Professor Raymond Tallis

Presenter0:00

Hello, I'm Kirsty Young, and this is a podcast from the Desert Island Discs archive. For rights reasons we've had to shorten the music. The programme was originally broadcast in two thousand seven.

Presenter0:27

My castaway this week is the physician, philosopher, poet, and novelist Professor Raymond Talas.

Presenter0:34

As one of Britain's foremost medical thinkers, he brings a passion to his work that extends well beyond the clinical, saying that most of his writing is about unpacking the miracle of everyday life. Yet it's in his specialism of geriatric medicine that the subject of death caused him a significant change of heart. Called upon to professionally investigate a sister dying, he ended up reversing his own view against it, and deciding that, in the right circumstances, patients should indeed be helped to kill themselves.

Presenter1:05

Your own father, Retalis, once posed the question what do you want to treat all those old people for? Everyone's got to die of something. But he had a point, didn't he?

Professor Raymond Tallis1:13

His point was undermined by the fact that he was ninety-two when he asked me and he was in receipt of a lot of good medical treatment and was benefiting from it. And I think in a way it's important not to think of medical care of older people as being hedged around with lots of ethical problems. Most medical care of older people, like the medical care of younger people, actually consists of getting people back on the feet and returning to everyday life.

Presenter1:34

I've said that one of your preoccupations is unpacking the miracle of everyday life, which is a gorgeous phrase. And if you are preoccupied with that and concerned with that.

Presenter1:43

Um it seems interesting that you didn't choose to go into, for example, obstetrics or pediatrics, areas of medicine where life is bursting out all over.

Professor Raymond Tallis1:52

Um why? Well, someone once said of diplomacy that it was consists of hours of boredom and moments of terror, and that's really what obstetrics is like, really. A lot of it is routine, and then there's things that go wrong very rapidly.

Professor Raymond Tallis2:04

Whereas geriatric medicine is incredibly rich and varied, not only are people living longer.

Professor Raymond Tallis2:10

But they're living in better nick for a high proportion of their life.

Professor Raymond Tallis2:14

And I think the great challenge of geratic medicine, indeed the great challenge of medicine, is to make the health span approximate more and more closely to the life span, and we're making huge progress in that direction.

Presenter2:24

When you started off on the geriatric uh wards, it would have been the beginning of the eighties, nineteen eighty one. I mean, w can you paint a little picture of how things looked on your ward rounds in in those days?

Professor Raymond Tallis2:29

You can see one.

Professor Raymond Tallis2:34

Things were pretty grim. I mean, many patients were not managed well. The patients on the whole were in their seventies and early eighties, whereas now they're largely in their eighties and early nineties. The health of older people has improved enormously. There's no patient for whom you can't do something that will make their life better, even if they have a condition that isn't essentially reversible.

Professor Raymond Tallis2:56

You can manage even dying better.

Presenter2:58

Much of your writing is dedicated to what makes us unique, what makes humans so very different from the animals. And your contention is that there is something very distinctive, that there's something about the being that makes us special.

Professor Raymond Tallis3:03

Excuse me.

Presenter3:13

Have you witnessed, as a doctor, things that have essentially formed that view, solidified that view, and what have they been?

Professor Raymond Tallis3:20

No, I think it's come really from everyday life, and curiously, scientific medicine tries to close the gap between ourselves and animals. The success of scientific medicine is based on the fact that we approach our bodily ills as the ills of an organism, an organism that is not too different from the other organisms in nature. And that's one of the paradoxes of medicine, because obviously the knowledge that we have of the human body is unlike any knowledge that any other animal has of its body. So there is a paradox there.

Presenter3:49

Let's take a break for your first piece of music. Tell us about it.

Professor Raymond Tallis3:52

Oh, my first choice is a Mass by Palestrina, the Missa Pape Marcelli Mass. It is a marvellous combination of joy and sadness. It's a bit like a rainbow on a waterfall. It has that extraordinary feeling, and also the sense of the world being trans illuminated with awe.

