathic remedies are indeed mere placebos.

In other words, their benefit is based on nothing more than wishful thinking. The latest and most definitive overview of the evidence was published in the Lancet in 2005 and was accompanied by an editorial entitled "The end of homoeopathy". It argued that ". . . doctors need to be bold and honest with their patients about homoeopathy's lack of benefit".

An unsound investment

However, even if homoeopathy is a placebo treatment, anybody working in health care will readily admit that the placebo effect can be a very powerful force for good. Therefore, it could be argued that homoeopaths should be allowed to flourish as they administer placebos that clearly appeal to patients. Despite the undoubted benefits of the placebo effect, however, there are numerous reasons why it is unjustifiable for the NHS to invest in homoeopathy.

First, it is important to recognise that money spent on homoeopathy means a lack of investment elsewhere in the NHS. It is estimated that the NHS spends £500m annually on alternative therapies, but instead of spending this money on unproven or disproven therapies it could be used to pay for 20,000 more nurses. Another way to appreciate the sum of money involved is to consider the recent refurbishment of the Royal Homoeopathic Hospital in London, which was completed in 2005 and cost £20m. The hospital is part of the University College London Hospitals NHS Foundation Trust, which contributed £10m to the refurbishment, even though it had to admit a deficit of £17.4m at the end of 2005. In other words, most of the overspend could have been avoided if the Trust had not spent so much money on refurbishing the spiritual home of homoeopathy.

Second, the placebo effect is real, but it can lull patients into a false sense of security by improving their sense of well-being without actually treating the underlying conditions. This might be all right for patients suffering from a cold or flu, which should clear up given time, but for more severe illnesses, homoeopathic treatment could lead to severe long-term problems. Because those who administer homoeopathic treatment are outside of conventional medicine and therefore largely unmonitored, it is impos sible to prove the damage caused by placebo. Never theless, there is plenty of anecdotal evidence to support this claim.

For example, in 2003 Professor Ernst was working with homoeopaths who were taking part in a study to see if they could treat asthma. Unknown to the professor or any of the other researchers, one of the homoeopaths had a brown spot on her arm, which was growing in size and changing in colour. Convinced that homoeopathy was genuinely effective, the homoeopath decided to treat it herself using her own remedies. Buoyed by the placebo effect, she continued her treatment for months, but the spot turned out to be a malignant melanoma. While she was still in the middle of treating asthma patients, the homoeopath died. Had she sought conventional treatment at an early stage, there would have been a 90 per cent chance that she would have survived for five years or more. By relying on homoeopathy, she had condemned herself to an inevitably early death.

The third problem is that anybody who is aware of the vast body of research and who still advises homoeopathy is misleading patients. In order to evoke the placebo effect, the patient has to be fooled into believing that homoeopathy is effective. In fact, bigger lies encourage bigger patient expectations and trigger bigger placebo effects, so exploiting the benefits of homoeopathy to the full would require homoeopaths to deliver the most fantastical justifications imaginable.

Over the past half-century, the trend has been towards a more open and honest relationship between doctor and patient, so homoeopaths who mislead patients flagrantly disregard ethical standards. Of course, many homoeopaths may be unaware of or may choose to disregard the vast body of scientific evidence against homoeo pathy, but arrogance and ignorance in health care are also unforgivable sins.

If it is justifiable for the manufacturers of homoeopathic remedies in effect to lie about the efficacy of their useless products in order to evoke a placebo benefit, then maybe the pharmaceutical companies could fairly argue that they ought to be allowed to sell sugar pills at high prices on the basis of the placebo effect as well. This would undermine the requirement for rigorous testing of drugs before they go on sale.

