Category Archives: tuberculosis

Postcards from Switzerland

Screen Shot 2016-05-29 at 10.34.24Entering Switzerland at Geneva, writes Dalrymple,

one enters a bourgeois paradise. One feels one lowers the tone by entering. The streets are spotlessly clean, the wealth vast. Even the interiors of the lifts in public car parks are clad in marble and lit with crystal. In England, such luxury would invite, and call forth, immediate vandalism.

The Swiss, he notes, are

rigidly, almost morbidly, and intimidatingly law-abiding. If you break a traffic regulation, even in a harmless fashion, ordinary citizens are likely to stare at or gesture to you in a hostile way, or reproach you.

Screen Shot 2016-05-29 at 10.37.18There is one thing, however, about which they are, he points out, highly flexible: tax.

Not only every canton, but every commune, sets its tax: and each commune is in competition to attract wealthy, or potentially wealthy, people. The beauty is that the taxes raised locally are kept locally. If you go to the tax authorities and tell them that an authority down the road has just offered you residence if you pay x francs a year, they are quite likely to offer you residence if you pay x − 1 francs. A virtuous competitive circle to lower taxes is set up. All the authorities are interested in is whether you will represent a net gain to the area; they have no interest in knowing the size of your income and then squeezing you until your pips squeak.

Screen Shot 2016-05-29 at 10.32.16Moreover,

since the money raised locally is spent locally, the population has a genuine and abiding interest in making sure that it is spent wisely. In large centralised states or societies, the bureaucracy has a vested interest in spending money unwisely, for by doing so it creates the very population that allegedly needs its ministrations. Not so in Switzerland: the population is the master of the bureaucracy.

Screen Shot 2016-05-29 at 10.35.13Dalrymple goes to a friend’s flat

a little way out of Geneva and up the mountainside. It overlooks the lake, and you can see Mont Blanc in the distance.

The cold air

is bracing, and gives a pleasantly scouring sensation in your lungs. I almost wish I had tuberculosis, to experience the relief such air would provide. I understand The Magic Mountain and the lure of sanatoria a little better.

Screen Shot 2016-05-29 at 10.42.28The neighbour below

has a balcony so huge that it has a real garden in it, including a lawn and miniature palm trees. It is so perfect, so clean, that one could safely perform surgery in it.

Dalrymple takes his dog for a walk.

I am very nervous, in case he relieves himself in the wrong place and calls forth retribution.

Screen Shot 2016-05-29 at 10.32.00When Dalrymple’s dog urinates against a garden wall,

I look around me as I used to look around me in the Communist bloc when meeting a dissident.

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The questions some doctors wouldn’t dream of asking

Screen Shot 2016-05-01 at 18.15.41In John Buchan’s Sick Heart River (1941), Dalrymple explains, Sir Edward Leithen has been given a year to live by the Harley Street specialist Acton Croke.

A gas attack in the First World War has awakened tuberculosis as a delayed effect, and it is galloping through his lungs.

Although occurring only a handful of years before the discovery of streptomycin,

Sir Edward’s tuberculosis is a death sentence.

Screen Shot 2016-05-01 at 18.21.02Presumably, writes Dalrymple, Sir Edward’s tuberculosis is of the open variety, yet the appropriately named Croke

never mentions the danger of spreading it to others or shows any interest in that possibility. Was it that, in those days, certain people were so socially prominent that doctors dared not suggest to them so vulgar a matter as contagiousness?

Something similar is related in Reginald Pound’s 1967 survey Harley Street, though in this case the specialist takes a more robust approach than the general practitioner:

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94 Harley Street

94 Harley Street, where Sir James Purves-Stewart practised. Here a church dignitary consulted the neurologist about syphilis-related symptoms of paralysis affecting his palate. (94 Harley Street was once the home of Meredith Townsend, successively editor of the Friend of India, the Calcutta Times and the Spectator, and author notably of the 1901 work Asia and Europe.)