Archive for the ‘Life’ Category

The Hungry Ghost Festival

May 24, 2020

‘My dislike of the city was almost violent, something I had never encountered elsewhere,’ writes Felicia Nay about Hong Kong. ‘If somebody had predicted that one day I would write a novel born out of nostalgia for it, I would have doubted the person’s sanity.’

Nay’s experiences seem remote from what would eventually become Red Affairs, White Affairs‘My room had no windows, the door was secured by an immense gate, the TV ads consisted of warnings against violent crime and HIV infections, and I had no bottled water.’ This is a way off her narrator Reini’s journey in the novel. Reini’s Hong Kong is about staggering views, sensual meals, long conversations, splendid ritual, tours of gorgeous landscapes – truly ‘Fragrant Harbour, Incense Port, Pearl of the South China Sea.’

Still, the happiness of the city is tempered by Reini’s knowledge of its delineations. Her role as an aid worker is very well defined by the faith based charity that employs her. When Reini gives a talk at an upscale women’s function her listeners only want to know ‘So, do you have a maid?… Why don’t you want one?… My helper feeds seven persons in the Philippines with her salary. She puts her children through school with my money.’

Reini loses patience with this, and says:

You think you’re good employers? Maybe you are. Maybe you are, maybe you’re not. According to our surveys, seventy-five percent of domestic workers work fourteen hours day. And all of them have to play by the rules of the system…. A system where losing your job means losing your visa and losing your home. And these are the good moments. The post-colonial, no, the proto-colonial moments…. The moments when the air conditioning is turned on for the master’s dog but never the maid… In the bad moments—and I get to work with the bad moments, remember—it’s modern slavery…. It starts with withheld wages and confiscated passports, wrongful promises by employment agencies and employers.

Reini can’t help break the rules. The novel takes its title from a traditional delineation. ‘White is the colour of death. Red, on the other hand, is auspicious, the glaze of happiness, the hue of protection. Red affairs are weddings, that lucky joining of two individuals, two families.’ Reini (or ‘Kim’) blurs the divisions without meaning to. She has lost her previous post in Khartoum for an act of altruism that her employers found inappropriate. Her best friend in the city is Virginia, a lonely woman who teaches her Cantonese. She has inherited her family’s disappointment by remaining unmarried, and her passages are some of the saddest in the book. Reini sees how a rule bound life has let Virginia down. Assigned back to casework after her angry speech at the woman’s function, Reini befriends Ronda, one of Hong Kong’s unseen army of domestic workers, and tries to fix the two women up. The transgressions feel vague but they are there.

As Isabel Costello says, Reini is ‘intense company, occasionally at the expense of narrative drive’. Her feelings, drives, sensations dominate the novel, whenever she’s eating, exercising, or blushing, you feel it. Reini also has a habit of reading strange portents into everyday occurrences: she’s forever quoting Emily Dickinson (so much like Chinese dynastic poetry, now that I think of it, with its blunt sensuality) and while this is clunky sometimes, maybe it’s the sort of thing you’d have to know Hong Kong at that period to understand. (The time frame is another vague thing, there’s no mention of the civil unrest of 2019.)

The book also gives terrific insight into Cantonese views of life and death: dying unmarried and childless is a sin for women because there will be no one to look after them in the afterlife, when people die they can become ancestors, but that’s the best case scenario – those who die of accidents or suicide haunt the earth as ghosts. Virginia has a neighbour who keeps a live chicken in her flat. She theorises that the rooster is her ‘ghost husband… Maybe they were engaged and then he died.’

Red Affairs, White Affairs is a strange, sometimes maddening novel, but in its way it’s a masterwork of sense and sensuality. There’s not a story there in the linear way I understand it, but a vivid, seamless rush of impressions and images like the view from some fast-flowing river, in high current.

Mental Health in Lockdown

May 8, 2020

There is a tendency in political commentators to support, near uncritically, the government’s COVID-19 lockdown, to hit hard at the lockdown’s few dissenters, and to downplay adverse consequences of the lockdown. Oliver Kamm’s latest article for Cap-X isn’t coming from what I call ‘Gov.Uk Twitter’ but it shades into that sensibility at times. His bold claim is that ‘The critics of the lockdown in Britain typically stress not only the immense costs to the economy of current policies but also the psychological toll of keeping people isolated. That objection is wrong.’

When Kamm talks about mental illness he speaks with authority. He suffered from clinical depression, and was also targeted by political nuts online, who sought to intimidate and psychologically break him. So this para is not throat clearing: I have respect for Kamm but I believe (respectfully) that he is wrong in this case.

Kamm does acknowledge potential harms of the lockdown, and the questions of privilege that run through it: he concedes that ‘low mood is what you’d expect when we can’t visit our friends or loved ones, engage in normal recreation, or even just change the scenery by getting on a train. It will particularly affect those who live in cramped or substandard accommodation, without access to green spaces, and in dysfunctional or abusive domestic relationships.’

Keeping ourselves sane, however, ‘will require challenging two myths that are incompatible but that perversely give sustenance to each other.’ For his myths, Kamm picks two bad takes on mental health and society – the callous cod libertarianism of the dimwitted Spiked Online crew, and the argument of the 2010s left that capitalism fries our brains by keeping us poor, or by making us rich. These are indeed stupid takes that reading about mental health you will encounter.

Once the straw men have been bundled back into the haybarn, however (Kamm quotes a Laurie Penny column going back to 2015) what exactly is Kamm’s advice? It is Gov.UK Twitter advice: ‘Following the advice of PHE to stay in touch with people, to support others, to look after your physical wellbeing and to take time to focus on the present will make our society as well as ourselves more resilient in dark times.’ Of course, Kamm concedes again, ‘while the habits recommended by PHE can make you more resilient against mental illness, resilience itself is not a remedy for those who have depressive disorders.’

For depression, Kamm recommends cognitive behavioural therapy: ‘A stressful event, such as bereavement or the breakup of an important relationship, can stimulate a self-reinforcing chain of negative thoughts and stress. CBT works to correct these disorders of thought. It is cheap for the health service to provide and has a record of success.’ The therapy is particularly useful in lockdown as you will be able to do it online.

But chances are, you know what CBT is – because it’s everywhere. Employers use it, jobcentres use it, it’s a tool that’s been proven useful so naturally organisations see it as the go to and cure all. But CBT is just that – one tool in the box – it’s not necessarily going to work on its own and it’s not going to work for everyone. Individuals are complex. Different tools and methods are needed.

