Quotulatiousness

May 13, 2016

British doctors and the attraction of moving to Australia

Filed under: Australia, Britain, Health — Tags: , , , — Nicholas @ 03:00

Scott Alexander talks about the dispute between the junior doctors and the British government:

A lot of American junior doctors are able to bear this [the insane working hours] by reminding themselves that it’s only temporary. The worst part, internship, is only one year; junior doctorness as a whole only lasts three or four. After that you become a full doctor and a free agent – probably still pretty stressed, but at least making a lot of money and enjoying a modicum of control over your life.

In Britain, this consolation is denied most junior doctors. Everyone works for the government, and the government has a strict hierarchy of ranks, only the top of which – “consultant” – has anything like the freedom and salary that most American doctors enjoy. It can take ten to twenty years for junior doctors in Britain to become consultants, and some never do. […]

Faced with all this, many doctors in Britain and Ireland have made the very reasonable decision to get the heck out of Britain and Ireland. The modal career plan among members of my medical school class was to graduate, work the one year in Irish hospitals necessary to get a certain certification that Australian hospitals demanded, then move to Australia. In Ireland, 47.5% of Irish doctors had moved to some other country. The situation in Britain is not quite so bad but rapidly approaching this point. Something like a third of British emergency room doctors have left the country in the past five years, mostly to Australia, citing “toxic environment” and “being asked to endure high stress levels without a break”. Every year, about 2% of British doctors apply for the “certificates of good standing” that allow them to work in a foreign medical system, with junior doctors the most likely to leave. Doctors report back that Australia offers “more cash, fewer hours, and less pressure”. I enjoy a pretty constant stream of Facebook photos of kangaroos and the Sydney Opera House from medical school buddies who are now in Australia and trying to convince their colleagues to follow in their footsteps.

Upon realizing their doctors are moving abroad, British and Irish health systems have leapt into action by…ignoring all systemic problems and importing foreigners from poorer countries who are used to inhumane work environments. I worked in some rural Irish towns where 99% of the population was white yet 80% of the doctors weren’t; if you have a heart attack in Ireland and can’t remember what their local version of 911 is, your best bet is to run into the nearest mosque, where you’ll find all the town’s off-duty medical personnel conveniently gathered together. This seems to be true of Britain as well, with the stats showing that almost 40% of British doctors trained in a foreign country (about half again as high as the US numbers, even though the US is accused of “stealing the world’s doctors” – my subjective impression is that foreign doctors try to come to the US despite barriers because they’re attracted to the prospect of a better life here, but that they are actively recruited to Britain out of desperation). Many of the doctors who did train in Britain are new immigrants who moved to Britain for medical school – for example, the Express finds that only 37% of British doctors are white British (the corresponding number for America is something like 50-65%, even though America is more diverse than Britain). While many new immigrants are great doctors, the overall situation is unfortunate since a lot of them end up underemployed compared to their qualifications in their home country, or trapped in the lower portions of the medical hierarchy by a combination of racism, language difficulties, and just the fact that everyone is trapped in the lower portions of the medical hierarchy these days.

If Britain continues along its current course, they’ll probably be able to find more desperate people willing to staff its medical services after even more homegrown doctors move somewhere else (70% say they’re considering it, although we are warned not to take that claim at face value). I work with several British and Irish doctors in my hospital here in the US Midwest, they’re very talented people, and we could always use more of them. But this still seems like just a crappy way to run a medical system.

I don’t know anything about the latest dispute that has led to this particular strike in Britain. Both sides’ positions sound reasonable when I read about them in the papers. I would be tempted to just split the difference, if not for the fact several years of medical work in the British Isles have taught me that everything that a government health system says is vile horrible lies, and everybody with a title sounding like “Minister of Health” or “Health Secretary” is an Icke-style lizard person whose terminal value is causing as many humans to die of disease as possible. I can’t overstate the importance of this. You read the press releases and they sound sort of reasonable, and then you talk to the doctors involved and they tell you all of the reasons why these policies have destroyed the medical system and these people are ruining their lives and the lives of their patients and how they once shook the Health Secretary’s hand and it was ice-cold and covered in scales. I don’t know how much of this is true. I just think of it as something in the background when the health service comes up to doctors and says “Hey, we have this great new deal we want to offer you!”