Presenter5:06

The opening of the Kyrie from Palestrina's Misa Pappi Marcelli, sung by the Procanzione Anticua, directed by Mark Brown. Now, your other passions are philosophy and poetry. You've dedicated your professional life to medicine, but what is it about those two things that so captures your mind? A mind that I should tell listeners was named by Prospect magazine as one of the foremost thinkers of our times. That's quite something.

Professor Raymond Tallis5:31

At this stage I'll now leave. Yeah, absolutely.

Presenter5:34

So, what is it? I mean, philosophy and poetry are your passions. Why do they?

Professor Raymond Tallis5:39

So ignite you.

Presenter5:39

Yeah.

Professor Raymond Tallis5:40

They have something in common, which is an attempt to capture a large piece of the world in a relatively small space.

Professor Raymond Tallis5:47

Philosophy, of course, tries to open dormer windows in our consciousness, to make us see beyond our normal wakefulness, to untake for granted.

Professor Raymond Tallis5:55

And by looking

Professor Raymond Tallis5:57

at things from a great distance to encompass the world in which we live.

Presenter6:01

Are these the things that make us uniquely human, these preoccupations?

Professor Raymond Tallis6:05

I think those preoccupations arise out of what is deepest in what makes us uniquely human. But one doesn't have to be a poet or a philosopher to be very human. It is uniquely human to have such temporal depth as we have, to be related specifically and explicitly to a past, and to reach into a future. It is even more uniquely human if one can have degrees of uniqueness, which one can't, of course. I'm not going to pay.

Presenter6:29

The QR

Professor Raymond Tallis6:30

Thank you. To reach into a future that is formatted, that is set out in a calendar, to have the sense of future years of future generations, to have a sense of the future of the planet, which we have responsibility for those who follow from us.

Presenter6:30

Thank you.

Presenter6:45

When I listen to you talk about it, of course, you articulate things beautifully, but for a lot of people these are these are not their proof preoccupations. For a lot of human beings, their preoccupations are simply getting through the day. Does it make their experience of being a human lesser because they can't think in the terms that you can?

Professor Raymond Tallis6:58

Not at all. I mean, but that's a very good question. I mean, I think it was Brecht who once said, you know, grub first and then ethics, and I imagine philosophy comes in a, you know, a long way behind that. I guess I am thinking a lot of the time. But the truth is, for most of the time, I'm a busy, preoccupied person running for a bus like anybody else, and I have arias, if you like, of philosophy, but most of the recitative is non-philosophical.

Presenter7:20

In the introduction I said you were a physician, a philosopher, a poet, and a novelist, and and I want to pick up on the poetry now, because it seems to chime very beautifully with what you've just spoken about. Can I ask you to read a little bit of one of your poems, which is the one I'd like you to read from, is Fathers and Sons, which seems to be on this very subject.

Professor Raymond Tallis7:38

A year ago I lived almost at ease with knowing that my father had grown old.

Professor Raymond Tallis7:42

There's nothing much amiss with growing old. Ageing's not an illness doctors treat.

Professor Raymond Tallis7:48

That a body used through seven or more decades is touchy being a field self-sown with mines is precisely what the healthy mind ignores.

Professor Raymond Tallis7:58

like the heightened probability of pain.

Professor Raymond Tallis8:01

of something going wrong that won't come right resistless, drifting down decrepitude deportation to those camps fenced in with ills, policed by strutting gauliters of death.

Professor Raymond Tallis8:14

Since that wind blown autumn, when my infant son first raised his cries, his colour's in the air.

Professor Raymond Tallis8:22

An equanimity has gone from me.

Professor Raymond Tallis8:25

I see you, father, now as one afraid, afraid like me for what the end may bring.

Professor Raymond Tallis8:31

I had not feared for you as for myself As for my son, whose every minor ill Makes time itself go grimy with unease.