Say you have a recurring, intrusive thought – ‘I am going to die of the coronavirus.’ You lose sleep, have panic attacks, become low and afraid. A CBT practitioner will help you develop counterpoints to that bad thought, such as:

  • I am catastrophising – the worst thing doesn’t always happen
  • I practice social distancing – I am doing everything I should to avoid catching the virus
  • Even if I get the coronavirus – I probably won’t die

The problem is – in many people the more you engage with irrational intrusive thoughts the more these thoughts will dominate your mental landscape. You are wandering deeper into the woods, and looking inward rather than outside at the wider world. That’s a particular danger during the pandemic when we are encouraged to be agoraphobics in the home and OCD outside it.

The mind is amazing but most of the stuff it throws up is not relevant or even interesting. It’s best to take a step back from your own thought processes and treat the mind as a fast-flowing river that carries everything quickly downstream. Being in the present, and the wider world, is the way forward.

Of course – I am no clinician – CBT may work very well in the majority of people. But rolling out CBT barely made a dent in the mental illness epidemic under the austerity years of the 2010s. Most people supported austerity when it came in ten years ago, just as most people support lockdown today. But it is not easy to function under conditions of austerity. Weeks turn into months, and resilience ebbs.

In Life After Dark, social historian Dave Haslam wrote that ‘The bouyant demand for literary and other sorts of festivals and for live music suggest that face-to-face, primary experiences and social occasions have virtues the virtual world lack.’ Primary experience keeps us sane. Restricting it can only do psychological harm.

This is not the place for a critique of the lockdown. It may well be right and necessary. But I would like some acknowledgement that even if it is the best policy it will have adverse consequences. And one of those consequences will be an impact on mental health.

Captain Trips

March 12, 2020

Everyone wants you to be worried. And indeed there’s a lot to be worried about. I particularly feel for older people and people who have respiratory problems. A public health professional I chatted to on Twitter told me that for people in that situation, the idea of losing a breath is terrifying – of fighting, struggling for breath. I can’t imagine.

My point is only that being anxious is not the same as being careful. Anxiety is not a constructive condition. The redundancy and the harm of anxiety is compounded in this instance by the fact that there is only so much that you as an individual can do to prevent the spread of COVID-19 – beyond hand hygiene and consideration, which we should be doing anyway. The micromanagement of personal behaviour is finite.

So the question becomes what others should be doing. Government is throwing money at the virus – fair enough, we need more money for NHS response. Employers should let people work from home – sure, but our work culture of presenteeism makes that a hard sell. There are all kinds of tools like Skype to make public obligations like court hearings or occupational health interviews quicker and easier, but they’ve never been used – people are expected to travel halfway across the city for some mandatory training course or trek between counties to visit one of our few remaining public utilities. Maybe corona will help us overcome entrenched compulsory meeting culture, maybe it won’t. And it will also be a hard sell for the state to look after the gig economy workers who don’t get paid if they don’t show up – whatever the reason.

All this is a big ask for UK public sector. There are people who want the state to do yet more things. Dr Jenny Vaughan, law and policy lead for Doctors UK, discovered this when she called in to Love Sport talk radio. The presenters had been complaining about a news report saying that retired doctors would not be happy to come back to work in a crisis. Vaughan made the points that most of these doctors are completely burned out after many years in stressful frontline culture, that many bureaucratic and occupational hoops would need to be jumped through to get back to the frontline, and that as retired people tend to be old, the doctors would be more at risk. No dice. ‘Absolute nonsense!’ said the presenters. ‘Get rid of her.’

Then last night, Piers Morgan complained that ‘1000s of Atletico Madrid fans are in Liverpool – despite their own city being in virtual lockdown, INCLUDING their own matches, because Madrid’s been ravaged by Coronavirus (782 cases, 35 deaths). This is total madness. What the hell is the British Government doing????’ Piers is an easy target of course but he represents something sinister in the national corona worry – not just anxiety but the demand that Something Must Be Done: to be given stuff, or for the state to do stuff to other people.

I apologise for what will seem a flippant tone to this post. Do I come off as the lazy sceptic who assumes that nothing bad will ever happen? I’m not – I love my life and live partly in fear and vigilance that someone or something might try and take it from me. National events do worry me. My point is that it is not clear that China or Italy style lockdowns (or Trump’s travel ban that Piers Morgan is so fond of) has been effective in fighting the virus, or that such measures should be imported to England. I know I’m an uninformed layman, but come on, what happened to the good old British devil-may-care insouciance in the face of disaster?

The philosopher Kenan Malik saw all this coming, back in early February. He argued that state based cures can sometimes be worse than the disease:

In 2009, the H1N1, or swine flu, pandemic caused up to 550,000 deaths and, like the coronavirus, was declared a global health emergency. In Mexico, where the virus was first detected, the government shut schools and businesses, banned public gatherings and imposed quarantines. These moves helped limit new cases of H1N1, but were abandoned after 18 days, partly because of the huge social and economic costs they imposed. Although between 4,000 and 12,000 died from the outbreak in Mexico, the cost of preventing it spreading further was seen as greater than the cost wreaked by the virus itself.

When some West African states imposed cordons sanitaires to seal off large areas during the 2014-16 Ebola epidemic, tens of thousands were left starving, leading to mass violence. Quarantines have their place in the medical toolkit, but demonstrating you’re in control may not be the best way of tackling an epidemic.

The authorities want to transmit other messages, too. There is no medical reason for Australia to quarantine its nationals returning from Wuhan on Christmas Island, 2,000 miles from the mainland. But it is making a point. For years, Canberra has incarcerated undocumented migrants in ‘offshore’ camps. ‘You will not sully Australian soil’ is the message. It’s the same message about those who might be infected with the coronavirus.

For all that we should take care, and be aware of the seriousness of the pandemic, it doesn’t hurt to learn from the history of such things.

Update: Mind have useful guidance on corona and mental health, plus links to NHS advice.

Caroline Flack and The Conversation

February 21, 2020

One of the best essays on mental health in recent years was from the Guardian journalist Hannah Jane Parkinson. Parkinson has been through the psychological mill, and has the scars to prove it. In 2018, she summed up a contemporary commonplace on the subject.

