The Doctor’s Surgery

The best diet? It’s a fishy question

Fish is good for you – but not in great amounts theodore dalrymple

Flesh is, in the last analysis, grass. But increasingly enlightened medical opinion believes that more of it ought to be, at least in the intermediate phases, fish.

Fish is said to be good for you, even if it is a myth that it does for your mind what we were once told that carrots did for our eyesight. Fish is often thought to stave off heart attack and stroke.

I first realised that diet was more than a matter of taste when a (much older) cousin of mine tried to impress upon me that we inevitably took on the psychological characteristics of the animals whose flesh we ate. He had recently converted from gangsterism to vegetarianism, and being a disrespectful, sly little boy, I asked him what we became (mentally) if we ate cabbage.

Many years later, by the way, quite a number of my patients complained to me, ‘My ’ead’s cabbaged, doctor.’

Fortunately, I always liked fish. My brother, brought up on the same diet as I and sharing half my genes, detested it. Perhaps one day the vagaries of personal taste will be fully explicable, though I certainly hope not. Explanation would lead inevitably to abuse and manipulation.

It is not easy conclusively to demonstrate the benefits of a diet of fish. Populations rarely differ only by their consumption of this commodity. It would be difficult to perform prospective trials in which the participants were unaware of whether they were in the experimental or the control arm of the study.

Still, an attempt at answering the question must be made. A paper published by the Journal of the American Medical Association (JAMA) tried to compare the rate of heart attack and stroke in 191,558 people in 58 countries (pooled from four separate studies) who ate less than 50 grams, up to 175 grams and more than 175 grams of fish a week.

After what must have been immensely complex calculations, an answer resulted that might at first sight please some and disappoint others. Those who ate at least 175 grams of fish a week had a roughly 10 per cent lower rate of heart attack or stroke than those who ate hardly any.

Still, eating more than 175 grams conferred no additional protective effect among those who had cardiovascular disease in the first place. Oily fish was more protective than white fish, which conferred little or no benefit. No protective effect was found among those who had no disease at the outset of the studies.

The deficiencies of this research are obvious. Fish is expensive in most countries, and so those who eat it tend to be better off than those who do not, and we know that people who are better off are less susceptible to disease. The paper gives an average body mass index (BMI: weight in kilos divided by height in metres squared) for the various subgroups of the 191,558 people, but it is not credible that this could be known for more than a small proportion of them.

Since a high BMI is a known risk factor for cardiovascular disease, this means that the results are simply not trustworthy. Uncertain data cannot lead to certain conclusions.

Fish is not medicine. If it were eaten as such, the effect of its consumption would have to be compared with that of its consumption for pleasure, for the difference between the two types of consumer might affect the results.

Incidentally, I notice that JAMA considers 175 grams of fish to be two portions. Not for me, it isn’t – but then I’m slightly overweight, so I’m told.

There is a lot to worry about in this world.

Those who ate at least 175g of fish a week had a lower rate of heart attack or stroke

The Oldie, 23–31 Great Titchfield Street, London, W1W 7PA letters@theoldie.co.uk To sign up for our e-newsletter, go to www.theoldie.co.uk

Anne Robinson’s knickers

SIR: I too was at school with Anne Robinson, a year below her, and wonder why her recollection of reading to the school while standing on a chair with her knickers showing is so often repeated in interviews (Getting Dressed, July issue).

As I remember it, the chair was like that of a tennis umpire and was sat on. Our skirts were below the knee and we wore big green over-knickers, known as passion-killers, which wouldn’t have alarmed a visiting bishop.

Still, I suppose it makes a good story. Julia Ashenden (née Ross Williamson), Woodbridge, Suffolk

Sergeant Wilson’s farewell

SIR: Ken Pyne’s cartoon (June issue) – a ‘NOT DEAD, JUST RESTING’ gravestone prompting a passer-by to say, ‘He was a great actor’ – put me in mind of John Le Mesurier’s grave in Ramsgate, shown in this photo [below].

Yours faithfully, James Pringle, Broadstairs, Kent

My most vivid memory is of being taught to cast a trout rod with my left hand by the ghillie, so that I could sit in the other end of the boat from my father when fishing on Loch Shin. He put a matchbox on the lawn and I was expected to land the fly on it. Fortunately I proved an apt pupil, and I enjoyed some happy fishing trips with my father.

Thank you for the memories! Yours, Grizel Care, Fishguard, Pembrokeshire

Le Mesurier’s last words were allegedly ‘It’s all been rather lovely’

Fishing at Skibo Castle

SIR: The photograph of Skibo Castle and the article (Overlooked Britain, June issue) brought back happy memories of several holidays spent there with my parents in the late 1940s.

My grandfather, Dr James Simpson of Golspie, was the Carnegies’ doctor, and his daughter Margaret and my mother were lifelong friends. My mother played the organ in the magnificent hallway! I remember the piper walking up and down the terrace while we were at breakfast.

