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Doctor at large

05 December 2014


IT IS enough to make even the most composed patient into a hypochondriac. In the 13 different organ systems of our body, there are at least 60,000 things that could go wrong. But, as this year's Reith Lecturer, Professor Atul Gawande, said, these are statistics that we should embrace rather than be frightened of. In his first lecture, Why Do Doctors Fail? (Radio 4, Tuesday of last week), the Harvard professor tells us about how to deal with the limits of human knowledge, and how we manage our ignorance.

He opened his four-lecture campaign with the story of his son, whose malfunctioning aorta was diagnosed only after a doctor noticed that they were taking blood-oxygen levels from the wrong finger. On some occasions, it just requires somebody to do their job properly; but other medical misunderstandings require more heroic efforts, as when, back in 1929, Werner Forssmann disproved the long-held view that you could not penetrate the heart with medical instruments by manoeuvring a catheter into his own.

This first lecture was only ever going to be a stall-setter; and I, at least, have grown inured to the over-managed style of 21st-century Reith Lectures: globe-trotting and glitzy on the one hand, but all too rarely delivering deeper insights.

But one must be particularly cautious in this instance - where the subject is the culture of medical practice - about the cosmopolitan profile of the series. The experience of medicine, and the doctor-patient relationship, will be considerably different in Boston, Massachussets, and Boston, Lincolnshire; or in Delhi and Edinburgh. I hope that the British faith in our medical profession is a little stronger than the American audience member who boasted that she had received numerous diagnoses for her condition, and not believed any of them.

Lord Reith would perhaps be disconcerted by the way in which a flagship strand, carrying his name, has moved - but no more than his bemusement at the way another flagship educational strand, Singing Together, managed to survive for so long. In Archive on 4 (Radio 4, Saturday), Jarvis Cocker looked back over the 50 years of a show that was, for much of its career, looked down on for its lack of educational rigour. For some, the idea of children singing for enjoyment, with no complementary harmony and counterpoint exercises, seemed exceedingly frivolous.

Many teachers and children who remember the show disagree. Singing as an expression of community, as therapy, as a way of bringing focus to a group of children - all this and more was delivered through Singing Together, even when the singers employed delivered their assort- ment of folk songs with the kind of BBC accent that would make children nowadays titter uncontrollably.

Sadly, the lowly status of Singing Together has meant that only three programmes survive in the BBC archive. An appeal to the public has unearthed more resources; but this was a programme always regarded as ephemeral. Indeed, that might have been its greatest strength - music as activity, enjoyed in the present, never to be recorded, analysed, or assessed.

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