In recent years the discussion around mental health has hit the mainstream. I call it the Conversation. The Conversation is dominated by positivity and the memeification of a battle won. It isn’t a bad thing that we are all talking more about mental health; it would be silly to argue otherwise. But this does not mean it is not infuriating to come home from a secure hospital, suicidal, to a bunch of celebrity awareness-raising selfies and thousands of people saying that all you need to do is ask for help – when you’ve been asking for help and not getting it. There is a poster in my local pharmacy that exclaims, ‘Mental health can be complex – getting help doesn’t have to be!’ Each time I see it, I want to scream.

Parkinson’s point was that attitudes have changed for the better while the practical reality of treatment – appointments, clinics, beds, medications – has got worse.

When the news came last weekend that Caroline Flack had killed herself I expected the reactions to be sophisticated. I was drinking red wine and reading Robert Caro on LBJ – on a Saturday night, rock and roll, yeah? – and between chapters I would glance at my social media to keep up with the conversation.

And I am afraid that what I saw was one of the biggest piles of horseshit that I have witnessed in liberal left discourse.

These are a few examples.

I had no idea who Caroline Flack was until she died and read the about the hounding she got in #TheScum. Can we create #CarolinesLaw to stop the press abuse of people who have done no harm to anyone? Maybe call it #AmysLaw? Before it’s too late for Meghan.

The press hounded Princess Diana. After her death, we said it would never happen again. Then others. They splashed Amy Winehouse’s suffering across front pages. Meghan has been so attacked she had to leave. Our society hunts women down for kicks and can’t seem to stop.

Faceless keyboard warriors hounded her to her death – I know about this stuff after 8 years of abuse whilst trying to do my job & the devastating impact it has on your mental health. Life is precious & we are here too short a short time to waste it hating

You will think I’m being harsh – but consider. These aren’t just Twitter randos. They have large followings. And they wrote these takes on Saturday. No time to reflect or digest the news. No thought. I have not linked to them because I don’t want to embarrass the tweeters – but the takes are real.

And subsequent days have not matured the conversation. We have had press boycotts, calls for Leveson part two, further regulation of journalists, lectures against the evils of social media. The Society of Editors protested that ‘it is wrong to blame the media for [Flack’s] decision without knowing the facts. Indeed, the Samaritans guidance on reporting suicides makes clear that speculation over causes or presumptuous explanations often oversimplify the complex reasons behind an individual’s decision to end their life.’ Too late. Flack had already been enlisted in the service of a number of ailing liberal left culture war industries, from the Hacked Off brand to the Big Tech temperance movement. (On a lighter note, bookshops gave away copies of Matt Haig’s memoir to anyone who asked – because the Kübler-Ross model of woke grief is basically ‘shock… outrage… virtue signalling… Matt Haig’.)

Jim Waterson pointed out that ‘for all the public’s anger at celebrity news outlets whom many are blaming for hounding a woman to her death, privately people are flocking to tabloid sites to read every possible detail about her.’ It’s an irony that feeds into the creepy mythos that sometimes surrounds celebrity deaths, particularly of women. It’s not enough to say the paparazzi killed Diana, or Facebook killed Caroline. It’s the idea that we killed Caroline and Diana, that it’s our sins and prurience that killed them. It’s a horrible, reducing myth, that turns human beings into martyrs. And it is more misogynistic than the tabloids could ever get away with being.

The dead deserve better than this. So do the living. Philip Roth’s words have never been more true. ‘All that we don’t know is astonishing. Even more astonishing is what passes for knowing.’

Caroline Flack, 1979-2020. (Image: BBC)

The Horse and the Man

February 2, 2020

There’s an episode of South Park where the town is shocked to hear that rival cartoon Family Guy are planning to show an image of the prophet Mohammed in their next episode. Cartman sets off to the studio to get the show shut down – not because he respects Islam or fears terror attacks, but simply because he dislikes the programme’s writing style. In an angry tirade he declares:

Do you have any idea what it’s like? Everywhere I go, ‘Hey Cartman, you must like Family Guy, right?’ ‘Hey, your sense of humor reminds me of Family Guy, Cartman.’ I am NOTHING like Family Guy! When I make jokes, they are inherent to a story! Deep, situational and emotional jokes based on what is relevant and has a POINT! Not just one interchangeable joke after another!

When al-Qaeda threaten retaliation, their spokesman criticises Family Guy in much the same tones that Cartman does. ‘Family Guy isn’t even that well written,’ says a scary-looking terror boss. ‘The jokes are interchangeable and usually irrelevant to the plot.’

Both these criticisms was South Park’s way of saying that the animation genre was running out of steam. We all remember watching Simpsons on BBC2 in the evenings but now this type of thing doesn’t have the same impact – although I still get belly laughs from Archer, King of the Hill and South Park.

Yet something different is happening with Bojack Horseman. It’s about a lazy, irresponsible Hollywood celebrity who drinks too much and just doesn’t care, the first few episodes are clever and funny but predictable, but around halfway through season one you start noticing things.

One aspect critics picked up on was the show’s eerie prescience. The 2017 Oscars farce when Faye Dunaway read off the wrong name mirrored a previous episode in which Bojack’s friend Mr Peanutbutter the celebrity dog is supposed to host the Oscars but he loses the list of winners and simply makes them up, getting several wrong. And the episode ‘Thoughts and Prayers’ underscored America’s acclimatisation to horrific gun violence to the extent that the phrase – perfunctorily reiterated by J K Simmons’s weathered film exec Lenny Turtletaub whenever a shooting occurred – has become shorthand for ineffective symbolic gestures in the face of preventable atrocities. (The line is even used in Don Winslow’s The Border when the bad guys are planning out the aftermath of a targeted assassination.)

There’s plenty more subtle stuff going on in the background. Bojack’s Hollywood is a city of man and beast, but the animals aren’t just humanised animals. They act like real animals. A woodpecker drills through his restaurant table, debutante horses dressage through a tony ballroom, and Bojack even helps a male seahorse give birth (‘yes, it’s a thing!’) Guest characters from one episode recur and recur through the series, glimpsed on sets and at parties: Lisa Hanawalt’s deft busy scenes ensure that we care about the little people in Bojack’s life even though Bojack never does.

