Beautiful obituary of the wonderful classical guitarist and lutenist Julian Bream. Some of this story I knew already.

Almost as he started his long love affair with the guitar, Julian Bream was aware he was doing something disreputable. When he was caught as a teenager practising Bach in the Royal College of Music, he was warned not to bring that instrument into the building again. It lowered the tone.

Even the Army shared the snobbery

Signing on to do his National Service in an army band, he was told he could play piano and cello, fine, but the guitar only “occasionally”.

And it is not just rock musicians who sleep in the van before driving back up the M1 (note: an Austin, rather than a Transit)

Audiences clapped long and hard when he performed in the Wigmore Hall at 18, in 1951, but as he toured round Britain in the mid-1950s, sleeping in his Austin van to save on hotels, not many came to hear him.

Those from the home of the guitar were no less enthusiastic about this man from those Isles.

And from Spain, the spiritual and historical home of the guitar, came the loudest scorn of all. An Englishman playing a guitar, said one virtuoso, was a kind of blasphemy.

What I didn’t know was that he was essentially self-taught. This is common in rock, folk, and jazz and blues, but I assume rare in Classical music. Although Segovia was moderately well known, perhaps the lack of popularity of the guitar in the UK made this necessary. Readers of this rag will know that I am fascinated by autodidacts and what skills you can — and cannot —learn to a high level without formal instruction. My prejudice is also-taught: the energy needed to acquire mastery alone is worth so much more than the competence gained on the transactional shoulders of others. Passion and perspective are worth more than 50 IQ points, as they say.

There are limits, however. In this video he talks about his fingers and technique:

‘Unfortunately the Almighty bequeathed me with a very clumsy pair of hands… and very slow’ (link)

He had form on the lute as well, playing with the nails rather than the fingers, and again faced the distain of the ‘experts’.

Below, a video on why Bream thought of himself as a meat and potatoes Englishman.

Those qualified need not apply

From a letter in last week’s Economist from Andrew Carroll, commenting on the Economist’s own description of Clement Atlee

He “lacks the conspicuous attributes of a leader” but “has undeniable ability, judgment and integrity” (“Mr Attlee and Sir A. Sinclair”, November 30th 1935)

Now I know where we have been going wrong.

A few months back, I was walking past the entrance of the old Edinburgh Medical School, founded in 1726. A not-so-crazy thought came into my head, one that I could not dismiss: we need to move on from the idea that a Medical School must be situated within a University (and of course, it wasn’t always, anyway).  The founding set of ideas that we have struggled with ever since Flexner, we should now recast for a very different world. We need to create something new, something that makes sense in terms of a university and something that puts professional training within a professional context. At present, we fail on both of these accounts. Rather than integrate we should fracture. We need to search out our own new world.

Specialisation and the division of labour is as old as humanity, and of course it goes way back further when we are talking biology. Adam Smith may have formalised why and how it was important economically but he did not invent it. Most specialisation relies on expertise, at least it used to until Crapita and the like started mining the seams of government ignorance.

The quote below is from an article in the Economist in May this year. It is about Public Health England (PHE) and how since they only possessed 290 contact tracers, they needed to call on those wonderful experts in everything, Serco, to help them out. Of course, expertise in such tasks always used to reside with Local Government, not PHE, but Boris and his bunch of Maoists, when they are not having their eyes tested in the fast lane, have decreed that Local Government — along with the opposition, the judges, the education sector and more — are enemies of the people. Given this mindset, we are left with those whose main area of expertise is commercialising ignorance.

Firms such as Serco, a big contractor, are in talks with the government to provide the workforce. It should be possible to train new recruits fairly quickly—the requirements of the job are similar to those of 111 operators, for whom the training time is just four hours. They will work from a script that guides them through the various stages of an interview [emphasis added].

Awhile back, I ended up corresponding with somebody in the Scottish government about how misleading their self-help pages on skin disease were: they contained factual errors, and would mislead people seeking medical help. The content had clearly not been written by a medical practitioner — defined as somebody with domain clinical expertise and who might have actually dealt with patients by shaking hands with them. Asking for validation studies or some sort of empirical evidence to support the content, was unhelpful as the content was supplied by another agency and was commercially ‘confidential’. I didn’t follow up because the person I corresponded with clearly knew that his own position was both untenable, and uncomfortable. Its just business: you know, ‘new ways of working’, ‘direction of travel’, and all those other vacuous suitcase terms that just mark a space where reason or domain expertise used to reside.