Presenter8:41

Beautiful. Thank you.

Presenter8:43

It seems a good time to take a break for a record. What have you chosen?

Professor Raymond Tallis8:47

This is the lullaby from Faure's Dolly Sweet.

Professor Raymond Tallis8:51

It's probably the first bit of music that I remember, because it was the signature tune for Listen With Mother, and I can remember.

Professor Raymond Tallis8:58

as the quarter an hour came to an end, cursing as woman's hour replaced listen with mother. But actually this piece of music extends throughout my life, because towards the end of his life my father went blind and he developed an interest in classical music, and we used to play a lot of tunes, including the lullaby from Faure, and he enjoyed it enormously. So it really it is a piece of music that's extended throughout my life.

Presenter10:16

The lullaby from Foray's Dolly Sweet performed by Katia and Marielle Le Beck. So we have some sense then, Ray Tellis, of your adult thoughts some sense, a little taster. But but tell us where those thoughts began then. Were were you a a serious child?

Professor Raymond Tallis10:32

I was very serious. I mean, I've often said that I was middle aged by the age of eight. I think it's probably true anxious, slightly timid, and very preoccupied with the problems of the world in one way or another.

Professor Raymond Tallis10:45

Well, my father

Professor Raymond Tallis10:47

made it very clear to us that the world was a very serious and quite unforgiving place, and that has certainly been his own experience, and I think that communicated to us.

Presenter10:55

And what had made him believe that that was the case?

Professor Raymond Tallis10:58

He'd had a very tough life. He was one of seven kids. He had a feckless father, whom they eventually got rid of. His mother went blind at a fairly early age in her life, and he had to fend for himself, in terms of leaving school at twelve, thirteen, or whatever. And no no one was going to look after him.

Professor Raymond Tallis11:17

He was a man of great integrity. Also a very tough character. Um he was quite irritable. He was very much a control freak. But I could understand that. You know, in a world that was unforgiving, I think I would want to control things, particularly in relation to money.

Presenter11:30

Tinker.

Presenter11:31

And and what had he made of his life? I mean, he was a successful man.

Professor Raymond Tallis11:34

He was very successful, and if you look at where he came from and where he took us, his children, I think it's a life he should have looked back with great satisfaction.

Presenter11:43

Were you scared by him or inspired by him?

Professor Raymond Tallis11:47

I bet of both. I mean, he had a high voltage frown, that's for sure. And we didn't he never struck us, he never even had to shout at us, he just had to look at us, and we beha you know, behaved ourselves. Um I also was inspired by him. There was an assumption that the world was an interesting place. He read enormously. You know, had he had the opportunity I had, who knows what he might have achieved.

Presenter12:09

So you were a very clever little boy then. It was clear from the beginning. You you were the middle of five children?

Professor Raymond Tallis12:14

I think it's a very good idea.

Presenter12:15

And it was clear from the start that here was a brain.

Professor Raymond Tallis12:19

I guess so, yes. Yeah.

Presenter12:21

What were what were your hobbies when you were little?

Professor Raymond Tallis12:24

Um I was very into natural history. We used to spend hours um bird spotting, badger watching. I mean we'd go out at temperature of twenty degrees Fahrenheit, sit all night in a forest outside a badger set, see a badger come out, have a pee, and go back into its set, and we'd feel we'd had a good night out.

Presenter12:42

Yeah.

Professor Raymond Tallis12:42

Uh Uh

Presenter12:43

And who's to say that's not a good night act? Tell me about your third record.

Professor Raymond Tallis12:48

Hey Jude, of course. Inevitably being a child whose adolescence coincided with the rise of the Beatles, and what's more, being a liver puddlin, I must have one of the Beatles' tunes. And the one I have chosen is Hey Jude, because that, more than any other tune, captures for me the sense of the infinite possibility you have when you're young.

Speaker 413:06

Hey Jew.

