Re-reading Struwwelpeter

Re-reading Struwwelpeter

Our neighbour is a author, most celebrated for her books for children and young adults. She recently had discussions with her publishers about new book ideas and had been informed that they advised against discussion of death or themes of mortality in books aimed at a young audience. This rather surprised me as most of the books I read, or had read to me, when I was young were primarily concerned with the grisly fates of bad children. All the fairy tales I can remember were light on fairies and rather heavy on wolves, ogres and axemen. I recall when I was reading the “Big Book of Children’s’ Tales” to my three children that these were not fantasy stories; these were largely morality tales, heavy on judgement and often quite gruesome. I remember the kids preferred the most gruesome ones the best.

I think her publisher might have been surprised had he seen my recent purchase. Stuwwelpeter by Dr. Heinrich Hoffman. I was able to find a hardback copy of this in good condition on ebay and have thoroughly enjoyed re-reading it. Published in 1845 this was one of the earliest children’s’ picture and story books. It was written by Dr. Hoffman a psychiatrist who was disappointed by the lack of good books for children. Unable to find one suitable for his own son’s birthday present he wrote his own which was subsequently published to great, international success. This is a collection of ‘improving’ tales with clear moral messages for the young reader.

It is still the case that children’s books often have an educational aspect and often have an ethical and moral message woven through the story. When I looked at the shortlists for children’s fiction this year in Britain it was clear that the majority still had such a message. However, there was a significant difference. The books were less concerned with a range of moral dilemmas but rather focussed on a very few themes. Indeed, if nearly all of them concerned the theme of tolerance of diversity and even those concerned with mental illness, or gender identity, also took this tack.

Tolerance of diversity is very obviously a good thing and we’d wish our children to be open minded and not to be prejudiced. However, I am not sure we need to inculcate this. The scientific evidence would tend to suggest that children are intrinsically open to others and do not fear or dislike people who look different to them. It seems very likely that racists and bigots have to be made, we have to teach these sins, children are not born that way. That this theme predominates in these books probably reflects the preoccupations and concerns of the writers, publishers and buyers of these books – this is a fear of adults rather than children. Having said this even in this collection there is one cautionary tale warning children against judging people by the colour of their skin.

The ten tales in this book tackle a wide range of concerns and give a range of instructions : Don’t be cruel (to people or animals); Don’t be greedy; Be prudent and careful; Be honest and don’t lie; Listen to good advice and Always remember your actions have consequences. This is an effective moral toolbox for young children and as useful today as it was then. More importantly the stories are told in rhymes that just cry out to be read aloud and are accompanied by illustrations which wonderfully detail the stories. As I have discovered, even the oldest decrepit grandfather can become an accomplished thespian when reading these stories with the powerful rhymes and the correct hand gestures. I think you will be able to guess the hand movements that accompany this part of “The Story of Little Suck-A-Thumb”:-

The great, long, red-legg'd scissor-man.
Oh! children, see! The tailor's come
And caught out little suck-a-thumb.
Snip! Snap! Snip! the scissors go;
And Conrad cried out --- Oh! Oh! Oh!
Snip! Snap! Snip! They go so fast,
That both his thumbs are off at last.

When my daughter saw that I had this book as bedtime reading for my grandchildren, I saw a worried frown pass over her forehead. I could see a question of “Is that suitable ?” cross her mind. I reminded her that she had grown up unscathed by its effect and had developed as a mature moral individual. Then as she looked again, and saw the pictures, the memories rushed back. She could remember the stores especially the tale of ‘Henrietta and the matches ‘and particularly recalled the kittens crying for poor deceased Henrietta. She remembered also that it made her very wary of playing with fire or matches, which was largely the point.

The acid test for this book, however, was not my opinion although I did enjoy it greatly. More importantly my two young grandchildren now look forward to reading from this book and have it as their bedtime favourite. They have no awareness that it is nearly two centuries old despite the dated pictures and the clothing of the characters. To them they are simply fun stories with engaging pictures which is largely what Heinrich Hoffman called it originally.

