There’s nowhere quite like the North East of England, and nothing quite like living within walking distance of the quayside.

Published in 2022, this is a brief history of sixteen cathedrals. I decided to read it after seeing a review in The Spectator. As I’ve previously reflected, one of the major things the book made me consider was that—at least traditionally—cathedrals have had functions which span way beyond the sacred. As Wells puts it,

Between them, the cathedrals featured tell a narrative faith, intellectual culture, art, politics and economy.

In her introduction, Wells drew a comparison between buildings and books:

We can argue, quite plausibly, then, that buildings are books without words—and through their stones the dead may speak.

What I failed to realise before embarking on this tome is that while buildings may be books without words, I’m not necessarily all that interested in what they have to say. Most of this book was detailed histories of buildings with which I have no particular relationship. Therefore, while I’m sure these histories represent years of detailed research, if I’m honest, I found it all a bit dull. However, it did still give me some tangetial food for thought. This was, in part, because this isn’t normally the sort of thing I read.

Wells has a short section about the devastating fire at Norte-Dame de Paris in 2019. In the context of the histories of these 16 cathedrals, a devastating fire does not stand out at all: nearly all of them have suffered over the years. However, the response to the fire—to replicate and rebuild as closely as possible to what went before—is truly exceptional. In the history of these grand historic buildings, fires have generally been followed by modifications befitting the social and architectural mores of the time. This trend is also true of the York Minster fire of 1984, also briefly covered in the Wells’s book.

I remember feeling a tinge of disappointment when President Macron announced the plan to rebuild exactly what was destroyed. The announcement came after fevered speculation about possible new additions, and it felt a little dull. It wasn’t until I read this book that I also reflected on how historically anomalous it was.

I was reading earlier this year about an inspired campaign to introduce a new Grade III listing for buildings on ecological grounds: “The status would apply automatically to every building and it would come with just one rule: the property may only be demolished if it is structurally unsafe, or is given special dispensation by the local planning authority.”

It strikes me that preserving old building often means modernising them, not dunking them in aspic. And I think that’s what Wells made me reflect on most. Cathedrals were once ever-changing hubs of both religious and secular activity, adapting to serve society as the world changed. These days, they typically feel frozen in time, suspended in antiquity, serving more as curiosities than as community hubs.

Given the opportunity to redefine one of the world’s greatest Cathedrals for the 21st century, with a dash of modern relevant architectural flair, society shrugged its shoulders and said, “put it back like it was before.”

And maybe that means Cathedrals are over.

Thank you to the London Library for letting me borrow this book.

Further to previous on cathedrals, my brother was agog to learn that, despite living in Newcastle for 15 years, Wendy and I have entered none of its three cathedrals.

I set out to resolve this by visiting the Cathedral Church of St Nicholas, which seems to have rather cheekily rebranded itself as Newcastle Cathedral. I wonder how the other two feel about that.

Regrettably, despite attending at a time when both the website and the sign on the door declared the building to be open to visitors, the door was firmly closed. So I still haven’t been in any of the three Cathedrals.

I have, however, followed what is possibly the world’s shortest ‘heritage trail’ outside the building, which took all of 45 seconds, and gazed upon Newcastle’s celebrated vampire rabbit, pictured above.

Better luck next time, I suppose.

Surrealist art tends to be the sort of thing I like, the sort of art that I wish I could take home. There’s something about its playfulness and inventiveness always makes me think a little differently, provoking reflection and contemplation in a way that other art sometimes doesn’t.

I don’t know very much about art or the history of art. I never studied it, and it’s not something that has cropped up in much of my reading. Nor is it something I’ve really sought to read about. But I do enjoy a good exhibition. And to my mind, this collection of surrealist art at London’s Design Museum constituted an excellent exhibition.

There were five objects that especially stood out to me: none of the pictures of these are my own, they are all outrageously stolen from various museum websites.

This is Salvador Dalí’s Lobster Telephone, the archetypical surrealist object and the hero image used in most of the advertising for this exhibition. In the exhibition, it is presented alongside examples of Dalí’s Mae West Lips Sofa and Champagne Standard Lamp in a mock living room.