A fourth reason for spurning placebo-based medicines is that patients who use them for relatively mild conditions can later be led into dangerously inappropriate use of the same treatments. Imagine a patient with back pain who is referred to a homoeopath and who receives a moderate, short-term placebo effect. This might impress the patient, who then returns to the homoeopath for other advice. For example, it is known that homoeopaths offer alternatives to conventional vaccination - a 2002 survey of homoeopaths showed that only 3 per cent of them advised parents to give their baby the MMR vaccine. Hence, directing patients towards homoeo paths for back pain could encourage those patients not to have their children vaccinated against potentially dangerous diseases.

Killer cures

Such advice and treatment is irresponsible and dangerous. When I asked a young student to approach homoeopaths for advice on malaria prevention in 2006, ten out of ten homoeopaths were willing to sell their own remedies instead of telling the student to seek out expert advice and take the necessary drugs.

The student had explained that she would be spending ten weeks in West Africa; we had decided on this backstory because this region has the deadliest strain of malaria, which can kill within three days. Nevertheless, homoeopaths were willing to sell remedies that contained no active ingredient. Apparently, it was the memory of the ingredient that would protect the student, or, as one homoeopath put it: "The remedies should lower your susceptibility; because what they do is they make it so your energy - your living energy - doesn't have a kind of malaria-shaped hole in it. The malarial mosquitoes won't come along and fill that in. The remedies sort it out."

The homoeopathic industry likes to present itself as a caring, patient-centred alternative to conventional medicine, but in truth it offers disproven remedies and often makes scandalous and reckless claims. On World Aids Day 2007, the Society of Homoeopaths, which represents professional homoeopaths in the UK, organised an HIV/Aids symposium that promoted the outlandish ambitions of several speakers. For example, describing Harry van der Zee, editor of the International Journal for Classical Homoeo pathy, the society wrote: "Harry believes that, using the PC1 remedy, the Aids epidemic can be called to a halt, and that homoeopaths are the ones to do it."

There is one final reason for rejecting placebo-based medicines, perhaps the most important of all, which is that we do not actually need placebos to benefit from the placebo effect. A patient receiving proven treatments already receives the placebo effect, so to offer homoeopathy instead - which delivers only the placebo effect - would simply short-change the patient.

I do not expect that practising homoeopaths will accept any of my arguments above, because they are based on scientific evidence showing that homoeopathy is nothing more than a placebo. Even though this evidence is now indisputable, homoeopaths have, understandably, not shown any enthusiasm to acknowledge it.

For now, their campaign continues. Although it has not been updated for a while, the campaign website currently states that its petition has received only 382 signatures on paper, which means that there's a long way to go to reach the target of 250,000. But, of course, one of the central principles of homoeopathy is that less is more. Hence, in this case, a very small number of signatures may prove to be very effective. In fact, perhaps the Society of Homoeopaths should urge people to withdraw their names from the list, so that nobody at all signs the petition. Surely this would make it incredibly powerful and guaranteed to be effective.

"Trick or Treatment? Alternative Medicine on Trial" (Bantam Press, £16.99) by Simon Singh and Edzard Ernst is published on 21 April

Homoeopathy by numbers

3,000 registered homoeopaths in the UK

1 in 3 British people use alternative therapies such as homoeopathy

42% of GPs refer patients to homoeopaths

0 molecules of an active ingredient in a typical "30c" homoeopathic solution

$1m reward offered by James Randi for proof that homoeopathy works

This article first appeared in the 21 April 2008 issue of the New Statesman, Food crisis

Martin O’Neill
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How nostalgic literature became an agent in American racism

From To Kill a Mockingbird to Gone With The Wind, literary mythmaking has long veiled the ugly truth of the American South.

Alongside this summer’s debate over the meanings of the Confederate flag, sparked by the Charleston shootings, another story about the history of American racism flared up. Harper Lee’s Go Set a Watchman, an early draft of To Kill a Mockingbird, revealed further discomfiting truths, this time about the background to one of the nation’s most beloved fictional standard-bearers for racial equality.