Upfront is Bojack’s psychodrama and it doesn’t take long for the show to uncover his own formative demons. Bojack’s father was an narcissist, alcoholic and failed author, who like all narcissists rejects his son because he will never provide the true reflecting pool of himself that the narcissist craves. (The dad Butterscotch has a brilliant toxic masculine death – he’s killed in a duel with a book reviewer who criticised Butterscotch’s only published novel.) With no positive male influence to lean on, the boy Bojack becomes a huge fan of Secretariat – in this world, another hybrid celebrity horse. There is a moving scene, written from different angles over two episodes, where Secretariat in a chat show appearance reads out a letter from then nine year old Bojack and gives some advice on how Bojack can make his way in the world. But Bojack never hears of what Secretariat has to say because his parents start one of their predictable arguments and drown out the TV with yelling. Secretariat himself commits suicide soon afterward.

Bojack has come a long way since childhood – he has got rich from silly 1990s sitcom ‘Horsin’ Around’, he has a luxury home in the hills, while he doesn’t have a wife or family he can find sex and companionship any time he wants it. As Mr Peanutbutter says – in a rare moment of fury – ‘What more do you want? What else could the universe possibly owe you?’ In the first episode Bojack starts having panic attacks, and a doctor tells him to take it easy. To Bojack’s agent Princess Carolyn this advice is meaningless – Bojack does nothing but take it easy. So what’s causing the attacks? Bojack is in his fifties but doesn’t seem to fear old age or death, it’s not that he’s ashamed of the stupid commercial hit that made his name, in fact he’s proud of it, he feels that he delivered a great escapist comedy that would make people laugh and forget their aches and cares for a while. It often seems that Bojack is looking for that uncomplicated and predictable happiness of a half-hour’s good television.

Midway through the show develops its central theme of masculinity and its consequences. Bojack does a film tribute to his male role model Secretariat then moves on to a hardboiled cop show written – in a brilliant sendup of the auteur showrunner – by the obnoxious and self obsessed Flip McVicker. As Bojack goes on he accumulates more and more ghosts: the people he’s let down start to haunt his present, from the Horsin’ Around mentor who died of cancer to the ex colleague Sarah Lynn who overdosed on heroin under his care. Bojack is masculine but not toxic, even when he’s an asshole he’s warm and entertaining to be around, but as the show incorporated the real life MeToo events you’re constantly on edge for Bojack’s own reckoning.

One thing creator Raphael Bob-Waksberg empathised in the show was the importance of personal responsibility. At the end of season three Bojack’s sidekick Todd – voiced by Aaron ‘Pinkman’ Paul – finally tires of Bojack’s selfishness and rants:

You can’t keep doing this! You can’t keep doing shitty things and then feel bad about yourself as if that makes it okay! You need to be better!

No! No, BoJack, just… Stop. You are all the things that are wrong with you. It’s not the alcohol, or the drugs, or any of the shitty things that happened to you in your career or when you were a kid. It’s you. Alright? It’s you.

Neither of them speak for a moment, and we’re taking in the trashed apartment, the words that can’t be taken back, and Todd adds: ‘Fuck, man…What else is there to say?’ Credits roll on a scene just as powerful as Paul ever did with Bryan Cranston, if not more.

All this is heavy going for a cartoon, and there’s times you think you’re in a graphic novel written by John Cheever, even F Scott Fitzgerald. The novel has abandoned this whole subject of life and death and happiness and responsibility, but apparently we still want to see it on TV, in particular a TV show about a talking horse.

Numerous episodes take the form of hallucinations experienced by characters in the throes of a drug binge or mental degeneration, and there is one – screening this weekend, if you’ve seen it you’ll know – that happens in purgatory. The cold tragedy of these moments can be a hard watch. Perhaps better than other artists, the comic animator has the skill to portray the finality of things broken that won’t be fixed, things done and said that can’t be undone or taken back, and the terrifying separation between human beings.

As against that there’s a warmth and essential goodness to the show, expressed in the wonderful set piece episodes: the comic funeral eulogy of ‘Free Churro,’ the quiz battle ‘Let’s Find Out,’ the multiple Halloween narratives of ‘Mr Peanutbutter’s Boos’ and the underwater odyssey of ‘Fish Out of Water’. All of it makes this a programme its hapless hero would love to have created – something that makes us laugh and forget our cares, even as it tells us how hard it is to be a horse, and a man.

Great Expectation

July 24, 2019

Looking back at her hard living past, singer Florence Welch writes in Vogue:

I wonder if my young self would be horrified at my Friday nights now: eating pasta and watching TV with someone who is nice to me. Would she think me mundane? I have certainly had journalists bemoan to me ‘the lack of rock stars behaving like rock stars’, but hedonism never gave me the freedom I desired. And I’m no longer sure about the rock’n’roll behaviour often expected of artists. Too many talented people have died, and the world feels too fragile to be swigging champagne and flicking the finger at it.

Most of the friends that I drank with have had to stop. They wash up one by one like driftwood, and we stand together on the shore in shocked relief. We cook, we talk, we work. People have started having children and going to bed early. And all the boring ‘grown-upness’ that we rejected then now seems somehow rebellious.

The characters in Anna Hope’s Expectation might identify. While none of Hope’s three woman protagonists have the eventful past of Florence Welch, they face a similar dilemma. The book opens on an urban pastoral of the three close friends living out the tail end of their youth in London Fields. When we then fast forward to 2010, there’s a definite contracting of freedom and possibility. Life has become smaller, and dominated by young dreams that have turned into obsessions. Lissa aspires to Hollywood but makes do with commercials and community theatre, Hannah wants a child but can’t conceive, Cate has been priced out of London and is living a dull suburban life in the Home Counties.

It all sounds banal when I write it down but Hope writes so well that it works. You feel Hannah’s despair as she focuses every detail of her routine around the elusive miracle of childbirth: she measures out her life in ovulation circles instead of coffee spoons. She is the most well realised character, but all three convey something in common – the fraught feeling of life slipping away from you, taking you away with it to a place you’re not comfortable with. Your old houseshare has been flipped and carved and rented out at unimaginable prices, the legends of your youth grown old and driven out to the exurbs, the world changing in ways you don’t understand. To go back to Florence Welch one last time, it’s hard to get through the sea storm, but sometimes it’s harder once you’ve actually reached the shore – if you get a stretch that’s bare and rocky, with gulls wheeling through an overcast sky.

Not much happens for long reams of the book, but there’s no tiredness or ennui to Hope’s prose, it all feels terribly important while you’re reading it. Hope has an understated style that somehow carries and captures the moment. There is no false sentiment or artifice in Expectation. It feels real. It even sometimes feels numinous:

The woman speaks about the tomb, about how it was found on her father’s land, a mile or so from where she and her family live today. About the human remains that were found there – no skeletons, only jumbled bones, thousands upon thousands of them. About the eagle talons found in amongst them. About the theory that the bodies were left out to be eaten by the birds. Like the sky burials of Tibet. How only the clean bones were saved.

