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The New Paganism & Medicine (cat & mouse)

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Paganism reduced to its essentials is the worship of idols. It is usually talked of as primitive religion. The concrete idol acts as intermediary between the mere human and the divine. These idols can be anything from naturally occurring items in the physical environment such as trees, rocks, the sun or moon or the items can be fashioned artefacts such as masks, dolls, or what the French refer to as fétiche. So, the idea goes that the primitive person cannot grasp the divine without intercession, without a concrete image. And, the major religions did away with this. That is, at least, the theory but it is very far from the truth. All you have to do is enter a Catholic church and the images of Christ on the crucifix or of Mary the mother of God will dismiss the idea that paganism is flourishing only in those places far from the epicentre, from the metropolis, in some backwater somewhere. These are pure idols.

I want to argue that paganism, fetishism flourishes in the most unexpected places. That taking the token for the thing itself, that valorising the token (for that is what idolatry and paganism is) is everywhere in the modern world and that it is at its most rampant in healthcare, particularly in the NHS. Our fetishistic attachment to bureaucratic forms, to meaningless certificates and awards, to grades and audits, to numbers as purveyors and icons of excellence, all these in my view are part of the new paganism.

The new idolatry has evolved out of the desire to have accountability systems in place within the public services. But, these systems have been perilous for the NHS as for other public services.  Onora O’Neill in her Reith lectures wrote

‘Perhaps the culture of accountability that we are relentlessly building for ourselves actually damages trust rather than supporting it’. And, ‘The new accountability takes the form of detailed control. An unending stream of new legislation and regulation, memoranda and instructions, guidance and advice floods into public sector institutions. For example, a look into the vast database of documents on the DOH website arouses a mixture of despair and disbelief’.

She goes on

‘I think that many public sector professionals find that the new demands damage their real work. Teachers aim to teach their pupils; nurses to care for their patients….Each profession has its proper aim, and this aim is not reducible to meeting set targets following prescribed procedures and requirements’.

Furthermore, she says

‘Much of the mistrust and criticism now directed at professionals and public institutions complains about their diligence in responding to incentives to which they have been required to respond rather than pursuing the intrinsic requirements of being good nurses and teachers, good doctors and police officers..’

And Onora O’Neill understood the pernicious influence of the accountability systems on trust. She quotes Samuel Johnson

‘It is better to be cheated than not to trust’

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My topic is ‘trust’. How what Michael Power has termed the ‘Audit Society’ actually damages trust and in turn damages the basis of society, the compact we form one with another. There are innumerable systems of verification, pathological rituals of verification that have come to cripple the smooth running of public services and have more or less dealt a fatal blow to the healthcare system. Many people are not alive to the lethality of the wounds sustained by the healthcare system.

Power writes

‘The Labor government’s new Commission for Health Improvement (aka CQC in present incarnation) perfectly illustrates my concept of ‘control of control’, whereby high-level organizations are created to check on lower-level checking processes’.

It is obvious that these arrangements are not designed to identify error but merely to produce comfort and reassurance as the events in Stafford show and the Francis report accurately demonstrate and as the current investigations in the North West also underline. The point that Power is making is that ‘Accounts only become objects of explicit checking in situations of doubt, conflict, mistrust and danger’. In ordinary times, accounts seem to serve an assurance role only,  so that even when there is substantive poor performance as there was in Stafford, audit systems can give the all clear.  Power goes on ‘Trust releases us from the need for checking’ and ‘The more one thinks about it, the more apparent it is that the imperative ‘never trust, always check’ could not be a universalizable principle of social order’.

Power concludes

‘The audit society is a society that endangers itself because it invests too heavily in shallow rituals of verification at the expense of other forms of organizational intelligence’. Yet this conclusion is yet to be understood by those in authority. The actual seeing of patients in the NHS is accompanied by elaborate form filling whose central purpose is part of a verification system that is at most tangentially related to clinical care. Indeed these administrative/bureaucratic systems which started of as a token of the clinical care of patients have metamorphosed into the thing itself, this despite being only tangentially reflective of the actual clinical care. In short the token has come to be taken for the thing itself. And there is a whole army of people whose purpose in life is to serve these systems, to worship, as it were, these idols. Without much notice we have the new idolatry, the new paganism with all the accoutrement of religion: temples, acolytes, priests, liturgy, rituals and sanctions. In the event of breach of sacred rites there is always the risk of excommunication!