In Watchman, Atticus Finch is discovered, twenty years after the action of Mockingbird, fighting against desegregation during the civil rights era. The shock readers have felt is akin to finding an early draft of Nineteen Eighty-Four in which Orwell defends surveillance in the name of national security – but stumbling upon a segregationist Atticus Finch should not surprise readers who know their history. In the end, he proves just as problematic a symbol as the Confederate flag, and for exactly the same reasons: both flew in the face of civil rights to defend white prerogative in the South. And both were gradually romanticised through the process of revision, wrapping America in comforting white lies.

Like our euphemistic habit of calling Jim Crow laws “segregation” rather than apartheid, all of this partakes in a time-honoured communal practice of deracination through whitewashing, through popular fictions of innocence such as Mockingbird and ­popular histories such as folk tales about the innocence of the Confederate flag. America keeps willing its own innocence back into being, even as racist ghosts continue to haunt our nation’s dreams of the pastoral South, a society whose fantasy of gentility was purchased at the cost of brutal chattel slavery and its malignant repercussions.

An essential aspect of the history of American racism is also the history of its deliberate mystification. Many Americans continue to accept an idealised view of the antebellum and Jim Crow South, which emerged as part of a national romance known as the Lost Cause, a legend that turned terrorism into a lullaby. In the aftermath of the South’s crushing defeat in the civil war, southerners began trying to reclaim what they had lost – namely, an old social order of unquestioned racial and economic hierarchies. They told stories idealising the nobility of their cause against the so-called War of Northern Aggression, in which northerners had invaded the peaceful South out of a combination of greed, arrogance, ignorance and spite. Gentle southerners heroically rallied to protect their way of life, with loyal slaves cheering them all the way. This Edenic dream of a lost agrarian paradise, in which virtuous aristocrats and hard-working farmers coexisted peacefully with devoted slaves, pre-dated the war: merging with Jeffersonian ideals of the yeoman farmer, it formed the earliest propagandistic defences of slavery. One of the most powerful broadsides against this spurious fantasy was launched in 1852 by Harriet Beecher Stowe, a north-eastern preacher’s daughter who had lived in border states and seen what really happened to ­fugitive slaves. The South responded to Uncle Tom’s Cabin with a furious denunciation of Stowe’s knowledge and motives, insisting on the benevolence of their “peculiar institution” – an especially sordid ­euphemism that recast plantation slavery as an endearing regional quirk.

Once institutional slavery was irrevocably destroyed, nostalgia prevailed, and southerners began producing novels, ­poems and songs romanticising the lost, halcyon days of the antebellum era. Reaching their apotheosis in Margaret Mitchell’s Gone with the Wind in 1936, and its film version in 1939, they have become known as the “moonlight and magnolia” school of plantation fiction, exemplified by the novels of Thomas Nelson Page, whose books, such as In Ole Virginia (1887) and Red Rock (1898), helped establish the formula: devoted former slaves recount (in dialect) their memories of an idyllic plantation culture wantonly destroyed by militant northern abolitionists and power-crazed federalists. A small band of honourable soldiers fought bravely on the battlefield and lost; the vindictive North installed incompetent or corrupt black people to subjugate the innocent whites; southern scalawags and northern carpetbaggers descended to exploit battle-ravaged towns. Pushed to the limits of forbearance, the Confederate army rose again to defend honour and decency – in the noble form of the Ku Klux Klan.

