If symptoms

persist . . .

IN THE labour ward of our hospital, young women don't give birth to little boys or little girls: they give birth to social problems. Male social problems are des- tined for prison; female for mental hos- pital.

From the moment of birth, the jugger- naut of compassion rolls; social workers, health visitors and district nurses are alerted and — to change the metaphor slightly — descend on the infant's house- hold like vultures on a carcass. It is an ill wind that blows nobody any work. But destiny is not to be denied by all the machinations of the social services.

Last week, I talked to a mother-to-be on the ward, her pregnancy recently diagnosed. In our neck of the woods, it is considered indelicate to ask who the father is: it is taken as an accusation, not a question. Nevertheless, in this case I ventured to ask it because the girl (she was only 18) seemed so young and vulnerable.

'And who,' I asked, adopting my equivalent of Mrs Thatcher's interview- compassionate tone of voice, is the father?'

'My brother,' she replied, with a pertly triumphant expression on her face, the kind of expression adolescents have when they know they are shocking their elders.

I admit I was taken aback. Thoughts of ancient Egypt swirled through my mind. All medical textbooks that deal with the subject mention pharaonic incest, and we know the disastrous effects it had: Egyp- tian civilisation lasted only 3,000 years. On the other hand, of course, it is probable that the Pharaoh's social cir- cumstances were rather different from my patient's. He didn't have to live on £37.22 per week from what is known locally as the Unemployment; and he had soothsayers instead of social workers.

What, then, was I to do? Naturally, I assumed that the baby was unwanted: round here, the vast majority of them are.

'What are your plans?' I asked, the names of gynaecologists who might per- form the necessary operation running through my head.

'I want to keep it,' she replied. 'I don't agree with abortion.'

You could have knocked me down with a surgeon's glove. However, it is part of the doctor's aura of infallibility never to appear surprised or shocked by what a patient says to him.

'My brother didn't force me,' she continued. 'I'm as much to blame as him. It was different with my father.'

'Different with your father?' I repe- ated, adding the interrogative inflection.

'Yes, he forced himself on me from when I was eight.'

I am afraid that at this point a rather frivolous question came to the forefront of my mind. Would the offspring of the illicit liaison call his or her father Uncle or Dad? The question kept at bay my feeling of utter despondency.

But whether the offspring be a daughter-niece or son-nephew, we stand prepared. One one side of our hospital is a mental hospital, a Victorian cathedral of madness. On the other is a prison, a Victorian castle for the undeserving poor. Not all the doctors, nurses and social workers can prevent the denouement of this little story.

Theodore Dalrymple