Speaker 413:09

Don't make it bad

Speaker 413:13

Take a sad song and make it better

Speaker 413:19

Remember to let her into your heart.

Speaker 413:25

Then you can start. To make it

Presenter13:29

Yeah better.

Presenter13:31

The Beatles and Hey Jude. This uh serious little boy then turned into a relatively serious teenager. Is it true that you read philosophy as a teenager?

Professor Raymond Tallis13:40

Well, I mean, I had a series of quite significant crises when I was a teenager. I became very anxious about death a strange sense that perhaps things weren't real. So I was aptly astonished that there was such a thing called philosophy, and philosophers were concerned with the difference between appearance and reality, and whether we had access to reality.

Presenter13:59

And so once you started reading The Philosophers and you started understanding that other people had thought these thoughts before, w was that a sense of comfort? Did it quell the inner anxiety?

Professor Raymond Tallis14:08

It was a trivic sense of joining a massive conversation. Suddenly all these peculiar feelings were really, you know, rather more superior than I'd actually thought they were. They weren't just basical evidence that I was about to go mad.

Presenter14:19

Did you actually think you were going to go mad?

Professor Raymond Tallis14:22

There were times when I felt very strange indeed, and I felt

Professor Raymond Tallis14:26

My thoughts and my moods were completely out of control.

Presenter14:29

Did anyone in the family recognize that any of your brothers and sisters or your your mother?

Professor Raymond Tallis14:34

I guess in a way it was a sort of embarrassing, and you I mean it's not the kind of thing you would sort of talk about. Um going a bit dippy didn't seem like the kind of thing you would naturally drop into a conversation.

Presenter14:44

Uh w what sort of person was your mother, actually? We haven't spoken about her.

Professor Raymond Tallis14:47

Very gentle and kind. Uh she in many ways uh modified the harsh is the wrong word but father's regime. She was a a softening influence.

Professor Raymond Tallis14:57

She was also the person to whom I brought all my achievements and such as they were, you know, so if I had got ten out of ten, she'd be the first person I'd rush home to and tell, and that was always the case.

Presenter15:06

What did your parents expect of you when when it was clear that quite often you were getting ten out of ten?

Professor Raymond Tallis15:12

Initially I looked quite good at mathematics. My father had great hopes that I'd become a mathematician.

Professor Raymond Tallis15:17

Um he accepted it when I decided I would become a biochemist, but I discovered I was no good at biochemistry, and decided to do medicine, and that was quite a disappointment for my father. An even greater disappointment, of course, is when I became a geratrician and looking after all those old people. So it's been a series of disappointments in a way.

Presenter15:34

Ray, that is extraordinary, though. I mean, to to say that your father was disappointed because you were going to become a doctor for for most parents that's the very pinnacle of achievement, my son the doctor.

Professor Raymond Tallis15:45

Yes, I think he thought there was an element of the quack about doctors, and he'd spent his nineteen thirties as a drug rep selling samples, and he knew what doctors were like, and it looked a pretty homely, shabby business, and I guess he saw me going to this homely shabby business.

Presenter15:58

You were young uh when you went up to Oxford, only seventeen.

Presenter16:02

Um nobody around, I would imagine, would have been cleverer, not much than you were, but they would have been posher, they would have been richer. Did those two things matter?

Professor Raymond Tallis16:10

They did. I was very aware that people were posher. I also thought people were brighter. And I think I was very conscious that people were richer. I was pretty hard up at Oxford, actually. My father kept a tight rein on the expenses. One of the first things would happen when I would come home at the end of each term. We'd go through the notebook, and in the notebook I'd have to note down every single item of expenditure. And I wasn't above sort of balancing the books by putting down an extra tube of toothpaste, but I never got past the auditor. He would say, Well, I see you got toothpaste on the thirteenth of March, and then there's another tube of toothpaste on the twenty ninth of March. What are you doing with toothpaste?

Professor Raymond Tallis16:48

to which is no easy answer.

