I have noticed the disappearance of the word “unhappy” from common usage, and its replacement by the word “depressed”. While unhappiness is a state of mind that is clearly the result of the circumstances of one’s life, whether self-inflicted or inflicted by circumstances beyond one’s control, or a mixture of both, depression is an illness that is the doctor’s responsibility to cure. This is so, however one happens to be leading one’s life. And the doctor, enjoined to pass no judgement that could be interpreted as moral on his patients, has no option but to play along with this deception. The result is the gross over-prescription of medication, without any reduction in unhappiness.
Theodore Dalrymple, interviewed by James Glazov in “Our Culture, What’s Left Of It”, FrontPage, 2005-08-31.
February 5, 2026
QotD: The medicalization of unhappiness
January 22, 2026
QotD: Higher education
No; I came to the conclusion that the cause of the revolutionary guerrilla movements was the expansion of tertiary education in countries where it had not long before been the province only of the elite, largely, though never entirely, hereditary. (For the poor, gifted, and ambitious, the army was the route to social ascension.)
Tertiary education, however, was expanded with comparative suddenness. Before it was expanded, those who had it, being few, were more or less guaranteed important roles in the economy and government. They had already drawn a winning ticket in the lottery of life. Not surprisingly, a false syllogism insinuated itself into the minds of the newly educated: If the rich were educated and important, then being educated would make you rich and important. Again not surprisingly, this turned out not to be the case. If you turn out thousands of lawyers, for example, the remuneration of their work, if they find any, will be reduced and they will be disappointed in their hopes and expectations. They become angry, bitter, and disaffected, believing themselves not to be valued at their inestimable worth. They and their ilk became the middle ranks of the guerrillas (the very uppermost reaches being filled mainly by the narcissistic, spoiled sprigs of the upper classes). Only revolution would acquire for them the positions of influence and importance to which they felt that their education entitled them, and which such education had always entitled people to in the past.
Is it possible that Latin America was not so much in the rear as in the forefront of this modern social development (the case of Sendero Luminoso, the Shining Path of Peru, was a pure culture of this phenomenon)? Is it not possible that we in our societies have duped tens of millions of young people into believing that the prolongation of their formal education would lead them inexorably into the sunny uplands of power, importance, wealth, and influence, when in fact many a PhD finds himself obliged to do work that he could have done when he was 16? No one likes to think that he has been duped, however (it takes two for fraud to be committed, after all), so he looks around for some other cause of his bitter disappointment. It isn’t ignoramuses who are pulling down the statues, but ignoramuses who think that they have been educated.
Theodore Dalrymple, “Bees With Degrees”, Taki’s Magazine, 2020-07-02.
Update, 24 January: Welcome, Instapundit readers! Have a look around at some of my other posts you may find of interest. I send out a daily summary of posts here through my Substack – https://substack.com/@nicholasrusson that you can subscribe to if you’d like to be informed of new posts in the future.
December 20, 2025
QotD: Women’s Rugby
Now, however, the sport is professional and played by men who seem to be eight feet wide and run straight into one another, very fast and often headfirst. Not surprisingly, a significant proportion of them suffer from traumatic dementia very early in their lives, and some, understandably though I do not think justifiably, try in the early stages of their sad condition to obtain financial compensation. The sport has become so violent that even people who are not unduly sensitive to violence shrink from observing it close-up.
Freud might have taken these women’s desire to participate in a sport that is so radically unsuited to them as an instance of what, in one of his absurd speculations about the psychology of women, he called penis envy. I think, rather, it is a sign of the masculinization of at least some women, who are responding to the overvaluation in our culture of the exercise of power as the supreme end in life. The exercise of all power is fleeting, sporting prowess being among its most fleeting forms; but the illusion dies hard.
Theodore Dalrymple, “All in a Day’s Irk”, New English Review, 2025-08-29.
December 11, 2025
QotD: Being a bore
My problem is that I have two modes of socializing: to be silent or boring. I cannot make small talk, for when I try to do so my words turn to dust in my mouth, as it were, before I have even uttered them. I can talk only on matters of impersonal interest.
My problem is that I am a serial monomaniac, with one subject occupying the foreground of my mind for up to a few months. In the midst of my enthusiasm, I cannot imagine that other people are not as fascinated by the subject as I. The subject of my monomanias are various: Haitian history; the disappearance of the cuckoo from the English countryside; the life of Caradoc Evans, the Welsh writer of the early part of the 20th century; etc. I never stick with anything long enough to be a scholar of it.
When my wife kicks me under the table, it is usually in mid-anecdote. I cannot stop straightaway, abruptly, for that would look peculiar, as if I were having a fit or a stroke. But I have to bring it to a quicker end than I had anticipated, omitting details that to me had seemed choice and amusing. Often, I have to admit, my wife has heard them before.
Of course, I don’t agree that I am being, or have ever been, boring. Bores don’t know that they are boring, just as people with halitosis don’t know that their breath smells. I look at the people around the dinner table and think they are glued to what I am saying. The fact that I don’t really give them any alternative doesn’t occur to me. How, in any case, could anyone be uninterested in the story of le Roi Christophe who built, or had built, one of the wonders of the world, La Citadelle, near Cap-Haitien, or of how people threw bricks through Caradoc Evans’ windows, so disgusted were they by his literary portrayal of his countrymen? In those days, literature was important.
Theodore Dalrymple, “Full Bore”, Taki’s Magazine, 2020-05-29.
December 8, 2025
QotD: Austerity versus “austerity”
Words have connotations as well as denotations, and one way of insinuating an untruth into someone’s mind is to disconnect the two, so that the denotation and the connotation are at variance and even opposite. An excellent example of this is in the use of the word austerity as applied to certain government economic policies. Frequently one reads, for example, that the difficulties of countries such as Britain and France in the matter of responding to the Covid-19 epidemic were caused by previous government austerity, that is to say, failure to spend more. But irrespective of whether, had the governments spent more (and France already devotes a greater proportion of its GDP to healthcare than the great majority of countries at the same economic level), the epidemic would have been more easily mastered, their policies in restricting their expenditure cannot be called austerity, because they still spent more than their income: as, in fact, they had done almost continually for forty years.
Supposing I were to say, “This year I’m going in for austerity. Last year I spent ten per cent more than my income, but this year I am going to spend only five per cent more,” you would think I were uttering a sub-Wildean paradox. But if I were to say only, “This year I’m going in for austerity,” you would think I were going to wear a hair shirt and subsist on locusts and honey. To say that the British and French governments have exercised austerity is to mean the first and imply the second, which is clearly dishonest: though we should note that the proper term, reduction of the deficit, is neutral as to whether it is economically wise or unwise. After all, I can borrow equally to start a business or drink champagne for breakfast.
Theodore Dalrymple, “Controlling Thought”, New English Review, 2020-06-09.
Update, 9 December: Welcome, Instapundit readers! Please do have a look around at some of my other posts you may find of interest. I send out a daily summary of posts here through my Substack – https://substack.com/@nicholasrusson that you can subscribe to if you’d like to be informed of new posts in the future.
December 2, 2025
QotD: Brutalism “is to architects what propaganda was to communist leaders: It serves to make them feel powerful”
I have long suspected, but cannot prove with an indisputable argument, that this architecture has played its part in the brutalization of daily life and social behavior in the country. Certainly, it has dehumanized the appearance of many towns and cities; its harsh surfaces and willfully austere and jagged designs leave the mere human being feeling that he is about as welcome as an ant on a kitchen counter — which, indeed, he now much resembles.
This architecture is to architects what propaganda was to communist leaders: It serves to make them feel powerful, not despite the fact that so many people detest it, but because so many people detest it. They are like the doctors of old, who, if they could not cure their patients, could at least make them take the most repellent and noxious medicine, on the grounds that a little bit of what revolts you does you good.
The projected museum is in a former school in the north of London, designed in 1968. Here is fairly typical commentary on the building:
Despite decades of wear and some unfortunate interventions, the raw concrete structure has remained a cherished example of socially driven modernist design.
It is to be noticed that the cherishing done here is independent of anyone who cherishes; as for “socially driven modernist design”, we might read “totalitarian”. Indeed, the building exudes totalitarianism, as raw reinforced concrete exudes ghastly stains after a short time.
Le Corbusier, one of the founders of this kind of architecture, was indeed a fascist in the most literal sense, though he had no real objection to communist totalitarianism, either. What he most hated was what he called the street, that is to say the place where people behave spontaneously and without direction from above, and where they are not corralled into functions imposed on them by all-wise socially driven architects. It was for this reason that he and his acolytes preferred to build urban wildernesses of the kind that have now been built the world over, but especially in Britain.
The architects who have been given the task of renewing the school building where the museum dedicated to architectural brutalism is to be housed have “noted its distinct geometry, as well as its symbolic presence reflecting the ideals of the school’s broader 1960s Brutalist architecture conceived in an era of social progress”.