At the heart of all of this is low trust and regulatory overkill. And, yet we cannot do without trust. Every time we drive down the road we have to trust that all other road users know what they are doing, that they are licensed to drive, that the authorities have designed the roads with safety in mind, and that the car and all its component parts is safe. The kind of regulatory overkill that we have instituted in healthcare would totally kill off traffic: imagine having to fill a 25 paged form in every time you got in a car, and having a troop stop everyone every mile to confirm that the car is as it ought to be and so on. Well that is the system that we have created in healthcare. But, if only that was the sole damage being caused. But, alas it is not.

Francis Fukuyama in his book on Trust wrote

‘Trust is the expectation that arises within a community of regular, honest, and co-operative behaviour, based on commonly shared norms…That is, we trust a doctor not to do us deliberate injury because we expect him or her to live by the Hippocratic oath and the standards of the medical profession’.

He continues quoting Kenneth Arrow

‘Now trust has a very important pragmatic value, if nothing else. Trust is an important lubricant of a social system. It is extremely efficient; it saves a lot of trouble to have a fair degree of reliance on other people’s word. Unfortunately this is not a commodity which can be bought very easily’.

And he concludes

‘There is usually an inverse relationship between rules and trust: the more people depend on rules to regulate their interactions, the less they trust each other, and vice versa’

The upshot of all of this is that the society we have created, this one that we now have, with its new paganism, it bureaucratic fetishism, is decidedly unhealthy, is at variance with the desire for a compassionate workforce, is definitely noxious in effect if not in intent. This week we have had the Secretary of State for Health make pronouncements about nurse training, about compassion, and about a legal duty of candour. But the fundamental desire for clinicians who hold the imperative of responsibility as their beacon is not likely to occur without an analysis that recognises what it is that has gone wrong. Not that the diagnosis has not been made several times over and communicated.

Finally, Hans Jonas in The Imperative of Responsibility wrote

‘The first and most general condition of responsibility is causal power, that is, that acting makes an impact on the world; the second, that such acting is under the agent’s control; and third, that he can foresee its consequences to some extent’. In this model, Hans Jonas is describing how responsibility and accountability connect. In healthcare, the clinicians no longer have causal power and their authority for the integrity of the work environment has been markedly constrained. Hence the correspondence between responsibility and accountability has become tenuous if not fractured.

In conclusion, Jonas says

‘The well-being, the interest, the fate of others has, by circumstance or agreement, come under my care, which means that my control over it involves at the same time my obligation for it. The exercise of the power with disregard of the obligation is, then, “irresponsible”, that is, a breach of the trust-relation of responsibility. A distinct disparity of power or competence belongs to this relationship. The captain is master of the ship and its passengers, and bears responsibility for them’. In our case, the captain is not master of the ship or of its passengers.

New blog about misuse of language

MindReadings

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I have to say that my interest in words is elemental. I study words, enjoy them, and gaze at them as one would a sculpture. Indeed for me, a word is a sculpture. Imagine the word ‘obfuscate’, the ‘fus’ in it has all the attraction for me, of carrion for ravens, it is a basic even primordial attraction. Much like eyes has for a splendid curve. So, it is true it is not language itself, not sentences, not prose but words that delay me, that keep me awake at night, that I dream about and imagine and feast upon. As J-P Sartre said

‘poetry is on the side of painting, sculpture, and music…It does not use [words] in the same way [as prose], and it does not even use them at all. I should rather say that it serves them. Poets are men who refuse to utilize language’.

Sartre went…

View original post 1,992 more words

Language of health care

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I have to say that my interest in words is elemental. I study words, enjoy them, and gaze at them as one would a sculpture. Indeed for me, a word is a sculpture. Imagine the word ‘obfuscate’, the ‘fus’ in it has all the attraction for me, of carrion for ravens, it is a basic even primordial attraction. Much like eyes has for a splendid curve. So, it is true it is not language itself, not sentences, not prose but words that delay me, that keep me awake at night, that I dream about and imagine and feast upon. As J-P Sartre said

‘poetry is on the side of painting, sculpture, and music…It does not use [words] in the same way [as prose], and it does not even use them at all. I should rather say that it serves them. Poets are men who refuse to utilize language’.