‘Lets face it. No one uses cash any more’

Peter Cook v Ted Dexter

SIR: Ted Dexter may not remember Peter Cook (On the Road, July issue), but Cook is on record knowing Dexter – though not with affection. They were contemporaries at Radley when I was there. Paul Chaudoir, Bath, Somerset

Barry’s dream dinner party

SIR: Reading Barry Humphries’s thespian dinner-party guest list (July issue), I could not help myself, so here are my ten – more A than B list:

Eileen Atkins

Michael Kitchen

Maureen Lipman

Ruth Wilson

Toby Stephens

Harriet Sansom Harris

Sophie Okonedo

Nina Conti

Joan Plowright

Michele Riondino And, if it were possible:

Thora Hird

Colin Blakely

Terry-Thomas

Robert Shaw

Frank Finlay

James Stewart

Hermione Gingold If Barry wished to join us, he would be most welcome as honorary guest. Sincerely, Oliver Wells, London SW1

Bazza strains the potatoes

SIR: What happy memories Dame Edna brings (July issue), of my

James Thellusson (July issue) asked for your school reports...

SIR: In 1986, my 12-year-old daughter produced a hideous, sludge-green pot in her pottery class. In her report, the art master said, ‘We must look to James Elroy Flecker to describe Annabel’s pot. Dragon-green, luminous, dark, serpenthaunted.’ We have the pot to this day, with his comments stuck on the bottom. A family heirloom! Best wishes, Alice Cleland CBE, Devizes, Wiltshire

Could do lots better

SIR: The two best comments I know of are set out below. 1. ‘The dawn of legibility reveals a total inability to spell.’ 2. ‘Andrew and I have both failed. But at least I tried.’ P J Walter, Wellington, Somerset

A successful failure

SIR: My English and Latin master Monsieur Boret wrote, around 1953 when I was ten,‘If this boy spent half as much time doing work, instead of finding ways of avoiding the task, he could do well.’

I failed all exams throughout my school life, except the O Levels: I passed them all, plus two further subjects not taught at that school.

I had decided M Boret was right after all and spent a year following the axiom of doing. I went on to do A levels, earned a county major scholarship, went to university and was MD of a small international company at 27. I bought the company and from the ashes formed my own company, which I ran for 28 years. The word ‘doing’ echoed in my mind for all that time.

Thank goodness for school reports and may they long continue. Rod Davis, Jávea, Spain

A teacher writes...

SIR: I was a schoolmaster who began teaching physics in 1962. Unlike my final years, in those days one handwrote – and signed – a report on each pupil at the end of each term. My reports were factual and, I hoped, helpful, but some colleagues would give free rein to their wit. Two reports from that time I have not forgotten.

The first was ‘He can do this subject standing on his head, and often does.’ That report was read to the boy before being submitted and he pleaded, ‘Please, Sir, do not send that or my father will beat me!’ Such a report today would probably bring the father to the school to attack the teacher.

More memorable was ‘I would hesitate to breed from this boy.’ Tim Hickson, Pershore, Worcestershire

Will Hay, 1941

Bad at sports

SIR: The following was on my son’s report (submitted with his permission) after his first term at Handcross Park School in 1977, when he was eight years old.

‘He is like a fish out of water on the football field, and conveys the impression that football is rather beneath him.’

After the summer term in 1979, when he was 11, a different teacher reported on his cricket: ‘He has enjoyed his time in the Colts game and, once he discovered his glasses, actually managed to stop or hit a moving ball. The mystery of throwing a ball still lies beyond some distant horizon.’

I felt that these were proof that he was my son. Yours sincerely, Tim Neville, Silverstone, Northamptonshire

visiting the Odeon Leicester Square, and being given an Aussie/pom phrasebook for the Barry McKenzie première, and witnessing the first urination on cinema as Bazza and friends put out a BBC studio fire.

If the person I lent the phrase book to would return it, I would be most grateful. John Zimnoch, York

Bazza’s wonderful world

The longest sermon?

SIR: The Old Un’s opening item in the July issue, concerning the history of spectacles, states, ‘In a sermon at Santa Maria Novella church, given between 1303 and 1306, Friar Giordano da Pisa…’

I am baffled as to whether this was the world’s shortest sermon (of only three minutes between 1303 and 1306) or the longest (of three years between 1303 and 1306). Yours in admiration, Mac Greenwood, Bramhall, Cheshire

Aspirin – a bitter pill

SIR: Theodore Dalrymple writes (July issue) that he detests the taste of aspirin.

If my memory serves me at all, it is not aspirin that has the distinctive taste but Bitrex, an artificial flavouring added to aspirin to deter people, particularly children, from taking too much, or even any at all.

I believe this because, during the 1980s, when I worked in advertising at Metro Radio, our team of creatives was tasked with advertising this additive.

One of the team – Martyn Healy, I think – came up with the idea of a taste test: he would offer other staff a glass of cola laced with Bitrex (the bitterest taste on the planet) and record their extreme and outraged reaction.

Even funnier was when some wag dipped the blunt end of every pencil and biro in the radio station in Bitrex, then replaced them on people’s desks.

For weeks after, musing salespeople, DJs and secretaries could be heard gasping, spluttering and swearing as they absent-mindedly let their writing tools stray between their lips.

This is how I remember it, anyway – perhaps another reader might be able to confirm, expand or otherwise? Yours, Mike Bersin, Gresham, Norfolk