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Mass Listeria: The Meaning of Health Scares
Life expectancy has increased dramatically in the last fifty years, yet we have never been so obsessed with our health. As our state of health improves, our anxiety about our health does not decrease, but on the contrary increases almost exponentially. The less likely we are to die in the near future, the more avidly we consume information about what may go wrong with us. The media whips up scare stories about potential epidemics-from listeria to salmonella poisoning and mad cow disease-and we believe them implicitly. Hardly a month passes without the announcement of some dire new threat to our wellbeing, or some miracle cure.
Why are we now so obsessed with health matters? Should we be worried, or are we worrying without reason? In his controversial and highly provocative new book, Theodore Dalrymple takes a scalpel to many of the current assumptions-and myths-about health matters that so preoccupy us. As his many readers will know, Dalrymple does not mince words. His conclusions are bound to provoke a storm of comment.
Why are we now so obsessed with health matters? Should we be worried, or are we worrying without reason? In his controversial and highly provocative new book, Theodore Dalrymple takes a scalpel to many of the current assumptions-and myths-about health matters that so preoccupy us. As his many readers will know, Dalrymple does not mince words. His conclusions are bound to provoke a storm of comment.
160 pages, Hardcover
First published February 1, 1998
About the author
Theodore Dalrymple
95 books637 followersAnthony Malcolm Daniels, who generally uses the pen name Theodore Dalrymple, is an English writer and retired prison doctor and psychiatrist. He worked in a number of Sub-Saharan African countries as well as in the east end of London. Before his retirement in 2005, he worked in City Hospital, Birmingham and Winson Green Prison in inner-city Birmingham, England.
Daniels is a contributing editor to City Journal, published by the Manhattan Institute, where he is the Dietrich Weismann Fellow. In addition to City Journal, his work has appeared in The British Medical Journal, The Times, The Observer, The Daily Telegraph, The Spectator, The Salisbury Review, National Review, and Axess magasin.
In 2011, Dalrymple received the 2011 Freedom Prize from the Flemish think tank Libera!.
Daniels is a contributing editor to City Journal, published by the Manhattan Institute, where he is the Dietrich Weismann Fellow. In addition to City Journal, his work has appeared in The British Medical Journal, The Times, The Observer, The Daily Telegraph, The Spectator, The Salisbury Review, National Review, and Axess magasin.
In 2011, Dalrymple received the 2011 Freedom Prize from the Flemish think tank Libera!.
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Displaying 1 - 7 of 7 reviews
September 16, 2015
Subtitle: The Meaning of Health Scares. This book was written by a crotchety old British doctor, who has practiced in several countries (some of them poor), and thinks we (meaning the residents of the wealthier nations of the world) are a bunch of neurotic hypochondriacs. If you can enjoy a crank with a good vocabulary and a lot of data readily at hand, regardless of whether you agree with him or not, this is a fun read. Kind of like the kvetching old grandpa some of you may have had, who was fun to listen to as he teed off on everything about the world around him.
Which isn't to say that he doesn't have some valid points. Most of the really objective measures of health, such as infant mortality, average age at time of death, etc. show us to be in better health than every before. This has not led to a decrease in the amount we worry about our health and threats to it, however; in fact it seems that the reverse is true.
This may be because there's more sense worrying about something when you might have some control over it, than when public hygiene and the medical establishment are so poor that there's just no point in worrying about it (as a fairly rational peasant in 1750 might have concluded). Dalrymple, however, believes instead that we're all more or less neurotic.
"To agonise over trifles is not merely foolish, it is self-indulgent and wicked. It is an expense of spirit in a waste of shame."
Dalrymple delights in informing us of such tidbits of information as that it was Nazi doctors who first declared cigarette smoking to be bad for your health. Not that he's a Nazi, or a smoker; in fact he dislikes both. He just likes bringing up facts which make us uncomfortable. He's a gadfly. Gadflies make me smile, even (perhaps especially) when I don't agree with their points, and Dalrymple is no exception.
Disagreements aside (for example, Dalrymple thinks we long since passed the point where problems with our diet impacted our health in any significant way), he does have some points which I agree with. One is the general public's difficulties in thinking clearly about topics involving probability and percentages. For example, a 1% increase in the rate of heart disease is far more important than a doubling in the rate of mad cow disease, because while a smaller percentage it is a much greater number of lives lost. This is not reflected in the news coverage given. Our method of transport (primarily car-based) causes far more deaths (compared to the alternatives) than second-hand smoke, but would-be guardians of the public health spend far more effort on the latter.
He mentions the desire of many today to be "more fit", and remarks that upon asking them, "fit for what purpose?", they are thrown into a near existential panic because they have no answer. His point being: it's not just how long your life lasts that matters, it's doing something with it. So, stop obsessing over your cholesterol counts and go do something; fair enough.
