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Once upon a time ...
  1. J W Puntis
  1. The General Infirmary at Leeds, Belmont Grove, Leeds LS2 9NS, UK; john.puntisleedsth.nhs.uk

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I very much enjoyed reading Storr and Rudolf’s review of literary perspectives on childhood.1 Appropriately enough, Charles Dickens loomed large. Oliver Twist is the first novel in the English language that takes a child as its central character. The book is also polemical and the early chapters are very much an attack on the working of the New Poor Law, a series of measures introduced to cut down the cost of the poor by precluding the able-bodied pauper from relief and by making the life of the workhouse as unappealing a prospect as possible.2 Dickens strongly objected to the fact that by consigning sexes to different quarters within the same workhouse, the need for family life among the poor and needy was totally disregarded. He satirised the new dietary provisions in Oliver’s asking for “... some more”, no doubt provoked by angry memories of his own deprivation and separation from family in childhood, and his obsessive comparison of the need for food and the need for love.3

In fact, there is much in Dickens to interest paediatricians. Our Mutual Friend, published in 1864, even contains a brief description of what it was like in Great Ormond Street Hospital, opened 12 years earlier. He describes the admission of a sick orphan to “... a fresh airy room ... a little quiet bed and a little platform over his breast on which to arrange toys ... doll’s houses, woolly dogs, tin armies, Moorish tumblers, wooden tea-things, and the riches of the earth”.4 Dickens was very clear that childhood experiences fundamentally influenced the way people behaved as adults. Pleasant Riderhood in Our Mutual Friend is a pawn shop owner and grown up daughter of a reprobate father. Dickens makes allowances for her mercenary and predatory nature in stating, “... observe how many things were to be considered according to her own unfortunate experience. Show her a wedding and she only saw two people taking out a regular licence to quarrel and fight. Show her a Christening, and she saw a little heathen personage ... (who) was not in the least wanted by anybody, and would be shoved and banged out of everybody’s way, until it should grow big enough to shove and bang ... Show her a live father and she saw a duplicate of her own father, who from infancy had been taken with fits and starts of discharging his duty to her, which duty was always incorporated in the form of a fist or leathern strap, and being discharged, hurt her”.5Our Mutual Friend portrays a London of wastelands, of disconnection and alienation, and a society dominated by financial speculation and commodity fetishism. As a cautionary tale warning against the moral dangers of greed and materialism it has lost none of its relevance.

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