‘Excarnation,’ the woman says in her soft voice.

‘Excarnation,’ says Hannah, tasting it. A new word.

The action speeds up once you get to the last third of the book, but in its way it’s a supremely contemplative novel – the brisk progression of events seems to give you a faith in the natural processes of time and age and youth and death. Lissa and Hannah have a phrase that’s almost an injoke – this shit are what life withstands’. Expectation is a kind of Zen novel – one that goes about its work so subtly and well that you don’t realise you’re being entranced.

Also: Susan Osborne’s review available here

Wellness Among the Ruins

June 11, 2019

Looking at the papers in the cafe this morning, my roving satirical eye caught this piece by Dan Button, of the New Economics Foundation, in which he argues that the government should prioritise well being over GDP.

Yet last week, New Zealand broke new ground by eschewing GDP in favour of wellbeing as a guiding indicator when setting budgets and assessing government policy. Bids to the Treasury for money from now on will not only need a cost-benefit analysis, but an assessment of their wellbeing impact. Decisions about spending will be made on the basis of a project’s contribution to the wellbeing of the population, measured through four dimensions: human capital; social capital; natural capital; and financial and physical capital. It follows the Welsh government’s innovative Well-being of Future Generations Act, which places a legal requirement on public bodies in Wales to think about the long-term social, cultural, environmental and economic wellbeing impact of their decisions.

These are radical steps in the right direction that the UK should learn from by adopting a broader range of indicators when deciding how to spend money. Government departments should have a legal duty to routinely assess new policy for its impact on a broader range of criteria, including wellbeing. If improving quality of life is not the point of government policy, then what is?

The concept of wellbeing seems a bit overused and dated at the moment. It brings to mind Gwyneth Paltrow and her alt health company GOOP, which apparently advises women, in the pursuit of wellness and sexual health, to insert jade eggs into an intimate orifice. I am sure this is not what Dan Button means when he says that ‘departments should have a legal duty to routinely assess new policy for its impact on a broader range of criteria, including wellbeing.’ But even in the more prosaic political sphere, we’ve been here before.

In late 2010 prime minister David Cameron wanted to ‘make happiness the new GDP.’ This is how the Guardian reported it at the time:

He is sticking to a policy commitment he made before the economic crash when growth figures were still rosy. He said: ‘It’s time we admitted that there’s more to life than money and it’s time we focused not just on GDP but on GWB – general wellbeing.’

Speaking at the Google Zeitgeist Europe conference, he added: ‘Wellbeing can’t be measured by money or traded in markets. It’s about the beauty of our surroundings, the quality of our culture and, above all, the strength of our relationships. Improving our society’s sense of wellbeing is, I believe, the central political challenge of our times.’

We know the rest of this story – as Button says, ‘most of the population saw their living standards stagnate or fall, and austerity measures picked up pace.’ But Button goes on to claim that: ‘An economy with wellbeing at its heart would make it much harder to make such claims, and harder to enforce a policy such as austerity again.’

This seems unlikely. A focus on general wellbeing is usually a excuse for failures on real economics. In 2016 the Leave campaign and numerous Brexit commentators told us that leaving the EU would mean exciting new trade deals and money for the NHS. Now, with industry walking away and no signs of austerity letting up, these same commentators tell us to forget about the numbers, the point of the project is about restoring national pride and intangible British values. (Boring old Remainers, banging on about people’s jobs!)

Of course British values are real, and important. My argument is only that in quitting the antibiotics of GDP we could end up having to insert into ourselves the jade eggs of national sovereignty.

What is wellbeing? Button makes many good points but can’t seem to define it, and for a good reason, because wellbeing is subjective. It would be a hell of a thing for the state to decide what constitutes wellbeing and happiness, particularly as we British have become rather judgemental about how others enjoy themselves. We drink too much, smoke too much, watch reality TV. The difficulty is that government isn’t set up to foster subjective human emotions, it can only provide the resources, time and space for people to foster wellbeing in themselves and their communities and pursue their own happiness.

I’m reminded of Rachel Clarke‘s medical memoir Your Life in My Hands. Though I don’t have my copy to hand, one passage stayed with me. Dr Clarke wrote about working impossible shifts in UK hospitals and every now and again being sent internal mail offering yoga sessions and other wellness activities that the doctors could enjoy during lunch breaks.

We work through lunch break, said Clarke. We don’t have time for this.

Meanwhile, workloads soared and clinicians regularly burned out from stress. Next to nothing was done.

For all Dan Button’s good intentions, I suspect that any attempt to incorporate ‘wellness’ into the heart of British government would end in some scaled-up version of the pointless mailshots Dr Clarke describes, while the rest of the country firefights. It’s about time the state quit its emotionalist thinking and concentrated on keeping the lights on. To paraphrase P J O’Rourke: what we need is less wellness, more lunch.

Let’s Talk About SSRIs

February 3, 2019

‘Let’s address the elephant in the room,’ the neuroscientist Dean Burnett wrote last year, reviewing Lost Connections.

Johann Hari does not have a flawless reputation. He has been absent from the spotlight for many years following a plagiarism scandal, compounded by less-than-dignified behaviour towards his critics. Admittedly, he has since shown remorse and contrition over the whole affair, but even a cursory glance online reveals he’s a long way from universal forgiveness. Logically, someone with a reputation for making false claims should be the last person making high-profile, controversial, sweeping statements about something as sensitive as mental health. And yet, here we are.

I was astounded by the scandal. I didn’t see it coming. I loved Hari’s writing. You will find pages in this blog where I quote him approvingly and rave about his work. I met him once at a panel event in Manchester. I shook his hand and gushed like a helpless fanboy.

These days I’m older and more cynical, I was certainly sceptical about Lost Connections when it was first published last year. The book was an international bestseller. The paperback edition has four pages of praise, including from Emma Thompson, Brian Eno and Alastair Campbell. I was sceptical about the marketing and extracts from the book. People have gone through Lost Connections and stress tested Hari’s claims. I am not going to drill down here, you can follow the links in Burnett’s article for that kind of critique. Nor do I want to go over Hari’s past misbehaviour, this is well documented, some people have forgiven and forgotten, others have not, I respect their feelings in both cases. I think that whatever else he lied about, Hari told the truth about his own clinical depression. The demons that haunt him are real. So when I saw the paperback edition of Lost Connections on the supermarket rack I picked it up, out of curiosity, and from a desire to give him a fair hearing, as a brother in recovery.

