The
Pharmaceutical Journal Vol 266 No 7129 p2 Starting
the year
Testing Leadership
Promoting paradox
There is nothing natural about New Year’s Eve and New Year’s
Day, no changes in the weather or the seasons, no regular change in the moon’s
face. They are a human convention since the early times when people adopted
customs to mark an artificial point in the counting of time. On New Year’s Day
the Greeks and Romans made a habit of giving one another gifts, and it is strange
to think that in Britain the same custom, but this time aimed at bribing magistrates,
continued until it was made illegal in 1290.
In many places it was customary on New Year’s Eve for young women to carry a
wassail bowl of spiced ale - a special brew of ale with nutmeg, sugar, toast
and roasted apples - from house to house in a locality, gathering gifts in the
process. Another curious custom was “first-footing”, where the first person
permitted to enter a house after midnight should be a man, usually dark skinned
and dark-haired, but sometimes fair-haired, otherwise ill-fortune would await
the household. Flat-footed or cross-eyed individuals had to be avoided. The
first-footer carried symbolic gifts of bread or coal or sometimes whisky. On
entering a house a first-footer was expected to remain silent until he had poked
the fire, and he was required to enter by the front door and leave by the back.
As a reward he would be presented with food and drink, or sometimes money. Such
a custom was more prevalent in the north of Britain.
Sometimes the rules were applied in a manner that was acutely embarrassing.
For example, it is on record that in Nottinghamshire a young woman who had been
attending a midnight church service returned home to find that her father or
brother had to enter the house before she did so. She was forced by her mother
to wander the streets in the early hours until they arrived home. Fires should
not be carried from the house, and were not allowed to be extinguished until
New Year’s Day was past.
Divination was regularly practised at this time. Examples were digging into
a biblical text and reciting the passage turned up. The ashes on the domestic
hearth were examined to find shapes that suggested future events. If the New
Year opened with dusky red clouds in the morning sky, the coming year would
be full of civil strife and robbery.
In the Scottish highlands it was customary when New Year arrived to have a man
dressed in a dried cow’s hide, upon which other men beat with sticks, making
an unearthly noise. Elsewhere, boys were expected to roam the local orchards
and beat the trees with their sticks. Juniper was burnt over cattle in the highlands,
but precisely why is not clear, unless it was to avert evil influences.
It is noteworthy that New Year’s Day was not declared a bank holiday in Britain
until 1974, but prior to that date unofficial holidays, involving not only not
working but also not washing oneself, were customary in some areas.
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Many of the troubles with which we have to contend in a civilised society
stem, I believe, from the fact that many people are plain ignorant or stupid
or both, unable to relate ideas and convert them into action. The repercussions
of this situation vary with the influence which individuals can bring to bear
on regulations and developments. They become more troublesome when they relate
to government - local, regional or national.
One way to make the world a better place for those living in it would be to
disqualify from influential office the people who are stupider than their fellows.
After all, we professionals, whether pharmacists, doctors, nurses or other responsible
experts, are expected to maintain close contact with developments in our field
of endeavour and to keep out knowledge and faculties up to date. Why not a parallel
approach to elected representatives who carry responsibility for our daily welfare?
It has been suggested to me by a near relative in the teaching profession that
Members of Parliament and elected local counsellors should be required to take
an intelligence test every six months. The actual frequency would be negotiable.
The tests would be overseen by a body called, provisionally, OFFMP, not a quango
but an independent concern, which would arrange for inspectors to visit, without
prior notice, the Palace of Westminster and council offices and spend several
days observing the conduct of affairs and quizzing individual counsellors and
MPs. They would, of course, draw up league tables from their findings, and take
action to close down any bodies that failed to meet minimum standards.
There are grave difficulties to overcome: first, to find truly unbiased examiners
and judges with suitably high IQ; second, to ensure that bribery and corruption
are eliminated from the process. To the counter-argument that such a process
might infringe human rights and justice, there is the answer given by advocates
of identity cards for all — if you are innocent you have nothing to fear.
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The subject of exercise and its benefits is much in the public eye today,
mainly because there are far too many people about who resort to machines to
do what their muscles used to do, and because organising exercise machines and
leisure facilities for those who complain that they feel unfit is big business
for some people. Yet, as Barry Maron of the Minneapolis Heart Institution Foundation
points out in the New England Journal of Medicine for November 9, 2000,
physical exercise presents a paradox. Sudden death from cardiac failure is common
during or just after vigorous physical exertion. It may occur during organised
youth sports, but “more frequently, sudden deaths occur in persons of all ages
during recreational activities or informal conditioning programs.”
Atherosclerotic coronary artery disease is responsible for most deaths related
to physical activity in athletics participants older than 35 years, whether
trained or untrained. Activities involved include long distance running, racquet
sports and weight lifting. On the other hand, physical inactivity and a sedentary
lifestyle are recognised risk factors in the development of adverse cardiac
events and consequent deaths.
A study reported in the same issue of NEJM underlines a paradox, that
vigorous physical exertion can simultaneously increase the short-time risk of
death from underlying coronary artery disease and also reduce this risk in those
who regularly exercise. The study involved 12,481 men followed up for 12 years.
It demonstrated that short-term risk increase attributable to vigorous exercise
was significantly reduced, though not eliminated, in subjects who reported an
active lifestyle involving habitual, as opposed to sporadic, exercise.
Although attention has been focused upon the virtues of vigorous exercise, there
is evidence that less intense activities, such as brisk walking, offer similar
cardiovascular benefits. It must be recognised that among young athletes with
congenital or genetic cardiac disorders, systematic training by way of vigorous
exertion may not offer protection against sudden death. Overall, the hazards
of physical activity are outweighed by the cardiovascular benefits in a complex
and contradictory manner.
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