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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 September 29; 335(7621): 673.
PMCID: PMC1995484
Between the Lines

Doctor-anarchists in class war

Theodore Dalrymple, writer and retired doctor

There is no more distinguished a writer in Britain today than J G Ballard, who was briefly a medical student but gave up to become a writer. He was born in Shanghai in 1930, but was interned in a Japanese camp there in 1943. Having previously lived the comfortable life of the rich and privileged expatriate in a poor country, he became sensitive as no one else in contemporary letters to the fragility of our well ordered existence.

Many of his books record the barbarism that lies just below the surface of our apparently civilised conduct, and that our highly technological society favours because of its tendency to isolate us emotionally from one another. Ballard is the prophet of social pathology, particularly among the educated middle classes: the vile behaviour of middle class football supporters, for example, would not surprise him in the least.

It is irrational, no doubt, but I feel some kind of personal connection with Ballard because my grandfather, a doctor, was in Shanghai at the time that Ballard was in the camp.

Doctors figure prominently in Ballard's fiction, as if he somewhat regretted not having become one. But the doctors of his dystopian novels do not behave better than others—far from it; and the fact that they so frequently behave badly, or at least not well, is symbolic of how fragile the author thinks that their ethical standards are, and therefore (since doctors are generally so highly regarded by the rest of society) how fragile all ethical standards are. We should not forget that many Japanese and German doctors committed some of the most sadistic atrocities of all.

Ballard's novel, High-Rise, has several doctors as characters: a lecturer in physiology at a medical school, a psychiatrist, some neurosurgeons, and a gynaecologist. The book is typical of his dystopian genre. The high-rise of the title is one of four 40-storey apartment blocks built in the docklands area of London (as the novel was first published in 1975, the very location is an instance of Ballard's uncanny prescience).

The residents of the new development, all of the professional classes, start a war against each other of a class nature (the higher the floor you live on, the higher your social status). Eventually there is total anarchy. Everything is vandalised, the services cease to work, garbage accumulates everywhere, the walls are covered in graffiti, and the residents raid one another for food and eat each other's pet dogs. Almost every element of the horror is visible today, in less extreme form, and so we cannot just dismiss the author's vision as morbid or ridiculous.

Pangbourne, the gynaecologist, is among the worst characters in the breakdown of order. Rich and successful, he lives on the highest floor, the 40th, and has led a raid with women acolytes to the lower floors, capturing “a cost-accountant from the 32nd floor with a bandaged head, and a myopic meteorologist from the 27th.” Pangbourne playfully asks what should be done with them:

“Pangbourne turned to his guests [the captured men]. ‘I rather like Flying School. Did you know we've been running a flying school here? No—?'

“‘We've decided to offer you some free lessons,' Anne Royal [an acolyte] told them.

“‘One free lesson,' Pangbourne corrected. ‘But that's all you'll need. Isn't it, Anne?'

“‘It's a remarkably effective course.'

“‘Solo first time, in fact.'”

Then they fix some papier maché wings to the “guests,” preparatory to throwing them out of the window.

Which of us has never met a Pangbourne?

Ballard is the prophet of social pathology, particularly among the educated middle classes

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