This thoroughly specious story is familiar to anyone who knows Gone with the Wind, but Mitchell learned it from Page and other novelists, including Mary Johnston and Thomas Dixon, Jr. Dixon wrote a series of books celebrating the rise of the Ku Klux Klan, of which the most notorious remains The Clansman (1905), for the simple reason that ten years later a director named D W Griffith decided to adapt it into a film he called The Birth of a Nation. Released exactly a century ago, it faithfully follows the same narrative blueprint. This was neither an accident nor a coincidence: Griffith was himself the son of a Confederate colonel (memorably known as “Roaring Jake”) and had listened to legends of the Lost Cause at his father’s knee. Reading The Clansman, Griffith said, brought back “all that my father had told me . . . [the film] had all the deep incisive emotionalism of the highest patriotic sentiment . . . I felt driven to tell the story – the truth about the South, touched by its eternal romance which I had learned to know so well.” That “truth” was a story in which the cavalry that rode to the rescue of an imperilled maiden was the KKK, saving her from a fate worse than death at the hands of a white actor in blackface. Griffith had considered hiring black actors for the film, he told an interviewer in 1916, but after “careful weighing of every detail concerned”, none of which he imparted, “the decision was to have no black blood among the principals”, a phrase that says it all by using the so-called one-drop rule to justify racist hiring practices in a film glorifying racism.

The Birth of a Nation was a national phenomenon, becoming the first film ever screened at the White House, in March 1915, for President Woodrow Wilson. Born in Virginia, raised in Georgia and South Carolina, Wilson was the first southern president since before the civil war. He attended Johns Hopkins University with Thomas Dixon, who became a political supporter of his; Wilson also appointed Thomas Nelson Page his US ambassador to Italy. Many members of his administration were equally avowed segregationists; their influence reverberated for generations. Wilson’s history books were quoted verbatim by Griffith in some of The Birth of a Nation’s titles, including: “‘The white men were roused by a mere instinct of self-preservation . . . until at last there had sprung into existence a great Ku Klux Klan, a veritable empire of the South, to protect the Southern country.’ – Woodrow Wilson”.

Wilson does not, however, actually seem to have said the quotation most frequently attributed to him, that The Birth of a Nation was “like writing history with lightning, and my only regret is that it is all so terribly true”. The source for this appears to be Griffith, who told a 1916 movie magazine: “The motion picture can impress upon a people as much of the truth of history in an evening as many months of study will accomplish. As one eminent divine said of [moving] pictures, ‘they teach history by lightning!’” They can teach myths the same way, as Griffith’s film regrettably proved. Northern white audiences cheered it; black audiences wept at the malevolence it celebrated; it prompted riots and racist vigilante mobs in cities across America, and at least one racially motivated murder. Together, Griffith and Dixon worked to elevate a regional legend, designed to save face after a catastrophic loss, into a symbolic myth accepted by much of the nation.

 

***

The Birth of a Nation helped to invent the feature film. It also helped to reinvent the Ku Klux Klan, which enjoyed a huge resurgence following the film’s release, spreading up through the north-east and Midwest. The Klan had a strong presence on Long Island in the 1920s, for example, which is why F Scott Fitzgerald made Tom Buchanan a believer in “scientific racism” in The Great Gatsby, a story set there in 1922, the same year in which Thomas Nelson Page died while working on a novel about the Klan called The Red Riders.

Four years later, a young writer named Margaret Mitchell began her own tale of the Lost Cause, a story that follows the same pattern, to the extent of describing Scarlett O’Hara on its first page in coded terms as a woman with “magnolia-white skin”. Gone with the Wind became a global sensation when it was published in 1936. Mitchell’s ideas of southern history were deeply influenced by Dixon’s racist ideology, although she was considerably more knowledgeable about the workings of plantation slavery than is often recognised. In fact, the great majority of antebellum southern planters (some 75 per cent) were what historians class as yeoman farmers (growing primarily for domestic use, selling only a small portion of their crop), not aristocratic owners of vast plantations. Such farmers often did not even own a slave, but rented or borrowed one or two during harvest time. But although the Hollywood version dispensed entirely with Mitchell’s sense of history (and her considerably more interesting take on historical sexism), it retained her racism, despite the stated intentions of its producers. The film of Gone with the Wind contributed greatly to the gradual displacement and dislocation of the historically specific time and place that had given rise to the antebellum plantation myth. Ben Hecht’s famed floating preface to the 1939 big-screen version labours at making the story timeless, a legend dissipating in the mists of history:

There was a land of Cavaliers and Cotton Fields called the Old South . . . Here in this pretty world Gallantry took its last bow . . . Here was the last ever to be seen of Knights and their Ladies Fair, of Master and of Slave . . . Look for it only in books, for it is no more than a dream remembered. A Civilisation gone with the wind . . .

as history recedes into ellipses.

