Search Results for: London Review of Books

England’s National Health Service Is Suffering Growing Pains

Peter Byrne/PA Wire URN:34998098

As T.S. Eliot said, “This is the way the world ends. Not with a bang but a whimper.” Recently, much whimpering has come from the thousands of infirm people waiting in England’s overcrowded, understaffed hospitals. The sick lay on stretchers in hallways for entire days, or on the floor. Some wait for hours in the ambulances that brought them to the hospital.

For the London Review of Books, James Meek examines the crisis that has struck England’s National Health Service. Preparing for a surge of aging citizens with various ailments and a dependence on caretakers, NHS initiated a transition from an old hospital-based system to a new ambitious system centered around home health care. Unfortunately, the transition has not been smooth, and the future looks uncertain. The reform also has people asking what kind of country they want England to be: one of solidarity and publicly funded health care, or one of privately funded care where, like the United States, everyone fends for themselves.

A whistleblower told the Health Service Journal that ambulance delays in the east of England had led to the deaths of at least 19 patients and serious harm to 21 more. On 1 January, an 81-year-old woman in Clacton, Essex, dialed 999, complaining of chest pains. The ambulance took three hours and 45 minutes to arrive. It was too late. A few days later, a 52-year-old man in Norfolk collapsed with severe chest pain and vomiting. He was taken to the Norwich and Norfolk Hospital, but had to wait in the back of the ambulance that took him there for four and a half hours before being seen by a doctor inside the building. He was told to go home and collapsed again when he got there. Two ambulances sent to get him were diverted to other calls and by the time he returned to hospital, his life couldn’t be saved.

One doctor in a major A&E department in the east of England told me he’d witnessed short cuts taken by staff under pressure. For a time, ambulance crews had been allowed to leave patients in a hospital area that wasn’t technically A&E reception. One elderly patient with abdominal pain was diverted within the hospital from emergency medicine to a GP-style consultation, sent home, returned to the hospital a few hours later, and died. “What I’ve seen is the relentlessness of the shifts,” the doctor said. “The intensity. The feeling of higher and higher accountability. And then a lack of investment in staff. Asking them to do more and more and more, to cover more and more patients. There’s no give and take. The staff they should be investing in get more and more demoralized. You’re at risk of creating a Mid-Staffs environment where people don’t really know who they’re working for and start accepting risk that previously would have been deemed unacceptable. They stop reporting things because they reported them before and nothing happened. It’s creating a dangerous culture.” What should be done? “Stop decreasing capacity. Build capacity and build staffing. The party line is always ‘it doesn’t affect patient care.’ Of course it fucking does.”

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The Unknowable Diana, 20 Years On: A Reading List

(Princess Diana Archive/Getty Images)

There are two events that can define a separation of generations: Where were you when Princess Diana got married? Where were you when she died?

I was a tiny toddler sitting on my young mom’s lap for the first, an awkward 17-year-old for the second. San Diego’s Starlight Musical Theatre was in the middle of a production of Singin’ in the Rain and my job was to get costumes onto cast members before they hurtled out onstage.

Somehow I learned she was dead during the performance, in the time before widespread cell phones or internet. News spread fast, through the usual backstage channels, in whispers and passed notes. The busy dressing rooms were oddly quiet. People danced off stage and started crying in the wings. Downstairs, near the costume shop, they used the pay phone to find out details from friends.

The world seemed stunned, half silent. But why? Why did we spend the next few days glued to the television and the radio? Why did we leave flowers and sing songs and feel personally affected by a woman few knew and even fewer ever understood? Who was this bashful princess, anyway? This reading list contains a few answers—but 20 years after her death, the enigmatic Diana is harder to grasp than ever.

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When Is an Internet Company Evil?

In the aftermath of Donald Trump’s election, Facebook founder Mark Zuckerberg spoke publicly about the role Russian trolls and fake news on Facebook played in shaping public perception and influencing the presidential election. The company has since changed its mission statement from “making the world more open and connected” to “give people the power to build community and bring the world closer together.” The timing is no coincidence. The slogan’s also hogwash. Facebook is concerned with its brand, and with two billion monthly users (there’s 7.4 billion people on earth) and an 18% growth rate, Zuckerberg does not want bad publicity to disrupt the lucrative company’s continued expansion, which is based on the acquisition of free content from users, which it then uses to target users with advertising. Calling Facebook users ‘users’ is fitting, since it was always the public that was being used.

At the London Review of Books, John Lanchester examines three actual books to look closely at what Facebook really is on the inside and how it goes about its data-collecting business. It’s essentially an advertising business, which means, in Lanchester’s words, “Facebook is in the surveillance business.”