Rather than making clever machines, or allowing humans to do what only humans can do¹, it seems we are content to make humans behave as stupidly as Excel spreadsheets. 111 is not for BoJo et al.; 111 is for poor people waiting to be levelled up, even if the best way to do that, is to go to straight to A&E. ²

TIJABP

1. See Norbert Wiener’s classic The Human Use of Human Beings ↩
2. Image at top of page via Wikimedia here ↩

I read about the QALY (quality adjusted life year) during my intercalated degree in 1980-81, when we were exposed to some health economics. It was considered new and interesting at the time. It took me about 10 minutes to sense that it was nonsense, even if I couldn’t quite put my feelings into words that quickly¹. The goal was fine, but the methodology was metaphysical in nature, rather than grounded in the world that you could touch with your fingers. At least not if you look at the world through the prism of the natural sciences.

Economists have a disturbing habit of confusing how the world works with their own (strange) ideas of rationality. If only the world could be said to work in a way that was amenable to their methods. When physicists wanted to estimate the speed of light they recognised that they had to create some theory and some technology in order to obtain the correct answer. Embarrassingly — at least from the economists point of view — they had to do some experiments and see if their answer made sense when applied to new observations in the external world. Until they had done this, they stayed shtum.

Not so, for our economists. Their solution is effectively to agree some conventions, and then define what the speed of light should be. Whether their theory explains the way the world really works is neither here-nor-there. So QUALYs became a make-believe that suited both economists and the technocrats in government. The former, because the need for QUALYs became a job creation scheme for health economists (just as evidence based medicine (EBM) became a lifeline for all those epidemiologists who belatedly realised that much of their subject was methodologically deeply flawed). The technocratic governments liked what the economists brought them because it exiled judgement (and hence blame), allowing human suffering to be traded in arbitrage markets from which they could metaphorically wash their hands — ‘just following the science’, ‘just following the science’ (ring any bells?). Many politicians don’t want to do politics, but they do want to stay in power. As do economists², who appear pathologically obsessed with rank and status³. The Economist had a nice line earlier this year germane to my doubts:

But unlike poets, economists prefer to quantify their analogies—to measure whether thou art 15% or 20% more lovely and more temperate.

But if you think that artificial models that cannot predict the world are still useful — useful in the way the philosophers trolley problems are — then the quote below should indeed make you sit up and stare.

If we’re willing to pay $150,000 for each quality-adjusted extra year of life (a commonly used estimate), then we ought to view a 10% increase in spending per capita as a good investment if it extended average life expectancy by 2.5 days. That number may give readers pause — hence the importance of clarifying our spending priorities and focusing on care that produces real value for patients. With such a focus, we could feel more confident that higher health care spending was worth it.

Do We Spend Too Much on Health Care? | NEJM

1. A nice critical (and perhaps dated) introduction from a once QUALY-enthusiast who returned from the dark side is Erik Nord’s, Cost-Value analysis in Health Care: Making Sense out of QALYs, CUP, 1999. The rearguard action is still ongoing (advance proceeds one funeral at a time …(Max Planck)). ↩
2. Here is a revealing quote from Alan Maynard, a health economist: “… unless we tackle the doctors, health reforms will fail to deliver … processes of health care are dominated by clinicians, who merely represent their own vested interests, we must therefore strengthen the role of health managers and economists, who would speak for society at large.” Quoted in Julian Tudor-Hart, Lancet 2004. Well good luck with that! ↩
3. A strange quirk of economists is that they appear obsessed with proxies for their own self-doubts. US economists cannot help but focus on why you have to graduate from the top five schools with a PhD in order to obtain a faculty position at the same school, and how critical math scores are to being academically successful(‘I could have been a physicist — honest!’) It is quite a contrast with the lives of some of the greatest natural scientists. Natural science is much more open. ↩

(Image of NotGeld (emergency money) at top of page from here)

Just three?

Doctors need three qualifications: to be able to lie and not get caught; to pretend to be honest; and to cause death without guilt.” So wrote Jean Froissart, a diarist of the Middle Ages, after an outbreak of bubonic plague in the 14th century. Fake news then meant rumours that the plague could be cured by sitting in a sewer, eating decade-old treacle or ingesting arsenic.

The Economist | Return of the paranoid style

I read Educated by Tara Westover earlier this year (it was published in 2018 and was a best seller). It is both frightening and inspiring. And important. Her story is remarkable, and it says more about real education than all the government-subjugated institutions like schools and universities can cobble together in their mission statements. WikiP provides some background on her.

