AA Gill faces up to his cancer

AA Gill used to think that being a NHS patient was like travelling second class on a train, glitter than first class, but in the end everyone ended up at the same destination. 

But now, he’s discovered that the drug that might keep him alive is not available on the NHS…

It seems unlikely, uncharacteristic, so un-“us” to have settled on sickness and bed rest as the votive altar and cornerstone of national politics. But there it is: every election, the National Health Service is the thermometer and the crutch of governments. The NHS represents everything we think is best about us. Everyone standing for whatever political persuasion has to lay a sterilised hand on an A&E revolving door and swear that the collective cradle-to-crematorium health service will be cherished on their watch.

When you look at our awkward, lumpy, inherited short-tempered characters, you’d imagine we might have come up with something more brass-bandy Brit: a bellicose, sentimental military fetishism, perhaps, or sport, or nostalgic history, boastful Anglophone culture, invention, exploration, banking avarice. But no. It turned out that what really sticks in our hard, gimpy, sclerotic hearts is looking after each other. Turning up at a bed with three carnations, a copy of Racing Post, a Twix and saying,“The cat misses you.”

We know it’s the best of us. The National Health Service is the best of us. You can’t walk into an NHS hospital and be a racist. That condition is cured instantly. But it’s almost impossible to walk into a private hospital and not eetingly feel that you are one: a plush waiting room with entitled and bad-tempered health tourists.

You can’t be sexist on the NHS, nor patronising, and the care and the humour, the togetherness ranged against the teetering, chronic system by both the caring and the careworn is the Blitz,“back againstthewall”,sternandsentimentalbest of us — and so we tell lies about it.

We say it’s the envy of the world. It isn’t. We say there’s nothing else like it. There is. We say it’s the best in the West. It’s not. We think it’s the cheapest. It isn’t. Either that or we think it’s the most expensive — it’s not that, either. You will live longer in France and Germany, get treated faster and more comfortably in Scandinavia, and everything costs more in America.

I’ve wanted to write about the National Health Service for a long time, but it’s resistant to press inquires. While the abstract of the NHS is heart-warming, the truth for patients is often heart-stopping. And junior doctor strikes, executive pay, failing departments, slow-motion waiting times and outsourcing tell a di erent story, and I’m regularly, ritually refused access by PRs and administrators, or they insist on copy approval or preplanned stories.

One of the doctors I approached was Professor Brian Gazzard, who has a reputation mostly for being an exemplary and inspirationally brilliant physician, but also as something of an ocean-going eccentric. He treats, teaches at and runs the Chelsea Aids clinic. I asked him what had changed most about his job.

“When I started, I told every patient that they were going to die. I could make it easier, make them live a little longer, but everyone died. Now I tell every patient they will live. They will need to do what I tell them, they’ve been silly, but they’ll live to die of something else. That’s astonishing.” He paused so I would understand the e ect it has on a doctor. “Look, I really don’t want to be written about. You won’t remember, but we met once before.”

A decade ago, Gazzard diagnosed my foreign correspondent’s dodgy tummy as acute pancreatitis, the result of alcoholism. “Of course I remember. You told me I could never drink alcohol again and I said, ‘You haven’t read my notes, I’ve been teetotal for 20 years.’ And you gave a sigh and reached into a drawer and lit a cigarette and said you’d been dreading telling a restaurant critic he couldn’t have a glass of wine.”

Gazzard laughed.“You’re one of the lucky ones,” he’d said as he walked onto the street clutching an armful of patient les and raised a hand in farewell. He repeated again: “You’re one of the lucky ones. I can always tell.” It was his rst misdiagnosis of the day.

What neither of us could know is that my pancreas was already a stuffed wallet of cancer, though not pancreatic — a migrated, refugee, desperate, breathless lung cancer.

