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Perspectives
In brief
362 www.thelancet.com Vol 369 February 3, 2007
about health should be primarily directed: patients and the public.
I don’t agree with Richard’s conclusion that journals are corrupt, that we are too fond of the mass media, that we are overinfl uenced by the pharmaceutical industry, that we are neglectful of patients, and that the studies we publish are “increasingly” found to be fraudulent. I think that journals, at their best (and, Richard, were we not always striving to be at our best?), are acutely sensitive to those who lack voice, to the manipulations of mammon and media, and to the need to be vigilant about research integrity.
Journals can change the world for the better. Almost every day I meet or talk with physicians and scientists who want to make this planet a safer, healthier, and more sustainable place not only for themselves but for others
and for future generations. I recognise the same risks as you do Richard. But I don’t feel defeated by them. I feel inspired by a community of medicine that, at its heart, is committed to a professionalism that puts the patient fi rst, that fi ghts against forces that undermine the values of medicine, and that puts science in the service of human compassion.
Since Richard left the BMJ, the journal has been redesigned and relaunched under the leadership of a new editorial team. The new look and feel of the BMJ refl ects a generational change—and it is an impressive revision of the journal’s purpose and personality, one that deserves applause. The BMJ is now more a lively magazine than a sombre journal, more nationally focused than globally diff use, more news and features led than research and science
responsive, more interested in primary care than trying to appeal to all types of care, more online than print.
Richard used to say that the BMJ was in the debate (not the truth) business. That mantra has been fi rmly discarded. The BMJ’s tag-line today is “helping doctors make better decisions”. Richard saw the journal as a place to mediate an intellectual ferment. His successors see the BMJ as a locus for collegial support. At a time when the profession in the UK feels unloved and under threat, that more pacifying approach may be sound. For now. But don’t rule out a comeback for Richard Smith. Journals need colour. And he was a bright and vital rainbow of surprise, optimism, and revolt.
Richard [email protected]
Exhibition Paranoid visions“You are cautiously invited to the opening of paranoia”, read the exhibition invitation. Walking up the garden path towards the house in Hampstead, London, where Sigmund Freud spent the last year of his life, three crudely lettered signs—”NO ENTRY”, “KEEP OUT”, and “NO TRAVELLERS”—could have been intended to halt the faint-hearted in mid-stride.
Inside, all was confusion with a large-screen video projection accompanied by a soundtrack of loud music in the normally hushed entry hall; and a throng of people, including several performance artists, crammed into the other rooms. The highly chaotic form of this exhibition is evidently a major part of its content, challenging spectators to sort what is real from what is distorted. “The exhibition presents the essence of paranoia as the deluded interpretation of
events, not the perception of the events themselves”, says the show’s curator Predrag Pajdic. Indeed, the 42 international artists whose work is displayed in Paranoia seem to have found a spiritual home.
A bearded man in traditional white Muslim dress sat impassively in the dining room, with downcast eyes and outstretched fi ngers resting on his knees, on a utilitarian chair in the middle of a wire sheep pen. Did he evoke a terrorist detainee or a lamb for ritual slaughter? On the half-landing, two bearded men, one dressed as an Orthodox Jew and the other as a Muslim, off ered simultaneous right-hand and left-hand massages, seated on either side of rather self-conscious guests trying to project bravado. A little later, the men had swapped sides. Perhaps this was intended to refl ect the shifting political stances in the Middle East or to suggest that the two sides
had more in common that is usually acknowledged? Three women in traditional Muslim black dress and veils went from room to room, moving as one in a beautifully choreographed sequence, alternately swooping forward in unison to peer intently at exhibits and leaning back abruptly. Were they aesthetically gratifi ed or recoiling in horror from decadent western art?
As might have been anticipated, the single work that resonated the clearest meaning was displayed on a table in Freud’s study and library. A folio book, Die Welt in Der Wir Leben, struck through by a double-edged axe provided an unequivocal and powerful visual analogy for the seismic fracture that occurred on Sept 11, 2001; and heightened global paranoia irreversibly.
Colin [email protected]
ParanoiaAn exhibition at The Freud
Museum, London, UK, until March 11, 2007.
See http://www.aionarap.com