Sartre went on

‘it seems at first he has a silent contact with them [words], since, turning towards that other species of thing which for him is the word, touching them, testing them, fingering them, he discovers in them a slight luminosity of their own and particular affinities with the earth, the sky, the water, and all created things’.

I might add that for me words can be beautiful, ugly, tactile, euphonic, slender, robust, rotund, emaciated, empty, dense and so on. Some of the trends in the use of language within the NHS are irksome and distressing, some comical and incomprehensible. Think of the little boy in the tub out in the South China Sea. It is a surprise to see him paddling in the ocean that one imagines that one’s mistaken. Actually he is a grown up in a yacht! That is how language in healthcare sometimes operates.  It can be deceptive. My aim is to talk about this kind of language. I shall examine the titles of government green and white papers, I shall examine some of the changes in use of language in clinical psychiatry for example, and finally I will ask what is it that motivates these changes. Are these language uses driven by the same factors that linguists believe drive language in general? Or is there some other hitherto unrecognised malevolent impulse at play?

Governmental language of health

Since the new coalition government in May 2010, there’s been a subtle shift in the language of healthcare. The old language is out and the new language is in. This is exemplified by shifts in emphasis such as

  1. Bottom-up rather than top-down
  2. Local rather than regional/national
  3. Society rather than state
  4. Social responsibility rather than stakeholder
  5. Principles-based rather than evidence-based.

The Labour government ushered in and entrenched its own language in 1997. The most memorable were partnership, stakeholder, clinical governance, excellence as in (NICE) & clinical excellence awards, world class commissioning, and choice agenda. It also consolidated the use of commercial language within the NHS so that instead of financial audit there was now clinical audit, instead of managers, there were CEOs, executives and non-executives of boards, and business plans and audit trails became the order of the day.

Here are some of the titles of green and white papers from 1998 onwards:

  1. The new NHS: modern and dependable.
  2. Our healthier nation: a contract for health.
  3. Our health, our care, our say
  4. Shaping the future together
  5. Liberating the NHS

These titles suggest an aspiration for government to work with the wider population towards something desirable and good. It starts off with ‘the new NHS’ and continues with ‘our healthier nation’ and so on. Of course, M&S have since discovered that the tagline ‘your M&S’ is more user friendly! So I suppose we might in due course see titles that say ‘your NHS’, ‘your health, your care’, etc. What is obvious is that government recognises the importance of language as a tool in shaping the response of its audience and also recognises that there is scepticism, even cynicism in its audience, therefore there is a need for language that declares a common, shared interest, and that is collaborative in intent, hence the use of ‘our’. On occasion, the language can be mystifying: very few people had realised that the NHS was in need of liberation from a colonising force by the joint efforts of Comrades Cameron and Lansley before the publication of Liberating the NHS! In truth, whatever the intentions of government, the titles of these papers belie the unilateral thrust of much of government action and direction of travel.

The language of mental health

For much of my career in psychiatry, language use and modifications of the conventions exemplified by language change have been central to the practise of psychiatry. I will not delay by exploring changes of terms such as ‘dementia praecox’ to ‘schizophrenia’, of ‘manic-depressive psychosis’ to ‘bipolar affective disorder’, or of terms such as ‘idiot’, ‘imbecile’ to terms such as ‘mild and moderate mental handicap’. These changes are interesting and some of the determining motives in these changes are important and interesting in their own right and I might return later to talk about them.

My concern is to examine terms such as “community care” as opposed to “hospital care”, “home treatment”, “early intervention”, “mental health problems” as opposed to “mental illness” or indeed “mental health” coming to stand as a synonym for “mental illness” as in “he has mental health”. Finally in this list is the term ‘recovery’ which is used to mean ‘lack of recovery’ but in a positive manner, that is to give hope. For example a recent article wrote as follows:

‘Recovery’ is usually taken as broadly equivalent to ‘getting back to normal’ or ‘cure’, and by these

standards few people with severe mental illness recover. At the heart of the growing interest in

recovery is a radical redefinition of what recovery means to those with severe mental health problems.

Redefinition of recovery as a process of personal discovery, of how to live (and to live well) with

enduring symptoms and vulnerabilities opens the possibility of recovery to all. The ‘recovery

movement’ argues that this reconceptualisation is personally empowering, raising realistic hope for

a better life alongside whatever remains of illness and vulnerability. This paper explores the background

and defining features of the international recovery movement, its influence and impact on

contemporary psychiatric practice, and steps towards developing recovery-based practice and services’.

