The Meldrewfication of Mick.

In relatively recent times key aspects of society have without doubt been insidiously changing for the worse. Some time ago George Ritzer (1993) drew our attention to a process of McDonaldisation, whereby expanding aspects of our social realm and experience are degraded by forces of rationalization mirroring the organization of fast-food restaurants. Two decades later David Graeber (2013) argued persuasively that the world of work under neoliberal capitalism is increasingly characterized by bullshit or pointless jobs, and the vulnerability of other occupations to a creeping bullshitisation, squeezing out the meaning and fulfilment in our work. I have argued that not even nursing work is immune to these disheartening tendencies, and advances of artificial intelligence might accelerate the detriment (McKeown, 2023). More recently, Yanis Varoufakis (2023) has put the spotlight on Techno Feudalism: how modern capitalism is being overtaken by new modes of serfdom, with huge concentrations of wealth and power amongst a few hyper-rich individuals predicated on new technologies. All of these changes are hugely detrimental for human well-being and democracy. My career as a nurse has traversed the same timeline as these negative developments in the character of our society and political economy. In this time, I have noticed some parallel changes in my own character. Primarily, I find myself being increasingly vexed by things that happen or that I see around me. This vexation can be accompanied by anger and irritation, sometimes by sadness or even despair, and the overriding impulse is, typically, massive incredulity often expressed in sarcastic outbursts or shaking of head in disbelief. I find myself shouting at the TV set, losing patience with friends, family and colleagues, and don't even get me started about social media content. The person I now seemingly resemble is Victor Meldrew. Victor was the main character in the old BBC sitcom ‘One Foot in the Grave’. He was most notable for his frequent and disapproving utterance of an exasperated catchphrase ‘I don't believe it!’. He is perpetually pained by the seemingly unbelievable nature of some people's behaviours, particular happenstances, or events he finds himself wrapped up in. Victor's wider expressive repertoire included other such declamations as ‘in the name of sanity!’, the exaggeratedly stretched out ‘Un-be-lieeeevable!’, or the more pointed, ‘Bloody Hell!’. Though plenty of people who know me well say I have always been like this, I think my Meldrew tendencies are getting worse, and increasingly so in recent times. In conversations with others, I believe that I am not alone in this regard. This is so much the case that I think we can arguably make a case that mine and others' increasingly psycho-emotional tendency for critical astonishment can be appropriately named as a process of Meldrewfication. And the escalation of this has gathered pace with, and is inextricably linked to, experiences under neoliberalism and the aforementioned shifts in social structures and relations pointed out by Ritzer, Graeber, Varoufakis and other critical commentators. Hence, for me, exposure on an almost daily basis to the deficiencies of government policy and associated ministerial pronouncements on (variously but not exclusively) austerity, tax and benefits, immigration, homelessness, or the complete failure of private administration of public goods prompt an atavistic squeal of ‘I don't believe it’! The couldn't make it up shenanigans concerning, amongst other things: raw sewage in our rivers, the cost of living crisis (compounded by years of austerity, the disastrous Brexit ‘dividend’ and kamikaze management of the economy), endemic poverty and the proliferation of foodbanks, eye-watering energy price inflation, the demonisation and floating incarceration of asylum seekers (negligent of fire or Legionella contagion risks), and the scandal of the immoral and illegal Rwanda policy (a ‘hostile environment’ indeed), the war on the poor (including stigmatization and denigration of benefit claimants along with sanctions, conditionality/work capability assessments), occurring against a backdrop of pigs at a trough governmental venality, corruption and incompetence …. All these and more precipitate a resounding ‘Un-be-lieeeevable!’ So, what has any of this got to do with nursing? Well, I reserve peak-Meldrew for health service related issues, especially regarding mental health care, and recognizing these are not at all independent of the damage caused by much of the above. The aforementioned inadequacies of government thus extend crucially into health and mental health domains. More specifically to health care, we have: the catastrophic failings of the Covid crisis (from PPE procurement scandals to letting the bodies pile up), the woeful absence any strategic thinking on social care, the abject underfunding and mismanagement of the NHS, the nursing and wider workforce recruitment and retention crisis, the undervaluing of staff and corollary entrenched lack of appropriate remuneration … in the name of sanity! And even more particularly about mental health: the creeping genericisation of nurse training, and the excessively coercive character of mental health care under neoliberalism, with corollary harms to patients and alienation for nurses … Bloody Hell! Seriously, there is much to be exasperated about, and our collective capacity to deal with all of this is being tested to the limit. That's even before we factor in the other major existential threats that afflict the planet, humankind and the rest of nature – notably impending climate catastrophe, the grossly unfair distribution of economic injustices, and the horrendous persistence of militarism, notably immediately evident in Ukraine and Gaza, but also numerous almost forgotten conflicts across the globe, where typically non-combatants face the brunt of the misery, destruction and death. The fact that this is often prosecuted using high grade military hardware manufactured in the west, with the approval of governments committed to austerity at home, is a further twist of the Meldrewfying knife. I have noted the fact that for Meldrews there is a complex of responses to vexatious phenomena, combining incredulity, exasperation, irritation/anger and despair. Various commentators over the years have noted the propensity of features of the neoliberal order to provoke such emotions and attendant anxieties, and argue persuasively that much of what gets signified as mental illness might well be fomented in this social-political-economic tumult. