Wednesday, 15 December 2010

The National Health Service?

You feel mildly unwell and attend the doctor for her opinion. She takes a blood sample so that a complete blood test can be done. A few days later, you are asked by the secretary at your medical clinic to make an appointment for one of the next ten days, so that another blood sample can be taken and another complete blood test done. She is not able to explain why this is necessary, but only reads the doctor's note, which states nothing more than that another test is required within that duration of time. You attend the clinic again the following week, and this time meet a nurse who reads from a screen that a blood sample is to be taken in order to be sent for a complete blood test and that this is a repeat procedure because some readings from the last blood test were "borderline." She is not able to tell which readings were "borderline," nor, therefore, what problem may or may not be at issue. Blood is taken and you are asked to ring for the results in two days' time. You do, to be told by the secretary that the doctor has noted "No further action required" next to your name.

Emma's Mr. Woodhouse is badly served by the history of Austen appreciation, summarily dispatched as a prosing hypochondriac, a caricature background for the protagonist's domestic life. He is all absorbing interest in draughts, and gruel, and the dampness of the dew and the oppressiveness of the summer sun. He objects, though always mildly, to the late nights and rich food in which his neighbours indulge and battles to reconcile his sense of hospitality with a grave concern at his guests' propensity to eat the oysters handed round by his servants. But the fact that only Mr. Woodhouse shares with Mr. Knightley the distinction of having judged correctly of the "not quite the thing"-ness of Frank Churchill's character before, towards the end of the novel, it is revealed for everyone to see, might give pause to his too hasty dispatch; Mr. Woodhouse may be dull and wordy, he may be over-gentle and unadventurous, but this effective semi-retirement from the social world does provide him with a certain perspective, which facilitates his withstanding the storm of Frank Churchill's brisk manners and involving humour to see the man's character for what it really is. And this perpective also gives Mr. Woodhouse what we might do well to think of, less as an irrational hypochondria and more as an attentiveness to his and others' wellbeing, less as the constant imagining of illness, actual, remembered, or imminent, and more accurately as a disposition towards health. What we have in Mr. Woodhouse, we might consider, is: an example of the experience of and care for health; a demonstration of a mode of attentiveness that has no real object - only illness, for the most part, manifests itself objectively - and no real end - there is no "cure" for health - and so can never be finished with; a kind of knowledge - of health, that one is healthy - that is also a way of life. If Mr. Woodhouse is a caricature, then, it is of a life lived for health, and not a life lived in illness.

This relatively minor point of interest with regard to interpretations of Emma has a surprising significance for the quality of our lives. It shows us that our National Health Service is, in fact, our National Illness Service; unless our experience of living congeals into a "case" of something, unless there emerges an object to be named and treated, there is "no further action required." Anything on the other side of the "borderline" - that is, all those endemic but undramatic conditions, of anaemia, depression, anxiety, excema, and so on, which affect the quality of our lives more even than we ourselves are able to know (we are no Mr. Woodhouses after all) - anything that might impact on that enigmatic experience that is the experience of health, is of almost no concern. Perhaps there would be nothing wrong with this in itself - after all, it is comforting to think that there is a National Illness Service, for illnesses are common and need to be treated - except that at its frontline is a set of professionals - the General Practitioners - whose title indicates that they would be much better placed in a National Health Service rather than a National Illness Service, so that the general character of the experience of health, or lack thereof, and the in-practice nature of the work required to understand and improve this experience, is not undermined by the expectation that only that which can be tightly specified and, ideally, automatically treated is worth attending to.

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