These uses of words and language in psychiatry mimic some of the use of language by the government; they are conscious attempts to alter the meaning and emotional value of words for a defined purpose. This is a good place to ask what are the factors that determine change in language use?

I am no linguist and must therefore rely on Thomas Pinker and Guy Deutscher to guide me. In talking about ‘spoon’ Deutscher wrote

‘Initially, it seems odd that the meaning of ‘spoon’ has managed to change so much over a relatively short period of time. What is more, such somersaults in meaning may appear alien to the very purpose of language, namely providing a stable system of conventions that allow coherent communication. For how can speakers reliably convey their thoughts to one another if the sense of the words they use can suddenly change?’

Deutscher argues that the motives for change are economy, expressiveness and analogy. Economy refers to the tendency to save effort, expressiveness to the speakers’ attempts to achieve greater effect for their utterances and to extend their range of meaning, and analogy is the mind’s requirement to establish order.

Let’s concentrate on ‘expressiveness’. We need to keep in mind here, that these motives refer to the inner restlessness in language for change and not to the positive actions of those who Pinker refers to as ‘language mavens’ whose desire is usually to crystallize language in a state of statuette elegance, close to some purported past glorious age.

A good example of how expressiveness works in our time is the change of meaning of the word “wicked”. The word “good” has lost much of its immediacy and power so that in response to the question ‘what was the gig like?’ “good” seems hardly an adequate response compared to “wicked” which captures the thrill and danger of the new music and its exquisite vibrancy! Such words as ‘resent’ that, originally meant ‘appreciate’, have radically changed meaning, much as ‘wicked’ is doing now. Excessive intensifiers also do the same sort of work: extra-, super-, and hyper-, as in extra-strong, superhuman, and hyperactive. These new words appear to be responding to the debasement of the ordinary words.

However in the NHS and in psychiatry, language change is conscious and deliberate rather than fuelled and driven by the inner restlessness of language itself. This is where George Orwell comes in.

1984 & Borges

In the Appendix to 1984, ‘The Principles of Newspeak’, Orwell wrote

‘Newspeak was the official language of Oceania and has been devised to meet the ideological needs of Ingsoc, or English Socialism…The purpose of Newspeak was not only to provide a medium of expression for the world-view and mental habits proper to the devotees of Ingsoc, but to make all other modes of thought impossible. It was intended that when Newspeak had been adopted once and for all and Oldspeak forgotten, a heretical thought – that is, a thought diverging from the principles of Ingsoc – should be literally unthinkable, at least so far as thought is dependent on words’.

Here Orwell makes plain the drive behind Newspeak, which is to control thought:

‘Its vocabulary was so constructed as to give exact and often very subtle expression to every meaning that a Party member could properly wish to express, while excluding all other meanings and also the possibility of arriving at them by indirect methods…Newspeak was designed not to extend but to diminish the range of thought, and this purpose was indirectly assisted by cutting the choice of words down to a minimum’.

At least this way, it could be guaranteed that Ingsoc members would be ‘on message’, no need then for pagers that minute by minute tell members what to think or say in response to queries from the Press. Newspeak was a political programme that limited how the word ‘free’ could be used. ‘This dog is free from lice’ and ‘this field is free from weeds’ were possible constructions but not ‘free’ as in ‘free to think’ or ‘free to do as you please’. As Syme said to Winston ‘Do you know that Newspeak is the only language in the world whose vocabulary gets smaller every year?’

What is frightening even terrifying about the language of government and of some of the language deployment in psychiatry is the combination of Orwellian ‘doublethink’ and ‘newspeak’! Doublethink is characterised by knowing and not knowing, of being conscious of complete truthfulness while telling carefully constructed lies, of holding simultaneously two opinions which contradict one another, repudiating morality whilst laying claim to it. ‘Even to understand doublethink involves the process of doublethink’. In the new language, it can both be true that one does not fully recover but that one does recover! It can both be true that we can make choices of where to be treated but have an even more restricted choice than ever before. The NHS can be ‘modern and dependable’ yet ‘old and unreliable’. We can have ‘world class commissioning’ that fails any test of commissioning for its local, very parochial community’. Or we can have ‘a contract’ that is only a word that suggests a legal document which isn’t legally binding.