Apologists for such architecture write a pure Soviet langue de bois — or perhaps I should say langue de béton, since concrete rather than wood is their favorite material:
Consultation with the school, families and local stakeholders has underpinned the project from the outset, ensuring that the building’s next chapter remains tied to its founding ethos centered on architecture as a tool for collective learning and expression.
Does anyone, after the death of the late, not much lamented, Leonid Brezhnev, have thoughts that correspond to, or are couched in, words such as these? By their language shall ye know them.
Theodore Dalrymple, “Architects of Our Own Destruction”, New English Review, 2025-08-08.
November 5, 2025
QotD: Progressive anger
As they did so in this case, I could not help but think of the analogy with our present situation. We have a huge fund of very angry people buzzing about in mobs looking for somewhere on which their anger can settle. It seems an epoch ago that it landed on #MeToo and turned all men into Harvey Weinstein. Then, under the direction of little Greta, who somehow managed to combine an autistic manner with hysteria, opposing tendencies reconciled no doubt by the ineffable self-pity of the privileged, global warming provided a temporary resting place. However, with the killing of George Floyd, climate change seems as passé as Mussolini’s spats. (“Too many spats, too many spats!” someone once said of him.) But if no new thing is found after all the statues have been pulled down, the books burned, and the films withdrawn from circulation, climate change could return faute de mieux. On the other hand, free-floating anger is highly inventive as to the reasons for its existence: It can attach itself to almost anything, as flies can walk upside down on ceilings. Being no prophet myself, I have no idea what will be the next object of angry righteousness by people brought up to believe in moral relativism.
Theodore Dalrymple, “Bees With Degrees”, Taki’s Magazine, 2020-07-02.
November 1, 2025
QotD: Bullies
Theodore Dalrymple, interviewed by James Glazov in “Our Culture, What’s Left Of It”, FrontPage, 2005-08-31.
October 14, 2025
QotD: The trade in fake doctor’s notes
A reporter for the Daily Telegraph newspaper managed to obtain a certificate from the company to excuse him from work for five months, because he claimed (falsely) to be suffering from the long-term effects of COVID. He obtained the note without providing any medical evidence whatsoever.
The only thing that surprised me about this was that anyone thought that it was necessary in Britain to buy or pay for such a certificate. I thought of the famous lines of Humbert Wolfe, the otherwise all-but-forgotten England man of letters:
You cannot hope
to bribe or twist,
thank God! the
British journalist.
But, seeing what
the man will do
unbribed, there’s
no occasion to.The same might almost be said of British doctors, many of whom, I suspect, issue such certificates incontinently, for one of two reasons: fear of their patients, and sentimentality.
Not surprisingly, doctors do not like unpleasant scenes in their consulting rooms, and refusal of requests for time off sick can easily lead to such scenes, and occasionally to threatened or actual violence.
Naturally, no doctor likes to think of himself as a coward, the kind of person who caves in to such threats. The best way to avoid so humiliating a thought is never to risk having to think it, that is to say by granting the patients’ wishes in this matter immediately.
But in order to do this without feeling self-contempt, it is necessary to rationalize, that is to say to find supposed reasons for why everyone who wants a certificate should be given one. The English philosopher F.H. Bradley once said that metaphysics is the finding of bad reasons for what we believe on instinct, adding however that it was a human propensity to do so. In like fashion, we could say that doctors find bad reasons for giving sick certificates when they suspect that not to do so might lead to a confrontation with a patient.
Thus they convince themselves that if a person tells them that they are unfit for work, for whatever reason, it would be wrong to question it. No one would make a claim to be unable to work unless he were in some way discontented, unhappy, depressed, anxious, stressed, in a word suffering, and it is the object of doctors to reduce human suffering.
The doctor is aided in this train of thought by the looseness of psychiatric diagnosis, so that practically all forms of distress can be fitted into the procrustean bed of diagnosis. Even outright faking can now be construed as an illness or disorder, provided only that it goes on for long enough or is deceptive enough.
Does this mean that the patients seeking sick notes are all faking it? The matter is more complex than this would suggest. There is, of course, conscious, outright fraud, but this is comparatively rare. Just as doctors don’t like to think of themselves as cowards in the face of their patients, so patients don’t like to think of themselves as frauds.
