This book details Bloodworth’s experiences as he tours through various low paid jobs in England. He starts working in an Amazon warehouse in the Midlands where he works as a ‘picker’ with a GPS tracker and under near constant surveillance. The work is gruelling, walking many miles per day. It’s also apparent that there are few employment rights. The workers are issued with ‘strikes’ for minor offences, even being off sick for genuine reasons, and once they reach six they are sacked. It is mostly staffed by European immigrants. Few can stick it for any length of time.

Then he comes to Blackpool to work as a carer for CareWatch. Again, it’s incredibly low paid work and exhausting with unreasonable demands and little training. Next down to South Wales where he spends time working in a call centre for Admiral, speaking to people in the old mining communities that no longer exist. He comes back to London to do a spell as an Uber driver.

This is Orwell’s The Road to Wigan Pier for the 21st century and the gig economy. Bloodworth doesn’t spare any time in gouging the myth of ‘be your own boss’. It almost feels like it is verging on some Orwellian pastiche in its descriptions, especially when he lingers on the descriptions of the accommodation and the hard scrabble lives of people in low quality accommodation and gig economy wages. Like Orwell, he is scrupulous about the money, offering detailed figures on the incomings and outgoings. The reality of how much one can earn and how the costs of daily living soon fritter it away. The outsourcing of work to agencies adds to this pressure with pay often being late, or wrong. And, of course, when it is wrong people are underpaid.

Bloodworth doesn’t spend much time dwelling on the health implications but there is an interesting digression into this during his time working for Amazon. Despite the physical element to the work he puts on weight and feels unhealthy. His accommodation makes it hard to cook and he slips into comfort eating at McDonalds, drinking beer regularly (though probably not beyond recommended limits), and smoking. I’d also be willing to wager that the areas of the towns in which he stayed there is a high density of takeaways outlets, fried chicken shops etc. They will be particularly obesogenic. I’m reminded of the idea of the all-consuming cognitive bandwidth toll that this poverty places on people.

People don’t like migration in the general but in the specific they are usually unfussed. They fret about migrants taking their jobs, taking benefits, clogging up the NHS but only when they don’t link this to the people they know. Those ones are usually regarded as perfectly OK, somehow the exception to the rule. They are no longer part of the out-group, they are the in-group, and people will perform cognitive contortions to make this work. This is something we all do as humans, it’s not some special quality of people in poverty. We all carry that bias with us all the time.

Hired is not a cosy read and it’s an uncomfortable insight into the hardship of hard-working people trapped in work environments without rights and with very few options.

In a sense there is a mythologising of Colvin that occurred during her lifetime and has certainly intensified since her death. Her website° states she was “the greatest war correspondent of her generation” and pays tribute to her achievements. That’s understandable and it doesn’t dwell on any moments of personal unhappiness or any self-destructive behaviour that brought those plaudits. We have to celebrate her work and life but did it have to come at such an appalling cost to the individual? Is being the greatest war correspondent about being the person who runs the biggest risks?

Hilsum does a very good job of presenting the facts and we’re left to fill in the gaps. Her admiration and love for Colvin shines through but this is no hagiography; Colvin’s flaws are left open for examination. There has clearly been much introspection about the role of the war correspondent in past years but this book should certainly generate plenty of discussion amongst journalists. I would hope that this is a topic that is debated regularly. How close must one be to “bear witness”? From my perspective, as a doctor involved with vulnerable people, it’s difficult not to listen to this book and be appalled at the pathology on display.

We need to talk about alcohol. Early in the book it’s very apparent from Hilsum’s descriptions that Colvin was using alcohol spectacularly. She offers descriptions of Colvin being drunk at key moments, not filing copy in time, flouting the advice of editors and bosses. It made me wince to listen to someone who seemed to need help and was often desperately unhappy. It all rather depends where one let’s one lens fall — Colvin had more moments of joy and intense pleasure than most people can imagine. Yet, there is a lingering note of regret here.

I listened to the audiobook and it was narrated by the author, Lindsey Hilsum. This always makes me nervous. Hilsum has written a very fine book but the qualities of professional narrators aren’t to be under-estimated. In the end, it works out just fine, if lacking some of the seamless qualities of the top narrators, but the hint of an American accent when Hilsum reads quotes from Colvin made me twitch a little.

