London, the most grotesque city in the world: haunt of Bashar, Boris and Ken

To be tired of London is to be tired of life, ran the famous declaration of Dr Johnson, who was denied the thrill of participating in an election that would anoint either Boris Johnson or Ken Livingstone the figurehead of his beloved city. Forgive the posing of a weary question I asked the last time this same banquet of choice was spread before the capital's populace, but if London is The Greatest City In The World, how come it's between Boris and Ken? Two more diversely ghastly individuals you could scarcely hope to find – yet each insists London is TGCITW, as do assorted luminaries of the capital's dysfunctional police force, Olympics minister Tessa Jowell, and any number of bigwigs who should receive a sustained electric shock every time they utter the cliche.

For it is in reading the pronouncements of another London doctor this week that the truest picture of modern London's attributes emerges. Dr Fawaz Akhras is not a doctor of letters, like Dr Johnson, but marks himself out as one of the capital's most exciting polymaths by the manner in which he apparently combines offering repulsively morally relativist advice to his son-in-law, the Syrian president Bashar al-Assad, with his career as a Harley Street cardiologist. Do join me in a theatrical shrug and a muttered "Only in London!"

"Why did the UN Human Rights Council not meet [to discuss Libyan civilian deaths] and are now so concerned about the Syrians' deaths?" wonders our heartless heart surgeon – though I hasten to clarify that I do not mean to impugn his professional reputation as a mender of that most romanticised of human organs. After all, one of London's other charms is its status as the libel capital of the world, with it costing on average 140 times more to fight a libel action in London than it does in mainland Europe.

But I think I may avoid an appearance before m'lud for the mere observation that there is an intriguing Venn diagram intersection between doctors and people connected in some way to acts of violence. Middle East-wise, there was the Jordanian paediatrician-turned-al-Qaida-triple-agent, and Ayman al-Zawahiri, the al-Qaida CEO who also got his start in child medicine. (Again, let's not cast aspersions on al-Zawahiri's clinical competence – I have no reason to believe he was anything other than excellent, ending each consultation by presenting his little patients with a lolly and a sticker reading "I'VE BEEN BRAVE TODAY".) And there's Assad himself, who obtained his ophthalmology degree in London. Naturally.

The above article was published in guardian.co.uk on March 16th, 2012 (22:00 GMT).

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