I want to end by way of reference to my favorite writer, Jorge Luis Borges. It is said that Borges once claimed that the basic devices of all fantastic literature are only four in number: the work within the work, the contamination of reality by dream, the voyage in time and the double. For Borges, the problem of illusion and reality is at the heart of literature. And we are all of us fabricators, making up our world anew everyday, trying but often failing to decipher the symbols around us. In this quest we are endlessly immersed in language, continuously grasping and grappling with words to say what we feel and think, trying to tie down that which is indefinable and amorphous, that which is vague, subtle, evanescent, formless. And the world like Borges’ Tlön is mere chaos, an irresponsible license of the imagination and it is language that orders and preserves it for us. Not the language devised for politics, not the language that aims to restrict imagination even for good reason but the language in which great writing is done because there is so much more to write and say for ‘the certitude that everything has been written [or said] negates us or turns us into phantoms’.

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Agora

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I am briefly in the Arabian Gulf. The sky is cloudless today. The sun bright and clear as it can be in Southern Europe. An artist’s kind of light. One that renders the world sharp in outline, although it can also bleach the colours. Leaves having an impoverished green that is closer to grey than it is to lush impenetrable green. There is a slight taint of dust, of sand in the air too. This can give a feeling of dilapidation to the most pristine of scenes.

From my vantage point, cars and buses are speeding past on the vast motorways. There are hardly any walkers. Perhaps the temperature is far too forbidding. Perhaps there is no tradition of walking if you don’t have to. The consequence is that the streets are deserted and empty of people. Where are the people?

Swallows dart from the eaves of the numerous towers and then slowly skate and glide down towards the tops of the palm trees. These are date palms, I think. I am reminded of my grandmother’s house in the evening. Swallows angle their wings and black against the dusk half-light seem to emerge from a dreamland beyond memory. The swallows skim the air like a stone thrown with precision that travels, picking up speed as it touches the skin of the sea, curving back upwards before sinking, disappearing forever.  African dusks can be like that. The swallows merging with the memory of a boy who throws a stone, the stone and air and the splash of sea spray all part of a dusk that is readying to close shop.

If you sit long enough on the ledge outside my grandmother’s window you will imagine that you can see in the distance, in that reddish half darkness, when the sun is setting and before the new moon is out, a procession of ethereal beings, sometimes in ghostly unreality, sometimes in shadowy figuration, but always graceful, always moving swiftly and elegantly. You will know that you have seen what is usually unseen, spirits, wraiths, in the interstices of life. Maybe even an intercession. Their processing is their manner of praying.

That is why the world of the living and the dead is so closely connected in Africa. You sense the presence, the palpable interconnection between us and the invisible. And the swallows in their diving and rapturous skating of the air seem also like a form of speaking, a vernacular that is verse and poetic. A language in need of an interpreter. But you also feel very human and vulnerable. What if these figures were malign? What if the swallows were not birds at all but bats taking the form of birds, witches? What if life is itself already seeping out from your own entrails, unseen, a miasma that gaseous and without odour, leaks out and enfeebles you?

These questions reveal the essential weakness of the human condition in a world that is untrustworthy, unreliable, and liable to fracture, to coalesce against our interests. That is the beginning of superstition, maybe even of religion.

The track past my grandmother’s house leads in one direction to the King’s precinct. This is the space for ritual, a communal space. In the other direction, it leads slightly uphill to the market where my aunt Alice has a stall. The market is the centre of life. The goods are excuses for human intercourse. Not like supermarkets where the goods displace courtesy, the exchange of gossip, preclude flirtation and chill the warmth that is the glue of society. The marketplace is more than all this. It is the arena where the human comes to be scrutinized, where social conventions gather in the robes of men and the wrappers of the women, where conformity sits under umbrellas, and social judgment whispers or shouts its opinion. Mores are here to be reinforced. Shame hangs out waiting to be painted, nailed, or handcuffed unto someone or some family.

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You must not imagine that I think of Shame as something we can do without. We are in need of it, perhaps in small measure. Take these two recent experiences on trains.

You could tell that they were tough, easily. The young woman was already prematurely aged. Her skin was coarse, thickened both by excessive exposure to the cold and to cigarette smoke. She was ugly. Her nose, lips and jaw seemed unrelated, as if swiftly and without much thought thrown together. Her two male companions were loud and insensitive to the feelings of others in the quiet coach, swearing indiscriminately.