Yet even this feudalist imagery has a specific history of its own, forming another crucial part of the popular culture of the Lost Cause. It was Mark Twain, whose works remain one of our most powerful literary antidotes to the toxin of moonlight and magnolia, who most famously named its source: the novels of Sir Walter Scott. Scott “did measureless harm”, Twain insisted in his 1883 Life on the Mississippi, “more real and lasting harm, perhaps, than any other individual that ever wrote”. Scott’s bestselling romances filled southerners’ heads with enchanted “dreams and phantoms . . . with the sillinesses and emptinesses, sham grandeurs, sham gauds and sham chivalries of a brainless and worthless long-vanished society”. In fact, Twain concluded acidly, “Sir Walter had so large a hand in making Southern character, as it existed before the war, that he is in great measure responsible for the war.” This is only slightly exaggerated: Scott’s novels were as popular in early-19th-century America as were the films of The Birth of a Nation and Gone with the Wind a century later. It is certainly thanks to the popularity of novels such as Ivanhoe and Waverley that the cult of the “clan” was distorted into the Ku Klux Klan, with its bogus orders and knights. Scott’s novels may even have given rise to antebellum America’s use of the medieval word “minstrel” to describe itinerant blackface musicians; the OED offers no logic for the coinage, but its earliest citation is from 1833, when the mania for Scott’s work in the American South was at its highest. The feudal fantasy of “gallantry”, “cavalier knights” and “ladies fair” is a powerful one, not least, doubtless, because it gives America a sense of a much older past than it has, merging our history with a faux-feudalism in which slaves are rewritten as serfs, bound by devotion to the land and the family they serve.

***

But even as Gone with the Wind was in its ascendancy, another national narrative was slowly gaining traction. Black writers including W E B DuBois, Zora Neale Hurston, Langston Hughes and Richard Wright were vigorously challenging the dominant racist narrative, while white southern writers such as Ellen Glasgow and, especially, William Faulkner, also began debunking and complicating this facile tradition. Faulkner took from the Lost Cause legends that he, too, had heard as a child in Mississippi, some much darker truths about memory, history, distortion, perspective. Faulkner’s Absalom, Absalom! is probably his greatest meditation on the processes of myth-making and how they intersect with national history, writing a Homeric epic of America. Absalom came out in 1936, the same year as Gone with the Wind, and in many ways can be read as a corrective to it, shaking off the dreams of moonlight and magnolia to show the Gothic nightmare underneath.

Just twenty years later, a young woman who had been born in the year Margaret Mitchell began to write Gone with the Wind, named Nelle Harper Lee, produced her own version of the story of America’s struggles with its racist past. To Kill a Mockingbird takes place between 1933 and 1935 (just before Gone with the Wind was published), during which time Atticus Finch tells his young daughter, Scout, that the Ku Klux Klan was “a political organisation” that existed “way back about 1920” but “couldn’t find anybody to scare”, relegating the Klan to ancient history, instead of a mere dozen years before Lee’s story.

