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.