Mostly, though, this is just a fun romp through our current society's obsession with safety and long life, with lots of great opportunities to needle their pompous and ill-informed self-regard. It is, I admit, somewhat of an intellectual guilty pleasure, as much of this is shooting fish in a barrel. In the next to last chapter he analyzes the common characteristics which most health scares have, and the requirements for them to be successful (in the sense of widely promulgated). Then, as an exercise in the scholarly equivalent of a ten-year old boy's joy in blowing things up, he designs and proposes a health scare of his own (he chooses tea).
Dalrymple is no role model here, but he does serve a role not unlike that of the jester in a royal court. He says things we may not agree with, but he also asks questions we may not want to answer, and does it in a way that is humorous enough to forestall our anger. What are we wanting to live so long for? The question cuts at least two ways, and at least one of them is well worth thinking about.
Which isn't to say that he doesn't have some valid points. Most of the really objective measures of health, such as infant mortality, average age at time of death, etc. show us to be in better health than every before. This has not led to a decrease in the amount we worry about our health and threats to it, however; in fact it seems that the reverse is true.
This may be because there's more sense worrying about something when you might have some control over it, than when public hygiene and the medical establishment are so poor that there's just no point in worrying about it (as a fairly rational peasant in 1750 might have concluded). Dalrymple, however, believes instead that we're all more or less neurotic.
"To agonise over trifles is not merely foolish, it is self-indulgent and wicked. It is an expense of spirit in a waste of shame."
Dalrymple delights in informing us of such tidbits of information as that it was Nazi doctors who first declared cigarette smoking to be bad for your health. Not that he's a Nazi, or a smoker; in fact he dislikes both. He just likes bringing up facts which make us uncomfortable. He's a gadfly. Gadflies make me smile, even (perhaps especially) when I don't agree with their points, and Dalrymple is no exception.
Disagreements aside (for example, Dalrymple thinks we long since passed the point where problems with our diet impacted our health in any significant way), he does have some points which I agree with. One is the general public's difficulties in thinking clearly about topics involving probability and percentages. For example, a 1% increase in the rate of heart disease is far more important than a doubling in the rate of mad cow disease, because while a smaller percentage it is a much greater number of lives lost. This is not reflected in the news coverage given. Our method of transport (primarily car-based) causes far more deaths (compared to the alternatives) than second-hand smoke, but would-be guardians of the public health spend far more effort on the latter.
He mentions the desire of many today to be "more fit", and remarks that upon asking them, "fit for what purpose?", they are thrown into a near existential panic because they have no answer. His point being: it's not just how long your life lasts that matters, it's doing something with it. So, stop obsessing over your cholesterol counts and go do something; fair enough.
Mostly, though, this is just a fun romp through our current society's obsession with safety and long life, with lots of great opportunities to needle their pompous and ill-informed self-regard. It is, I admit, somewhat of an intellectual guilty pleasure, as much of this is shooting fish in a barrel. In the next to last chapter he analyzes the common characteristics which most health scares have, and the requirements for them to be successful (in the sense of widely promulgated). Then, as an exercise in the scholarly equivalent of a ten-year old boy's joy in blowing things up, he designs and proposes a health scare of his own (he chooses tea).
Dalrymple is no role model here, but he does serve a role not unlike that of the jester in a royal court. He says things we may not agree with, but he also asks questions we may not want to answer, and does it in a way that is humorous enough to forestall our anger. What are we wanting to live so long for? The question cuts at least two ways, and at least one of them is well worth thinking about.
April 2, 2025
Review of *Mass Listeria - The Meaning of Health Scares* by Theodore Dalrymple
I have read quite a few books by Theodor Dalrymple (Anthony M. Daniels), and for the most part, I found them good or even excellent. However, I have now been disappointed by two in a row. First, *Examined Life*, which is an unfunny exaggeration that treats both completely irrational behavior and justified concern for one’s health in the same way. As if, for Dalrymple, any concern for one’s health is complete overreaction. This is strange because, in *Life at the Bottom*, he actually criticizes the "lower" class for buying "junk" food instead of healthy options. But yes—the impression is not incorrect, because in *Mass Listeria*, this issue becomes more than clear—Dalrymple sees individual concern for personal health as an irrational fear of death or even a striving for immortality. In his view, the circumstances today are such that we are guaranteed a sufficiently long life—so there is no need to make any special efforts for our health.
If a reader were unaware of the extent to which people actually take action for their health today, they might think—reading Dalrymple—that it is truly a mass phenomenon, a "mass hysteria" (which is probably hinted at in the title *Mass Listeria*). But that is simply not true—just like many other things we read in that book. The book is interesting because Dalrymple (well-read and experienced as he is) shares many fascinating insights. However, despite this, his main theses are very wrong.