Lustige Geschichten und drollige Bilder
mit 15 schön kolorierten Tafeln
für Kinder von 3–6 Jahren

Funny stories and whimsical pictures
with 15 beautifully coloured panels
for children aged 3–6

Perhaps current manufacturers of children’s book could have a peek at Hoffman’s book (or those by Grimm, Andersen or Aesop) and realise that children can cope with the important themes of life and are receptive to thinking about moral issues.

The Incredible Journey

The grandchildren visited this week. They came down from Scotland for a weeks mini-break during the school’s half-term. Their visits are the high point of our social calendar and something to which we really look forward. One ‘side-effect’ from these visits is that they make me feel my age. If you want to feel old then spend four days with a 7 and 9 year old. Halfway through you will remember what it was like when you had kids of your own and shortly afterwards you will wonder how you ever managed. Looking after kids is a young person’s game.

There used to be a huge beech tree here.

Their visit coincided with the visit of Storm Ciara to Wales. We had days of gale force winds and torrential rain followed by the light relief of a day of snow when we built a snowman. This gave us the opportunity to go for walks to see the results of the power of the wind, to see the uprooted and torn trees and the destroyed outbuildings. When we were able to go outside we were able to occupy the children by getting them to help us re-roof the turkey house and repair the fences around the hen runs. They really enjoyed this as they got to use real tools like a hammer and a staple gun. This was a better way to entertain the children; free, educational, and useful providing them with skills for the future and without all the noise and cost of the activity parks and play centres we often used.

We were, for long periods, unable to go outside but, sticking with a theme, we kept our spirits up by teaching new skills. The kids are aware that in Taid’s house, ‘taid’ is Welsh for grandfather, the fire and cooker don’t come on by flicking a switch. Here you need to set a fire and light it and there are different approaches for the open fire and the Rayburn.The kids really enjoyed setting a fire; making tinder out of newspapers, collecting and arranging kindling, getting logs ready and finally striking a match to start it all off. I also hope that now they know the true meaning of the word ‘tinder’ and this might inoculate them against the future definitions from their smartphones. However, there was a feeling that their grandparents were not only ‘old’ but almost ‘historical’ like something you might see on a visit to a heritage centre!

In the evenings the education was much more two-way. They taught me games I still don’t fully understand, on the Nintendo Switch and with Pokemon cards, and for the first few nights they chose the films we would watch. Two of these were surprisingly enjoyable. “Early Man” and “Abominable” were good fun tales on the themes of friendship and loss and well worth watching. The less said about “Teen Titans Go”, “Steven Universe” or “The Thundermans” the better. However, it was when I chose a film that I felt extremely old and began to see some of the differences in the culture my grandchildren inhabit and mine.

Less tears than Old Yeller

I chose “The Incredible Journey” having recollections that I enjoyed this film when I was their age. As we started watching, for the first quarter of an hour, it was clear this this was not holding their attention. There were no effects, no action, and not even any talking animals and I noticed that the kids were giving as much time to the screens on their laps as to the television itself. They thought they were much wiser than I was at their age, they knew that the animals would not die “they never do in films”. I forbore from telling them the fate of Bambi’s mother or that of “Old Yeller” . As the film progressed they decided that it must be all CGI as animals “can’t act”. They refused to consider that they may be real animals handled by wranglers. I guess that the rabbit, that Luath chased, might have hoped that the kids were right and he had had a CGI stand-in stunt rabbit. However, once they started to believe that these were actual dogs and a cat they started to be more interested in their actions.It seems you have to think something is real before you will truly care for it.

By halfway through the kids had been captured by the story. Having seen the bird and rabbit eaten they now knew that sometimes animals don’t make it through. They had started to worry about the trio of animals fate, and they started to think perhaps they wouldn’t get home. By the end they were on tenterhooks and when the last of the trio, Bodger, came over the hill in the final scene there were gasps of relief and joy.

Chatting afterwards about the film it was clear that the themes of friendship, loyalty and perseverance had been taken on board. It was touch and go at the start and if I hadn’t insisted I don’t think they would have persevered with the film. A good story, wonderful photography and landscapes and good acting seem no longer enough for a film to succeed with an audience of children. Like our food, our books, our music and so much of our culture we now need high intensity, easily digestible pap. This does not bode well for our future.

Next time they arrive, and it is my turn to choose, it will be “Old Yeller” we will watch. The simple tale of the love of a boy and his dog will be perfect. I hope that I’ll be able to avoid crying at the end. I’ll be rather depressed, disappointed and worried if, however, the kids don’t cry.