Lost Connections is a book about mental health. In it Hari makes several carefully crafted assertions.

  1. Too many people are taking antidepressants. These are the only real option in mental health treatment.
  2. This is because the medical establishment thinks of depression as purely a neurological problem. In fact depression has mostly social and environmental causes. The biochemical causes for mental illness are hugely exaggerated. They might not even exist.
  3. Antidepressants provide some temporary relief for a minority of users. But they carry side effects and are likely to give only superficial benefits. They may even make you worse.
  4. Doctors only prescribe antidepressants because the medical establishment has been irredeemably compromised by big pharma. Big pharma companies set the terms of the debate and game chemical trails to make their products look more effective than they really are.
  5. A lot of anxiety and depression is caused by the impact of living in an urbanised neoliberal society where we are bombarded with advertisements that raise unrealistic expectations of how we should be living. People are conditioned to want more and more stuff and to look totally perfect and get rich and it’s the difficulty of living up to these expectations that makes us sick.
  6. The neoliberal model compounds this because it takes the meaning out of our work and makes us feel like we have no control over our own lives. Social media makes us more isolated because we are stuck behind screens rather than being part of real life, meaningful communities.
  7. There are loads of different treatments and ways of living that can cure anxiety and depression but the medical establishment won’t explore these because there’s not the money in these alternative treatments as there is in big pharma.

There is truth in some of these assertions. But in Hari’s book there is always the sense that you are not being told the whole truth. Disingenuousness sparkles across his pages like mica.

There are problems with prescribing. There is no doubt that drug companies have ruined lives. In America entire communities have been destroyed by overprescribing of opioid medications, that have been pushed onto clinics by aggressive marketing strategies. Opioids kill more people than AIDS in the 1980s. Thousands and thousands of people have died of overdose – mainly the young, and the white working class. It is a modern Vietnam. There are parts of Appalachia where people will cash in Gramps’s life insurance and the kids’ college fund to buy pills. There were clinics where the doctors carry guns. The problem is way beyond the scope of this blogpost. I would recommend Beth Macy‘s Dopesick and Chris McGreal‘s American Overdose, both outstanding works of longform journalism. Can’t happen here, right? Don’t be so sure. McGreal says that opioid related deaths have more than doubled in England and Wales since 2012.

But fine, let’s talk about SSRIs.

There are problems with treatment. The number one cause of death for working age people in the UK is suicide. Many sufferers in the UK have no access to effective mental health care at all. They will also be discriminated against in other areas of life – try getting insurance with a known mental health problem, for example. It is difficult to get in front of a psychiatrist in the UK because the state has little interest in training skilled professionals or supporting them on the frontline. It’s also hard to get inpatient treatment unless you’re completely off the reservation and even if you are admitted you might not be safe. That’s not anyone’s fault in particular, clinicians in the NHS work incredibly hard under very difficult conditions, but talented people can only do so much.

If you seek help the first thing that happens is triage. MH professionals will ask you to fill in the PHQ9 with priority being the question that asks how likely you are to kill yourself. If you’re particularly high risk the MH professional will then go through your protective factors. What is it keeping you alive? You say something like ‘I have these thoughts of ending my life but I would never go through with it because my wife and kids would be devastated.’ I understand why professionals focus on protective factors but I think this approach compounds the problem in many people because it adds a sense of guilt and obligation to what is already going to be a volatile mix of emotions. Throw too much into that mix in someone’s head and sooner or later the tornado’s going to descend. Some people don’t come out of the tornado.

But fine, let’s talk about SSRIs. This is where Hari’s assumptions begin to fall apart. Hari took antidepressants since his teenage years. He writes several times that he researched this book with a mindset that SSRIs work and that he only reluctantly changed his mind after talking to sceptical practitioners and people from different walks of life. I’m afraid I personally don’t believe him on that point, I think he wrote Lost Connections based on the assumptions I listed at the beginning of this post.

Here is Hari’s problem. Practitioners already know that a lot of people are anxious and depressed because they lead sad and difficult lives. A couple of months before his book came out, Financial Times reporter, Sarah O’Connor, visited Blackpool in the UK. Blackpool has some of the highest prescription rates in the country. O’Connor spoke to local GPs about the problem.

Doctors in places such as this have a private diagnosis for what ails some of their patients: ‘Shit Life Syndrome’. [Dr] Rajpura laughs when I mention it. ‘Yeah, I’ve heard that from GPs in Blackpool.’ The term isn’t meant to sound dismissive. People with SLS really do have mental or physical health problems, doctors say. But they believe the causes are a tangled mix of economic, social and emotional problems that they — with 10- to 15-minute slots per patient — feel powerless to fix.

As Burnett says:

Personally, I’d always assumed the role of life events was widely accepted, and has been for decades. In psychiatry/medicine/psychology, this is often known as the Biopsychosocial model, and any decent professional will be very aware of it. Far from being a revelation of Hari’s, it was mooted back in the 70s, and has been part of standard teaching for at least 20 years.

Hari even visits a GP practice in his part of London that has pioneered a ‘social prescribing’ approach where long term patients get together, get to know each other and work to improve the local environment. This stuff works, and Hari could have visited a dozen other GP practices with in house social prescribers who offer 60-minute appointments and can help with housing and financial issues. There is loads that can be done even in hard times but often you’re back to the ten minute triage consult with the GP trying to figure out – is this person going to kill himself and can I stop him? Medicine’s job is to keep you alive and functional. It’s not to unravel the trauma in your soul or give you the secret to eternal happiness – which doesn’t exist, for we’re wired for survival rather than contentment. The NHS struggles even to keep elderly people alive through a hard winter. Medicine’s job is to keep you upright and breathing air. Nothing loftier should be demanded of it.

When I was last in therapy in 2016 my psychologist told me that there are two ways to undergo psychotherapy. You can take a quick fix, fine-tune your mind a little bit and then leave. Or you can deep dive into yourself and find out what it is that’s at the heart of your sickness. There is absolutely no shame, the psychologist told me, in taking option one. Bear in mind that if you’re in front of a therapist you will likely have been triaged and you’re likely at absolute rock bottom. It might have been an epic struggle just to leave the house to get to the appointment. There is no disgrace in taking the easy option of a few sessions to get you functional and working again. It’s okay not to open some doors.