The telephone stood out to me as an object I’d previously seen and which raised a smile, but whose meaning I hadn’t grasped (or really considered) until it was presented in this exhibition. I hadn’t appreciated that Dalí considered both the lobster and the telephone to be inherently sexual, nor that he positioned the sexual organs of the lobster directly over the mouthpiece.

The absurdity, intrigue, and humour of those details made me appreciate the object anew.

I’ve been to see some of Gaudí’s work before, most notably La Sagrada Família, and while I’ve been awed by the way his work reflects the natural word, I’ve not always been wild about the aesthetic of the end result.

An example of Gaudí’s Calvert Chair is featured in the exhibition as part of a commentary on how his work influenced surrealist art. This is a connection I would never have made without it being pointed out to me. This was a bit of art education encapsulated in a single object, which gave me new understanding. Isn’t that the real power of exhibitions?

They make a bigger deal in the exhibition guide about the connection between Dadaism and surrealism, and feature some work by DuChamp, but to me, the Gaudí connection was less obvious and more interesting.

Conquest by Nina Saunders was, of all the objects I’d love to pilfer, the most obviously impractical option.

This is a 2017 piece with so much to say about the forces which impact the illusion of domestic norms and, depending on how you look at it, either destroy the perception, or force the perception to warp around them. This would certainly make an impact in my living room, and I think you could probably work out some comfortable unorthodox positions to sit on it too (though I’m not certain how Saunders would feel about that).

Wolfgang Paalen’s Le Génie de l’espèce felt like an object of the moment, inseparably representing both guns and death. It actually dates from 1939, very shortly before the outbreak of the Second World War.

This made me think a lot about how humanity never seems to learn the lessons of the past.

I enjoyed the fact that the Campana Brothers’ chair made of plush Disney toys provoked a sense of immediate repulsion, despite being made of soft, friendly characters. If Wendy had been with me, I know she’d have said: “too much.”

’Objects of Desire’ continues at the Design Museum until 19 February.

Luke O’Neil recommended 2022 film The Menu in Welcome to Hell World, saying

Do not read this piece if you haven’t seen the film yet. In fact I’d recommend watching it without knowing anything at all if you can.

I followed his advice. When I pressed play on the stream, I didn’t even know the film’s genre. I assumed (correctly) that it had the excellent Anya Taylor-Joy in it, as she was in the header image at the top of Luke’s post. I knew it had a running time of 1h 48m because I needed to know if I had time to watch it. But I knew nothing else.

I agree with Luke that this is probably the best way to watch it: having looked at reviews and descriptions since, I would have been put off, and would have thought it wasn’t for me.

So, I will say little more about it, apart from that it was excellent in both writing and performance. I’m pleased that news of the film totally passed me by, and that Luke’s blind recommendation encouraged me to watch something I’d never normally choose.

When thinking about risk assessment, it is often useful to separate the hazard (the bad thing that might happen) from the risk (the hazard plus the likelihood of it occurring). Things which are quite hazardous (wild tigers) can be low risk if they’re unlikely to cause harm (there aren’t any wild tigers in the UK). And things which can seem non-hazardous (coconuts) can be high risk if very likely to cause harm (perilously dangling above someone’s head on a windy day).

In a conversation recently, someone commented in passing that it wasn’t possible to meaningfully assess risk when a hazard is so large as to be unquantifiable: say the end of the earth, a world war, or a global pandemic.

I entirely disagree.

Firstly, no hazard is unquantifiable large: of the examples cited, a pandemic is less hazardous than the apocalypse.

But even ignoring that point, it’s self-evident that an activity with a low likelihood of causing the apocalypse is lower risk than one with a high likelihood of causing the apocalypse.

“Okay,” you might say, “but what I really meant is that you can’t compare with between hazards because the apocalyptic one will always win out.”

But that’s nonsense too. A threat with a negligible likelihood of causing a cataclysmic event is self-evidently lower risk than a threat with an extremely high likelihood of killing someone. Firing a gun in a crowded place is riskier than allowing visitors to tour nuclear power plants, even though there is an infinitesimally small chance of the latter being the start of a chain of events that leads to a nuclear disaster.