Weather back to normal

Serendipitous Arboreal Knowledge

You never know when good luck will find you. This week it appeared when I was standing aimlessly in the charity shop while my wife was looking at curtains. There seemed to be an enormous amount of inspection required to check these window hanging and my spirits were beginning to flag. I thought I had checked all the possible wares on display that might interest me. But I was wrong. Hiding in amongst all the paperbacks, concealed between the Lee Childs and the Judy Picoult’s, was a little gem : “Trees: Shown to Children” by C.E. Smith.

This little book, probably published around 1910 as far as I can determine, was one of the “Shown to children series”; a series of short educational works for children. Other works concerned ‘Beasts’, ‘The Seashore’ and ‘The Farm’. It is a simple book; each chapter is the description of a tree and these are accompanied by 32 colour pictures (by Janet Harvey Kelman) of the tree, its leaves, flowers and nuts.

The descriptions are wonderfully vivid and really make it very easy to identify tree types. The descriptions are followed by detailed information about the tree’s life cycle, its place in the local ecology and the uses of its produce and timber. Consider a little of description of the aspen below :-

But you will always know an Aspen tree by its leaves. These are never still unless when a storm is brooding and the air is perfectly calm; at all other times they shake and quiver incessantly, and you can hear the gentle rustle they make as each leaf rubs against its neighbour. In the Scottish Highlands the country people tell you that the Aspen trembles because at the Crucifixion the cross of Christ was made of Aspen, and the tree must always shudder at the cruel purpose it served.

In addition to evocative portrayals of the trees there are also passages which promote an interest and sympathy with nature. Any child (even one in his 60’s like me) will find pleasure from reading this.

And do you remember what secrets the trees told us as we lay under their shady branches on the hot midsummer days, while the leaves danced and flickered against the blue, blue sky? Can you tell what was the charm that held us like a dream in the falling dusk as we watched their heavy masses grow dark and gloomy against the silvery twilight sky ?

He had learned that the mystery of tree life is one with the mystery that underlies our own; that we share ths mystery with the sea, and the sun, and the stars,and that by this mystery of life the whole world is “bound with gold chains” of love “about the feet of God”

I hope I am wrong but I fear that books like this, heavy with information and lacking in action and adventure, will be found to be less interesting to young readers today. I have, instead, to hope that google and the internet will kindle their interest in the natural world and start them on their journey outside to look at the beauty of the world around them.

In any event, the child in me really enjoyed being shown these trees and this has certainly been the best 50p I have spent in a long time. I will certainly keep my eyes peeled for the other books in the series. And, as a further stroke of good fortune, my wife didn’t buy the curtains in the long run)

In Loco Parentis – the terrifying tale of Charlie Gard

In Loco Parentis – the terrifying tale of Charlie Gard

As a doctor I have found the unfolding tragedy befalling Charlie Gard and his family extremely upsetting to follow.  This poor boy and his family are butterflies being crushed on a wheel to press home a legal point, they are unfortunates being punished having committed no crime.

Let us firstly be clear what this case is not about. Despite protestations to the contrary this case is not about the best interests of Charlie Gard. The best interests of the child (1)  are clearly important and made paramount both in the UN Convention of the Rights of the Child (2) and in British Law with the Children Act of 1989 (3) . It is clear that all the parties involved in this debate are acting because they have the best interests of Charlie at heart. The doctors and hospital feel that they, by virtue of their knowledge, know what is best to do. His parents, through love and affection, also believe that they can see the best plan and hope for their son. Both are acting in the best interests of Charlie, this is not the problem. The problem is who decides what exactly are Charlie’s  best interests.

It has always been the case that the parents of the child decide what is in the best interest of the child. This is as it should be as it reflects the natural law and ensures that the people most attached to the child’s interest are those who act as the child’s guardian. There are very few circumstances when this can be changed and they depend upon proving that the parent is being either negligent or malevolent. Neither of these factors are in play here and, if anything, the parents have taken extraordinary steps to secure chances for their child, well over and above what many parents would have been able to do.

