The English, it was observed by an aristocratic Frenchman as long ago as the eighteenth century, take their pleasures sadly. Nowadays, they also take them passively, like a drug addict who seeks happiness and oblivion simultaneously by the simplest means possible.

I do not mean that the English make no effort to seek out entertainment; on the contrary, like the addict's search for his drug, this pursuit is often the only serious business of their lives. But the entertainment, once found, should require—for it to be truly entertaining—as little active mental contribution from the entertained as possible.

Primum inter pares is, of course, television. The average English adult now watches 27 hours of it per week, it is said, twice as much as two decades ago. In this, the English are no different from many other nations; indeed, the Americans while away about the same proportion of their lives in front of the small screen as the island race.

In any case, the figure could be misleading; experience from doing medical house calls convinces me that a television switched on is not necessarily a television watched. It flickers in the background, competing for fragments of divided attention with a radio and perhaps a domestic quarrel or two. And even when it is watched, there is no guarantee that anything gets much further than the optic nerves: I have many times asked patients whom I have visited at home while they were sitting in front of a television to describe what they were watching, only to be met with the blank silence of inability or incomprehension. One might as well have asked an habitué of an opium den for the contents of his consciousness as ask modern viewers of television for theirs.

When I was young and inexperienced, I used to ask the patient or his relatives to turn the television off; but in England, that means (at best) only a slight reduction in its volume. It is disconcerting to conduct a medical examination with a moving picture casting a changing light over the room, and the patient trying to peer over one’s shoulder, or round one’s side, to catch a glimpse of it, while confusing one's questions with the dialogue of a soap opera. Once I went to a paralyzed old lady’s house and found the television on. 1 asked the daughter, who was present, to turn it off.

“I don't know how,” she said. And she didn’t.

Nowadays, I march into a house and turn the television off myself. It is the only way to get the patient’s full attention—even if he or she is seriously ill and likely to die without medical treatment.

In the hospital, it is now regarded as cruel to deprive the patients of their daily screen: so much so that watching it has become virtually compulsory for them, or at least inescapable for those not in a position to remove themselves. Gone are the days when the hospital was a place of quiet (insofar as possible) and repose: no one dies nowadays without benefit of chat-show.

I have many times tried the following simple experiment: in a ward full of incapacitated patients, I have turned off the television or televisions and then left the ward for five minutes. Unfailingly, the television or televisions are switched on again by the time I return; but who has turned them on again, I have never been able to discover. The patients could not have done so, and the nurses deny it; it is a mystery as complete as that of the Turin shroud. But the nurses always say, “The patients want it on,” and will continue to say it even though a straw poll usually reveals precisely the opposite.

It seems to me prima facie unlikely that an 80-year-old lady with a right-sided hemiplegia after a stroke, and with difficulty swallowing her own saliva, really wants to watch Mr. Motivator, a keep-fit fanatic in a body-hugging Lycra outfit of fluorescent colors, demonstrating to the insistent beat of disco music the exercises by means of which the viewer may rid herself of the cellulite on her thighs. There is someone in the ward, however (a postmodernist, perhaps), who believes otherwise, who believes that a moment unentertained is a moment wasted, and that a mind unfilled by someone else’s drivel is a vacuum of the kind Nature abhors.

But it is on Saturday night, provincial downtown, that the unquenchable English thirst for entertainment—at least among the young—is seen to best advantage. To reach Saturday night is the summit of ambition of much of English youth. Nothing fills their minds with such anticipation or eagerness. No career, no pastime, no interest, can compete with the joys of Saturday night, when the center of the city turns into a B movie Sodom and Gomorrah, undestroyed by God only because (it must be admitted) there are worse places on earth, which call for more immediate elimination.

On Saturday night, the center of the city has a quite distinct atmosphere. It is crowded, but gone are the shoppers, browsing on shop windows like sheep on grass; almost no one over 30 is to be seen on the streets. It is as if a devastating epidemic had swept over the country and left alive no one who has reached middle age.

There is festivity in the air, but also menace. The smell of cheap perfume mingles with that of take-away food (fried and greasy), stale alcohol, and vomit. The young men—especially those with shaved heads and ironmongery in their noses and eyebrows—squint angrily at the world, as if they expect to be attacked at any moment from any direction, or as if they have been deprived of something to which they were entitled. It is, indeed, dangerous to look them in the eye for longer than a fraction of a second: any more prolonged eye contact would be construed as a challenge, inviting armed response.

Even some of the young women seem aggressive. Two of them pass me in the street, eloquently discussing their rivalry for the affections of Darren.

“You fancy him,” snarled the first.

“No I fucking don’t,” snarled back the second.

“You fucking do.”

“Oh fuck off.”

I recall a recent patient of mine, her eyesight permanently damaged by a group of girls in a club who glassed her (that is to say, broke some glasses and pushed the jagged edges into her face and neck) because she looked for too long and with too intense an interest at the boyfriend of one of her assailants.