One could spend a lifetime trying to derive where the lines lie: and, indeed, as a society, we do just that. Through time, democracy, effort and research, we try to reach a societal consensus on where the balance of risks lies. We end up taking actions that have potentially world-ending consequences (say, building nuclear weapons) because we believe it’s the least risky approach.

In reality, risk assessments are generally much more complex than this implies: the theoretical balancing of risks is often easier than understanding the likely effects of each course of action. Any given action (or inaction) has myriad effects, only a fraction of which are pertinent to the specific risk under consideration.

In medicine, giving antibiotics might reduce the risk of a bacterial infection ending someone’s life. It may also cause side effects for an individual, including death. When applied as a general rule in guidance, it will also have extensive wider societal implications: financial cost, the opportunity cost of choosing to prescribe antibiotics rather than spending time doing something else, antimicrobial resistance, and so on. Not giving antibiotics is also very likely to have a whole host of implications, which take effort to foresee. And both courses of action will almost certainly have unforeseeable consequences, too.

The process of working out the implications of each course of action can become enormously complicated, and can often be extremely uncertain. But it must be done because we must make a decision.

In medicine, at least, well-written and considered guidelines constantly try to take a reasoned, explained judgement as to which path is most likely to lead to net benefit in most circumstances. NICE, for example, is typically great at explaining its committees’ thinking on these things—and also great at changing guidance when the real world implications of implementation turn out to differ from predictions.

But sadly, not all guidelines are well-written and considered. Astonishingly, I still come across newly published guidance which reports that intervention X will reduce the risk of disease Y, with no consideration even of side effects for individual patients, let alone wider societal consequences. The guidance vacuously recommends X based on its impact on Y alone.

If Y is common but mild and self-limiting, and X is extraordinarily expensive, then prescribing X will rarely be justified.

If the risks are such that you’d need to prescribe 3,000 doses of X to prevent one case of disease Y, and X has common side effects, then prescribing X may not be justifiable.

It shames my profession that some of this faulty guidance is public health guidance—the part of the medical profession that ought to be most attuned to accounting for costs and unintended consequences.

Balancing risks can be very hard, but it is always possible and indeed always necessary, especially in medicine.

Published in 2015, this was Suzanne O’Sullivan’s first book, and it’s the first of her books that I’ve read. I was motivated to seek a copy after seeing excellent reviews of all of her books.

O’Sullivan is a neurologist, and in this book she discusses patients she has seen with psychosomatic neurological presentations, such as seizures, paralysis, and—in one particularly memorable case—blindness. Based on my experience, O’Sullivan is right to say that psychosomatic illness is not discussed in any great length during medical training. I took a lot away from this book as a result. In particular, it is always useful to be reminded that psychosomatic illnesses are no more under the patient’s control than those with organic causes.

The book is beautifully written, and I found O’Sullivan’s deep reflections on her practice and her uncertainties especially valuable.

Some quotes that I particularly liked:

Modern society likes the idea that we can think ourselves better. When we are unwell, we tell ourselves that if we adopt a positive mental attitude, we will have a better chance of recovery. I am sure that is correct. But society has not fully woken up to the frequency with which people do the opposite – unconsciously think themselves ill.

If you take one hundred healthy people and subject them to the exact same injury you will get a hundred different responses. That is why medicine is an art.

Anger has a purpose. It tells others we are not alright. It also has a lot in common with psychosomatic symptoms. It can be misleading because often it is something else in disguise – hurt or fear repackaged. It is easily misinterpreted, both by those who feel the anger and those at the receiving end. And its effect may be detrimental. It is frightening. The person at whom the anger is directed may well be compelled to flee, possibly just when they are most needed. Anger can destroy the relationship between patient and doctor. The doctor escapes or avoids or ends up treating the anger and not the patient.

