A mouthful of explosive helps the medicine go down

YOU KNOW how it is when you've spent all morning searching for a small experimental anti-personnel device and you simply cannot lay your hands on it. A chap gave it to me in a war zone once, in return for a go on my passport, but I can't remember what I did with it. I think I may have left it behind in the war zone, which is a pity, because, as I recall, it was exactly the right size to push down Michael Portillo's throat, where it would go off with one of those muffled wet whump noises and an eruption of glistening pink slime, with gristle, which is how we like our Tory ministers round here.

Immature? Pointlessly violent? Quite so, but don't pretend the thought doesn't fill you with joy; and if it doesn't, why, you may get the hell out of my column right this moment. If it's mature, reflective animadversion you want, go and have a look at Leviathan. Otherwise, stop pretending to be so bloody grown-up because that's what has got us into this mess in the first place, and if you think I'm talking balls, just read on.

First, you should picture me, a figure of immaculate metropolitan sophistication in my Red Wing work-boots and Betty Ford Clinic T-shirt ("Clean & Serene"), sitting outside Vats Wine Bar nurturing a glass of St Emilion and someone else's wife. We speak of this and that, and then a man walks by. He has a strange, ataxic, high-stepping gait, as though treading through deep, soft snow in cotton-wool shoes. Quick as you like, the words stroll into my mind and quietly announce themselves: tertiary syphilis. Tabes dorsalis.

Well, sod me. It's at least a quarter of a century since my father or grandfather, both doctors, told me about tabes dorsalis, but the odd thing is, I have never forgotten anything I have ever been told about medicine, not since I was five years old and decided I wanted to go in for the family trade. I gave it up in the end there wasn't enough scope for showing off but the genetic defect remains. Other stuff goes in, is indulged and played with for a while, and then forgotten. Medical matters creep in unobserved and take up permanent residence, and every time they pop their heads above the parapet, I feel a curious stab of shame that I abandoned them to become a hack, a scribbler, a professional smart-arse.

But only a stab, do you see? "Carissima," I murmur, turning back to my little friend and taking her hand in mine. "That man has tabes dorsalis. Also, your husband is a beast. Come with me back to my manly lodgings, where I shall remind you what it is to be a woman once more!" She slaps my face. I order another bottle of wine and so the day proceeds on its corrupt and disreputable way.

Which is also the way forward. It is far too late to change my ways now, and adopt a regular life, healing the sick and ministering to the defeated and dispossessed. I know and admire men who do so. My father, for one. His father before him. My friend Philip Hopkins on Haverstock Hill, the last proper doctor in London. These are good, honourable men who make you feel better just by saying hello. They humble me, but I cannot be one of them, and I think I am finally starting not to mind so much. What I do mind is that I cannot write about them; their uncelebrated graces come scratchily to the pen, and it's just when you're most sincere that you sound most phoney.

Feh. Some of us are grown-up and live good, useful lives; and some of us are childish, and think it would be both appropriate and fun to go round and wee on Virginia Bottomley (no, sugarplum, we haven't forgotten, and never will). But the world is a big place. There is room for both groups.

What there isn't room for is the bunch in the middle, the ones who pretend to be grown-up without having learnt the necessary lessons: independence of thought, compassion for the unfortunate, the ability to call things by their proper names.

There are two main sorts. The vicious, vampirical ones operate under forged credentials: pompous suits, yapping in boardrooms; overgrown schoolchildren, honking in Parliament; sleek bankers, still rifling the other boys' desks after lights out; clumsy judges, hiding their shame under wigs and gowns, cracking dry, legal jokes while they think, "Here I am, cracking a dry, legal joke"; wide-boys in Ferraris, their pockets full of conkers.

And the want-to-be-good ones provide this League of the Undead with willing, complicit victims. They seek refuge in the rules, believing that obedience and neatly-combed hair will protect them from harm. Like timid virgins in a vampire film, it is their very compliance that leads them to destruction. Poor things! Their savings are plundered, their pension schemes fail, their jobs are snatched from them, their homes devalued... and still they believe that Sir knows best; so, instead of shouting "Sod this!" and starting to fill milk bottles with petrol, they try even harder to be good and obedient and behave like grown-ups.

Well, it won't do. The time has come to remove the League of the Undead, the water-board men who won't bathe, the yapping frauds at political conferences, the fat-necked glossy magazine folk who see humanity as a harvestable resource, the wet-lipped spin- doctors, the one-in-a-bed judges, and all the rest. Let's leave being really grown-up to the people who know how it's done, the doctors and pilots and sea-captains for whom an error of judgement means that people die, not just a quick call to Sir Tim Bell.

For the rest of us, grown-up-ness hasn't worked, and now it's time to be childish. On with the fedora and the Inverness cape, and round to Mr Portillo with our little device. Whump. And you know what? We'll wonder why we didn't do it years ago, instead of pretending to be reasonable, objective and oh-so-grown-up. !