May 12, 2016

The State is not actually monolithic

Filed under: Britain, Bureaucracy, Government — Tags: , — Nicholas @ 02:00

In a comment on Facebook, Sean Gabb explains why even a government in a non-federal system sometimes seems to act inconsistently from moment to moment:

Sean Gabb In a country as large and rich as ours, The State is best regarded not as an entity with a single will, but as a collection of interest groups with agendas that sometimes overlap and sometimes conflict. The job of the people at the top is largely to try balancing these interests.

May 7, 2016

Tiger Day 2016 at The Bovington Tank Museum

Filed under: Britain, Germany, History, Military, WW2 — Tags: , — Nicholas @ 02:00

Published on 4 May 2016

This weekend we popped down to the Tank Museum for a spot of big game hunting. Tigers, Leopards, Comets…. okay the analogy starts to break down a bit now…

QotD: The Borderers (aka the “Scots-Irish”)

Filed under: Britain, History, Quotations, USA — Tags: , , , , , — Nicholas @ 01:00

The Borderers are usually called “the Scots-Irish”, but Fischer dislikes the term because they are neither Scots (as we usually think of Scots) nor Irish (as we usually think of Irish). Instead, they’re a bunch of people who lived on (both sides of) the Scottish-English border in the late 1600s.

None of this makes sense without realizing that the Scottish-English border was terrible. Every couple of years the King of England would invade Scotland or vice versa; “from the year 1040 to 1745, every English monarch but three suffered a Scottish invasion, or became an invader in his turn”. These “invasions” generally involved burning down all the border towns and killing a bunch of people there. Eventually the two sides started getting pissed with each other and would also torture-murder all of the enemy’s citizens they could get their hands on, ie any who were close enough to the border to reach before the enemy could send in their armies. As if this weren’t bad enough, outlaws quickly learned they could plunder one side of the border, then escape to the other before anyone brought them to justice, so the whole area basically became one giant cesspool of robbery and murder.

In response to these pressures, the border people militarized and stayed feudal long past the point where the rest of the island had started modernizing. Life consisted of farming the lands of whichever brutal warlord had the top hand today, followed by being called to fight for him on short notice, followed by a grisly death. The border people dealt with it as best they could, and developed a culture marked by extreme levels of clannishness, xenophobia, drunkenness, stubbornness, and violence.

By the end of the 1600s, the Scottish and English royal bloodlines had intermingled and the two countries were drifting closer and closer to Union. The English kings finally got some breathing room and noticed – holy frick, everything about the border is terrible. They decided to make the region economically productive, which meant “squeeze every cent out of the poor Borderers, in the hopes of either getting lots of money from them or else forcing them to go elsewhere and become somebody else’s problem”. Sometimes absentee landlords would just evict everyone who lived in an entire region, en masse, replacing them with people they expected to be easier to control.

Many of the Borderers fled to Ulster in Ireland, which England was working on colonizing as a Protestant bulwark against the Irish Catholics, and where the Crown welcomed violent warlike people as a useful addition to their Irish-Catholic-fighting project. But Ulster had some of the same problems as the Border, and also the Ulsterites started worrying that the Borderer cure was worse than the Irish Catholic disease. So the Borderers started getting kicked out of Ulster too, one thing led to another, and eventually 250,000 of these people ended up in America.

250,000 people is a lot of Borderers. By contrast, the great Puritan emigration wave was only 20,000 or so people; even the mighty colony of Virginia only had about 50,000 original settlers. So these people showed up on the door of the American colonies, and the American colonies collectively took one look at them and said “nope”.

Except, of course, the Quakers. The Quakers talked among themselves and decided that these people were also Children Of God, and so they should demonstrate Brotherly Love by taking them in. They tried that for a couple of years, and then they questioned their life choices and also said “nope”, and they told the Borderers that Philadelphia and the Delaware Valley were actually kind of full right now but there was lots of unoccupied land in Western Pennsylvania, and the Appalachian Mountains were very pretty at this time of year, so why didn’t they head out that way as fast as it was physically possible to go?

