'Shattered' by Hanif Kureishi

Cathleen Schine, Ungovernable, Capricious Life, The New York Review of Books, April 10, 2025, Volume LXXII, Number 6, pp.15-16.

Shattered by Hanif Kureishi. Ecco, 328 pp., $28.00

'Shattered' c/o Penguin  

'Hanif Kureishi, the English playwright, screenwriter, and novelist, posted these words on his Substack in January 2023: 

  On Boxing Day, in Rome, after taking a comfortable walk to the Piazza del Popolo, followed by a stroll through the Villa Borghese, and then back to the apartment, I had a fall.

I had been following Kureishi's Substack for a while out of admiration, curiosity, and loyalty-though Id met him only once, briefly. His dispatches were warm and entertaining, often about the writer's life. But this one was shocking: 

   I cannot move my arms and legs. I cannot scratch my nose, make a phone call or feed myself. As you can imagine, this is both humiliating, degrading and a burden for others. 

According to his hospital report, his fall resulted in neck hyperextension and immediate tetraplegia. An MRI scan showed a severe stenosis of the vertebral canal with signs of spinal cord injury from c3 to C5. It was unclear, he said, whether he would be able to walk again "or whether I'll ever be able to hold a pen." He was speaking these words through Isabella, who was slowly typing them into her iPad.' p.15.

individual

|
INTERPERSONAL : SCIENCES             

humanistic ------------------------------- mechanistic

SOCIOLOGY : POLITICAL   

|

group

shattered	SHATTERED
SHATTERED	shattered

'A hospital is the place from which modesty and dignity disappear, desert you, seemingly forever, as soon as you cross the threshold. Kureishi, a reliably sexy, unrestricted writer, presents the physical deterioration and indignities he undergoes with his usual wit. The sense of vulnerability is crushing, but it is also one of the characteristics Kureishi reveals about himself that makes him so likable here, and the writing so intimate. The tone is remarkable: even the self-pity has no self-pity. One way he achieves this is by sprinkling punch lines throughout:

I woke up and started to cry. When you cry you must wipe away your tears, which is something I'm unable to do. So my eyes filled with bitter salty water and I got into a panic and thought I might lose my eyesight along with everything else. Finally, a kind nurse came into my room and downed me with a good dose of Lorazepam, then she touched me on my cheek and said, "It's not so bad, at least you're not in a coma."' pp.15-16.

'Health and Wellbeing Boards' - hiding the obvious

Does the language we use really matter? A public NHS document includes the following:

'PHARMACY

2.1

Background

Health and Wellbeing Boards (HWBs) in England hold statutory responsibility to publish and keep up to date a statement of the needs for pharmaceutical services of the population in its area, referred to as a pharmaceutical needs assessment (PNA). PNAs are used by the NHS to make decisions on which NHS funded services need to be provided by local community pharmacies.'

I'm not asking, or demanding, change to this but the words we employ do matter. One of them above matters greatly. The question of responsibility and its attribution. In the response to mental illness,  responsibility has always been played out on the public stage. Even when society's response was to leave 'care' to religious and charitable agencies. Then the state stepped in with the first legislation. The state assumed responsibility as per the previous post. Not only where the keys thrown away, but many people admitted there, did not need be. The 'reason for referral' was more accurately described as a social ill. In this way, individuals were incarcerated and forgotten.

It is in the gift of Hodges' model, care of its vertical axis [INDIVIDUAL - GROUP], to be able to negotiate the contextual switch from personal to group and population. There is a marked contrast from self-medication, a nurse doing a medicines round - to the design, testing and research effort of production of a specific drug or intervention. The focus then is obviously at the population scale. The pharmocological business, is not just a business. It is a pharmaco-industrial complex, e.g.

Grouse L. Cost-effective medicine vs. the medical-industrial complex. J Thorac Dis. 2014 Sep;6(9):E203-6. doi: 10.3978/j.issn.2072-1439.2014.09.01. PMID: 25276402; PMCID: PMC4178073.

When we think of dependence it is often framed at the individual level. But how can we expect to change health services, health systems to see them as they truly are: Illness and Infirmity Boards masquerading as Health and Wellbeing Boards?

individual

|

INTERPERSONAL : SCIENCES

humanistic ------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

	drugs manufactoring testing
	Sybil Shainwald (April 27, 1928 – April 9, 2025)

Sybil Shainwald 

https://en.wikipedia.org/wiki/Sybil_Shainwald