Home » Medical humanities
Category Archives: Medical humanities
Pheromones are the lineal ancestors of hormones as EO Wilson says. These chemical signals have several outstanding advantages. Small amounts can produce a signal that lasts for hours. They are energetically cheap to manufacture and can be broadcast quite readily. At one extreme they can cover barely a few millimetres. At the other extreme they can generate an active space of several square kilometres. And as to function, in algae, for example, they can be used by female gametes to attract male gametes much as they do in fungi. In Arthropoda they’re female sex attractants. In insects,male sex attractants and aphrodisiacs exist. In vertebrates, pheromones acts as dominance odours, and territorial & home-range markers. But do pheromones have any role in primates and in particular in human beings?
There is no strong evidence for pheromones in humans. The vomeronasal signal transduction systems are at the very most vestigial in humans. Nonetheless there’s some evidence of pheromone effects during the menstrual cycle where it may be that they act as primers, and in the maternal recognition of a newborn where they probably act as signals and in mood displays as modulators.
Well, that’s the science. It seems that with the development of colour vision in male primates and the visible sign of female oestrus, there was less need for chemical signals and hence the markedly reduced reliance on pheromones, or so it is argued. But, I’m not so sure that pheromones are that vestigial.
I can recall that long trip from Lagos out to the country. We were squeezed close together against the door in the backseat of an old Peugeot 304. And it was not long before the closeness of our bodies, the softness of her thighs against mine, and our breathing called to the deep well of desire and I for one was stirred. But, yet the awakened desire had to be muffled, battened down as we were travelling with other companions and it was not night but broad daylight.
That was when I first noticed the aroma of desire. I have no idea whether other people too know of this odour, this effluence that is at once personal and public. It had a cloying substance to it of musk, of sweat mixed with dampness and dusk. It was revelatory.
Many years before I had witnessed a fight, I had caught just the rarest glimpse of a knife flash in the sunlight, and then as if the bare skin was pulled tight and then sliced, glistening red blood welled up along the slice, beads on a string. But it was the smell of fear, something much like the sea, saline rinsed in sea weed. I have associated this rare smell with fear since then and I can smell it, an effluent from a grown man’s armpits. Sometimes it is rancid and sharp and sometimes sour but with a tang to it.
Well it was much the same, the aroma of desire wafted in the atmosphere, technically speaking, in an active space, but to my surprise the other occupants of the vehicle did not seem to have caught any whiff of how the aroused vitals secreted their inner mysteries, their secrets, broadcasting ardour and lust.
This talk of the past has brought back to mind memories that were until just now deeply buried. I can remember visiting my great grandmother in Isale Eko, within her agbole ile just off Eti Osa. We would park the car and then cross the road away from the canoes bobbing by the lagoon side, where the women had their crayfish stalls and fried crabs were sold. To get to her quarter you crossed over an uncovered gutter. Inside the quarter the residences were built along three sides of the courtyard. My great grandmother must have occupied a single room in this courtyard. I stayed with the Ss once, overnight. It was a single room with the parents’ bed separated off from the living space by a curtain that barely reached to the ground. We, the children slept on the floor together and the parents slept on the double bed of wrought iron. Sometime in the middle of the night, I was woken by the older boy who whispered that we look through a discretely torn hole in the curtain to look at the parents locked in an embrace that alternated between wrestling and rapid breathing and ugly and harsh noises. It was a mystery that only became clear many years later. Did the parents not realise that we were watching in tense silence?
Down the courtyard from my great grandmother’s was my mother’s aunt, aunty Mrs Johnson, or more precisely “anti”. She lived on her own, a frail light skinned woman. Her skin was yellowish and wrinkled, but not exactly. The skin seemed loose and too large for the underlying flesh. But it was her smell that I am always reminded of when I think of her. It is really an indescribable smell of dryness, of dandruff, of something ancient like parchment or the hollowed out earth where the drinking water pitcher was kept. She was my mother’s “anti” in the way that all older women were our aunties and older men were uncles. In the sense that all men, who were older in conversation were referred to as “my father” or “my mother” if female.
The correct use of language has bled my rich and profuse relationships of their vitality and vigour. Where I had innumerable brothers I now have one and my countless sisters and cousins are stripped to manageable single numbers rather than dozens. It is how the European norm of nuclear familyhood has eroded the entanglements of extended and luxurious fecundity, of the Niger Delta turning into the arid spittle like stream of a dried riverbed.