Nor is it any coincidence that Mrs Dubose, the racist old lady addicted to morphine, forces Jem Finch to read Walter Scott’s Ivanhoe to her as a punishment: there are more encoded traces of Lost Cause history in Mockingbird than many readers have recognised. Mockingbird resists this history on balance, but it also participates in collective myth-making, most significantly in its depiction of lynching as a furtive, isolated practice in the dead of night. It would be pretty to think so. In Lee’s version, a lynch mob is dispersed by the innocent prattle of the child Scout, who unwittingly reminds its members of their basic “decency”. In fact, by the 1920s, lynching in the South was often publicly marketed as a tourist attraction, in a practice historians now refer to as “spectacle lynching”, which took place in the cold light of day, with plenty of advance warning so people could travel from outlying areas for the fun. There were billboards and advertisements letting tourists know when and where the lynching would take place; families brought children and had picnics; postcards were sold and sent (horrific images of which are easy to find online). Burning at the stake was common; victims were often tortured or castrated, or had limbs amputated, or were otherwise mutilated first; pregnant women were burned to death in front of popcorn-crunching crowds. This was so well established that in 1922 the National Association for the Advancement of Colored People took out a full-page advertisement in the New York Times with the headline “The shame of America”, demanding, in underscored outrage: “Do you know that the United States is the Only Land on Earth where human beings are BURNED AT THE STAKE?” It went on to outline a few salient facts: between 1889 and 1922, 3,436 people had been lynched in America. Of these, “only 571, or less than 17 per cent, were even accused of rape”. Eighty-three of the victims were women, which further undermined the myth that rape led to lynching.

Lee’s picture of lynching in To Kill a Mockingbird is not merely sentimental, but an active falsification: it participates in a wider American story seeking to minimise, even exonerate, the reactions of white southerners to African Americans’ claims to equal rights under the law. It functions as a covert apology, suggesting that lynching was anomalous, perpetrated by well-meaning men who could be reminded of common humanity – when, in fact, members of lynch mobs in the 1920s posed for photographs in front of their victims. But Atticus Finch stands up to racism, and Scout persuades Cunningham and the rest of the lynch mob to go home. This is why it matters that an earlier version of Atticus advocated segregation: it shows that the process of revising Mockingbird was a process of idealisation, promising readers that systemic racism could be solved by the compassionate actions of noble individuals.

This is the consolatory promise of individualism, that the nation can be redeemed collectively by isolated instances of benign action. The romance of individualism has always been how America manages injustice and unrest, how it pastes over irre­concilable differences and squares imaginary circles: the heroic figure who temporarily, occasionally, overcomes all structural and social impediments is taken as communal evidence that these obstructions don’t exist, or aren’t very obstructive. It is, of course, a deeply Christian idea: the redemptive individual who expiates collective sin, the original lost cause, sacrificed for the good of all.

The doctrine of individualism is further tangled up in yet another exculpatory logic: that of states’ rights. The remnants of this rationale also surface at the end of Go Set a Watchman: Atticus Finch argues that segregation is really a matter of states’ rights, and Jean Louise, his now adult daughter, though nauseated at his racism, accepts the legitimacy of that argument. What right has the federal government to insist that the people within its borders adhere to its laws, or even to the principles (truth, justice, equality, democracy) they purport to uphold? Some might conclude from reading this passage that, like paradise, causes are invented to be lost. The idea of the Lost Cause redeems a squalid past; it is an act of purely revisionist history, disavowing the notion that slavery or racism had anything to do with the civil war and its vicious, lingering aftermath. Glorifying that history as “gallantry” is not merely dishonest: it is ruinous.

Dismissing all of this as ancient history, or mere fiction, is not the solution, it is part of the problem. As Faulkner famously observed and this brief account shows, the past isn’t dead; it isn’t even past. The word “legend” comes from the Latin legere, to read. Many insist that the stories we consume endlessly are harmless entertainment, but that, too, is part of the mystification, pretending that these legends did not arise precisely to veil an ugly truth with moonlight, to smother with the scent of magnolia the stink of old, decomposing lies.

Now listen to Sarah Churchwell discussing the fiction of the American South with the NS's Tom Gatti:

An American in London, Sarah Churchwell is an author and professor of American literature. Her latest book, “Careless People: Murder, Mayhem and the Invention of the Great Gatsby”, is published by Virago.

This article first appeared in the 20 August 2015 issue of the New Statesman, Corbyn wars