The thought that kept running through my head was how Colvin was allowed to go back time and time again. It’s not as if Colvin was a model professional when not overseas; the impression I was left with was that she was drowning rather than waving. I found it difficult to conceive how any reasonable employer could send a person with serious mental health problems and severe PTSD back to a conflict zone. Repeatedly. Times change and I’ve no doubt that much of this stems from Colvin’s forceful personality but, in terms of duty of care, it feels hard to defend. Hilsum does cover this a little at the end: “There are those who blamed her editors for her death. She should have been taken off the road years ago, they said.”

Much of this biography is taken up with the personal details of Colvin’s life and that, to me, felt important. The reporting from war zones is punctuated by her rather jet-setting, somewhat hedonistic lifestyle, and Hilsum makes extensive use of Colvin’s diaries to flesh out Colvin’s emotional state. Colvin was a passionate, if not always objective, witness to many horrors but Hilsum offers a more rounded picture than the image of the journalist-warrior striding across the landscape in search of truth. It’s compelling and inspirational but it’s tinged with sadness.

This is another book that feels like it doesn’t have a name that entirely reflects the content and is just a little too click-baity but that shouldn’t stand in the way of what is a very lively and informative read. Hardman does cover a lot of ground and it’s a largely sympathetic portrayal of our politicians. Quite rightly, it doesn’t hold back from criticising them when needed — particularly when considering sexual harassment within the establishment. Hardman has been a political journalist for many years and she is exposing the systemic problems rather than taking a tilt at the individuals.

Initially, Hardman ventures back into the shocking selection processes to which all the parties subject prospective candidates. The financial and personal costs are hugely punitive with little chance of success in even the best circumstances. These go a long way to explaining why we get the ‘wrong politicians’. They are arduous and damaging to the individuals. Inevitably, that selection pressure will have an impact on those that do make it through.

The book is also very good at pulling back the parliamentary curtain and covering the processes of the Commons and Lords for primary and secondary legislation. The functioning of the chambers along with the role of select committees are detailed and how MPs can interact with these. Hardman uses this to expose how little time MPs, our supposed legislators, get to spend doing the job one might think they are in Parliament to do: scrutinising and refining existing and new laws. Hardman makes it clear just how the system is stacked against any tendency to voice an opinion. Any attempt to do so will quickly result in career-ending confrontations with their party.

And, if you are ever thinking of standing for parliament she details the stresses, the god-awful hours and the abuse that MPs receive. It is dismal. You may have little sympathy, and goodness knows there are plenty of villains and rogues, but it serves no useful purpose to have a system that is so very dysfunctional. We have enough difficulties with disproportionate representation as it is but, as ever, it seems that money and privilege are crucial to selection and survival as an MP. I don’t know if it was Hardman’s intention but she ends up presenting a compelling case for reforms at all levels.

I have, rather belatedly, given the 2020 list will likely appear next month, embarked on a small project to read, reflect, and write about all the books on the Orwell Long List from 2019. There are 15 of them and I will add links and (ticks) as I get through them. They are tagged ‘Orwell Long List 2019’ as well.

• Why We Get the Wrong Politicians by Isabel Hardman° ✅
• The Growth Delusion: The Wealth and Well-Being of Nations by David Pilling° ✅
• Hired: Six Months Undercover in Low-Wage Britain by James Bloodworth° ✅
• American Overdose: The Opioid Tragedy in Three Acts by Chris McGreal° ✅
• In Extremis: The Life of War Correspondent Marie Colvin by Lindsey Hilsum° ✅
• The People Vs Tech: How the internet is killing democracy (and how we save it) by Jamie Bartlett ✅
• Moneyland: Why Thieves And Crooks Now Rule The World And How To Take It Back by Oliver Bullough ✅
• Natives: Race and Class in the Ruins of Empire by Akala
• The Line Becomes A River by Francisco Cantú ✅
• A Certain Idea of France: The Life of Charles de Gaulle by Julian Jackson
• Bad Girls: A History of Rebels and Renegades by Caitlin Davies
• Nightmarch: Among India’s Revolutionary Guerrillas by Alpa Shah
• Our Boys: The Story of a Paratrooper by Helen Parr
• Say Nothing: A True Story of Murder and Memory in Northern Ireland by Patrick Radden Keefe ✅
• Heimat: A German Family Album by Nora Krug ✅