Facebook, in fact, is the biggest surveillance-based enterprise in the history of mankind. It knows far, far more about you than the most intrusive government has ever known about its citizens. It’s amazing that people haven’t really understood this about the company. I’ve spent time thinking about Facebook, and the thing I keep coming back to is that its users don’t realise what it is the company does. What Facebook does is watch you, and then use what it knows about you and your behaviour to sell ads. I’m not sure there has ever been a more complete disconnect between what a company says it does – ‘connect’, ‘build communities’ – and the commercial reality. Note that the company’s knowledge about its users isn’t used merely to target ads but to shape the flow of news to them. Since there is so much content posted on the site, the algorithms used to filter and direct that content are the thing that determines what you see: people think their news feed is largely to do with their friends and interests, and it sort of is, with the crucial proviso that it is their friends and interests as mediated by the commercial interests of Facebook. Your eyes are directed towards the place where they are most valuable for Facebook.

Now that the public knows how Facebook’s fake election stories have created more reader engagement than top New York Times stories, Zuckerberg has a social responsibility to use his powerful platform in a way that doesn’t further erode its users’ society. Instead of factoring in the social costs of social media, though, Facebook remains committed solely to growth and monetization. Google’s public maxim is “Don’t be evil.” Even if you doubt that maxim’s veracity, as consumers, we have to ask ourselves: when a company cares more about monetizing users’ data than about protecting users from a Russian misinformation campaign, why should anyone use their service? In Capitalist America, too many people see it as un-American to say that businesses have a social responsibility. But when it comes to capitalism, we consumers ultimately wield the most power: we can choose not to spend our money or time on businesses who ignore the social costs of their operations. If you’ve been on the verge of deactivating Facebook, now is a good time.

The fact is that fraudulent content, and stolen content, are rife on Facebook, and the company doesn’t really mind, because it isn’t in its interest to mind. Much of the video content on the site is stolen from the people who created it. An illuminating YouTube video from Kurzgesagt, a German outfit that makes high-quality short explanatory films, notes that in 2015, 725 of Facebook’s top one thousand most viewed videos were stolen. This is another area where Facebook’s interests contradict society’s. We may collectively have an interest in sustaining creative and imaginative work in many different forms and on many platforms. Facebook doesn’t. It has two priorities, as Martínez explains in Chaos Monkeys: growth and monetisation. It simply doesn’t care where the content comes from. It is only now starting to care about the perception that much of the content is fraudulent, because if that perception were to become general, it might affect the amount of trust and therefore the amount of time people give to the site.

Zuckerberg himself has spoken up on this issue, in a Facebook post addressing the question of ‘Facebook and the election’. After a certain amount of boilerplate bullshit (‘Our goal is to give every person a voice. We believe deeply in people’), he gets to the nub of it. ‘Of all the content on Facebook, more than 99 per cent of what people see is authentic. Only a very small amount is fake news and hoaxes.’ More than one Facebook user pointed out that in their own news feed, Zuckerberg’s post about authenticity ran next to fake news. In one case, the fake story pretended to be from the TV sports channel ESPN. When it was clicked on, it took users to an ad selling a diet supplement. As the writer Doc Searls pointed out, it’s a double fraud, ‘outright lies from a forged source’, which is quite something to have right slap next to the head of Facebook boasting about the absence of fraud. Evan Williams, co-founder of Twitter and founder of the long-read specialist Medium, found the same post by Zuckerberg next to a different fake ESPN story and another piece of fake news purporting to be from CNN, announcing that Congress had disqualified Trump from office. When clicked-through, that turned out to be from a company offering a 12-week programme to strengthen toes. (That’s right: strengthen toes.) Still, we now know that Zuck believes in people. That’s the main thing.

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Hilary Mantel’s Eulogy for the Unfinished Diana

(Tim Graham/Getty Images)

Hilary Mantel is an expert on the royal body; the mythology and reality of the nobility once anointed by God and now anointed by fame. In 2013, her controversial essay on Kate Middleton in the London Review of Books compared the future Princess of Wales to her predecessor: “Kate seems to have been selected for her role of princess because she was irreproachable: as painfully thin as anyone could wish, without quirks, without oddities, without the risk of the emergence of character. She appears precision-made, machine-made, so different from Diana whose human awkwardness and emotional incontinence showed in her every gesture.”