I stopped smoking 15 years ago and as a gift to myself, proof of the clarity of my lungs, I would spend a week stalking on Loch Maree in Wester Ross. Every autumn since, I have climbed the same hills, chasing the deer, and, trudging upwards, recited a doxology of mostly extinct snouts I no longer puff: Weights, Guards, Navy Cut, Olivier, Black Cat, Passing Clouds, Number 6, Sovereign, Gitanes, Gauloises (does anyone remember when Paris smelt alternately of Gauloises, pissoirs and Chanel?), Winston, Camel, Sobranie, my father’s pipe in the cinema — clouds of sweet latakia smoke in the ickering projection. A Greek cigarette in a red box with a lasciviously smiling girl that called itself Santé, without irony: an untipped fag called Health. 

This year, for the first time, I couldn’t make it to the top of the hill. I knelt in the heather, weak and gasping. It was the first time all was not well. There was also a pain in my neck that my doctor said was probably a cervical spine thingy and I should get a scan.

He sent me to Harley Street, where another doctor said: “You haven’t got insurance, it’s going to be expensive. Why don’t you get it done down the road and send me the pictures. A third of the cost.” I said: “I’m here now, just do it.” And he shrugged. A couple of hours later I went back for the results. He had the bland bad-news face.

“That was the best money you ever spent.” He turned the screen around and there was a beautiful spiral of colour clinging like an abstract expressionist collar to my spine.“This is cancer.”

That afternoon I was back in my doctor’s surgery. He was wearing the antiseptic face, the professional-doctor tragedy mask. I’m getting to see this a lot now. It is as much a protection against the infection of catastrophe for them as a respect for its victim. They glaze the bad news with sweet spittle. They’ll say: “The test results were not quite what we hoped. It might be trapped wind or it might be the thing that hatched from John Hurt’s stomach. Realistically, we’ll have to assume it’s more alien than fart.” My alien was the most common cancer in old men, our biggest single killer: an aggressive, nimble cat-burglar lung cancer that is rarely noticed till it has had kittens.

Guy has been my doctor for 30 years — 32 to be precise. He was the doctor who put me into treatment for addiction and he’s looked after me and my kids ever since. He’s private, so I pay. If I need a test, an x-ray, a consultant, I’ll pay. If I need anything more than a couple of antibiotics, I’m going to the NHS.

Within 24 hours I have an NHS consultant oncologist and early-morning appointments, for scans, blood tests and x-rays.

You couldn’t make up Charing Cross Hospital. Well, not as a hospital you couldn’t. It’s a monstrous, hideous, crumbling patched-up mess — the Elephant Building. On the way in I notice a couple of posters on the street saying “Save Charing Cross Hospital”. They’re stuck on a municipal noticeboard that’s falling over.

It’s plainly the result of dozens and dozens of attempts to make things better and, in fact, it is the physical embodiment of how most of us, trying to make our way through the teetering automatic doors, feel. It has a very good collection of contemporary British art. In some back corridor there is a series of Peter Blake’s best silk screens.

I love it: it’s how I feel. The lifts take hours to arrive, emphysemically, wheezingly opening their doors, and when they do, it’s without con dence or conviction. A man going up to the cancer ward puts his hand in front of the door and gets out.“I’m too frightened to take this lift,” he says.

In a waiting room, hundreds of us take numbers to sit like wilted potted plants in an autumn garden-centre sale, to take it in turns to meet the antiseptic face. If this were a set for a lm, all the actors and extras would be pulling looks of agony and sadness and fear, but the face of real cancer wipes our expressions to a pale neutral human.

The NHS has one of the worst outcomes for cancer treatment in Europe. It’s something to be borne in mind when you’re deciding to combine chemotherapy with a safari, or want to embark on a bar-thumping argument about health tourism. It was the rst question I asked my oncologist, Dr Conrad Lewanski.“Why is this such a bad place to get cancer, when we have lots of hospitals, when we teach doctors from all over the world, when we’ve won more Nobel prizes than the French?”

“It’s the nature of the health service,” he says.“The key to cancer outcomes is the speed of diagnosis and treatment.” The health service was set up with GPs separate from hospitals. The system means you probably have to wait a week or so for an appointment to see rst your GP, or a clinic. The average time for that consultation will be seven minutes. Perhaps your cough isn’t a priority. And then if your doctor thinks it does need a second opinion, he’ll suggest you see a consultant, and that’s likely to take a month. If the GP suspects cancer,that referral time is reduced to two weeks. He or she will probably write a letter, often two — all doctors still carry fountain pens.