A quiet month here on the blog, especially notable when the last post was January’s reading list… I’ve been busy enough reading and here are the books for the past month:

• Watching the Door: A Memoir 1971-78 by Kevin Myers
• Pills, Powder, and Smoke by Antony Loewenstein
• How to Have Impossible Conversations by Peter Boghossian and James Lindsay
• Still You Sleep by Kate Vane°
• The Socialist Manifesto by Bhaskar Sunkara
• Rose’s Strategy of Preventive Medicine by Geoffrey Rose
• Utopia for Realists by Rutger Bregman
• Mindf*ck by Christopher Wylie
• Why We’re Polarized by Ezra Klein
• The Growth Delusion by David Pilling

I’d have to say that my top recommendation from this month would almost certainly have to be _Mindf*ck_ by Wylie. The importance of the Cambridge Analytica story can’t be under-estimated and I’m very relieved to have stepped back from Facebook et al. Watching the Door was remarkable. I learned plenty from Impossible Conversations, though I don’t think the format is ideal for audiobook as it would be better to absorb the book over a longer period. Bregman was excellent and thought-provoking and Klein’s Why We’re Polarized opened up another window to see our current political landscape. If you are a fan of Ha-Joon Chang (I am) then Pilling’s The Growth Delusion is similarly excellent and you’ll never listen to broadcasters talk about GDP again without shouting at the television or radio.

Nothing too complicated about this. Here are the books I’ve got through in January 2020. As usual there is a mix of audiobooks, ebooks, and good old fashioned hardcopy.

• Bad Samaritans by Ha-Joon Chang°
• The Road to Wigan Pier by George Orwell
• On Immunity: an Innoculation by Eula Bliss°
• The Ascent of Nanda Devi by HW Tilman°
• Catch and Kill by Ronan Farrow°
• Essayism by Brian Dillon
• You Are What You Read by Jodie Jackson
• The Red Market by Scott Carney
• Narconomics by Tom Wainwright°
• Beast by Matt Wesolowski°

I’ve provided some links above when I’ve written something about them. I don’t use Amazon or affiliate links so click away with impunity. These span some seriously varied genres so it is hard to nominate a favourite. As a general rule, the ones I write about are usually the ones that have had most impact. The book I’ve found myself recommending the most and talking about has been Narconomics. I was shocked by Catch and Kill and I loved reading Tilman again after many years away from him. I think I would read a shopping list if it was written in Chang’s wonderfully accessible style and Bliss’s book was instructive in showing how science can be written with a wonderfully human, sidelong gaze.

Narconomics has been on my reading list for a long time now and I’m sorry I didn’t get to it sooner. It’s a sharp analysis, informed and informative, and I took a tremendous amount away from it. It reinforced some important points around the global drug market. Wainwright covers in some detail° the expense and largely futile policing of the drugs trade. In an early example, he takes us through the economics of destroying large amounts of the coca crop and how this has almost no impact on the final price for the consumer. Until then the policy of destroying the source of the drug seems to be entirely logical yet Wainwright dismantles it so comprehensively you are left wondering how you ever believed it in the first place.

The concept of the hard drugs market as being relatively inelastic is an important one. Reductions in supply don’t necessarily shift demand. Attacking the supply-side of the industry has very little impact, particularly in early links of the chain. Interestingly, one of the biggest changes in heroin use, in one case study, was the large-scale adoption of heroin assisted treatment in Switzerland. In effect, it reduced the market, but it also took out the low-level dealers with dramatic reductions in overall usage.

It is also worth reiterating an important point about the drugs debate. It is important to acknowledge the difference between decriminalisation and legalisation. The countries where drugs are used (UK, USA etc) are keen to lay the blame for the problem on the supply side with Johnny Foreigner. We need to be mindful that a half-baked decriminalisation could result in unintended consequences. It will not necessarily have the same effect as full legalisation and regulation. The murders, the deaths, and all the misery inflicted through the organised crime networks that supply the drugs may continue depending on the exact nature of the changes. Decriminalisation may work for the drug-consuming rich nations while entrenching violence and poverty in the drug producing and transit countries.

The move towards cannabis legalisation continues. Wainwright also explores this using economic principles and the often complex, not always intuitive, impact it can have on drug markets. There is a fascinating opportunity with legal cannabis production to ensure it is socially just. Handing over the industry and the profits to corporate regimes would be a mistake - try this article in The Correspondent° for more on empowering people through Big Marijuana.