The percentage of people who genuinely make an active effort to improve their health is no greater than 15%—it is not a mass phenomenon at all. The majority, in any case, do not see major problems in their lifestyle and do not think much about death (they have thousands of ways to escape such thoughts).
I am not aiming to provide a complete analysis of the book here, just to highlight a few points that particularly stood out to me or left a stronger impression.
One such claim is this:
*"In a sense, every meal is a leap in the dark, as far as one’s health is concerned; but fortunately it is a leap over a vanishingly tiny empty space, since there is every reason to believe that the content of one’s diet — within a wide range of adequate diets — plays little part in one’s health."*
This is simply not true. In fact, the food that is widely and commonly consumed—both at home and in restaurants—is the main cause of the diseases that lead to the highest mortality rates. Let’s look at the most common causes of death:
1. Cardiovascular diseases (heart attack, stroke)
2. Cancer (lung, colon, breast, prostate, etc.)
3. Respiratory diseases (chronic obstructive pulmonary disease—COPD, pneumonia)
4. Diabetes
5. Obesity and related diseases
6. Liver diseases (cirrhosis, liver cancer)
And all these causes are directly linked to diet!
Then comes an even more unbelievable claim from Dalrymple:
*"And the demands of consumer pressure groups for ‘complete’ information about the foods we buy are trivialising because they make the prolongation of life the main end of life itself."*
Yes, this is a very unusual accusation—mostly untrue. If I am spending my money on food, I want to know exactly what is in the package—regardless of why I want to know. When I buy dried fruit, for example, I want to know if sugar has been added or not. Similarly, with other foods, I want to know if salt, oil, and other ingredients have been added. It is my—and our—right to know what we are actually buying and eating! But Dalrymple dismisses this demand as impossible, claiming that such information would be dishonest because,
*"It may be dishonest because it is impossible to give a full chemical analysis of any food [...]".*
Is he serious? Who on earth is demanding a full chemical breakdown listing every molecule? Here, it becomes clear that Dalrymple is attacking a "straw man." Whether he does this deliberately or if it is his own "blind spot"—I really don’t know. But it is strange that in three of his books (one of which I have not read—I only saw a review), he consistently criticizes healthy eating.
The answer may lie in the fact that, despite being an extremely intelligent, learned, and experienced person who has seen much of the world—especially its "bottom"—his "orientation" is not toward the rational but toward a romantic or bohemian approach to life. To support this hypothesis, I will quote a full footnote from page 134:
*"I once had a patient who was diabetic and much overweight. He told me quite frankly that smoking, drinking and eating rich food were so important to him that he would rather continue and die young than live abstemiously to a ripe old age. He did not deny the risks: he accepted them. I respected his decision, and even admired it, though I doubt I should have had the courage to emulate him if I had found myself in his condition. He did die young, but he had undoubtedly enjoyed his life to the full."*
For Dalrymple, a person whose highest values in life are smoking, drinking, and food is worthy of admiration. Are you kidding me?! And this person supposedly "lived life to the fullest"? I doubt that—otherwise, he wouldn’t have been Dalrymple’s patient in the first place. Is this really "living life to the fullest"—where physical pleasures, which ultimately kill you, are the greatest value? Well—to each their own. It was his free choice, and we have no right to criticize him for it. But the issue here is Dalrymple—his perspective and values. In *In Praise of Folly*, he says:
*"In another life, I would like to have been a bohemian myself [...]".*
No problem, let him be bohemian, but then he should not try to sell us the idea that we are irrational for wanting to take care of our health.
I think what applies to him is precisely what he quoted at the beginning of his book:
*"... no man ever understands quite his own artful dodges to escape from the grim shadow of self-knowledge.*
Joseph Conrad, *Lord Jim*"
I have read quite a few books by Theodor Dalrymple (Anthony M. Daniels), and for the most part, I found them good or even excellent. However, I have now been disappointed by two in a row. First, *Examined Life*, which is an unfunny exaggeration that treats both completely irrational behavior and justified concern for one’s health in the same way. As if, for Dalrymple, any concern for one’s health is complete overreaction. This is strange because, in *Life at the Bottom*, he actually criticizes the "lower" class for buying "junk" food instead of healthy options. But yes—the impression is not incorrect, because in *Mass Listeria*, this issue becomes more than clear—Dalrymple sees individual concern for personal health as an irrational fear of death or even a striving for immortality. In his view, the circumstances today are such that we are guaranteed a sufficiently long life—so there is no need to make any special efforts for our health.
If a reader were unaware of the extent to which people actually take action for their health today, they might think—reading Dalrymple—that it is truly a mass phenomenon, a "mass hysteria" (which is probably hinted at in the title *Mass Listeria*). But that is simply not true—just like many other things we read in that book. The book is interesting because Dalrymple (well-read and experienced as he is) shares many fascinating insights. However, despite this, his main theses are very wrong.