At the time, the Appalachians were kind of the booby prize of American colonization: hard to farm, hard to travel through, and exposed to hostile Indians. The Borderers fell in love with them. They came from a pretty marginal and unproductive territory themselves, and the Appalachians were far away from everybody and full of fun Indians to fight. Soon the Appalachian strategy became the accepted response to Borderer immigration and was taken up from Pennsylvania in the north to the Carolinas in the South (a few New Englanders hit on a similar idea and sent their own Borderers to colonize the mountains of New Hampshire).

So the Borderers all went to Appalachia and established their own little rural clans there and nothing at all went wrong except for the entire rest of American history.

Scott Alexander, “Book Review: Albion’s Seed“, Slate Star Codex, 2016-04-27.

May 6, 2016

The British Surrender At Kut – Germany Restricts The U-Boats I THE GREAT WAR – Week 93

Filed under: Britain, Europe, History, Middle East, Military, WW1 — Tags: , , , — Nicholas @ 02:00

Published on 5 May 2016

After 140 days, the Siege of Kut ends with the biggest surrender of British forces in history. The remaining soldiers are starting their long march into captivity. Meanwhile the Italian front lights up again as Luigi Cadorna plans a new offensive and the Germans give in to diplomatic pressure and stop their unrestricted submarine warfare.

QotD: The Quakers

Filed under: Britain, History, Quotations, Religion, USA — Tags: , , — Nicholas @ 01:00

Fischer warns against the temptation to think of the Quakers as normal modern people, but he has to warn us precisely because it’s so tempting. Where the Puritans seem like a dystopian caricature of virtue and the Cavaliers like a dystopian caricature of vice, the Quakers just seem ordinary. Yes, they’re kind of a religious cult, but they’re the kind of religious cult any of us might found if we were thrown back to the seventeenth century.

Instead they were founded by a weaver’s son named George Fox. He believed people were basically good and had an Inner Light that connected them directly to God without a need for priesthood, ritual, Bible study, or self-denial; mostly people just needed to listen to their consciences and be nice. Since everyone was equal before God, there was no point in holding up distinctions between lords and commoners: Quakers would just address everybody as “Friend”. And since the Quakers were among the most persecuted sects at the time, they developed an insistence on tolerance and freedom of religion which (unlike the Puritans) they stuck to even when shifting fortunes put them on top. They believed in pacificism, equality of the sexes, racial harmony, and a bunch of other things which seem pretty hippy-ish even today let alone in 1650.

England’s top Quaker in the late 1600s was William Penn. Penn is universally known to Americans as “that guy Pennsylvania is named after” but actually was a larger-than-life 17th century superman. Born to the nobility, Penn distinguished himself early on as a military officer; he was known for beating legendary duelists in single combat and then sparing their lives with sermons about how murder was wrong. He gradually started having mystical visions, quit the military, and converted to Quakerism. Like many Quakers he was arrested for blasphemy; unlike many Quakers, they couldn’t make the conviction stick; in his trial he “conducted his defense so brilliantly that the jurors refused to convict him even when threatened with prison themselves, [and] the case became a landmark in the history of trial by jury.” When the state finally found a pretext on which to throw him in prison, he spent his incarceration composing “one of the noblest defenses of religious liberty ever written”, conducting a successful mail-based courtship with England’s most eligible noblewoman, and somehow gaining the personal friendship and admiration of King Charles II. Upon his release the King liked him so much that he gave him a large chunk of the Eastern United States on a flimsy pretext of repaying a family debt. Penn didn’t want to name his new territory Pennsylvania – he recommended just “Sylvania” – but everybody else overruled him and Pennyslvania it was. The grant wasn’t quite the same as the modern state, but a chunk of land around the Delaware River Valley – what today we would call eastern Pennsylvania, northern Delaware, southern New Jersey, and bits of Maryland – centered on the obviously-named-by-Quakers city of Philadelphia.

