If symptoms

persist. . .

ONCE UPON a time, long, long ago, I very nearly became a vegetarian. I had read a book describing the conditions in our factory farms, and was appalled; it seemed to me thenceforth that only bar- barians could contemplate eating meat. I gave up my incipient vegetarianism, how- ever, when I failed to find the vegetarian restaurant for which I was searching, and had a hamburger instead.

I suppose this demonstrates that, unlike my patient who said he sometimes wanted to shoot everyone in his local supermarket as a reprisal for the cruelty Inflicted upon the defenceless animals whose products appeared therein, I am not really cut out for grand moral cru- sades. In this I differ also from a prison- er whom I met last week, who is currently detained on charges of armed robbery, rape and blackmail.

He was sent to me by one of the warders because he had become socially withdrawn and morose. I had a long chat with him about his circumstances: his wife had stuck by him, his parents visited regularly and he was not in debt to the drug barons. This was about as good as could be hoped for on the in; yet he was depressed and dispirited. I asked whether there was anything bothering him.

The diet, doctor, it's the diet. Can't you give me no supplements?' Now a prison is like a ship: mutinies begin with complaints about the food. Therefore, considerable effort goes into ensuring that the food in prison is ample, nourishing and palatable insofar as it is possible to cook palatably within the Home Office budget for 1,000 men. I wondered aloud how well a man with LOVE and HATE tattooed on his knuck- les ate at home.

'But I'm a vegan, doctor. I need dietary supplements.' I asked him why he was a vegan: for ethical or health reasons?

'I think it's wrong to steal eggs off chickens,' he said. 'Or to steal milk off a cow.'

'But it's all right to steal a man's prop- erty?' I asked. 'And rape his wife?' 'If he murders animals and steals what they produce,' he said.

At this point in the argument, I resort- ed to power rather than reason: I declined his request for dietary supple- ments, and suggested he alter his princi- ples.

My next patient had an aggressively jutting jaw. 'I need Valium,' he said, a little men- acingly.

'What for?' I asked.

`To calm me down. Uwerwise I'm going to explode.' He was a drug addict of many years' standing, who — on his own admission — had sniffed glue, snorted cocaine and done smack and acid. In the circum- stances, I declined to prescribe.

'You mean you want me to go out and kill a screw? Because that's what I'm going to do.'

'No, I don't want you to go out and kill a screw, but I'm not prescribing Valium for you.'

He looked at me with all the malevo- lence of the righteous.

'Is that it, then?' he asked. 'Is that it?'

Long experience has taught me that when a patient says to me, 'Is that it, then?' he is an incorrigible psychopath.

The prisoner left my room. The sound of 'fucking doctor' echoed down the cor- ridor. I recalled another is-that-it patient from years ago who leaned forward towards me and said at the end of our consultation: 'Call yourself a doctor? You're no bet- ter than a fucking vet.'

'And what,' I asked mildly, 'does that make you?'

Theodore Dalrymple