The percentage of people who genuinely make an active effort to improve their health is no greater than 15%—it is not a mass phenomenon at all. The majority, in any case, do not see major problems in their lifestyle and do not think much about death (they have thousands of ways to escape such thoughts).
I am not aiming to provide a complete analysis of the book here, just to highlight a few points that particularly stood out to me or left a stronger impression.
One such claim is this:
*"In a sense, every meal is a leap in the dark, as far as one’s health is concerned; but fortunately it is a leap over a vanishingly tiny empty space, since there is every reason to believe that the content of one’s diet — within a wide range of adequate diets — plays little part in one’s health."*
This is simply not true. In fact, the food that is widely and commonly consumed—both at home and in restaurants—is the main cause of the diseases that lead to the highest mortality rates. Let’s look at the most common causes of death:
1. Cardiovascular diseases (heart attack, stroke)
2. Cancer (lung, colon, breast, prostate, etc.)
3. Respiratory diseases (chronic obstructive pulmonary disease—COPD, pneumonia)
4. Diabetes
5. Obesity and related diseases
6. Liver diseases (cirrhosis, liver cancer)
And all these causes are directly linked to diet!
Then comes an even more unbelievable claim from Dalrymple:
*"And the demands of consumer pressure groups for ‘complete’ information about the foods we buy are trivialising because they make the prolongation of life the main end of life itself."*
Yes, this is a very unusual accusation—mostly untrue. If I am spending my money on food, I want to know exactly what is in the package—regardless of why I want to know. When I buy dried fruit, for example, I want to know if sugar has been added or not. Similarly, with other foods, I want to know if salt, oil, and other ingredients have been added. It is my—and our—right to know what we are actually buying and eating! But Dalrymple dismisses this demand as impossible, claiming that such information would be dishonest because,
*"It may be dishonest because it is impossible to give a full chemical analysis of any food [...]".*
Is he serious? Who on earth is demanding a full chemical breakdown listing every molecule? Here, it becomes clear that Dalrymple is attacking a "straw man." Whether he does this deliberately or if it is his own "blind spot"—I really don’t know. But it is strange that in three of his books (one of which I have not read—I only saw a review), he consistently criticizes healthy eating.
The answer may lie in the fact that, despite being an extremely intelligent, learned, and experienced person who has seen much of the world—especially its "bottom"—his "orientation" is not toward the rational but toward a romantic or bohemian approach to life. To support this hypothesis, I will quote a full footnote from page 134:
*"I once had a patient who was diabetic and much overweight. He told me quite frankly that smoking, drinking and eating rich food were so important to him that he would rather continue and die young than live abstemiously to a ripe old age. He did not deny the risks: he accepted them. I respected his decision, and even admired it, though I doubt I should have had the courage to emulate him if I had found myself in his condition. He did die young, but he had undoubtedly enjoyed his life to the full."*
For Dalrymple, a person whose highest values in life are smoking, drinking, and food is worthy of admiration. Are you kidding me?! And this person supposedly "lived life to the fullest"? I doubt that—otherwise, he wouldn’t have been Dalrymple’s patient in the first place. Is this really "living life to the fullest"—where physical pleasures, which ultimately kill you, are the greatest value? Well—to each their own. It was his free choice, and we have no right to criticize him for it. But the issue here is Dalrymple—his perspective and values. In *In Praise of Folly*, he says:
*"In another life, I would like to have been a bohemian myself [...]".*
No problem, let him be bohemian, but then he should not try to sell us the idea that we are irrational for wanting to take care of our health.
I think what applies to him is precisely what he quoted at the beginning of his book:
*"... no man ever understands quite his own artful dodges to escape from the grim shadow of self-knowledge.*
Joseph Conrad, *Lord Jim*"
Want to Read
October 24, 2009Dalrymple is very good. I'm sure this book will be of great service during the current swine flu scare
October 19, 2012
Great book, I love Dalrymple's writing style. Reads smoothly but has a sarcastic bite to it, like a good whisky :)
January 6, 2015
Much sane wisdom .
July 3, 2021
A masterpiece of insight. If you have been wondering why the UK has been on and off lockdowns for 15 months (March 2020 to June 2021 as I write these comments) then there is probably no better way to understand it than this book, even though it was written in the 1990s the trends of our general innumeracy (absolute verses relative numbers), fear, media need for gross dramatization and more were already well developed. There is a plethora of impressive points in this concise book mostly corroborated with empirical evidence (Dalrymple has worked as a doctor here and overseas) one of the last observations in the book will give a flavour “if tea was not drunk we would all live an additional 37 minutes on average”.
November 1, 2025
As life and health improve, health anxiety increases. 1998, long before Covid.
People are abnormally anxious about rare health risks.
People are abnormally anxious about rare health risks.
This entire review has been hidden because of spoilers.
Displaying 1 - 7 of 7 reviews