Mrs Johnson’s son, my mother’s cousin worked for the Lagos Municipal Transport Service as a bus inspector. He was always well dressed, when he visited at Xmas, in a suit with a white shirt and tie. He brought my mother two books on consecutive Christmases- both by Alan Paton- Cry The Beloved Country & Too Late the Phalarope– describing the impossible and intolerable situation of Africans in South Africa and one year he brought Albert Luthuli’s Let My People Go. He must have been well educated and I mean in the sense of somebody who read widely and knew what to think when few people were aware of anything outside of the Nigerian situation. We lost contact with him when the houses, the land along the lagoon were requisitioned by the government for the development of the second Lagos bridge. The families were moved to brand new flats in Surulere without the courtyard design of their former homes. For the first time the families acquired indoor lavatories instead of having to use potties, etc.
In the same courtyard, across on the far side a young couple with a young daughter moved in. The daughter was reputed to have told her parents as soon as she could talk that she was not their daughter but that she had recently died and that her parents lived in Abeokuta. Apparently she named her presumed parents and their address and when inquiries were made it turned out to be true that such a family existed and her account was corroborated. How strange after all these years to recall this.
Much of my early memories are tied to real places that still exist except for the courtyard just across from Eti Osa. I think perhaps because the real places no longer exist there is a strange feeling of uncertainty about these memories, as if I have just woken up from a dream and that these places are somewhere in my imagination except that memories of smells persist.
Aside from Mr Johnson’s odour, to get to Eti Osa you had to go across Carter Bridge from Ebute Meta to Lagos island. You turned left at the statue to the unknown soldiers, Soja Idumota. Here the characteristic smell of old Lagos clung to the nostril. This was where the night soil men dumped their ware after midnight or before dawn. The stench was of faeces mixed with the sea like marinaded compost. This smell was nicknamed “Sasarabia”.
To return to that trip. It was the first time that a thigh acquired a new value simply for being female. Even now at my age I am still mystified by the ability of a body part to acquire a heightened value and to provoke interest and desire for being female. But the aroma of desire has long ceased to be something that I consciously detect. Maybe age atrophies this sense just as it does hearing and sight. Maybe too, pheromones act at subtle levels of discrimination directing and limiting, ensnaring and sometimes provoking. Or, it might just be that I am past that age where nature cares much for my desires.
Photos by Jan Oyebode
I don’t know whether you know about Nkisi nkodi. It is a Kongo nailed figure, a container or statue of forces directed at an end. It is one of the most potent figures of African art. The nails are hammered into the wood whilst ritual curses are spoken. Each object may have dozens of these iron bits. An nkisi is an extraordinary object. The best way to think of it is as concentrated power actively and consciously employed to a goal. The act of forcing the iron into the wood requires muscular tension, sweat, the appropriate words and the requisite atmosphere of terror. This is an example of commitment to an act, to a purpose and is bounded by faith in the possible. Often, the power that is sought for is retribution, for vengeance, or simply to charge envy with venom. But, it is the concentrated commitment that interests me. Think Coltrane playing the saxophone, every note charged with commitment as if his life depended upon it. His breath and spirit, his very vitality and vigor directed at one aim, to transform what is unseen and unheard, what is impalpable into what is concrete and transient, into music.
In Egil’s Saga, we find a Norse example
He took a hazel pole in his hand and went to the edge of a rock facing inland. Then he took a horse’s head and put it on the end of the pole. Afterwards he made an invocation, saying, ‘Here I set up this scorn-pole and turn its scorn upon King Eirik and Queen Gunnhild’ – then turned the horse’s head to face land – ‘and I turn its scorn upon the nature spirits that inhabit this land, sending them all astray so that none of them will find its resting-place by chance or design until they have driven King Eirik and Gunnhild from this land’. Then he thrust the pole into a cleft in the rock and left it to stand there. He turned the head towards the land and carved the whole invocation in runes on the pole.
I know that it is unusual to exemplify commitment to life in the very places that seek to deny life or invoke harm. But it is the focused attentiveness to an act that is alluring here. It displays for our observation, exposes what is often unobserved in the daring and courage of everyday life, the studious seeking of a goal. Egil’s life was lived with as much resolution as demonstrated in this act of poisonous hatred.