Penn decided his new territory would be a Quaker refuge – his exact wording was “a colony of Heaven [for] the children of the Light”. He mandated universal religious toleration, a total ban on military activity, and a government based on checks and balances that would “leave myself and successors no power of doing mischief, that the will of one man may not hinder the good of a whole country”.

His recruits – about 20,000 people in total – were Quakers from the north of England, many of them minor merchants and traders. They disproportionately included the Britons of Norse descent common in that region, who formed a separate stratum and had never really gotten along with the rest of the British population. They were joined by several German sects close enough to Quakers that they felt at home there; these became the ancestors of (among other groups) the Pennsylvania Dutch, Amish, and Mennonites.

Scott Alexander, “Book Review: Albion’s Seed“, Slate Star Codex, 2016-04-27.

May 5, 2016

QotD: The Cavaliers

Filed under: Britain, History, Quotations, USA — Tags: , , — Nicholas @ 01:00

Virginia had been kind of a wreck ever since most of the original Jamestown settlers had mostly died of disease. Governor William Berkeley, a noble himself, decided the colony could reinvent itself as a destination for refugee nobles, and told them it would do everything possible to help them maintain the position of oppressive supremacy to which they were accustomed. The British nobility was sold. The Cavaliers – the nobles who had fought and lost the English Civil War – fled to Virginia. Historians who cross-checking Virginian immigrant lists against English records find that of Virginians whose opinions on the War were known, 98% were royalists. They were overwhelming Anglican, mostly from agrarian southern England, and all related to each other in the incestuous way of nobility everywhere: “it is difficult to think of any ruling elite that has been more closely interrelated since the Ptolemies”. There were twelve members of Virginia’s royal council; in 1724 “all without exception were related to one another by blood or marriage…as late as 1775, every member of that august body was descended from a councilor who had served in 1660”.

These aristocrats didn’t want to do their own work, so they brought with them tens of thousands of indentured servants; more than 75% of all Virginian immigrants arrived in this position. Some of these people came willingly on a system where their master paid their passage over and they would be free after a certain number of years; others were sent by the courts as punishments; still others were just plain kidnapped. The gender ratio was 4:1 in favor of men, and there were entire English gangs dedicated to kidnapping women and sending them to Virginia, where they fetched a high price. Needless to say, these people came from a very different stratum than their masters or the Puritans.

People who came to Virginia mostly died. They died of malaria, typhoid fever, amoebiasis, and dysentery. Unlike in New England, where Europeans were better adapted to the cold climate than Africans, in Virginia it was Europeans who had the higher disease-related mortality rate. The whites who survived tended to become “sluggish and indolent”, according to the universal report of travellers and chroniclers, although I might be sluggish and indolent too if I had been kidnapped to go work on some rich person’s farm and sluggishness/indolence was an option.

The Virginians tried their best to oppress white people. Really, they did. The depths to which they sank in trying to oppress white people almost boggle the imagination. There was a rule that if a female indentured servant became pregnant, a few extra years were added on to their indenture, supposedly because they would be working less hard during their pregnancy and child-rearing so it wasn’t fair to the master. Virginian aristocrats would rape their own female servants, then add a penalty term on to their indenture for becoming pregnant. That is an impressive level of chutzpah. But despite these efforts, eventually all the white people either died, or became too sluggish to be useful, or worst of all just finished up their indentures and became legally free. The aristocrats started importing black slaves as per the model that had sprung up in the Caribbean, and so the stage was set for the antebellum South we read about in history classes.

Scott Alexander, “Book Review: Albion’s Seed“, Slate Star Codex, 2016-04-27.

May 4, 2016

QotD: The Puritans

Filed under: Britain, History, Quotations, USA — Tags: , , , , , — Nicholas @ 01:00

I hear about these people every Thanksgiving, then never think about them again for the next 364 days. They were a Calvinist sect that dissented against the Church of England and followed their own brand of dour, industrious, fun-hating Christianity. Most of them were from East Anglia, the part of England just northeast of London. They came to America partly because they felt persecuted, but mostly because they thought England was full of sin and they were at risk of absorbing the sin by osmosis if they didn’t get away quick and build something better. They really liked “city on a hill” metaphors.