At the Guardian, Mantel now takes on Diana herself, 20 years after her death. How could time have passed so quickly, she wonders? Royal time passes in centuries, in generations, and as Diana passes through our collective consciousness once more, Mantel considers the reality of Diana’s “fairytale” existence:

By her own account, Diana was not clever. Nor was she especially good, in the sense of having a dependable inclination to virtue; she was quixotically loving, not steadily charitable: mutable, not dependable: given to infatuation, prey to impulse. This is not a criticism. Myth does not reject any material. It only asks for a heart of wax. Then it works subtly to shape its subject, mould her to be fit for fate. When people described Diana as a “fairytale princess”, were they thinking of the cleaned-up versions? Fairytales are not about gauzy frocks and ego gratification. They are about child murder, cannibalism, starvation, deformity, desperate human creatures cast into the form of beasts, or chained by spells, or immured alive in thorns. The caged child is milk-fed, finger felt for plumpness by the witch, and if there is a happy-ever-after, it is usually written on someone’s skin.

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Leave Them Alone! A Reading List On Celebrity and Privacy

Todd Williamson / Invision for JDRF / AP

I read Alana Massey’s essay collection, All The Lives I Want: Essays About My Friends Who Happen to be Famous Strangerswith a pencil in hand. I read it behind the counter at work when it was quiet and customer-free. I read it in bed, long after my partner and cat had fallen asleep. I read it in Starbucks when I should’ve been writing but needed inspiration. Massey is a writer I’ve followed since I became interested in journalism. I admired her incisive blend of pop culture and literary criticism. I especially loved when she wrote about religion—Massey spent time at Yale Divinity School—because I went to a conservative Christian college and I was yearning to see how I could translate my weird, vaguely traumatic religious background into beautiful sentences. I bought her book as a reward for myself for meeting a writing deadline.

This reading list is partially inspired by Massey’s excellent writing about the way our society honors and rejects celebrated women—and also about society’s inclination, if not blatant desire, to know every little detail about our favorite celebrities and judge them according to our own arbitrary moral standards. (I’m not immune to this: I spent ten minutes in bed Googling potential paramours of one of my favorite YouTube stars, even though I know it’s none of my damn business.) Why do we feel like we own celebrities—not just their art or their products, but their images and their personal lives? What do celebrities owe us, if anything?

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Mary Beard’s Voyage Into ‘Herland’

Martin Bureau / Pool Photo via AP

Mary Beard opens “Women in Power: From Medusa to Merkel,” her cover essay in this week’s London Review of Books, with one of the most satisfying depictions of female dominance in American letters—Charlotte Perkins Gilman’s 1915 comic novel Herland. Gilman’s book is satisfying because it’s thoroughly realized and genuinely funny, writes Beard:

It’s a fantasy about a nation of women—and women only—that has existed for two thousand years in some remote, still unexplored part of the globe. A magnificent utopia: clean and tidy, collaborative, peaceful (even the cats have stopped killing the birds), brilliantly organized in everything from its sustainable agriculture and delicious food to its social services and education. And it all depends on one miraculous innovation. At the very beginning of its history, the founding mothers had somehow perfected the technique of parthenogenesis. The practical details are a bit unclear, but the women somehow just gave birth to baby girls, with no intervention from men at all. There was no sex in Herland.

For an all-female society that’s lived without men for 2,000 years, Herland is doing very well, thank you very much. The government functions smoothly, the air is clean, and the diet is vegetarian. No sooner do three male scientists bumble along than the sexist observations follow, and sadly, they still hold up.

Beard calls on Herland not to say what one might expect—that more than a century after Gilman’s imagined future the very thought of a powerful woman is still consigned to fantasy—but rather that powerful women don’t appear in our collective imagination at all. Why? Because “our mental, cultural template for a powerful person remains resolutely male.” It’s a continuation of an argument Beard began in her 2014 LRB essay “The Public Voice of Women,” which looked at the classical history of when and why women speak out in public, and how they often use male rhetoric. “It is still the case that when listeners hear a female voice, they don’t hear a voice that connotes authority; or rather they have not learned how to hear authority in it.” In that essay, she explored how women speak and are heard; here, it is how they are seen. Of course, there are the clothes.

The regulation trouser suits, or at least the trousers, worn by so many Western female political leaders, from Merkel to Clinton, may be convenient and practical; they may be a  signal of the refusal to become a clothes horse, which is the fate of so many political wives; but they’re also a simple tactic—like lowering the timbre of the voice—to make the female appear more male, to fit the part of power.

But to my surprise, given the prominent placement of clothing in Herland, this the beginning and end of Beard’s fashion critique, especially since the wardrobe Gilman devised for her citizens is ingenious. Instead of “modern” underwire bras poking them in the soft tissue, and “panties” (that gross, girlish word) that do or do not hide so-called VPL, the women of Herland wear “a one-piece cotton undergarment, thin and soft, that reached over the knees and shoulders.” On top of this very sensible base they layer several tunics, depending on the season, the middle of which is “shingled” with pockets (not a feature of women’s clothing at the time Gilman was writing). Their hair they keep short, “hatless, loose, and shining.” And, my favorite detail: The base under-layer, which is essentially a modified union suit, doubles as athletic wear, “as perfect a garment for exercise as need be devised, absolutely free to move in,” Gilman writes. No more lugging a bag to the gym! In Gilman’s novel, even the male interlopers are impressed:

The garments were simple in the extreme, and absolutely comfortable, physically, though of course we all felt like supes in the theater. There was a one-piece cotton undergarment, thin and soft, that reached over the knees and shoulders, something like the one-piece pajamas some fellows wear, and a kind of half-hose, that came up to just under the knee and stayed there—had elastic tops of their own, and covered the edges of the first.