What I want to say is that there are limits to the social model as well as the biochemical model. Imagine you go to the doctor’s again, except instead of GPs, the practice is run by a team of social scientists. If you’re poor and unemployed the social scientist might say: ‘Oh dear, it looks like you have mental illness caused by being a victim of capitalist individualism. Nothing to be done, I’m afraid, we’re stuck with it.’ If you’re an investment banker, the social scientist might say: ‘Oh dear, it looks like you have mental illness caused by becoming too successful in our neoliberal world and therefore you’ve cut yourself off from meaningful experience. No amount of worldly riches will heal your compromised soul. Try zumba classes or something.’

I’m simplifying, but I do feel there are limitations to exploring the social and environmental model of mental distress. It can make you feel helpless, and there is a darker current to thinking of problems in terms of entrenched and powerful systems, as the Trump and Brexit movements have proved. Hari concentrates on diseases of affluence such as obesity and social media burnout but I think in the near future these will give way to the more traditional diseases of want. I think the overavailability of SSRIs is going to be the least of our worries. If you liked neoliberalism, you’ll love nativism.

The very heavy focus on social issues leads Hari into some strange places. He interviews a woman in Arizona who lost her baby during labour. Hari says that the DSM has something called a ‘grief exception’ in which patients can show all the symptoms of depression but not be diagnosed. Then he says the grief exception was dropped in the DSM 2015 version. ‘So now if your baby dies and you go to the doctor the next day and you’re in extreme distress, ‘you can be diagnosed immediately,’ Joanne explained to me.’

Er, I’m not sure. There is always a sense in this book that Hari has not really thought through what he’s saying or really challenged himself with it. He discusses a study at the University of Essex that ‘tracked the mental health of people of more than five thousand households over three years. They wanted to look at two types of household in particular – people who moved from a leafy green rural area to a city, and people who moved from a city to a leafy green rural area.’ And, quelle surprise: ‘the people who moved to green areas saw a big reduction in depression, and the people who moved away from green areas saw a big increase in depression.’ We get depressed when we are cut off from nature.

No doubt that’s true, and well worth mentioning. But you can look at it from another angle. Young people who grow up in the rural leafy green area may be depressed because they don’t fit in to what could be a conservative small community. They will only get better if they move to a cosmopolitan city or somewhere where they feel they can be themselves. Lost Connections has loads of things like this. A month after publication of Hari’s book, the Lancet released a study that claimed that antidepressants were effective in treating major disorders. I don’t know if Hari discussed this on his website or social media at the time but a paperback afterword would have been the ideal opportunity to hit back against his critics and catch up with his interviewees. There’s no afterword. It is a curious omission.

I should declare an interest in all this. I have no clinical or scientific background. I have been fighting mental illness for fifteen years and been on SSRIs for at least ten of those. I’ve been in the tornado. I’ve been sectioned. I am technically disabled under the Equality Act (at least according to an occupational health report I once had). I get anxiety attacks that place significant limitations on what I can do. I can’t get in a moving vehicle. I can’t travel. I walk down to my local cafe bar, a place I’ve been a thousand times, and I’m sitting there with a pot of tea and the newspapers and suddenly I can’t breathe. Why?

I can’t complain though, I do not have ‘shit life syndrome’, I am privileged really, but I’m still getting these attacks. One of the reasons I was curious about Hari’s book was that I’m of the same generation as him and it was interesting to compare our different journeys through life and how we dealt with these significant problems. Hari’s book contains many inspiring moments and genuine psychological insight, and I’ve often thought that despite everything he would have made a good therapist. His chapters on the Berlin rent strike and the Baltimore bike co op are worth reading. So despite everything, I would recommend Lost Connections – with caution, and due diligence, and a small bucket of salt – but first I would recommend other mental health writers, like Emily Reynolds, and Bryony Gordon, and Sara Benincasa, and Elizabeth Wurtzel, and William Styron. I would also strongly advise to think long and hard, and consult a doctor, if you are thinking about stopping your meds.

One thing my therapist suggested to me was to imagine myself with a team of bodyguards who could talk me down from panic attacks. She advised me to make a list of five or six people. They could be people from real life, or fictional characters, or celebrities. The first bodyguard I thought of was Mike Ehrmantraut from Breaking Bad and Better Call Saul. It sounds ridiculous when I write it down, but often now when I’m crossing a busy road and feel an attack coming on, I imagine Mike Ehrmantraut standing next to me, and he says: ‘Relax, kid. You’re on the home stretch.’

Books Do Furnish A Room

January 19, 2019

Marie Kondo says you should only have 30 books at home. I literally have no idea who Marie Kondo is. I know Marie Kondo’s name because she has been quoted all over social media, often by people who don’t understand the full context of her words, saying that you should only have 30 books at home. I can’t really be bothered to watch the Marie Kondo show or read whatever interview where she says you should only have 30 books at home, and I understand that this makes me one of the people who bang on (without understanding the context) about Marie Kondo saying you should only have 30 books at home.

My friend Scout had the best take on this. Scout mocked the sometimes hysterical reactions to Marie Kondo’s point: how can Marie Kondo have only 30 books? Who is this unlettered philistine Marie Kondo? I should simply die if I did not have a house stacked on every available surface with books: Marie Kondo makes me want to drown in a bathtub of books! Scout’s point made me laugh because it touched on the odd fetishism that British intelligentsia has for the physical book.

I remember in the early 2010s people flapped about the impact of e books, and worried that kindles would kill the physical book. That didn’t happen because readers love the physical book. Publishers often (quite reasonably) market books as physical artefacts rather than stories and ideas. In Lena Dunham’s Girls Hannah Horvath is on contract to write an e book. Another publisher offers her a deal to write a physical book. Hannah is a product of the digital age. Yet she accepts the second offer with much more enthusiasm. Why? Because the physical book has authority.

So I can’t really laugh at the twee bourgeois lit world, its cooing and fluttering over the physical book, because I share that fetishism for books as objects and artefacts. My home is full of books. It just happened. My gf says, in jest of course: ‘You have filled our home with books! I feel like they’re closing in on me.’

‘Books do furnish a room,’ I’d say back.

On occasion, when I’m at work, and my gf working from home, she will send me a text with a picture of a box or package that has come in the mail, and ask: ‘Max! Have you been buying BOOKS!?!’