Distress can be conjured out of almost anything and is not necessarily proportional to whatever causes it. Dwelling on the ill treatment one has suffered — and who has not suffered ill treatment at some time in his life? — can magnify something minor into something major, to the point at which it seems almost to have ruined one’s life. And it is certainly capable of rendering a person unfit for work in his own estimation — though in fact continuing at work would be a remedy for, rather than an exacerbation of, the problem.
However, where economic loss is not too severe when stopping work on medical grounds is possible, medical grounds will be both sought and found. In the days of the Soviet Union, the workers had a saying: “We pretend to work, and they pretend to pay us.” In our kinder and more enlightened societies, we pretend to be ill, and they pretend to treat us — except that the word “pretend” does not quite capture the subtlety of the transactions between doctor and patients.
Theodore Dalrymple, “Make Me Sick”, New English Review, 2025-07-04.
September 27, 2025
QotD: Utopian revolution
This illustrates a point that Professor Chirot makes clear in his discussion as to why the Vietnamese communist regime, though often brutal, never descended to anything like the level of horror of neighbouring Cambodia. Among the factors must surely have been the character and personality of the leaders as well as of the countries themselves. In other words, the fate of countries cannot be reduced, either in prospect or in retrospect, to an invariable formula. Human affairs will, to an extent, always be incalculable.
Still, some degree of regularity is possible. I was rather surprised that Professor Chirot overlooked one such. He writes the following of the corruption endemic under communist regimes: “a function of a deliberately exploitative, thieving elite that staved the general economy by its dishonesty than it was the essence of the system itself. Avoiding corruption was impossible because without it the society could not function.”
What is surprising here is that he does not mention why it could not function, but the answer seems to me perfectly obvious: it was because the communist system abolished the price system and substituted political decision-making in its place. This explanation is sufficient, for where there are no prices, and the economy is thereby largely demonetarised, goods and services can be distributed only by corruption. This is not to say that where there is a price system there will automatically be no corruption, obviously this is not the case; but such corruption will be limited by the very need for money to retain its value where such a price system exists. To that extent, it imposes at least a degree of honesty. The mystery of the Soviet Union or any other communist country is not why it produced so little, but why it produced anything at all: and here Professor Chirot is quite right. The answer is because of corruption: an “honest” communist state would produce nothing. It could not survive.
Theodore Dalrymple, “Longing for Revolution”, New English Review, 2020-05-13.
September 3, 2025
QotD: The distance between NHS PR and NHS reality
It wasn’t difficult to promote such historiography by using horror stories from the past, stories which were perfectly plausible because almost any conceivable system will give rise to such stories. If, per impossibile, a new system were to replace the NHS, it would not be difficult to justify it by reference to horror stories, whether or not the new system was better. A war of anecdotes, while always gratifying to the human mind, is not the way to decide important questions such as the superiority or inferiority of a system of health care. Only anecdotes that also illustrate statistical trends or truths are valuable in such a context.
The statistics are not favourable to the NHS, at least if one chooses reasonable standards of comparison, namely other European countries. The results are not disastrous, but they are not good either. The NHS has failed even in its egalitarian goal: the gap between the health of the richest and poorest in society has only grown under its dispensation. And yet the belief in its levelling effect persists.
The propaganda in favour of the NHS has been so successful that it now accords with the sentiments of the population, a triumph that no communist regime achieved despite herculean efforts at indoctrination. The triumph has been achieved without compulsion or violence and ought to be an interesting case for political scientists who study the successful inculcation of political mythology. Of course, the danger of such a study would be that it might induce doubt or cynicism about other political mythologies, and we all need such mythologies to live by.
Theodore Dalrymple, “Worshipping the NHS”, New English Review, 2020-05-07.
August 6, 2025
QotD: Modern English night life
Recently I stayed overnight in a charming small cathedral city in England, genteel by day and Gomorrah by night. It is a little like H.G. Wells’ story The Time Machine, set 3,000 years hence, when humanity has divided into two: the effete, gentle, vegetarian diurnal Eloi, and the ugly, vicious, carnivorous nocturnal Morlocks, who emerge from underground once the sun goes down and prey on the Eloi.
I had booked no place to stay until the last minute, and found only a room above a cavernous, darkened bar, for me an antechamber of Hell, where the Morlock youth of the cathedral city gathered to enjoy themselves — or at least to pretend to do so, for I have long thought that those who cannot enjoy themselves without shouting and screaming are really hysterics, trying to convince themselves that they are enjoying themselves when actually they do not really know how to do so.