The most unusual aspect was their blatant, public use of crack cocaine. They had brought the paraphernalia with them: silver foil, water filled bottle covered with silver foil, and the brownish rock-like pieces of cocaine. There was a need, apparently, for ‘ash’. The woman went into the loo to smoke in order to produce the necessary ash. In the process she set off the smoke alarm. In their search for the crack cocaine, the shorter of the two men, excused himself and took off his baggy tracksuit trousers, to search in his dirty underwear, for the crack cocaine, retrieving it and then placing it on the table. The word ‘crack’ cocaine really did mean something then!

Then they proceeded to prepare and to use the cocaine, in public, casting furtive glances about, huddling together, guiltily but also brazenly ignoring all social strictures against the use of drugs. But why come to hide in the quiet coach to use drugs? Why not an empty building, a derelict canal side, an out of the way park venue in the dark?

It was a day of the utmost derogation of social conventions. Another young man on another train, and once again in broad inescapable daylight. This time, wearing a pair of dirty, soiled tracksuit trousers (are tracksuit trousers a sign of some undefined dereliction of morality?), sat at the end of the carriage with his hand in his trousers, stroking his penis, seemly unaware that this was a public space. How impoverished does the inner life have to be to need instant self-pleasuring to stoke its fire? And shame, has that become such a rare commodity?

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As the day draws to a close on a cool Spring day in the Arabian Gulf, the dust haze and the swallows diving and climbing prompt memories of other swallows in another life. This imaginative capacity to represent, to re-present, what is past and to reflect, well that is also the marketplace judging and condemning, within the self. Shame turning into guilt as we climb out of the pit of moral darkness.

Photos by Jan Oyebode

Sea of grass

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If you are in the Serengeti, and you look across the sea of grass, for that is what Serengeti means and is, a sea of grass, you will see how boundless is that space, the Eastern African plains. It stretches on forever and the eye cannot take in the vastness of it. Faraway, the air shimmers like delicate and translucent voile, the hot air rising, rippling like a wave in the distance. If you are there in the dry season, everything is that dull yellowish brown colour of dust.

And if you are that way inclined, you will come to know what transcendental means, the limitless space invading your inner world and drawing you out, your soul I mean. Suddenly you realise how insignificant we are, us humans, and how fragile, how vulnerable. If you look up at the sky and it happens to be a clear cloudless day, the infinite blue of the vault of heaven might transport your consciousness beyond the strictly mundane ordinariness of living, of waking and eating, and sleeping, and perhaps even climbing the greasy pole.

The eye needs to adapt to the light, to the distances, and the colour of the grass and the absence of contours. If you’re lucky you might chance upon a pair of cheetahs, reclining on their haunches. A studied indolence, nonchalant and indifferent to the heat and the surfeit of prey, is apparent. Majesty is not seated on a throne set on a dais. It is not perched on an ornamental and embroidered cushion. It is not weighted down by countless gems, neither by gold or silver. Its stateliness is not symbolic or constitutional. It is lived in the very speed and agility that it possesses. Power that is able to recline ought to be feared. If it is propped up and dressed in ermine, it is merely symbolic. It is for show.

But power has this insidious means of corrupting whoever wields it, even in the liberal democratic West. Soyinka’s A Play of Giants is a thinly disguised examination of four of Africa’s best-known despots, President for Life Macias Nguema, Emperor for Life Jean-Baptiste Bokassa, Life President Mobutu Sesekoko and Hero of Heroes, Life President The Field Marshall El-Haji Dr Idi Amin. This is a play about the psychopathology of power. In Soyinka’s hands power is exemplified by the arbitrary display of authority over life and death (see below) and also is intimately related to access to females (in the case of male leaders) for sexual favour:

GUNEMA. Zombies. Turn them into zombies. Is better. Any fool can understand government, but power! Amigos, that is privilegio. To control the other man, or woman. Even for one minute. Not many people understand that. When you control from birth to death, when the other man and woman know, in thousands or millions – I control your destiny from this moment, from this consciousness till the end of your life, now that is power. Even the animal world understands power, even the insect world. I have studied the colonies of ants in my garden. I sit down and meditate and collect my power from the night, and I watch the insects. Is very useful. I am not sentimental.