And then there are all the appointments — for tests, a cancellation, a missed x-ray, a scan — which can put months on a diagnosis. It’s not the treatment, it’s the scale of the bureaucracy and the Attlee-reverential, immovable-but-crumbling structure of a private-public doctor-consultant arrangement, which was the cornerstone laid down by the 1945 government at the insistence of doctors. That is the chronic tumour in the bowel of the system.

I’m given a talk by a nurse on the consequences of chemotherapy. She uses three pens. Two of them have three coloured barrels each. The scribbling, the underlining, the stars, the acronyms, the exclamation marks become ever more emphatic and decorative. Finally she hands me a notebook that is unintelligibly runic, but says not to worry because it’s all on the computer, which she then turns on to show me a heart-warming lm about sexual infections and high temperatures.

The hospital utters with bits of paper like mayflies. They’re propped up against screens, wedged up against keyboards, stuffed into teetering les, and then there is the constant Tourette’s questions,“When’s your birthday? What’s the first line of your address?”, all to collide you with the right cancer, to go with all the forms, the signatures, the screens, the machines, the radiation disclaimers and destiny. It makes Kafka look like ee cummings.

I like my oncologist. He doesn’t have the morphine face; he looks amused, inquisitive, like a shaved, garrulous otter. All he does
is lung cancer. This is his river, tumours his trout. He’s been a consultant for 15 years. Two years in, his father got it and died: “The worst thing I’ve ever had to go through. I do know what this is like — so how much do you want to know?” 

“Everything, and the truth.”

I’ve never Googled cancer, but I’ve discovered that every one of my friends who owns their own house has a preferred cancer specialist and a hospital to go with them. They also have a perfect gardener, an ideal interior decorator and a masseur that they insist — insist — I use, because they are all the best and, of course, you only get what you pay for. Lots of them are astonished I’m still in this country of catastrophic cancer statistics.

Those who don’t have money for their own homes have magical diets, homeopathy and religious new-age cures, or at least a conspiracy theory about big pharma hiding the e cacy of vitamin C, kale, magnetism and mistletoe. If it doesn’t make you better, at least you get snogged a lot.

And everyone, but everyone, will have a mantra story of their secretary’s husband or a woman they used to work with who was given three weeks to live and is still stacking shelves or conducting operas 10 years later. These little homilies are handed out with the intense insistence of lucky heather, using the language of evangelical religion and locker-room encouragement.

Why is our reaction to cancer so medieval, so wrapped in fortune-cookie runes and votive memory shards, like the teeth and metatarsals of dead saints? Cancer is frightening. One in two of us will get it. It has dark memories, unmentionably euphemised. In the public eye, not all cancers are equal. There is little sympathy for lung cancer. It’s mostly men, mostly old men, mostly working-class old men and mostly smokers. There is a lot more money and public sympathy for the cancers that affect women and the young. Why wouldn’t there be?

“How do men react when you tell them their cancers are fatal?” I ask Dr Lewanski. “Always the same way — with stoicism.”

“Bollocks,” I think. “I thought that was just me.”

Actually it’s not being told you’ve got cancer that is the test of character, it’s the retelling. Going home and saying to the missus: “That thing, the cricked neck. Actually it’s a tumour, the size of a cigar.” It ought to come with a roll of thunder and ve Jewish violinists, instead of the creaky whisper of fear.

People react differently to different cancers: most women think they’ll survive, and statistically they’re right. Most men think they’ll die — and likewise.

“So, what’s the treatment?”

“Chemotherapy. Platinum in your case. It has a very good chance.”

Someone should write a paper on the euphemistic size comparisons for tumours. There should be an esite, Euphotumours. The images are very masculine: golf balls, cricket balls, bullets, grenades, ruminant testicles. No one ever says, “I’ve got a cancer the size of a fairy cake.”

And what about after the chemo?

