Notebook
Heart transplantation seems to have established itself as one of the most unsuccessful forms of medical treatment available. The busiest transplant surgeons in the world are those of Stanford University, California, who have performed 154 such operations since 1970. They are also the most successful. Of their 154 patients, 66 are still alive. And the University proudly claims that it offers patients a 51 per cent chance of living for three years. This pitiful boast is Presumably the envy of British surgeons, Whose record so far has been a disaster. Before last Saturday's operation, six heart transplants had been carried out in Great Britain since 1968. All six patients are dead. The patient who survived longest, Mr Frederick West, lived for little more than three months. British surgeons would, no doubt, blame this 100 per cent failure rate on lack of experience. Because the Department of Health has refused to make money available, we have, according to the Daily Telegiaph, been 'leftp behind in the transplant One shudders to contemplate the cost Of catching up: more pathetic hopes raised; more press conferences by jubilant surgeons announcing the patient's astonishing recovery, to be followed by a desperate battle to save his life; then, more often than not, an undignified death amid a blaze of Mulish publicity, What a way to go. It is inevitable that the family of a man suffering from an incurable heart ailment should wish to try any means available of saving his life, hut do doctors, on the basis of their past record, have any right to offer heart transPlantation as a cure? We are delighted, of coarse, that Mr Keith Castle has come through his operation so well and we wish fervently for his complete recovery. But ho w Can Mr Terence English, the chief transplant surgeon at Papworth Hospital, .0tind so cocky when the best he can say is, M reference to the patient who died after three months: '1 believe that we have a better than even chance of Mr Castle living longer than that'? This, it should be noted, So far prediction for a patient whose recovery o ,, far is described by the hospital as emarkable'. What would it be if his recovery were less than remarkable?
It is. holiday of a shock to return from a August on the continent in the middle of -tagust to find the tube trains crowded, the Streets of London jammed with traffic, and everybody working as if it wasn't August at !1_1, ,The month of August -at least in France l'an in Italy (where I was staying) is a IS month of truce in which a halt to the rat race called. Nobody works unless he absolutely anybody has to. Nobody takes advantage of else's indolence. The workers do not strike. Even the terrorists go to the sea. One agreeable consequence is that those who are obliged to remain behind in the cities find themselves, if a little lonely, in an atmosphere of delectable tranquility. They feel like a privileged elite. There are disadvantages, of course. The beaches are intolerably crowded. The motorways and coastal roads are shimmering serpents of motionless traffic. The petrol pumps are dry. But isn't this preferable to the continuation of the miserable grind, which makes it difficult to distinguish one .season from another? And to cap it all, Harrods in Augusthas been sending out its Christmas catalogue.
The Italians continue to appear remarkably cheerful despite troubles which are generally considered to be more grave than ours. Their response to the energy crisis and to their government's promise in Tokyo to reduce energy consumption is typical. In July they consumed 10 per cent more petrol and 26 per cent more diesel than in the same month of last year. That there will apparently be no heating fuel next winter is a matter of deep concern to the British expatriates in the chilly Tuscan hills, but nobody else seems particularly interested. The principal novelty in Italy this year is the sight of naked or semi-naked Italian women on the beaches. The Germans, the Swedes, and even some of the English have always been eager undressers, to the fascination of the natives. But the Italians have not. It is a curious development on which my friend Luigi Barzini has been making disapproving observations in the Milan newspaper Corriere della Sera. His objections are aesthetic rather than moral, and he seems to hold the view a fairly common Italian complex that blond notherners are more physically alluring than Italians and therefore more acceptable as nudists. As for the Italians, he proposes that they should only be permitted to undress in public after obtaining a `cerr tificate of beauty' renewable every year; like an MOT test. He, too, is at a loss to explain why the Italians have so abruptly lost their sense of modesty.
Buster Keaton's film The Boat, which I saw at the Academy Cinema this week, has him caught at sea in a terrible storm aboard his leaking boat the Damfino'. As the boat sinks, he gets through by morse code to a coastguard, who asks him where he is. 'Dam fino', he replies. 'Nor do 1', says the coastguard, who returns to his newspaper. The coastguard, I thought for a moment, might have been Mr Sidney Bidwell, the Labour MP for Southwell. But no, of course not. Mr Bidwell is a good and compassionate man who would be the first to come to anybody's rescue. He might, however, send you a bill afterwards. 'It was, of course, totally right,' said Mr Bidwell after tabling a question to the Chancellor of the Exchequer about the cost of the Fastnet rescue operation. 'It was, of course, totally right that rescue services should have been brought into operation to save people in this dreadful storm. But it must also be recognised that those involved are normally well-heeled, well-to-do people indulging in a fairly expensive sport for their own pleasure.' According to the Mayor of Fastnet, 'those involved' to the extent of actually losing their lives were 'almost without exception ordinary working men who were acting as crew'. Be that as it may, the idea of charging people money for being rescued from death is a novel one. There need be no limits to its application. Vietnamese boat people, mountaineers, potholers why should they not all pay up if they are found to be risking their lives for no particularly useful social purpose? In Mr Bidwell's mean little world, we would all either work or watch television. 'Oh hear us when we cry to Thee for those in peril on the sea'.
I think it is time that the disabled banded together to campaign against discrimination. Like the Jews of Nazi Germany who were obliged to wear the Star of David, the disabled or at least those in cars have to advertise their misfortune with a ridiculous, modernistic sticker which is intended, I think, to represent somebody in a wheelchair. This is disturbing for other motorists who can only speculate on the nature of the disability of the driver in front and hope that it is nothing too dangerous. Why ablebodied motorists should be intimidated in this way I do not know, because in reality nobody is, or should be, allowed to drive a car unless he is fully competent to do so. And surely some more discreet method could be found to advertise a person's exemption from parking restrictions, As if this humiliation were not enough, I have seen a lavatory in a motorway service station which describes itself as a 'Unisex Disabled Toilet'.
Alexander Chancellor
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