TUBOUM. I like to see the fear in the eye of the other man. If he my enemy, it is satisfactory. But it does not matter. If friend, it is better still. Even total stranger. Because I see this man telling himself, Tuboum does not know me, I am nothing to him, so why should he do anything to harm me. But he is afraid, I know it. I can see it in his eyes. I walk into a village, nobody in this village has seen me before but, the moment I arrive, I and my striped leopards – the village head, his wives, the priest, the medicine man, they are afraid. Sometimes I ask what is this fear I see? Have they been discussing treason before my arrival? Have they been holding meetings with rebellious Shabira tribesmen? But I know this is not the case. My spies have reported nothing, and they are good. They are afraid, that’s all. Barra Tuboum has brought fear into their midst.

And,

GUNEMA. Ah, but it is possible. It happen finally. I tell you. It happen like this. I sentence one man to death who I suspect of plotting against me. While he is in condemned cell, his wife come to plead for him. She is waiting all day in the house and when I am going to dinner she rush through my guards and fling herself at my legs, I am sorry for her. So, I invite her to have dinner with my family. Well, I make long story short. I tell her what her husband has done, that he is an enemy of the state and that the tribunal is correct to sentence him to death. She cried and cried, I feel sorry for her but, justice is rigid span of power, it must not be bent.  My wife she is silent, she knows she must not interfere in affairs of state. That night, after my family retire, I take her to bed. Perhaps she think by that I will reprieve her husband, I do not know. We did not discuss it. But, I take her hand, and she follow me to my private bedroom. When I make love to her, I taste it at last. It is strong taste on my tongue, my lips, my face, everywhere. It rush through my spine, soak through my skin and I recognise it for that elusive, overwhelming taste. Every night I made love to the woman, the same taste is there, nothing to compare with it. Nothing [That elixir].

These are fictional elaborations of psychopathology. But, power has this tendency to shift how the land lies, to warp the hinges so as to distort how far doors open or whether they open at all. But there is a sense in which each character, in Soyinka’s play is saying something that we know already. Pol Pot, Clinton, Bush all become understandable once we acknowledge that power is associated with the desire for ultimate power, that is over life and death, and how masculine political power by extension cements its authority too on access to females. The animal kingdom exemplifies this.

There is a different kind of dynamic at work in those cases of power that clings on regardless of the mounting body count, and despite the seemingly obvious, that oblivion both historically and personally might be the end result. Ghaddafi and El-Assad are but two recent examples.  Elias Canetti’s Crowds and Power, a monumental work, written after the 2nd World War, attempts to come to terms with Nazi Germany, and the magnitude of the toll of life sacrificed for adherence to ideology. Canetti’s book was first published in 1960 but already it reads as if it was from  an entirely different time. It is ambitious in its scope, forensically detailed in its analysis, scholarly and well written. Its arguments have a symphonic architectural span, with clauses & sub-clauses, combining all the devices of rhetoric and polemic to make its points. For the Twitter age, with everything densely and pithily condensed into 140 characters, Canetti’s magnum opus might seem obese and indulgent. Nonetheless, this is a masterly examination of the nature of crowds and of power, particularly of the malign influence of power. Canetti draws particular attention to the role of survival, of being a survivor, on the actions of rulers

In order to satisfy this craving [for survival] it is not necessary to expose oneself to danger. No one man can himself kill enough other men. On a battlefield, however, there are thousands all acting in the same way, and, if a man is their commander, if he controls their movements, if the very battle springs from his decision, then he can appropriate to himself all the dead bodies which result from it, for he is responsible for them. It is not for nothing that the commander in the field bears this proud title. He commands; he sends his men against the enemy, and to their death. If he is victorious, all the dead on the battlefield belong to him, both those who fought for him and those who fought against him…The significance of his victories is measured by the number of the dead.

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The reclining cheetahs and the wildebeests as the evening draws in, in the Serengeti point to a different dispensation, not of transcendence, not of transfiguration, but of brute force. Darwinism played out nakedly, the logic of life and death without sentimentality. And, it is the only higher ape, here in the Serengeti or in the Ngorogoro crater, Homo sapiens, whose presence introduces values, aesthetics, morality, justice, even death, I mean the self-conscious awareness of death, into this primordial space.  Pure unadulterated power is in the purveyance of the cheetahs. Humans have the capacity to escape the lore of power, the capacity for freedom, but continue to be lured and embroiled in the nexus of power and often with malign consequences.

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