Outside the Ritzy club, as I walk past, there is a pool of as yet uncongealed blood, next to which lies a broken bottle of beer. The weapon is self-evident, if not the motive. Some unfortunate person has not even got as far as being glassed: he has been bottled.

The people in the line to get into the Ritzy are untroubled by the blood, however; it will not spoil their evening. The flashing pink neon bulb casts an intermittently lurid light on them as the bouncers frisk them two by two, checking them for the knives that, in other circumstances, at least half of them carry.

All the cars that go by relay the insistent beat of quadraphonic music via the stones of the sidewalk into the legs of people walking or standing there. My own legs tingle with the vibrations. Sometimes I wonder whether those who play their music so loudly do so with the idea that they are performing a public service.

I walk on. A group of young men stagger out of the Newt and Cucumber, drunkenly chanting—one couldn’t call it singing—an obscene song. This is the sound that terrifies the cheap coastal resorts of Europe and any Continental city unfortunate enough to play host to an English football team.

I enter the Newt and Cucumber. Everyone is shouting, but still no one can make himself heard (which perhaps is just as well). Twenty televisions blare: eight each playing two different songs (one rock and one reggae), and four relaying a wrestling match. Ten seconds of this, and one feels one has a food mixer inside one’s skull working at full speed on one’s brain: I, too, stagger out. The base of a lamppost nearby has been fertilized with vomitus during my brief visit to the pub.

I walk on, marveling at the wonderful vulgarity of English girls. Is this a country, I wonder, without mirrors? Or is it merely eyes that young English females lack? They have evidently chosen their clothes with great care, for such gaudy slatternliness is not natural. They squeeze their fat and suety figures—too much junk food consumed in front of the television—into tight iridescent outfits, which leave no contour unstated, or into extra-short skirts that they pull down by half an inch when a gust of autumn wind blows and they start to shiver. The only thin girls are those who smoke more than 50 a day or who have anorexia.

I find a pedestrianized passage in which every doorway enters a club. The passage is closed to all cars except for the scarlet BMW of a chief bouncer, who makes a point of scattering the crowd. He parks it ostentatiously where he shouldn't and swaggers out to greet his underlings.

Six feet tall and a yard and a half wide, he is a fine example of the species. Hitting him would be like trying to punch your way into a locked safe. He has three days’ stubble (how do they always manage to keep it at three days, I wonder?) and an earring. A gold chain ripples round his bull neck. There are scars on his shaven scalp. He oozes anabolic steroids and obviously spends more time in the gym than most Englishmen spend in front of the television. The lord of all he surveys—and he surveys his surroundings constantly—he engages in an elaborate hand-shaking ritual with his underlings, which would be of interest to anthropologists who study the ceremonies of primitives.

The truth is that nightclub bouncing is part job, part protection racket. I was told by a psychiatric nurse who was a club bouncer during his off-duty hours that the smaller clubs—those not owned by large corporations—are staked out by gangs of bouncers, who offer to keep the customers in order but who also threaten to turn the club over and destroy it if they are not thus employed. They then protect the clubs that employ them against other gangs of bouncers. The gangs recruit their staff in prisons, where grievous bodily harmers and armed robbers hone their skills and their physiques in the prison gymnasium.

Saturday night in provincial England belongs to the bouncers. For some reason, looking at them reminds me of my childhood, when the BBC ran an educational radio program for children in which correspondents were sent back 60 million years to report on the appearance and behavior of dinosaurs. How small and vulnerable the correspondents said they felt among the threatening saurian giants! Just like I feel this Saturday night, in fact.

I pick my club: it looks a little more respectable than the others (no jeans, no leather), and the bouncers seem calmer and more confident than elsewhere, though their musculature still bulges through their tuxedos. I am later told by one of them that my choice was wise; there is serious trouble here only once every two weeks or so.

So this is the Mecca of all those young people who have told me that their only interest in life is going out to clubs! This is the cynosure of a million English lives!

The music is loud, but at least there is only one song playing at a time. The lights flash kaleidoscopically. The dance floor is upstairs, the main bar downstairs. This is where the wallflowers (all women) sit, staring disconsolately into their drinks as in the painting by Degas. Two young girls, one fat and one so drunk that she must surely throw up soon, gyrate to the music, but without reference to its rhythm.

On the dance floor itself, a great seething mass of people move like maggots in a tin. With so large a number of people crammed into so small a space, it is astonishing that there is no social contact among them. Most of the pairs do not even look into each other’s eyes; because of the noise, verbal communication is out of the question. They dance solipsistically, each in a world of his or her own, literally entranced by the rhythm and the continual physical activity. They dance the way Scotsmen go to bars: to blot out the memory of their lives.

Some of the bouncers patrol the club, gripping walkie-talkies; some stay at lookout posts. I approach two of them—one white and one black-and ask them about their work: we have to shout to make ourselves heard.