Theodore Dalrymple, “Evening Above the Hell-Bar”, Taki’s Magazine, 2019-12-16.
August 1, 2025
QotD: The self-serving mythology of Britain’s NHS
The interesting question of why the NHS should continue to hold the affection of the British people, when it is at best mediocre in its performance and frequently unpleasant to deal with, is one that should be of interest to all political scientists. The answer is not pleasing to those who believe in human rationality.
The affection represents the triumph of rhetoric over reality. This rhetoric contains an implicit historiography, in which the pre-NHS era is akin to that of jahiliyya, the era of ignorance before the advent of Muhammad, in Islamic historiography: in short, that there was no healthcare for most of the population before the NHS. This historiography has for decades been continuously and successfully insinuated into the minds of the population. It has been Britain’s pale imitation of totalitarian propaganda. Intentionally or not, Boris Johnson recently reinforced the mythological status of the NHS. And when, in the present crisis, retired doctors such as I were asked to return to work if they were able, it was to help the NHS. This was like asking a soldier to lay down his life for the sake of the Ministry of Defence. It says something about the credulity of the public that the response to slogans like “protect the NHS” was dull compliance, rather than outraged demands as to why it wasn’t protecting us.
I suspect also that the sheer unpleasantness of the NHS is reassuring to the British population. It evokes the Dunkirk spirit: we are all stranded on the beach of illness together. And if we cannot all live in luxury, we can at least all die in squalor. Justice is served.
Theodore Dalrymple, “Empire of conformists”, The Critic, 2020-04-29.
July 24, 2025
QotD: Migrant farm workers
It is certainly true that the fruit-pickers would not be well-paid. Moreover, their accommodation during their stay would almost certainly be uncomfortable and overcrowded. The work they would do would be hard and possibly back breaking. It is certainly not the kind of work I should want to do myself, though I might have thought of it as a bit of an adventure for a couple of weeks to earn some pocket money when I was nineteen. But the Romanian workers are not coming for a bit of youthful adventure: they are coming because they are poor and need the money to live.
The fruit season is short. If the fruit is not picked, it will rot where it grows. Prices are such that farmers cannot offer high wages, and it is surely a good thing that fruit is available at a price that everyone can afford. There have been appeals to the British unemployed (in whose numbers there has been a sudden and great increase) to do the work, but they have not responded. The wages are not such as to attract them, and their economic situation would probably have to be considerably worse before the wages did attract them — and if their situation were to worsen to such an extent, they might choose crime, riot, disorder and looting rather than fruit-picking as a means of getting by economically. As for coercing the unemployed to take the work that is theoretically available to them, for example by withdrawing their social security unless they agreed to do it, the political repercussions would be too terrible to contemplate. It is easy to see in the abstract how our system of social security distorts the labour market, such that we have to import labour to perform such unskilled tasks as fruit-picking, but now is not a propitious moment at which to try radical reform. In politics as in life, you are always starting out from where you are, not from where you should have been had your past conduct been wiser or more prudent.
Theodore Dalrymple, “Contradictions of Labor”, New English Review, 2020-05-05.
Update, 26 July: Original link replaced. Link rot is sadly real.
June 30, 2025
QotD: Britons and their NHS
I have to run a gamut of procedures to do so and face a receptionist who treats me as a fraud trying to get something to which I am not entitled, and I have no practitioner whom I can call my doctor. The NHS has crowded out private competition, and the nearest private doctor is 25 miles away. Suffice it to say that, if I want to see a doctor, it is easier, quicker and more pleasant for me to go to France than to the health centre about 300 yards from my house in England.
I cannot in all honesty say, however, that my health has suffered in any measurable way as a result of this unpleasantness, because my health is good and I am not a doctor-botherer. But it does reveal something about Britain that is not true in France: in our dealings with the NHS, we are a nation of paupers who must accept what we are given by grace and favour of the system. It may be good or it may be bad, but we have to accept it.
Furthermore, under the NHS doctors themselves are becoming ever less members of a liberal profession and ever more executors of orders from on high, with little leeway to consider whether these orders are good or bad in the case of the individual case before them.
This is a problem in all systems in which a third party pays for patients’ treatment, but it is particularly acute in a highly-centralised and dirigiste system such as the NHS, in which uniformity is the goal, even if it be uniformity of error. And increasingly, it creates an atmosphere of technical, managerial and ethical conformity.
Theodore Dalrymple, “Empire of conformists”, The Critic, 2020-04-29.