My intention is not to romanticize the extreme violence of the Icelandic sagas or even to ignore the surprising amoral tone of the sagas. I am merely drawing attention to the manner of living, the transparency of intentions & how their guiltless and remorseless conduct displayed an arid moral landscape
Egil was paired against a boy called Grim, the son of Hegg from Heggstadir. Grim was ten or eleven years old, and strong for his age. When they started playing the game, Egil proved weaker that Grim, who showed off his strength as much as he could. Egil lost his temper, wielded the bar and struck Grim, who seized him and dashed him to the ground roughly, warning him that he would suffer for it if he did not learn how to behave. When Egil got back to his feet he left the game, and the boys jerred at him. Egil went to see Thord Granason and told him what happened. Thord said, ‘I’ll go with you and we’ll take our revenge’. Thord handed Egil an axe he had been holding, a common type of weapon in those days. They walked over to where the boys were playing their game. Grim had caught the ball and running with the other boys chasing him. Egil ran up to Grim and drove the axe into his head, right through to the brain. Then Egil and Thord walked away to their people.
In the Saga of the People of Laxardal, Unn, a heroine of this saga in her old age held a wedding feast for her favourite grandson, Olaf. At the feast
She entered the hall, followed by a large group of people. When the hall was filled, everyone was impressed by the magnificence of the feast. Unn then spoke: I call upon you, my brothers Bjorn and Helgi, and other kinsmen and friends as witnesses. This farm, with all the furnishings you see around you, I hand over to the ownership and control of my grandson, Olaf’. Unn the rose to her feet and said she would retire to her bedchamber. She urged them to enjoy themselves in whatever way they saw fit, and people could take pleasure in drinking. It is said that Unn was both tall and heavy-set. She walked briskly along the hall and people commented upon her dignified bearing. The evening was spent feasting until everyone went to bed. Olaf Feilan came to the sleeping chamber of his grandmother Unn the following day. As he entered the room, Unn was sitting upright among the pillows, dead. Olaf returned to the hall to announce the news. Everyone was impressed at how well Unn had kept her dignity to her dying day.
There was an indisputable conscientiousness about dying, as there was about living in the Icelandic sagas. Unn’s death in old age followed a format that was well established and perhaps even rehearsed. And we have notions too of ‘bad deaths’-
Kveldulf asked Olvir about the entire incident in Sandes when Thorolf was killed, about the worthy deeds he had done in battle before his death, and who had struck him down, where his worst wounds were and how he had died. Olvir told him everything he asked, mentioning that King Harald had dealt him a blow that by itself would have sufficed to kill a man, and that Thorolf had dropped face down at the king’s feet. Kveldulf said, ‘You’ve spoken well, because old men have said that a man’s death would be avenged if he dropped face down, and vengeance taken on the man at whose feet he fell […]
In our time, the thoroughgoing commitment to a unifying social goal in a single-minded manner seems to be present only in individuals rather than as a set of values widely distributed in society. You find it in athletes, in some academics, in explorers and artists. But, in wider society the explicit display of concentrated idolatry is for wealth and material goods. Here, the nkisi nkodi is a bank account, meticulously anointed and worshipped, studiously examined and protected, the bank account statement has all the status of a fetish, a charm that opens the secret vaults of life.
Photos by Jan Oyebode
It is now decidedly Autumn. The leaves are about all turned or already fallen off their branches. The pavements have that irritating layer of sodden, rotting leaves. Our back garden has the wonderful show of brown and reddish yellow, of mustard and red pepper, of berries and the yet to be plucked speckled apples. It is even more glorious in Hebden Bridge, looking upwards towards the valleys, especially with this late October sunlight that burnishes the bronze and golden, making them at once trophies to be worshipped.
Strangely, this variegation of autumnal leaves has put me in mind of the nature of identity but with emphasis on difference and its markers, its ambiguities, its horizontal barriers, its slurs and barbarities, and how it shapes narrative structures and experience.