Harvey Weinstein is appearing on television regularly as his trial continues. He looks broken and frail, a shell of a man, but I find it easy to harden my heart and watch, with grim satisfaction, some semblance of the justice process playing out. Before reading this, I understood the gist of the story but I hadn’t read exhaustive accounts in the mainstream media. In Catch and Kill°, Farrow lays it all down for inspection.

In some ways, the pictures of Weinstein now remind me of a few hard men I met when doing prison medicine. Only they weren’t hard men any more. They were weakened, spent, and preyed upon. They had meted out some violence in their time and were now, in their turn, feeling the threat. The difference is that Weinstein is facing appropriate legal actions and not some extra-judicial beating. And perhaps my biggest emotion when seeing Weinstein looking so elderly is one of regret. It has taken too many years and too many victims to get to this stage.

Catch and Kill portrays Weinstein as a predator and a man who deserves to face the full weight of the justice system pressing down on him. The book grimly details Weinstein’s modus operandi and Farrow’s dogged, if not plain obsessive, pursuit of the story. Farrow’s descriptions of the establishment, “the great white predators”°, closing ranks is enough to make you retch. Farrow also records in the book how he was trailed and investigated by a shadowy Israeli security company, a “private Mossad”, employed by Weinstein. NBC do not come out of it well. Actually, very few do. Perhaps only the women who went through it and the ones who were able to steel themselves to resist, to tell their story. And, Farrow as well, he certainly went through the wringer.

One small point, but it needs to be mentioned. I listened to the audiobooks and I have no idea what the producers were thinking of in letting Farrow do the accents. You will read many reviews commenting on it. The only thing I can say is that they did, as the book went on, grate less and less, and the story is too compelling, too astonishing, to even consider sacking it. Don’t let it stop you reading this important book.

There are few figures in the 20th century with as remarkable a story as HW Tilman.° He will be well known to anybody who has spent time working through any of the rich literature we enjoy on mountains and exploration. Inevitably, it won’t be long before your attention is drawn to the books of Tilman and his co-explorer Eric Shipton.° They are a justly famous pairing, though less celebrated beyond adventurer circles, whether armchair or active. I was going to write ‘sadly’ there, but given the style in which they went about their lives, there seems little to regret.

I remember, with great excitement, when the seven collected mountaineering exploration books by Tillman were published in the 1990s. The larger volume still sits on my bookshelf but the very size of it does somewhat restrict its use. As handsome a volume as it is, it’s not easy carting around 900-odd pages worth of hardback book.

I was delighted to discover that the Tilman (and Shipton) books have now been made available as individual volumes and also as e-books. So, I was able to enjoy The Ascent of Nanda Devi (1937) on my Kindle. I can scarcely add to the fine words that have been written about Tilman. He has a thoroughly laconic style, much imitated by would-be literary mountaineers, and famous enough in the 1950s to have helped inspire the parody, The Ascent of Rum Doodle.°

On the front of the new book it states: “I believe we so far forgot ourselves to shake hands on it” quoting Tilman’s self-parodying line on reaching the summit. It’s a delight.

My Debrief for the January 2020 issue is available on the BJGP website.° It was an odd one to write and it already feels like a long time ago. The lag with monthly publication always leaves me slightly disorientated when articles are published. I’m working ahead and, suddenly, something written many weeks in the past bobs back up. This one was particularly unusual as I wrote it in the feverish week before the general election and it was published a couple of weeks after.

I was determined to write something political but I didn’t want, with this particular article, to be overtly partisan. Not that I have a problem with that. I don’t think you’d have to dig too far back into my writings to determine where my loyalties lie but I figured the timing was critical here. I hesitate to invoke the imagery of a party to characterise the election campaign but further comment in the BJGP might have been about as welcome as being offered the previous night’s leftover cold kebab while nursing a brutal hangover. All that said, there has been an interesting reaction to it and it seems to have struck a note with a few people.

For those of the left-leaning persuasion, it’s tremendously easy to lurch into apathy, if not outright despair. Personally, I plan to find ways to dig in and get more involved. The responses I’ve had suggest I’m certainly not alone. Get in touch if you want to talk about it.