It is interesting that, at the 24th hour, Great Ormond Street Hospital has made an application to court to revise its plans (4) possibly starting to realise that the parents’ opinion may have been closer to Charlie’s best interests, than had their own opinion been. So in this difficult calculus of what is the best plan of action it appears that Charlie’s parents may have been the better judge all along.

While these arguments over the ‘best interests’ may mean that the parent disagrees with the medical team it does not mean that the parent can compel a doctor to do something they feel is inappropriate or wrong. But again this is not the case in this situation. Charlie’s parents have never asked GOSH or the NHS to undertake treatments they do no agree with. They have gathered together sufficient resources to enable Charlie to receive this treatment by doctors who believe it is, worth a trial, in the child’s interests. This should have been the end of the dispute. Charlie and his parents should have used their money to go and try this last ditch attempt, to catch this glimmer of hope.

GOSH and its staff, however, stopped this. Their court battle stopped the treatment and refused the parents the ability to move their child. In their paternalism they not only refused to help but also stopped anyone else helping. The thousands of people who collected money to help Charlie were thwarted by this as well as Charlie’s parents and the other hospitals and doctors who wanted to help.

I am a very old-fashioned doctor and I don’t fear paternalism per se. A desire to act like a father, is a a desire to be benevolent, guiding, helpful and wise. In itself not a bad thing. It becomes bad when it belittles another party and reduces their agency. When doctors worked in a professional relationship with their patients, the doctor’s paternalism would drive them to seek the best for their patient and was usually leavened by respect for the patient’s autonomy. This combination could be valuable when there were difficult scenarios – when the future was unpredictable and  the efficacy of plans of action difficult to assess. Much of the placebo effect of medical intervention depends on this aspect of the relationship and large parts of the benefit of of healthcare comes from this caring, guiding, advisory aspect of medical care.

There was always one very good safeguard against this paternalism becoming intrusive or  belittling, when the relationship was between doctor and patient, the patient could always terminate the relationship. If they felt that the doctor’s approach was wrong they had no need to continue to use them. This was a way to safeguard the patient and also a way in which the doctor would know that they had overstepped the boundaries and they could learn where paternalism started to erode patient autonomy. But in the NHS this is difficult. The patient can’t change their doctor without a great deal of difficulty. If they change they will probably be labelled a “difficult patient” which might mar relations with their next medical practitioner.

In addition, under the NHS the patient is no longer the employer of the doctor in the UK. The most important relationship for the doctor is the one with his employer – the state, the NHS – not the the patient directly. It is the state who pays his wages, sets his targets and assesses his performance and we know “he who pays the piper calls the tune“. In this scenario paternalism is largely unchecked and can be very dangerous. Paternalism, appearing kindly and wise, can mask actions that are not in an individual patient’s best interest. Rationing and refusal of therapy is hidden as medical advice and choices are withdrawn from the patient. Doctors often find, when working in the NHS, that their attempts to maintain professional standards and a focus on their relationship with the patient can cause them difficulties. They are made to feel as if they are being disruptive when they call for what is appropriate for the patient. They can be told they are jeopardising the budgets, failing to be a team player by not following the organisation’s line, and generally made to feel awkward if they behave in a manner that was formed by their vocation and training.

In this case paternalism seems to be being employed to sweeten a bitter pill. The state wants to end Charlie Gard’s life before all options that are available have been tried. Despite having seen parents act heroically and selflessly for their child, without an ounce of malice, they would prefer Charlie died rather than allowing the parents to try all they can do. But rather than admit this we are told that they are the wise and kindly people who know what they are doing, we are awkward and unruly children causing a fuss.

Well thank God for the fuss that Charlie’s parents have made;  it may not save Charlie but they will have opened the eyes of many people and might save future families from the horror that they have had to endure. They truly are a heroic family who deserve our support (5)

 

 

 

 


[1] https://en.wikipedia.org/wiki/Best_interests

[2] https://en.wikipedia.org/wiki/Convention_on_the_Rights_of_the_Child

[3] https://www.publications.parliament.uk/pa/cm201012/cmselect/cmjust/518/51807.htm

[4] http://www.telegraph.co.uk/news/2017/07/07/hope-charlie-gard-great-ormond-street-seeks-explore-new-evidence/

[5] http://www.charliesfight.org/