They love their work and are proud to do it well. They are doormen, not bouncers. They have certificates in first aid and in fire prevention. They are students of human nature (their words, not mine).

“We know who’s going to be trouble, even before they come in,” the black doorman says.

“We try to prevent trouble, not deal with it afterwards,” says the white.

“You don’t use words,” explains the black. “You don’t discuss with them. That only spreads the trouble, because if you stand there discussing it, everyone notices and joins in.”

“A quick surgical operation, and they’re out. You use the minimum force possible.”

I ask what kind of serious trouble they expect.

“Well, there’s a gang in the city called the Zulus, that gets its fun from wrecking clubs,” says the black. “There’s too many of them: we can’t handle them.”

“Mind you,” adds the white, looking on the bright side, “they know us, so they wouldn’t kill us or nothing.”

“No, they’d only give us a good kicking, no more than that.”

If I tried to kick either of them—and I’m not a dwarf—I should be more likely to break my toe than to injure them.

“And what do you do if you get a good kicking?” 1 ask. “Surely, you want to find other work?”

“No, you just got to go back the next night, or you lose your respect,” says the black, grinning but serious.

There is a scuffle on the dance floor. My two bouncers are called to assist with the ejection of a troublemaker. They move with surprising agility, in unison. I have seen such coordination before, among men who are like them in many ways: prison wardens, who deal with disturbances in the cells in a similar fashion.

A small young man, who resembles a pilot fish among sharks, is escorted off the premises by eight doormen. I notice as he goes by that he, too, is a bodybuilder: his biceps threaten to split the short sleeves of his shirt. He is drunk, but not so drunk that he does not recognize overwhelming force when he sees it.

I follow him out. Nearby, a girl in short cream satin pants, with fat lily-white legs and black velvet high-heeled shoes, is draped like a sack over the shoulder of her boyfriend, the Saint Christopher who carries her across the road because she is incapable of making it herself. She is drunk and vomits, fortunately missing his back but definitely hitting the sidewalk. The vomit will be cleared up by morning: it makes you proud to pay your local taxes.

It is two o'clock. A little farther on, a small crowd gathers below a first-floor window. A blowsy woman with peroxided hair and a cigarette stuck by dried saliva to the corner of her mouth shouts the name of a district of the city at the crowd below. This is a taxi office, and she shouts out the destination of taxis as they arrive. Some of the would-be passengers are too drunk to recognize the destinations of the taxis they themselves have ordered, and so she has to repeat them.

Only taxi drivers in desperate financial straits work Saturday nights. They’ve all been robbed, of course, mostly at knifepoint, and an informal survey I once carried out revealed that about a third of them have had their cars stolen. I remember one driver—working Saturday night to pay for his divorce—who had had seven of his ribs broken by passengers who were incensed by being asked to pay for their ride. Like the doormen after a good kicking, the driver returned at once to work.

The following Monday morning, I walk into my ward of the hospital. In the first bed there sits an 18-year-old girl, dressed in a gold satin bathrobe, staring blinklessly into space. Her blood pressure is high, her heartbeat too fast, her pupils dilated: When I speak to her, she does not hear me, or at least does not respond. I try three simple questions, and then she leans forward, shrieks “Help!”" and sinks back against her pillows, exhausted and terrified.

She has been to the XL Club on Saturday night, a large barn of a dance hall, where everyone takes Ecstasy—methylenedioxymethamphetamine, of very variable purity—and enters a trance. We have a steady flow of patients from the XL: not long ago, one of them was DOA (dead on arrival), and his friend who came with him suffered permanent brain damage. This girl, though, had begun to act strangely after leaving the XL—gesturing wildly at something that was not there—and had been brought to the hospital by a friend.

Next to her is another product of the XL club. She made it home on Saturday night but then tried to jump out of the window because she thought her boyfriend’s enemies were coming to kill her. She had taken Ecstasy every Saturday night for six months, and it had made her paranoid for most of that time. In fact, she had given up her work in an office because she felt the other workers there were plotting against her. Strangely enough, she knows that Ecstasy is not good for her, that it has nearly ruined her life.

“Then why do you take it?”

“I want to get through the night.”

In another part of the hospital lies a 16-year-old girl, who has taken an overdose to force the local authorities to give her an apartment. Such apartments are allocated on the basis of need and vulnerability, and a young girl who attempts suicide could hardly stand in greater need of help. She hates her mother because they argue all the time, and she has left home to live on the street; she doesn't know who her father is, and she doesn’t care. She hated school, of course, and left sooner than the law allowed—not that the law cares much.

“What are your interests?” I ask.

She doesn’t know what I mean, and pouts. I rephrase the question.

“What are you interested in?”

She still doesn’t know what I mean. All the same, she is of good intelligence—very good, in fact.

“What do you like doing?”

“Going out.”

“Where to?”

“Clubs. Everything else is shit.”

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