‘Books do furnish a room,’ I text back.

I do try. Sometimes – given energy enough and time – I’ll rearrange the books. I’ll even give books away. I can be stern with myself. I’ll happily give away duplicates, or books that have been discredited, or books that are just plain bad. But then it’s like: if I’ve got two or three of the same book, which edition do I give away? I have a copy of John Cheever’s Falconer which I accidentally ordered in French. I can’t read French so that one should probably go. Still, it’s not a bad looking edition. Also, some books can’t be donated (ask your local charity bookseller how much worthless crap his shop gets in every day). Also, a bad book is as special as a good book. I may need to refer to the bad book in passing at some point, in some customary throwaway witticism. You can see the bind I’m in.

Christopher Hitchens wrote about this, of course much more elegantly than I can, in his short piece ‘Prisoner of Shelves’. He found that despite living ‘in a fairly spacious apartment in Washington, D.C…. for some reason, the available shelf space, which is considerable, continues to be outrun by the appearance of new books. It used to be such a pleasure to get one of those padded envelopes in the mail, containing a brand-new book with the publisher’s compliments. Now, as I collect my daily heap of these packages from my building’s concierge, I receive a pitying look.’

It wasn’t always like this. I’ve lived in my current home longer than I ever lived anywhere since I left my mother’s house (which is, since I come from a family of readers, filled with books). As an adult I mainly lived in rented accommodation, sometimes moving several times a year. I didn’t care much about the physical book then. I remembered Robert Heinlein’s maxim – that you only truly own what you can carry on your back when you’re running from an angry mob. That was my credo then. Still is now to some extent. There’s a feeling when life is well that you’re gonna be hit by catastrophe at any moment. The sound of a plane somewhere, on a summer’s day. You prepare yourself mentally for homelessness and disaster. You’re packing the go-bag in your mind. Or is that just me?

You only own what you can carry on your back, running. You never really own anything. You can’t take it with you, and the world’s a volatile place: for all of us, sooner or later, the great comedy of ownership will end. So it’s kind of ridiculous to fill your house with books. But I don’t care. Why? Because life is impermanent, but clutter is human.

All About Edelstein

October 20, 2018

There’s a common British anecdote that goes: ‘We had some American friends here on holiday, and on the third day they drove to Stonehenge!’ The idea behind it is that because the UK is a small island, even driving to the next village seems like an epic poem. But Americans grow up on an enormous continental landmass, so travelling long distances comes naturally. If they come to England, they want to see Stonehenge.

Is there truth in the joke? Writer Jean Hannah Edelstein lived in Paris as a young woman, fell in love, followed the man to London, and begins her memoir when she is moving to New York via Berlin. Edelstein’s story is full of odd switchbacks and doublings. Her mother grew up in Scotland, married an American, moved to the US, took citizenship after twenty years, but returned to Glasgow after her husband died. Edelstein grew up with dual citizenship and only returned to the States when her father developed terminal cancer. Her father had something called ‘Lynch syndrome’, which is hereditary – and soon after his death Edelstein discovered she had it too. This Really Isn’t About You is a book about separation. And how love and family thrive despite separation. Maybe even because of it.

Edelstein sees things with the seasoned traveller’s clear eyes, and writes with crisp brevity about people and places. Moving to New York in her early thirties feels like going to some legendary houseparty that is just beginning to hinge:

Behind the people at the door of the party, behind the people who are getting their coats, are the people who are determined to stay until the bitter end. Some of them are the life of the thing, absolutely. You can tell by the way they’re dressed that they have money. The party has gone well for them so far. They’re sticking around to enjoy what else it has to offer. But some of the people who are still at the party are unravelling around the edges. They’ve overdone the drugs and booze, or they’re feeling pretty bad because at their age it is no longer fun or interesting to be the footloose and fancy-free life of the party.

It’s always interesting to read foreign writers talk about your own country. Edelstein’s London chapters are a delight of observational humour. I never lived in London and the difficulty of living full time in that city still shocks me. ‘By now the water pressure in the flat on Cephas Street was so bad that in the colder months there were many hours a day when we had no water at all… my friends expressed regret but never suggested that we move.’ Edelstein lived on two bowls of oatmeal a day, and worked for a literary agent well known in the business for her overbearing attitude towards staff. ‘Here are some things that my boss shouted at me about in her distinctive voice:’ begins one passage. Edelstein was clearly going through a nightmare at this company, but no one did anything to help: ‘For the most part the extent of the powerful people’s acknowledgement of my existence was to leave Jewish-themed books and magazines on my desk’.

And this was in the mid 2000s: god knows what the housing and job market is like now, and worse for young women, I think, because on top of everything else they have to fend off battalions of gropey middle aged married guys. Edelstein never complains. Again, she’s the seasoned traveller who takes nothing for granted. Her epigraph is from Nora Ephron: ‘Because if I tell the story, I can get on with it.’

She only tires of London when watching the royal flotilla in 2012, and has coalesced her disillusionment into one elegiac para:

Inside the living room, there was indeed little enthusiasm. There were sandwiches and Victoria sponge and several of the cheeriest people I knew, but there was also a devastating spectacle, the pride of a nation represented by a joyless and troubling procession of boats listing to and fro in the storm. I was transfixed: the sheets of rain were coating the television cameras just as they had my glasses, making it difficult to see. The boats drifted down the river, manned by soaked skippers. On a special barge, the Royal Family watched with gritted teeth.

It’s when Edelstein returns to her family, and comes to terms with her father’s death and her own diagnosis, that the prose gains a new burnish and intensity. It’s the simplicity of these lines that hits you:

My father was not crying, but I looked at him and he looked at me and at that moment I felt that I knew very clearly that even if your parents are very old and have had rich and well-loved life, if you love them there is never a time in your life when you will feel that you don’t want them any more. It was not something that I had ever considered, but at that moment I looked at my father and he looked at me and I knew that there would never be a time in my life when I would regard my parents and think: Yes, I’m ready.

It’s amazing to think that no matter how well equipped you are and how much you’ve endured, there are some life experiences that you just won’t be prepared for. In Edelstein’s book there’s none of the tweeness and sentimentality that makes many family memoirs unreadable, just a subtle and economic demonstration of family love – that most subtle and undemonstrative kind of love, that you take for granted because it always seems to be in the background, like the brisk hum of air conditioning: until, finally, that too flickers out.