“Well, there’s a new treatment, immunotherapy. It’s the biggest breakthrough in cancer treatment for decades. Cancers camou age themselves as chemical markers that tell your body’s natural defences that there’s nothing to see here, move along. These new drugs strip away the disguise and allow your body’s natural system to clean up. It’s new and it’s still being trialled, but we’re a long way along the line and it is the way cancer treatment is bound to go. It’s better for some growths than others, but it’s particularly successful with yours. If you were in Germany or Scandinavia or Japan or America, or with the right insurance here, this is what you would be treated with.”

The doctor looks at Nicola, the missus. His otter face has grown a little sphinxy. “You remember asking if the treatment Adrian got on the NHS would be any different from being a private patient? And I said a better cup of coffee and more leeway with appointments. Well, this is the difference. If he had insurance, I’d put him on immunotherapy — speciffically, nivolumab. As would every oncologist in the First World. But I can’t do it on the National Health.”

The National Institute for Health and Care Excellence (Nice), the quango that acts as the quartermaster for the health service, won’t pay. Nivolumab is too expensive — £60,000 to £100,000 a year for a lung-cancer patient; about four times the cost of chemo. And the only way to see if it will work for an individual patient is to give it to them all, and the ones it doesn’t work for will weed themselves out. What Nice doesn’t say about the odds is that immunotherapy mostly works for old men who are partially responsible for their cancers because they smoked. Thousands of patients could benefit. But old men who think they’re going to die anyway aren’t very effective activists. They don’t get the public or press pressure that young mothers’ cancers and kids’ diseases get.

As yet, immunotherapy isn’t a cure, it’s a stretch more life, a considerable bit of life. More life with your kids, more life with your friends, more life holding hands, more life shared, more life spent on earth — but only if you can pay.

I’m early for my first eight-hour stint of platinum chemo. The ward in Charing Cross looks like a cross between a milking shed and an Air Koryo business lounge. I am settled into a hideous but comfortable chair and a tap is jabbed into the back of my hand. A series of plastic bags full of combative and palliative cocktails slowly dribble into my body and every 10 minutes I have to shuffle to an invalid’s loo to dribble it out again.

I like it here. The nurses are funny and comforting, optimistic, and bear the weight of the sadness, the regret and the pity in the room on their shoulders with an amused elegance and sincerity that comes from their years of experience, or the naivety of inexperience. The other patients shuffle in with their partners to share sandwiches, talk about shopping and the cousins in New Zealand and window boxes. There are children with ageing parents, happy/sad to be able to repay an infant’s debt.

I manage to find the one dealer in the ward, or rather she finds me. Her boyfriend’s making hash cakes — they’ve definitely shrunk his tumour, I should definitely have some. I smile, shrug apologetically and say sadly I’m already a junkie. I don’t take drugs.

“Really? Even for this?” I’m not giving up 32 years of clean time for some poxy lung.

And there are the ones who sit alone, who don’t have any friends to play cards with them, to drip the will and the strength and the faith to face this. I don’t know how anyone manages to do this on their own.

An old friend sits through the mornings with me, Nicola comes with lunch and Flora and Ali, my grown-up kids, share the afternoon. If it wasn’t for the cancer, that would be a really lovely day. If it wasn’t for the cancer.

There’s a natural break in the article here. It should have been finished two weeks ago, but I had a bad night, a really bad night.

Nicola called Guy, the GP, and he came round and took a look and said: “He needs to be in A&E now.”

So I’m on a gurney in Charing Cross at nine in the morning. On the other side of the blue plastic curtain, a bloke is being held down by three policemen shouting, “Don’t flick your f****** blood over here, I don’t want what you’ve got.”

A young doctor comes and asks me questions. All doctors in A&E are preternaturally young. One of the questions after “What’s your date of birth and the first line of your address?” is inevitably “Can I put my finger up your bottom to see if there’s any poo or blood?”

The other question is: “On a scale of 1 to 10 — 1 being a scratch and 10 unspeakable agony — what do you think you’re suffering at the moment?” You wouldn’t describe this as thin pain. It’s 10 out of 10. My stomach is agonised with a terrible wrenching distension. I’ve lived a middle-class, sheltered, uncombative, anti-violent life, so I don’t know how this compares to other more manly men’s pain, but this is by miles and miles the worst thing I’ve ever been through, thank you for asking.