Speaker 416:51

Good.

Professor Raymond Tallis16:51

I don't defend him there because you know nobody ever gave him any free lunch, that's for sure. And it was only by controlling the money that he managed to actually.

Speaker 416:51

He couldn't.

Professor Raymond Tallis16:59

to bring us up in a reasonable

Professor Raymond Tallis17:01

Standard Living

Presenter17:02

Tell me about your fourth piece of music, Ray.

Professor Raymond Tallis17:04

Oh, yes.

Professor Raymond Tallis17:06

Well, the fourth piece in music is the Bach Cello Suites, and they are particularly associated for me with Chris Verity, who has been my longest standing friend. We were the only two medical students in Keevil College.

Professor Raymond Tallis17:17

And we struck up a friendship straight away. And for me, it was hugely beneficial. Chris was outgoing, he was extremely sociable, and in many ways, without him, I don't think I would have.

Professor Raymond Tallis17:29

as frequently crept outside of my room as I did, and enter

Professor Raymond Tallis17:33

Really, quite an interesting social set.

Professor Raymond Tallis17:36

Uh I particularly associate the cello suites with him because he gave it to Terry and myself as our wedding present, and uh therefore he's always associated with this particular piece of music.

Presenter18:46

Paul Tortellier, playing in part of the prelude to Bach's Cello Suite No. Six in D Major. Your life as you describe it as a student was on a pretty tight rein then, Raymond. But at twenty four you did an extraordinary thing. With your new wife, Terry, you went to Nigeria. You you said it was a a shocking time, a shocking experience. Can you describe it to us?

Professor Raymond Tallis19:06

It was I guess I wasn't prepared for the corruption, for the indifference people had to each other's suffering, for the disorganisation and incompetence.

Presenter19:16

At its worst, what what did you see in the wards?

Presenter19:19

Yeah.

Professor Raymond Tallis19:19

Uh

Presenter19:19

Uh

Professor Raymond Tallis19:19

I suppose one particular episode continues to haunt me is a woman who came in in the last stages of something called peripartal cardiac failure, and he responded extremely well to diuretics. This lady came in desperately ill, and we found the drug cupboard locked, and a member of staff who had the key had gone off for her lunch.

Speaker 419:37

Ooh.

Presenter19:37

Uh

Professor Raymond Tallis19:39

So we could not do anything. We just watched this woman die in front of us. And then her grieving husband took away her body over his shoulder down the corridor, and he was sort of set upon by porters who were trying to explain that the body had to be put into a mortuary and, you know, that the processes had to go through. And I thought that was such an awful mixture of incompetence, indifference, and bureaucracy, as I never hoped to see again.

Presenter20:02

You've said since that your books on philosophy indeed you've written more than a dozen and those of poetry have their roots in that time, that time in in Africa. Di did it really shape your thinking that much?

Professor Raymond Tallis20:14

Absolutely. In a sense that that one doesn't need many thoughts, one just needs fundamental ones. And it was I guess it was the fundamental thoughts that I had then that I've been unpacking since.

Presenter20:25

It seems a good time to take a break for a record. Record number five. What is it?

Professor Raymond Tallis20:29

Well I I've chosen the Razumovsky Quartet by Beethoven. This I associate with the time when Terry and I, Terry and my wife, and I met. And we both loved classical music and we both fell in love with chamber music. I mean this is an extraordinary happy time in my life. You know, we've been together for thirty seven years, married for thirty five years of it, and it is nice to think about the time when we first met, when we were together discovering this sort of music.

Presenter21:56

The Hungarian quartet playing the opening of Beethoven's quartet number seven in F major, the Rasumovsky.

Presenter22:02

For twenty years you were a consultant at Salford and a professor at Manchester. Your life was spent treating elderly patients, thinking about the sort of care they needed. Tell me what you think it means then to treat somebody, to treat an older person with dignity.

