If symptoms

persist.. .

I RETURNED home recently after a short break away from my patients any break from my patients is short, of course, however long it may be. I sup- pose I should not have been surprised or disappointed to discover that in my absence nothing much had changed in the hospital or in the country as a whole, thought the underside of the desk in my office had in the meantime acquired some used chewing gum. I should like to inform the ruminant interloper that he may reclaim his property on any weekday between 9 a.m. and 1p.m.

My first patient was a 17-year-old girl, wearing too much lipstick, who had taken the drug Ecstasy in the sleazy hotel in which social services had placed her after she decided that she had had enough of her parent. I asked her what she wanted to do in life.

`Nothing,' she said.

Welcome to Britain, I thought.

`Do you mean there's nothing you want to do, or you want to do nothing?' I asked. 'There's a slight difference, you know.'

But it was too slight for her compre- hension.

`Well, anyway,' I said consolingly, 'I should imaging you'll achieve your ambition.'

My second patient after my return to these islands was an alcoholic who had been mugged in the city one night the week before, and had been stabbed all over, apparently for the fun of it.

His was a lamentable life story. At the age of nine he was sent to children's homes because his drunken and violent father was considered a threat to his well-being. At the age of 16 he entered on a life of crime, and spent most of the next 20 years in prison. The last 10 years had been forensically blameless.

`I didn't mind prison in them days,' he said. 'I weren't afraid of it. I didn't mind being told what to do. In fact I liked it, but I wouldn't like it now.'

Unfortunately, his accretion of wisdom ih the intervening years was only marginal. He used his new-found free- dom to acquire cirrhosis of the liver.

His brother, a few years younger than he, was an alcoholic also. Four weeks ago, at the age of 38, he died of a cere- bral haemorrhage. Since that time, my patient had tried to hang himself and gas himself, he had jumped out of a first- floor window, thus spraining both his ankles, and had taken an overdose twice a week.

On the day his brother died, his daugh- ter, aged 17, gave birth to a baby.

`What did you think of that?' I asked. `I was really proud of her,' he said. `And what about the father?' I asked. `Oh, he fucked off.'

`What did you think of him?'

`If found him I'd punch him in the face.' 'Why?'

`Well, I always thought the blood on the walls and floor in her flat was because of her periods, but it was because he was beating her up. He used to drink. I didn't know that. My daughter never told me.'

`And your daughter: what does she think?'

`She says she'd like more children. She's really happy with the baby, like.'

Theodore Dalrymple