More x-rays and blood tests and the surgeon returns with the complete granite face and says: “Well, it could be a burst ulcer, but of course it isn’t. The tumour in your pancreas has increased in size very fast. It’s as big as a fist.” And he shows me a fist in case I’d misplaced the image.

I’ve decided to call the pancreatic tumour Lucky, as a nod to prophetic Professor Gazzard. So the chemotherapy isn’t working. I ask my oncologist what’s next.

“It’s a bugger,” he says. “It looked so hopeful, but you’re right, it isn’t working. The pancreas is a bad place. We can’t operate and the side effects of radiation aren’t worth the risk.” And there’s pancreatic pain, which is famously in a league apart, so at least I can be stoical about that.

“What next?”

“Well, on the NHS we can give you another round of chemo, a bit rougher with slighter outcomes … but there is really only one treatment for you: nivolumab.”

From behind the blue curtain, the nurse asks the policeman: “What do you want to do with him?”

“Oh, let him go,” says the copper.

“I thought you’d arrested him?”

“No. Let him go.”

That evening I’m sitting in bed on the cancer ward trying to get the painkillers stabilised and a young nurse comes in.

“There you are. I’ve been waiting for you all day. You’re supposed to be with me down in chemotherapy. I saw your name. Why are you up here?”

“Well, it turns out the chemo isn’t working.” Her shoulders sag and her hand goes to her head. “F***, f***, that’s dreadful.” I think she might be crying.

I look away, so might I.

You don’t get that with private healthcare.

Cancer survival rates in Europe
The UK has the worst cancer survival rates in western Europe — a third lower than those of Sweden.

“Five-year cancer survival rates are so low in the UK because we’re so slow at diagnosing cancer in the first place. A patient must first see their GP, then be referred to see a specialist. The lag time can be months. And when each GP consultation lasts a few minutes, people can slip through the net altogether. In European countries, patients can access specialist care easily and straightaway.”

Dr Conrad Lewanski, consultant clinical oncologist and fellow of the Royal College of Radiologists 

AA Gill began taking nivolumab after writing this article

TableTalk – The Magpie Café Whitby

I’ve got cancer. Sorry to drop that onto the breakfast table apropos of nothing at all. Apropos and cancer are rarely found in the same sentence. I wasn’t going to mention it, the way you don’t. In truth, I’ve got an embarrassment of cancer, the full English. There is barely a morsel of offal not included. I have a trucker’s gut-buster, gimpy, malevolent, meaty malignancy. And I’ve mentioned it because, as I write in the first person, and occasionally some of you might take me seriously enough to book a table on a recommendation, you ought to know if there are any fundamental, gastro, epicurean, personal changes that would affect my judgment. If I were, for instance, struck down with palaeo-sidereal veganism, which I hope we would all agree would be worse. Or if I had all my teeth kicked out by an Icelandic horse on his way to the butcher’s. Chemotherapy can alter the way things taste. I am being rinsed with commando doses of platinum. My insides are being turned into road-rail, pig-lead, firewood, iron-ware and cheap tin trays. If ever things start tasting like licked battery terminals, I’ll tell you. Either that or I’ll be eating at Sexy Fish.

I’m forbidden from travelling on trains, boats, buses and planes. Nor can I drive. Jeremy Clarkson says this has nothing to do with getting cancer. I’ve been banned from riding a bike — even on grass, added the oncologist unkindly. So I’m not going to be plashing through marsh and fen to find outré openings (no change there — ed). If there was a good thing to say about cancer, and frankly this is medical bowel-scraping, it’s that it gives permission and excuse to friends to say and do generous things that the onset of gout or herpes might not have elicited. So, just after my diagnosis, I got a call from Jimmy Carr, who said, “Awful news, but I’d like to fulfil a bucket-list wish. I can pretend to be Jimmy Savile for a day. I’ve always wanted to do Jim’ll Fix It.” “How kind. What were you thinking of ?” “Well,” he said, “I’ve got to go up and do 10 minutes’ filming with Jeremy on his new show, and there’s a spare seat in the whirlybird. We can be back in London for tea. What do you say?” “Where are we going? Paris, Deauville, Barcelona?”