Professor Raymond Tallis22:16

Well, first of all, not calling him by their first name. I if anybody calls me Raymond or Puppet when I am in hospital, I will not be accountable for my actions. I think the second thing is not speaking to that individual in a sort of kindergarten patois.

Professor Raymond Tallis22:32

The third thing is to actually acknowledge their individual needs.

Professor Raymond Tallis22:38

And of course, in addition, that you actually treat them appropriately in t in the in the technical sense.

Presenter22:43

You must have encountered in your years in medicine relatives who believe that their elderly parents or grandparents should be given every possible intervention. How do you deal with that sort of attitude?

Professor Raymond Tallis22:58

Sometimes people do find it difficult to accept, you know that life is a condition with our 100% mortality. Nobody gets out of life alive.

Speaker 423:04

Yeah.

Presenter23:04

Uh

Professor Raymond Tallis23:07

Every now and then it seems to me that people cannot accept that their loved one has actually got an irreversible disease and that no further treatment is going to benefit them, and it becomes quite a difficult discussion. It becomes particularly difficult in relation to things like cardiopulmonary resuscitation. I mean nothing is more appalling than jumping on the chest of somebody who has a fatal illness and trying to resuscitate them, as a result of which they have broken ribs, perhaps a few hours of twilight existence, and die in a state of indignity.

Presenter23:40

And how do you explain that to a a relative who is sitting in a room and with white knuckles grasping on to the the possibility that they're not about to lose their mother or father?

Professor Raymond Tallis23:52

I think the first thing is to make people realise we're all on the same side. You know, I would whatever I'm doing, I'm doing what I hope is the best for the patient.

Professor Raymond Tallis24:00

Uh once you can get

Professor Raymond Tallis24:02

That clear? Then I think the knuckles unwhiten to some extent, and one can then have a reasonable conversation about really what would misses Smith really want? Would the adverse effects of further treatment really w outweigh any remotely construed benefits?

Presenter24:17

Tell me about your sixth piece of music.

Professor Raymond Tallis24:20

I suppose it's absurd to describe anything as the greatest X or Y, but I have to say that if there is such a thing as a greatest piece of chamber music it must be Schubert's string quintet.

Presenter25:30

The opening movement of Schubert's string quintet in C major, played by the Malos Quartet with Mr. Slav Rostropilvich. So in October two thousand two then, Raymond Talas, you took over as chairman of the Royal College of Physicians Committee on Clinical Ethics, and part of your job there was to draw up a response from the college to the key ethical issues of the day. And within months of you beginning to chair that committee, Lord Joffey introduced what was called the Assisted Dying Bill for the Terminally Ill. At the beginning of that journey, what was your personal feeling?

Professor Raymond Tallis26:04

My view was I was very much against it. I mean the last member of the multidisciplinary team who went around the bedside of a dying person was a judge. I thought it would stunt the development of palliative care, and it would undermine the trust between doctors and patients, and possibly set us on a slippery slope.

Presenter26:22

And just to be clear, assisted dying then is when the the doctor, the physician, prescribes medication which a patient can then take to end their own life.

Professor Raymond Tallis26:30

You're absorbed, the final act is carried out by the patient, and that's what differentiates from euthanasia.

Presenter26:35

Which is where the doctor himself or herself would administer the medication.

Professor Raymond Tallis26:38

Yeah.

Presenter26:40

So you went on on this journey of discovering more about the subject, and as you went through the journey, you changed your mind.

Professor Raymond Tallis26:48

I changed my mind. Perhaps uniquely I've changed my mind in the light of facts. If you look at Oregon, for example, where they have a bill which is very similar to the proposed Joffee Bill, you can see all of those assumptions I had were incorrect. And it's important to realize the assisted dying bill would have a much broader impact on the whole process by which we discuss end of life decision making. At the moment it's shrouded in clinical and ethical and legal fudge, and I think that's dangerous for patients and I think it's dangerous for doctors.