There is a terribly delicate balance in the investigation of benign-sounding symptoms. One must investigate to rule out a physical cause if it seems necessary, but the line where investigations should be stopped is drawn very faintly. Primum non nocere. First, do no harm. If you investigate and find something incidental, what do you do? And when do you say no more tests?

Laughter is the ultimate psychosomatic symptom. It is such a normal part of the human experience that all its facets are universally accepted. Now all we have to do is take the few short steps to a new realisation. If we can collapse with laughter, is it not just as possible that the body can do even more extraordinary things when faced with even more extraordinary triggers?

I look forward to reading more of O’Sullivan’s books—especially her most recent one, The Sleeping Beauties, about mass hysteria events, as this crosses neatly with my professional interest in public health.

Thanks to Newcastle University Library for lending me a copy.

Pyrex, the thermally resistant glass, used to be made in Sunderland. In fact, between 1922 and 2007, all Pyrex sold across the commonwealth—excepting Canada—was made in Sunderland. You’ve probably got a bit of Sunderland in your home right now.

The city is proud of this heritage, and so Sunderland Museum has created Pyrex100—an exhibition to celebrate a century since the start of manufacture in the city.

When I think of Pyrex, I think of glass measuring jugs. I was therefore unsurprised to see that the earliest Pyrex manufactured in Sunderland was a range of clear glassware. I had no idea, though, that glass teapots were a thing in the 1920s and 1930s.

Around this time, Pyrex was also a pioneer in marketing products directly to householders—mostly housewives at that time—rather than to their household staff. It’s sometimes startling to be reminded of the pace of societal change over the last century.

Though the designs of these pieces look suspiciously familiar, I was also unaware of Opalware. These were products made of Pyrex, and therefore strong and heat-resistant, but designed to look like china. They don’t look like they’d fool anyone, but I’m not convinced that I’d immediately pick them out as glass.

The crockery we use in our house is made of reclaimed offcuts of glass products: I thought this was a really novel idea when we bought them, but clearly I’m 70 years behind the times.

Commemorative Pyrex was a thing, too: here’s a 1966 World Cup commemorative glass. I would perhaps have expected to see this sort of thing in crystal, but seeing it in Pyrex maybe illustrates that Pyrex was once desirable in a similar way.

And this is the last bit of Pyrex ever made in the UK, which rolled off the production line as the factory closed in 2007. As this was the last commercial glassware factory in Sunderland, this also brought to an end something like 1,500 years of glassmaking history in the city.

You might, like me, have assumed that the word Pyrex shares the Greek root pyr (fire) with pyrexia and, indeed, funeral pyre, given that its main property is heat resistance, and it is glass forged in a fire. But this exhibition made me wonder about the ‘ex’, and so I came home and looked it up.

And prepare to clutch your pearls because—amazingly—the brand has nothing to do with pyr and everything to do with pies.

The Oxford English Dictionary quotes the original company’s assistant secretary as saying:

The word ‘pyrex’ is a purely arbitrary word which was devised in 1915 as a trade-mark for products manufactured and sold by Corning Glass Works… We had a number of prior trade-marks ending in the letters ‘ex’. One of the first commercial products to be sold under the new mark was a pie plate and in the interests of euphonism the letter ‘r’ was inserted between ‘pie’ and ‘ex’ and the whole thing condensed to ‘pyrex’.

It just goes to show that you can never rely on etymological assumptions.

Pyrex100 continues at Sunderland Museum… but it ends on Saturday, so you need to get there quick if you want to see it.

One of my New Year’s promises to you was to grow the economy and today we’re announcing the second round of allocations from our levelling up fund … [to] help deliver on that promise to boost growth.

Politics aside… I can’t pretend that anyone will remember the content of Sunak’s remarks more than the fact that he was breaking the law as he gave them.

But I also can’t pretend that I didn’t wince at “delivering on” a “promise.”

Promises are for making, keeping, or breaking. Courier bikes are for delivering on.

And seatbelts are for safety.

I hope I leave New Zealanders with a belief that you can be kind but strong, empathetic but decisive, optimistic but focused.

Politics aside, as a set of aspirations for any national leader, those are hard to argue with—heck, they’re good rules for life.