“Now you’re talking.”

If I didn’t have cancer, I would probably have passed on Whitby in October. But the thought that this might be my last chance ever to visit the place again clinched it. Whitby has the best fish and chips in Britain. So, the next morning, I get into the helicopter and there’s a manic Jimmy, gurning, “Nowthen,nowthen…”and we take off into the chilly Elstree dawn and chug north.  “So,” he asks, “cancer — what’s the silver lining? There must be anupside.”Well,there is: you can stop worrying about Alzheimer’s, but even that is a bit tarnished because I’m already an ambassador for the Alzheimer’s Society, and getting cancer is like going over to a competing charitable condition. Hey ho.

Whitby appears like a William Blake doodle over the North York Moors. As with most east-facing seaside towns, it both perches and hunches on the grey wet, with its gothic ruin and nudge-nudge naughty postcards. It’s a place that is both eminently dour and practical and utterly, bonkersly up some seaside spectrum. So, everyone on the street has apparently decided to dress at Millets for under £15 and attach themselves to a terrier. Or they’re dressing up as role-play therapy groups: there are goths, vampires and, today, masses of pensioners in Dad’s Army costume, platoons of spavined Home Guard and women going to collect their rations. It’s a steampunk version of Westworld. There are no tourists or trippers. They are just doing it for their own amusement.

Jimmy and I go in search of the Magpie Café, a fish’n’chip shop I deemed the best in Britain more than a decade ago. It remains completely, perfectly true to its calling. At 11.30, the little restaurant is beginning to fill up with retired couples in cagoules, coming in for an early lunch. But seaside fish and chips isn’t like other meals. We approach it with a proprietary fondness. This is grade 1 listed dinner, cultural heritage, a communion of secular us-ness. No one is eating fish and chips for the first time. Jimmy and I were given the table in the bay window, looking out at the wandering Private Godfreys and Van Helsings.

The fish is generous, fresh off the boat, battered with a loving authority. Beef-dripping twice- fried chips are thick, crunchy and floury. The curry sauce is authentically indigenous, free from any Asian aspiration. Mushy peas are marrow-fat bland sog, not blitzed garden frozen. They dance with a surprising elegance when dabbed with a douse of malt vinegar. There is bread that has been buttered as if there was still rationing and pots of brown, round-vowelled tea, and jam roly-poly that comes with custard and cream.

Jimmy and I are absurdly happy with the whole modest but profound table, each constituent panto part perfectly fitting in with its neighbour with a warming familiarity. We decided to judge, once and for all, the ancient north-south question of haddock or cod. And, as a Scot, I’m happy to say my national preference for haddock won by a slim, opalescent flake.This is, all things considered, without pretension but with utter self-confidence, still the best fish and chips in the world. Naturally, Clarkson disagrees and has his own Whitby favourite, Mister Chips, which is run by a messianically enthusiastic team. They have a board on which they write the name of the particular trawler your fish was landed from and, out of fairness, we took another complete fish dinner back with us on the helicopter. I have to say it was pretty damn perfect, and no one else in the ether of the world was having superior in-flight catering.

We all know what “getting our country back” means. It’s snorting a line of that most pernicious and debilitating Little English drug, nostalgia

It was the woman on Question Time that really did it for me. She was so familiar. There is someone like her in every queue, every coffee shop, outside every school in every parish council in the country. Middle-aged, middle- class, middle-brow, over-made-up, with her National Health face and weatherproof English expression of hurt righteousness, she’s Britannia’s mother-in- law. The camera closed in on her and she shouted: “All I want is my country back. Give me my country back.” It was a heartfelt cry of real distress and the rest of the audience erupted in sympathetic applause, but I thought: “Back from what? Back from where?”