Julius, the protagonist in Teju Cole’s novel Open City, is a psychiatrist in training and fully understands how the nature of difference is at the centre of psychiatric practice: Is psychopathological difference a matter of degree compared to normal experience or is it significant qualitative difference? In other words, is melancholia an extreme version of sadness or is it radically different? Or, is delusional belief a specie of beliefs or as Karl Jaspers would have it “ununderstandable” and hence incomprehensible. Julius never discusses these matters- his emphasis is on identity, ethnic or racial difference. Nonetheless his approach and standpoint are relevant, for example, he says
“Each person must, on some level, take himself as the calibration point for normalcy, must assume that the room of his own mind is not, cannot be, entirely opaque to him. Perhaps this is what we mean by sanity: that, whatever our self-admitted eccentricities might be, we are not the villains of our own stories…” This issue arises in the prelude of Julius discovering that in someone else’s version of personal historical events he is a villain.
In psychiatry the issue is quite separate. It is that the psychiatrist uses him- or herself as the gauge, the thermostat, so to speak of normalcy. As Jaspers would say, by way of the empathic method, re-presenting to oneself the subjective inner world of another person we come to judgments about his normality or otherwise. This, of course, is a conscientious judgment, fraught with problems, not least the frailty of our own inner life and the fragility of the arbitrary boundaries demarcating normality from psychopathology.
Ascribed difference whether denoted by language, gender, sexual preference, ethnicity, race, tribe or whatever is a serious matter. It is at the root of some of the most malevolent actions that human beings take and the perversions of spirit exercised towards the Other. To fully appreciate the extent of the malign influence of ascribed difference Jerzy Kosinski’s The Painted Bird is the text that best explores the darkness of this territory:
Strange things happen in the farmyard. Yellow and black chicks hatched out of the eggs, resembling little live eggs on spindly legs. Once a lonely pigeon joined the flock. He was clearly unwelcome. When he made a landing in a flurry of wings and dust amidst the chickens, they scurried away, frightened. When he began to court them, cooing gutturally as he approached them with a mincing step, they stood aloof and looked at him with disdain. They invariably ran away clicking as soon as he drew closer. One day, when the pigeon was trying as usual to consort with the hens and chicks, a small black shape broke away from the clouds. The hens ran screaming toward the barn and the the chicken coop. The black ball fell like a stone on the flock. Only the pigeon had no place to hide. Before he even had time to spread his wings, a powerful bird with a sharp hooked beak pinned him to the ground and struck at him
What is this a metaphor for? That difference makes us more visible to attack, more vulnerable, less likely to be protected. As the Japanese say- the nail that sticks out is more likely to be banged in. Standing out from the crowd, not conforming, is risky business.
Difference, then, can urge on the self-aggrandising impulse, taking hold of the will to crush under the hooves of a steed (whose intention is wholly malign) the dignity of the Other. Marked and ascribed difference, the difference that is aimed for by the eye or the ear, that is clarified in the subtleties of bodily movement, gait, stance, dance! Difference that hangs in the air as a vapour, a nuanced coloured essence, an odour that steams and invokes hate as its passion. This is the difference that is sought for in the sheer presence of the “not self”.
Finally, after prolonged scrutiny, he would choose the strongest bird, tie it to his wrist, and prepare stinking paints of different colours which he mixed together from the most varied components. When the colours satisfied him, Lekh would turn the bird over and paint its wings, head, and breast in rainbow hues until it became more dappled and vivid than a bouquet of wild flowers. Then he would go into the thick of the forest. There Lekh took out the painted bird and ordered me to hold it in my hand and squeeze it lightly. The bird would begin to twitter and attract a flock of the same species which would fly nervously over our heads. Our prisoner, hearing them, strained toward them, warbling more loudly, its little heart, locked in its freshly painted breast, beating violently. When a sufficient number of birds gathered above our heads, Lekh would give me a sign to release the prisoner. It would soar, happy and free, a spot of rainbow against the backdrop of clouds, and then plunge into the waiting brown flock. For an instant the birds were confounded. The painted bird circled from one end of the flock to the other, vainly trying to convince its kin that it was one of them. But, dazzled by its brilliant colours, they flew around it unconvinced. The painted bird would be forced further and further away as it zealously tried to enter the ranks of the flock. We saw so afterwards how one bird after another would peel off in a fierce attack. Shortly the many-hued shape lost its place in the sky and dropped to the ground dead
Lekh in his anguish had exploited an innocent bird’s knowledge of its kind to put it at mortal risk. The actual attack was prompted by visible difference. Again, difference is at the heart of violent attack.