I knew about the Mayflower, I knew about the black hats and silly shoes, I even knew about the time Squanto threatened to release a bioweapon buried under Plymouth Rock that would bring about the apocalypse. But I didn’t know that the Puritan migration to America was basically a eugenicist’s wet dream.

Much like eg Unitarians today, the Puritans were a religious group that drew disproportionately from the most educated and education-obsessed parts of the English populace. Literacy among immigrants to Massachusetts was twice as high as the English average, and in an age when the vast majority of Europeans were farmers most immigrants to Massachusetts were skilled craftsmen or scholars. And the Puritan “homeland” of East Anglia was a an unusually intellectual place, with strong influences from Dutch and Continental trade; historian Havelock Ellis finds that it “accounts for a much larger proportion of literary, scientific, and intellectual achievement than any other part of England.”

Furthermore, only the best Puritans were allowed to go to Massachusetts; Fischer writes that “it may have been the only English colony that required some of its immigrants to submit letters of recommendation” and that “those who did not fit in were banished to other colonies and sent back to England”. Puritan “headhunters” went back to England to recruit “godly men” and “honest men” who “must not be of the poorer sort”.

Scott Alexander, “Book Review: Albion’s Seed“, Slate Star Codex, 2016-04-27.

May 3, 2016

QotD: Shakespeare

Filed under: Britain, History, Media, Quotations — Tags: — Nicholas @ 01:00

[Shakespeare] … could experiment so wildly with the language in his later plays. The earliest ones are strictly respectful of English syntax, and obedient with English grammar and vocabulary. The later ones break all the rules. Shakespeare knew he could hold an audience spellbound, whether they could follow his verbiage or not. He earned a freedom no subsequent poet in English till the twentieth century would dare to imitate; whenupon, those who tried, failed.

Yet he is a poet, a disciplined poet, and a thinker, too; and was a man of very broad if chaotic reading, as we are still discovering. His Latin was superb, and what he comprehended from the Roman poets, Ovid especially, was of a higher quality than dribbling academics can imagine. His thefts from Plutarch are always astute, but also from Livy. What he learnt from the ancient comedians, however, was nothing on what he could teach them.

To call him “the Bard” is to subscribe to the common, ignorant view that he was a “noble savage,” an untutored force of nature. The French, in their formality, are mostly responsible for this error of the Enlightenment; it was among the many things Voltaire got wrong, as the insidious depth of the master dramatist undermined his poppet classicism.

Shakespeare meditated deeply on English history, and on history at large. He went beyond presenting it in narrative form. Like a documentary filmmaker, he takes what he needs from the historical record, discards the rest, and changes anything that does not fit his programme. This is also his strategy in the Comedies and the Tragedies, never paying for a plot when he can steal one. For the world is full of plots, and one is like another. The world is full of mud and rock, but the master mason can shape and lay them. The master sculptor permits the stone to speak.

He did not have a theory of history, or a theory of anything else — a mediaeval mind does not think in “theories” — but a profound sense of how the world works, and of the contending spirits animating it. He summons spirits, and strange to say they come.

David Warren, “Four Centuries Later”, Essays in Idleness, 2016-04-23.

May 1, 2016

T.E. Lawrence And How He Became Lawrence Of Arabia I WHO DID WHAT IN WW1?

Filed under: Britain, History, Middle East, Military, WW1 — Tags: , , — Nicholas @ 02:00

Published on 30 Apr 2016

Check out HistoryBuffs review of Lawrence of Arabia: http://bit.ly/NickOfArabia

Big thank you to Nick from History Buffs for this collaboration. It was really fun!

T.E. Lawrence better known as Lawrence of Arabia is one of the biggest legends of World War 1. His adventures in the Middle East during the Arab Revolt were made into a movie and a bestselling book. But how did Lawrence actually end up in Cairo? And what was his relationship with Faisal?