Wanting the country back is the constant mantra of all the outies. Farage slurs it, Gove insinuates it. Of course I know what they mean. We all know what they mean. They mean back from Johnny Foreigner, back from the brink, back from the future, back-to-back, back to bosky hedges and dry stone walls and country lanes and church bells and warm beer and skittles and football rattles and cheery banter and clogs on cobbles. Back to vicars-and-tarts parties and Carry On fart jokes, back to Elgar and fudge and proper weather and herbaceous borders and cars called Morris. Back to victoria sponge and 22 yards to a wicket and 15 hands to a horse and 3ft to a yard and four fingers in a Kit Kat, back to gooseberries not avocados, back to deference and respect, to make do and mend and smiling bravely and biting your lip and su ering in silence and patronising foreigners with pity.

We all know what “getting our country back” means. It’s snorting a line of the most pernicious and debilitating Little English drug ,nostalgia. The warm, crumbly, honey-coloured, collective “yesterday” with its fond belief that everything was better back then, that Britain (England, really) is a worse place now than it was some foggy point in the past where we achieved peak Blightly. It’s the knowledge that the best of us have been and gone, that nothing we can build will be as lovely as a National Trust Georgian country house, no art will be as good as a Turner, no poem as wonderful as If, no writer a touch on Shakespeare or Dickens, nothing will grow as lovely as a cottage garden, no hero greater than Nelson, no politician better than Churchill, no view more throat- catching than the White Cliffs and that we will never manufacture anything as great as a Rolls-Royce or Flying Scotsman again.

The dream of Brexit isn’t that we might be able to make a brighter, new, energetic tomorrow, it’s a desire to shuffle back to a regret-curdled inward-looking yesterday. In the Brexit fantasy, the best we can hope for is to kick out all the work-all-hours foreigners and become caretakers to our own past in this self-congratulatory island of moaning and pomposity.

And if you think that’s an exaggeration of the Brexit position, then just listen to the language they use: “We are a nation of inventors and entrepreneurs, we want to put the great back in Britain, the great engineers, the great manufacturers.” This is all the expresion of a sentimental nostalgia. In the Brexiteer’s mind’s eye is the old Pathé newsreel of Donald Campbell, of John Logie Baird with his televisions, Barnes Wallis and his bouncing bomb, and Robert Baden-Powell inventing boy scouts in his shed. 

All we need, their argument goes, is to be free of the humourless Germans and spoilsport French and all their collective liberalism and reality. There is a concomitant hope that if we manage to back out of Europe, then we’ll get back to the bowler-hatted 1950s and the Commonwealth will hold pageants, fireworks displays and beg to be back in the Queen Empress’s good books again. Then New Zealand will sacrifice a thousand lambs, Ghana will ask if it can go back to being called the Gold Coast and Britain will resume hand-making Land Rovers and Sheffield plate teapots. 

There is a reason that most of the people who want to leave the EU are old while those who want to remain are young: it’s because the young aren’t infected with Bisto nostalgia. They don’t recognise half the stuff I’ve mentioned here. They’ve grown up in the EU and at worst it’s been neutral for them.

The under-thirties want to be part of things, not aloof from them. They’re about being joined-up and counted. I imagine a phrase most outies identify with is “women’s liberation has gone too far”. Everything has gone too far for them, from political correctness — well, that’s gone mad, hasn’t it? — to health and safety and gender-neutral lavatories. Those oldies, they don’t know if they’re coming or going, what with those newfangled mobile phones and kids on Tinder and Grindr. What happened to meeting Miss Joan Hunter Dunn at the tennis club? And don’t get them started on electric hand dryers, or something unrecognised in the bagging area, or Indian call centres , or the impertinent computer asking for a password that has both capitals and little letters and numbers and more than eight digits.

We listen to the Brexit lot talk about the trade deals they’re going to make with Europe after we leave, and the blithe insouciance that what they’re offering instead of EU membership is a divorce where you can still have sex with your ex. They reckon they can get out of the marriage, keep the house, not pay alimony, take the kids out of school, stop the in-laws going to the doctor, get strict with the visiting rights, but, you know, still get a shag at the weekend and, obviously, see other people on the side. 