Presenter27:19

Currently where we stand then is that doctors are allowed to administer painkillers, knowing that the secondary effect of administering that medication is to hasten the death of the patient. And this is known, I understand, as the double effect. So we're living with a situation where doctors quietly can get on with that, but it's not acknowledged that it's happening.

Professor Raymond Tallis27:40

Well, as long as the primary intention isn't to hasten the patient's death, and the primary intention is to control their symptoms, then that is within the law. But of course, how do you judge primary intention?

Professor Raymond Tallis27:50

It seems to me that in the end you cannot replace trust in doctors and m many bodies have done their best to blow a hole in the trust between patient and doctor and I think that's unforgivable because it leads actually to bad medicine, defensive medicine and also to the doctors basically protecting themselves as opposed to considering the needs of the patient.

Presenter28:12

Currently, legally, the alternative then is to withhold food and water from a patient. What is it like to see a patient dying under those circumstances?

Professor Raymond Tallis28:22

It is very unpleasant, and the idea you force a patient to fight their way out of life through this horrible barbed wire entanglement of dehydration and malnutrition, I think is quite unacceptable. And people have got to think about the alternatives. If you're against the assisted dying bill, you're condemning a small number of people to suffer for the sake of your beliefs, not theirs.

Presenter28:44

What about the right to die, though changing in the patient's mind to the duty to die, the worry that old people carry on them that in fact they will be nothing but a burden?

Professor Raymond Tallis28:55

Yes. I mean, that in a sense is another empirical assertion, and you need to check it against the data. If you look at Oregon, the people who have availed themselves of assisted dying are actually.

Professor Raymond Tallis29:05

Feisty.

Professor Raymond Tallis29:06

Very self-assertive individuals who, in their lives, have always been in charge, and that's.

Professor Raymond Tallis29:11

Not at all surprising. In many ways you have to requisition assisted dying for yourself. You've got to be fairly assertive.

Presenter29:18

As you describe it then, at this moment we we're in a fudge. We're in a sort of no man's land. I mean, as a practising doctor, have you you must have been in these situations where there is an understanding between you and a patient that now I want to go and now I know you can help me to go. What path do you choose?

Professor Raymond Tallis29:22

Whereas

Professor Raymond Tallis29:37

Well, I guess I fudge like everybody else, I know, and utilize the double effect, and hope it delivers what the patient needs.

Presenter29:45

And don't have straightforward conversations, but simply think that I believe as a fellow-human being that I know what it is you want me to do.

Professor Raymond Tallis29:54

I've had lots of conversations with patients and

Professor Raymond Tallis29:57

They make it very clear to me whether they want aggressive treatment, whether they want treatment.

Professor Raymond Tallis30:03

to be withdrawn, including life saving treatment, and whether they want the focus to be on controlling symptoms, even if it does hasten their death. Those are the kind of conversations one has. But one is not able to talk about the possibility of actually assisting them to die.

Presenter30:18

Tell me about your seventh piece of music.

Professor Raymond Tallis30:21

One of the wonderful things about Mozart is he can turn human bickering into the most delicious, fantastic music, and nothing could be better illustrated than this beautiful sextet from Figaro.

Speaker 430:41

Oh, I saw

Speaker 330:48

Swear it me.

Speaker 330:50

Sality Speak the question

Speaker 431:00

Uh

Speaker 431:16

Here is the layer of day farming.

Speaker 431:24

Yeah.

Presenter31:32

The end of the second act of Mozart's The Marriage of Figaro. Given how long you have spent working in the NHS, um, it would be tempting to be ground down by everything that's expected of you, and and yet you clearly are not.

Professor Raymond Tallis31:48

I think the NHS is a wonderful organisation.

Professor Raymond Tallis31:50

And when people talk about the NHS falling apart, I can remember Nigeria, so I have a benchmark there.

Professor Raymond Tallis31:57

I suppose for me the most exciting moment was in nineteen ninety seven when Blair Government came to power.