Kosinski is writing in the aftermath of WW 2. But, his gruesome account of superstitious reasoning, of paranoid anxiety, of vicious and unthinking malevolence towards people who looked different is still relevant today, perhaps even more so, given the response to refugees from Syria in Europe characterised as it is by suspicion.
Tennessee Williams in The Glass Menagerie also deals with the same issue. Laura Wingfield is loosely based on his sister Rose who suffered from schizophrenia. Laura is courted by Jim O’Connor. He visits at the invitation of Tom, Laura’s brother. Laura shows him her glass menagerie, and he looks at a small glass unicorn, the only one of its kind amongs the horses. Whilst Laura and Jim are dancing, Jim accidentally knocks over the unicorn and the unicorn loses its horn and Laura says
The horn was removed to make him feel less- freakish! Now he will feel more at home with the other horses, the ones that don’t have horns…
Later Jim says
Has anyone ever told you that you were pretty? Well you are! In a very different way from anyone else. And all the nicer because of the difference too…The different people are not like other people, but being different is nothing to be ashamed of. Because other people are not such wonderful people. They’re one hundred times one thousand. You’re one times one! They walk all over the earth. You just stay here. They’re common as – weeds, but – you – well, you’re – Blue Roses!
Tennessee Williams’ treatment of Laura is delicate, sympathetic and full of understanding. For Williams, Laura was not merely emblematic of difference, she was not a symbol, but drawn from flesh and blood. Yet, even he overvalued difference. But, better this than to stigmatise difference.
I return to autumnal colours. The variation in colour, the magnificence of rich and exquisite shapes and hues are a source of marvel, not of incomprehension or envy. There’s no active desire to destroy or injure. The sky is suffused in an iridescent shimmer of light. Darkness is rapidly on the way as the day closes. For a quick last glance the Pampas grass has its flowers glistening like ostrich feathers in the light before succumbing to the night.
Photos by Jan Oyebode
Oliver Sacks has just revealed that he has terminal cancer. This sad news from the voice of humane medicine put me in mind of Marguerite Yourcenar’s Memoirs of Hadrian, an account of the last days of a great man, looking back and forwards, in a letter to Marcus Aurelius.
The letter opens
Today I went to see my physician Hermogenes…I took off my cloak and tunic and lay down on a couch. I spare you details which would be disagreeable to you as to me, the description of the body of a man who is growing old, and is about to die of a dropsical heart. Let us say that I coughed, inhaled, and held my breath according to Hermogene’s directions. He was alarmed, in spite of himself, by the rapid progress of the disease…
Hadrian is 60/61 years old as he writes this letter. I am exactly the same age. In reading Hadrian’s memoirs and learning of Sack’s terminal illness, I am confronted by the inevitability of my own mortality. Aside from love, this is the most significant subject that human’s encounter, the fact of the limited span of our lives. And, this is amplified in the clinic as we face a doctor’s scrutiny
It is difficult to remain an emperor in the presence of a physician, and difficult even to keep one’s essential quality as a man. The professional eye saw in me only a mass of humours, a sorry mixture of blood and lymph. This morning it occurred to me for the first time that my body, my faithful companion and friend, truer and better known to me than my own soul, may be after all only a sly beast who will end by devouring his master.
In the clinic, despite the best intentions of the physician, naked, we are stripped not only of the garments that clothe us but also of the dignity that shields us from the slough, the mud & clay from which we come and to which we shall all return. This body which becomes a ‘corpus’ when it ails, an object that is distinct from us is, in the clinical encounter, objectified, “a mass of humours, a sorry mixture of blood and lymph” and suddenly it is alien, a foreigner who surprises!
It took Marguerite Yourcenar a quarter of a century to write Memoirs of Hadrian. She said
It did not take me long to realize that I had embarked on the life of a very great man. From that time on, still more respect for truth, closer attention, and on my part, ever more silence.
What is inescapable for the reader is that Marguerite Yourcenar was herself a “very great” person. She was able to circumnavigate, to encompass and then to narrate in the first person, this extraordinary life. The writing was itself as challenging, and as courageous as the lived life of Hadrian. Again Yourcenar said
The sorcerer who pricks his thumb before he evokes the shades knows well that they will heed his call only because they can lap his blood. He knows, too, or ought to know, that the voices who speak to him are wiser and more worthy of attention than are his own timorous outcries.