Really, that’s their best offer? That’s the plan? To swagger into Brussels with Union Jacks pants on and say “Ello luv, you’re looking nice today. Would you like some?” When the rest of us ask how that’s really going to work, leavers reply, with Terry- Thomas smirks, that “they’re going to still really fancy us, honest, they’re gagging for us. Possibly not Merkel, but the bosses of Mercedes and those French vintners and cheesemakers, they can’t get enough of old John Bull. Of course they’re going to want to go on making the free market with two backs after we’ve got the decree nisi. Makes sense, doesn’t it?”

Have no doubt, this is a divorce. It’s not just business, it’s not going to be all reason and goodwill. Like all divorces, leaving Europe would be ugly and mean and hurtful, and it would lead to a great deal of poisonous xenophobia and racism, all the niggling personal prejudice that dumped, betrayed and thwarted people are prey to. And the racism and prejudice are, of course, weak points for us. The tortuous renegotiation with lawyers and courts will be bitter and vengeful, because divorces always are and, just in passing, this sovereignty thing we’re supposed to want back so badly, like Frodo’s ring, has nothing to do with you or me. We won’t notice it coming back, because we didn’t notice not having it in the first place.

You won’t wake up on June 24 and think: “Oh my word, my arthritis has gone! My teeth are suddenly whiter! Magically, I seem to know how to make a soufflé and I’m buff with the power of sovereignty.” This is something only politicians care about; it makes not a jot of difference to you or me if the Supreme Court is a bunch of strangely out-of-touch old gits in wigs in Westminster or a load of strangely out-of-touch old gits without wigs in Luxembourg. What matters is that we have as many judges as possible on the side of personal freedom.
Personally, I see nothing about our legislators in the UK that makes me feel I can confidently give them more power. The more checks and balances politicians have, the better for the rest of us. You can’t have too many wise heads and different opinions. If you’re really worried about red tape, by the way, it’s not just a European problem. We’re perfectly capable of coming up with our own rules and regulations and we have no shortage of jobsworths. Red tape may be annoying, but it is also there to protect your and my family from being lied to, poisoned and cheated.The first “X” I ever put on a voting slip was to say yes to the EU. The first referendum was when I was 20 years old. This one will be in the week of my 62nd birthday. For nearly all my adult life, there hasn’t been a day when I haven’t been pleased and proud to be part of this great collective. If you ask me for my nationality, the truth is I feel more European than anything else. I am part of this culture, this European civilization. I can walk into any gallery on our continent and completely understand the images and the stories on the walls. These people are my people and they have been for thousands of years. I can read books on subjects from Ancient Greece to Dark Ages Scandinavia, from Renaissance Italy to 19th-century France, and I don’t need the context or the landscape explained to me. The music of Europe, from its scales and its instruments to its rhythms and religion, is my music. The Renaissance, the rococo, the Romantics, the impressionists, gothic, baroque, neoclassicism, realism, expressionism, futurism, fauvism, cubism, dada, surrealism, postmodernism and kitsch were all European movements and none of them belongs to a single nation. There is a reason why the Chinese are making fake Italian handbags and the Italians aren’t making fake Chinese ones. This European culture, without question or argument, is the greatest, most inventive, subtle, profound, beautiful and powerful genius that was ever contrived anywhere by anyone and it belongs to us. Just look at my day job — food. The change in food culture and pleasure has been enormous since we joined the EU, and that’s no coincidence. What we eat, the ingredients, the recipes, may come from around the world, but it is the collective to and fro of European interests, expertise and imagination that has made it all so very appetising and exciting. The restaurant was a European invention, naturally. The first one in Paris was called The London Bridge.

Culture works and grows through the constant warp and weft of creators, producers, consumers, intellectuals and instinctive lovers. You can’t dictate or legislate for it, you can just make a place that encourages it and you can truncate it. You can make it harder and more grudging, you can put up barriers and you can build walls, but why on earth would you? This collective culture, this golden civilisation grown on this continent over thousands of years, has made everything we have and everything we are, why would you not want to be part of it? I understand that if we leave we don’t have to hand back our library ticket for European civilisation, but why would we even think about it? In fact, the only ones who would are those old, philistine scared gits. Look at them, too frightened to join in.