Professor Raymond Tallis32:03

We thought, great, this is it After years of endless reorganization. What did we get? More years of endless reorganization. Of course we got the resources, which is wonderful.

Professor Raymond Tallis32:14

But the damage caused by endless reorganisation has been incalculable. It's like trying to repair a ship endlessly below the water in the roaring forties, and that's what we've had

Professor Raymond Tallis32:25

Since Riddy Blair came to power.

Presenter32:27

What would you say to the politician then, who is frustrated by the the I was going to say millions, of course, in fact it's billions that have been flooding into the NHS since Blair's well they call them reforms, the only implicit in that is the fact that they are doing good. But the the billions of taxpayers' money that have gone in and the apparent

Professor Raymond Tallis32:39

Yeah.

Presenter32:45

Lack of the ability of the NHS to reach the targets, to hit the mark.

Professor Raymond Tallis32:52

Well, the NHS has reached targets. When you have a target, you reach it. You know, that's one of those things that always happens. Things are fiddled, so you do reach a target. But it seems to me that the money has been wasted in endless reorganization. So I think that the politicians really have to ask themselves why the money hasn't delivered, and it is not due to the lack of commitment of people on the front line.

Presenter33:15

Tell me about your final choice, record number eight.

Professor Raymond Tallis33:18

Greece has been a very important part of my life and of Terry's life, the climate, the people, the music and so on. But Cornwall also matters enormously, and I associate it very much with our children. Every year we all used to go to Cornwall together. And of course the weather in Cornwall is not exactly what you might hope. And we spend at least as much time hiding behind windbreaks and sometimes underneath windbreaks on the beach as we did you know, playing in the sunshine. And when the weather got really bad we used to drive inland.

Professor Raymond Tallis33:47

And the boys, detecting there was a certain amount of mildew on the collective soul, would say, Come on, Dad, let's have the Greek and we would play some music by Theodorakis, who's one of my favourite Greek composers.

Speaker 433:57

Mesastamakya Suglikes Ta Yanyana Votes Tayanyana Foch Mesa Stamar Kyasulig Mesa Stamatya Suglikes Tayanyana Nifot

Presenter34:27

Micus Theodoracus and Ecomie Agope. So, of course, we give you the Bible, we give you the complete works of Shakespeare, and you can take one other book. What would it be?

Professor Raymond Tallis34:37

I had no problem making this choice. It would be Martin Heidegger's Being in Time. It is probably the greatest work of philosophy of the twentieth century. I have written a book about it already, but I feel I have hardly sort of dipped my toe in the water.

Presenter34:48

And what luxury would you take?

Professor Raymond Tallis34:50

Well, assuming I'm allowed to have all the necessary equipment, I'd like to have a video recording.

Professor Raymond Tallis34:56

Of the family, what Terry once described as our ideal day, which is when we were all in holiday on holiday in Cornwall towards the end of 1995, it was near the last day of the holiday, and it was an absolute perfect day. I'd love that for two reasons. One is it would stop my memory, as it were, eroding. I would remember how things actually looked, and the other is because I'm interested in unpacking the miracle of everyday life, I could use that basically as the material which I would endlessly unpack while I'm on the island.

Presenter35:22

And I'm going to make you choose one of the eight, of course. If you could only take one disc, what would it be?

Professor Raymond Tallis35:28

It'll be the Schubert, because I think of the conditions in which he he wrote it. He was dying of syphilis at the time. Thinking about Schubert facing death in that way it would probably stop me feeling too much self pity.

Presenter35:40

Professor Raymond Tannis, thank you very much for letting us hear your desert island discs.

Professor Raymond Tallis35:43

Well, thank you very much indeed. It's been a huge pleasure.

Presenter35:53

You've been listening to a podcast from the Desert Island Dists archive. For more podcasts, please visit bbc.co.uk slash radio four.

Speaker 436:44

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