Then there was a thicker variety of union suit, a lot of them in the closet, of varying weights and somewhat sturdier material—evidently they would do at a pinch with nothing further. Then there were tunics, knee-length, and some long robes. Needless to say, we took tunics.

Beard writes that when we imagine powerful women we imagine “national politicians, CEOs, prominent journalists, television executives and so on,” which “gives a very narrow version of what power is.” And so she asks us to rethink our very definition of power, first by “decoupling it from public prestige.” I’d add that it would also help with this project if we rethought our relationship to fashion, in a serious, systemic way, not merely on a case-by-case basis. If I wanted to swan about in Herland tunics, I would probably pop over to Eileen Fisher, a brand that has turned comfort into an unaffordable luxury, and top it off with a pink pussy hat while I’m at it. But isn’t that joke too easy? Shouldn’t there be more than just one mass-market designer who’s addressing what it means for women to present themselves in ways that feel both professional and physically forgiving? There are an infinite number of daily negotiations and frustrations with dressing oneself and being seen in this world that Beard misses in her binary between pantsuit armor and clothes-horse.

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God Save the Queen: Seven Stories about Elizabeth II

Image via NASA (public domain).

A couple of months ago I had a strange epiphany: the only thing currently keeping the world barely intact is a British nonagenarian who likes corgis.

The second half of the 20th century, the era in which we (kind of) still live, is in the process of vanishing, from Fidel Castro and the Voting Rights Act to Carrie Fisher and non-apocalyptic weather. Yet against all odds, the Queen — until not that long ago, the most boring member of a dysfunctional dynasty — has emerged as the embodiment of good sense and decency, an unflappable, gray-haired titan. Her very perseverance (she’s currently the world’s longest-serving head of state) proves: we’re not doomed. Yet.

Monarchies are ridiculous at best, vicious and blood-thirsty at worst. But after a year in which so many unthinkable things had come to pass, I find myself doing something previously unimaginable: rooting for Elizabeth II. She’s a mentsch. She survived 12 US presidents (chances of surviving #13: not amazing, but who knows? Windsors seem to hate dying). She’s found the precise balance between being real and unreal, flesh-and-blood and emblem. Here are a few great reads on the Queen.

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Riding the Rails: Celebrating Trains and Subway Commuter Life

My other half Rebekah and I recently returned from Japan, and we’re in that rapture phase where you wish the things you loved overseas were also available in America. I already miss the 24-hour action of Japanese cities, their automated restaurants, the street-side vending machines — and public transportation.

In Japan, trains run on time. When the Shinkansen says it departs at 2:43, it departs at 2:43. It travels at 200 miles an hour, so good luck catching it. If a train is late, it’s likely because the world has ended. If the world hasn’t ended and it’s still late, the train company will print a note for passengers to give their employers, confirming the train was in fact behind schedule, because no one’s going to believe that’s why you were late for work.

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The Top 5 Longreads of the Week

Below, our favorite stories of the week. Kindle users, you can also get them as a Readlist.

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Jenny Diski: 1947-2016

Jenny Diski wrote 11 novels and seven non-fiction books. She wrote 150 articles and 65 blog posts for the London Review of Books. She wrote about drugs, sex, and rock-n-roll; she also wrote about animals and train travel. She wrote historical fiction and memoir, and essays about literature and fashion. She wrote about her family, her loves, and in the last two years since her cancer diagnosis, she wrote about the life she lived. She wrote herself until the very end.

Jenny Diski died in April 2016 at the age of 68. Here are nine stories celebrating Diski and her work.

1. Jenny Diski’s End Notes (Giles Harvey, New York Times Magazine, June 2015)

Last July, when the English writer Jenny Diski was told she had inoperable lung cancer and, at best, another three years to live, she responded to the news characteristically — that is, in wry poor taste. “So,” she said, turning to her husband, the poet and academic Ian Patterson, “we’d better get cooking the meth.” The Poet — as Diski always refers to Patterson, with tender-ironic reserve, in her personal essays — was just about able to keep up his end of the morbid repartee that is the currency of their marriage: “This time we quit while the going’s good.” The oncologist and the nurse, apparently not watchers of “Breaking Bad,” looked on blankly.

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