Here, I thnk, Yourcenar is acknowledging that a) in speaking in another’s voice, b) doing this with honesty, and c) in imagining the authentic voice of the subject, the writer has to give something of herself, perhaps a drop of blood as sacrifice and as magical ingredient, perhaps even her own life. She writes of Hadrian’s illness and of his dying with the same intensity as of his love and his triumphs. There is a message here for doctors, psychiatrists in particular: full engagement and understanding of the patient comes at a price. It requires losing oneself in the world of another person, it requires sacrifice, perhaps even a drop of blood!
Hadrian’s medical condition deteriorates and we have that gradual but yet surprising disjunction between self and body
All my life long I had been on best terms with my body; I had implicitly counted upon its docility, and its strength. That close alliance was beginning to dissolve; my body was no longer at one with my will and my mind, and with what after all, however ineptly, I must call my soul…In fact my body was afraid of me…
And, then the question of death
One desires to die, but not suffocate; sickness disgusts us with death, and we wish to get well, which is a way of wishing to live. But weakness and suffering, with manifold bodily woes, soon discourage the invalid from trying to regain ground: he tires of those respites which are but snares, of that faltering strength, those ardors cut short, and that perpetual lying in wait for the next attack. I kept sly watch upon myself…Meditation upon death does not teach one how to die; it does not make the departure more easy, but ease is no longer what I seek.
In describing his attitude to his approaching death Oliver Sacks quotes David Hume
“I now reckon upon a speedy dissolution,” he wrote. “I have suffered very little pain from my disorder; and what is more strange, have, notwithstanding the great decline of my person, never suffered a moment’s abatement of my spirits. I possess the same ardour as ever in study, and the same gaiety in company.”
The last word to Hadrian/Yourcenar
Let us try, if we can, to enter into death with open eyes…
Photos by Jan Oyebode
What is terror? Is it that flash of white phosphorescent light that started in the innards and exploded soundlessly? First, a seizure quickened the pulse and the muscles of the heart, and then it dried the mouth, propelling every sinew, every nerve of the four limbs into a rush of running. It is definitely not like Lot’s wife at Gomorrah, there is no looking back. It is a straight flight, senseless, into the bayonet end. Let me recount, it is incendiary and blind. Lethal.
If you know how, you can see the early signals. In Monrovia, young hooligans loot a hospital for the blood-covered mattresses of death. In Freetown, doctors and nurses are killed for the mere fact of bringing concern to bear on a pernicious disease. In Lagos, more die in the first week from salt overload in the mistaken belief that saline drinks were panaceas. In Madrid, animal rights activists, ironically, clash with the police over the putting down of a dog when the owner is already mortally wounded. In Texas, there’s nowhere to quarantine a family already exposed to death.
And, this is only the firing of the starting gun.
Faced with the astronomical we can only comprehend the sluggish innumerate ten of the fingers on our hands. What are airport checks worth when the real and relevant distances are measured in six degrees of separation and not in nautical miles? This is like geologic to historic time, measured in millions of years compared to a few thousand years of history. Wholly incommensurate!
Tell me, what do you think about when in the centre of breathing, your breath catches on a snag? I lose all the thread of thought like geese flying formation style suddenly confronted by loss of air and unable to flap their wings or swoop through the warm current, plummeting, dropping like stone, like dead weight, their formation unraveling, so like my thoughts.
In this crisis, words miss the mark totally. As Camus said
even the sincerest grief [has] to make do with the set phrases of ordinary conversation.
current coin of language, the commonplaces of plain narrative, of anecdote and of their newspaper
must be enough since the anxiety & this sense of loss and of foreboding escapes the capacity of language. And hyperbole will not do. Yet, the extent of the disquiet, the panic and terror is extreme, very extreme.
In Saramago’s Blindness, another novel about an epidemic, this time not of the plague but of infectious blindness, metaphysical blindness, not the clinical blindness of cataracts or glaucoma, the only person with sight says
If we cannot live entirely like human beings, at least let us do everything in our power not to live entirely like animals.
Here, we have a talisman to live by. In this precarious period, fraught with anxiety, pregnant with panic, there is a serious risk of elemental emotions driving the humane out of the human, a very serious risk that like desperate animals, we shall sink our teeth into the neck of the other, salivating in the process. Yes, there is a real risk that we shall live entirely like animals.
Photos by Jan Oyebode