Westover was the youngest of seven children born in Clifton, Idaho (population 259) to Mormon survivalist parents. She has five older brothers and an older sister. Her parents were suspicious of doctors, hospitals, public schools, and the federal government. Westover was born at home, delivered by a midwife, and was never taken to a doctor or nurse. She was not registered for a birth certificate until she was nine years old. Their father resisted getting formal medical treatment for any of the family. Even when seriously injured, the children were treated only by their mother, who had studied herbalism and other methods of alternative healing.

All the siblings were loosely homeschooled by their mother. Westover has said an older brother taught her to read, and she studied the scriptures of The Church of Jesus Christ of Latter-day Saints to which her family belonged. But she never attended a lecture, wrote an essay, or took an exam. There were few textbooks in their house.

As a teenager, Westover began to want to enter the larger world and attend college.

The last sentence above has it, as The Speaker of the House of Commons might say.

She gained entry to Brigham Young University (BYU), Utah, without a high school diploma and her career there was deeply influenced by a few individuals who saw something in her. She was awarded a Gates scholarship to the University of Cambridge to undertake a Masters and was tutored there by Professor Jonathan Steinberg. Some of their exchanges attest to the qualities of both individuals, and not a little about a genuine education.

‘I am Professor Steinberg,’ he said. ‘What would you like to read?’

‘For two months I had weekly meetings with Professor Steinberg. I was never assigned readings. We read only what I asked to read, whether it was a book or a page. None of my professors at BYU had examined my writing the way Professor Steinberg did. No comma, no period, no adjective or adverb was beneath his interest. He made no distinction between grammar and content, between form and substance. A poorly written sentence, a poorly conceived idea, and in his view the grammatical logic was as much in need of correction.’

‘After I’ve been meeting with Professor Steinberg for a month, he suggested I write an essay comparing Edmund Burke with Publius, the persona under which James Madison, Alexander Hamilton and John Jay had written the Federalist papers.’

‘I finished the essay and sent it to Professor Steinberg. Two days later, when I arrived for our meeting, he was subdued. He peered at me from across the room. I waited for him to say the essay was a disaster, the product of an ignorant mind, that it had overreached, drawn to many conclusions from too little material.’

“I have been teaching in Cambridge for 30 years,” he said. “And this is one of the best essays I’ve read.” I was prepared for insults but not for this.

At my next supervision, Professor Steinberg said that when I apply for graduate school, he would make sure I was accepted to whatever institution I chose. “Have you visited Harvard?” he said. “Or perhaps you prefer Cambridge?”…

“I can’t go,” I said. “I can’t pay the fees.” “Let me worry about the fees,” Professor Steinbeck said.

You can read her book and feel what is says about the value of education on many levels, but I want to pick out a passage that echoed something else I was reading at the same time. Tara Westover writes of her time as a child teaching herself at home despite the best attempts of most of her family.

In retrospect, I see that this was my education, the one that would matter: the hours I spent sitting at the borrowed desk, struggling to parse narrow strands of Mormon doctrine in mimicry of a brother who’d deserted me. The skill I was learning was a crucial one, the patience to read things I could not yet understand [emphasis added].

At the same time as I was reading Educated  I was looking at English Grammar: A Student’s Introduction by Huddleston & Pullum (the latter of the University of Edinburgh). This is a textbook, and early on the authors set out to state a problem that crops up in many areas of learning but which I have not seen described so succinctly and bluntly.

We may give that explanation just before we first used the term, or immediately following it, or you may need to set the term aside for a few paragraphs until we can get to a full explanation of it. This happens fairly often, because the vocabulary of grammar can’t all be explained at once, and the meanings of grammatical terms are very tightly connected to each other; sometimes neither member of a pair of terms can be properly understood unless you also understand the other, which makes it impossible to define every term before it first appears, no matter what order is chosen [emphasis added].

(more…)

As a follow up to the previous entry

“Keep the company of those who seek the truth; run from those who have found it.”

Vaclav Havel, quoted by Randy Sullivan via the Economist

We should worry more about righteousness

I am no fan of Henry Kissinger (an easy statement to make), but the quote below says something worthy of careful consideration.

‘the most fundamental problem of politics… is not the control of wickedness but the limitation of righteousness’.

I am not certain where I came across the phrase so beware. If I had made it up I would be even happier.