April 29, 2016

Dividing Up The Middle East – The Sykes-Picot Agreement I THE GREAT WAR Week 92

Filed under: Britain, Europe, France, History, Middle East, Military, WW1 — Tags: , — Nicholas @ 08:22

Published on 28 Apr 2016

The secret agreement between France, Britain and Russia that was signed this week 100 years ago was a turning point in the relations to the Arab world. It negated all future promises made by the British and still has consequences 100 years later. The Middle East was becoming more and more important to the British in 1916 and people like T.E. Lawrence are starting to become major players in the background.

April 25, 2016

The Battle of Jutland

Filed under: Britain, Europe, Germany, History, Military, WW1 — Tags: , , — Nicholas @ 02:00

The Battle of Jutland Animation from NIck on Vimeo.

April 24, 2016

The Easter Rising – Ireland in World War 1 I THE GREAT WAR Special

Filed under: Britain, Europe, History, Military, WW1 — Tags: , , — Nicholas @ 03:00

Published on 23 Apr 2016

Easter 1916 was a turning point for Ireland and its situation between Home Rule and Irish soldiers serving on the fronts of Gallipoli and the Western Front. And even though the Easter Rising, the first armed uprising against the British was unsuccessful, the spark for Irish nationalism ultimately led to the establishment of the Irish Republic.

April 22, 2016

The Muddy Graves of Russia and Kut I THE GREAT WAR Week 91

Filed under: Britain, Europe, History, Middle East, Military, Russia, WW1 — Tags: , — Nicholas @ 03:00

Published on 21 Apr 2016

With the spring in Russia and the Caucasus came the thaws on the Eastern Front and all the way down to Mesopotamia. The soldiers had to adapt to survive let alone fight. The Battle of Verdun still rages on though the French are not moving more airplanes to the area to break the German air superiority.

Winston’s booze

Filed under: Britain, History, Wine — Tags: , , — Nicholas @ 02:00

Last January, Harry Wallop attempted to match Winston Churchill’s daily intake of whisky, Pol Roger champagne, brandy, and sundry other “refreshers”. He found it a challenge beyond his ready ability:

One thing is certain: his fondness for kickstarting the day with what he called “mouthwash” — a weak whisky and soda, which he would take from about 9.30 onwards and keep continually topped up. But the whisky (simple Johnnie Walker, no fancy malt) would only just cover the bottom of the tumbler; the bulk of the drink was soda.

It’s a rather delightful way to start the day, as I discover. Especially, when consumed in bed. Churchill would frequently spend all morning in his dressing gown, under the covers, surrounded by papers and secretaries. He would also happily have meetings while taking a hot bath — a habit I did not attempt to replicate.

Lunch was when the serious drinking began. A whole bottle of champagne was the norm, invariably Pol Roger, a brand Churchill drank from at least 1908. His attachment was cemented in 1944, after meeting Odette Pol-Roger (the grand dame of the champagne house) at the British ambassador’s home in Paris, where the 1928 vintage was served in celebration of the liberation of France. She ensured he was never afterwards short of supplies.

A bottle, however, was for Churchill nearly always a pint-sized one, a fairly common measure until it was phased out by champagne houses in the 1970s. He would often drink it out of a silver tankard, still served this way in some gentlemen’s clubs.

A modern politico drinking like this would already have the horrified attention of his or her M.D., but Sir Winston’s liver may have been the most superhuman part of him:

I then spent the rest of the afternoon (or what was left of it), drinking more whisky and sodas while attempting to write an article — a task I found increasingly difficult. When I returned to it the following day, I discovered it was barely literate with every other word misspelled.

After dressing for dinner (bombs raining down on London was no reason to let standards slip), Churchill would often have a sherry. A glass of Amontillado failed to sharpen my jaded appetite. Worse, I was rather dreading the second pint of champagne over dinner.

I am aware this sounds churlish, but it became progressively joyless to get through all those bubbles. By 9.30pm I was slumped in front of ‘Death in Paradise’, working out if the plot or yet another glass was going to finish me off.

[…]

Churchill, by 10pm, would have been moving onto either port or his favourite 90-year-old brandy and at least four hours of hard work.

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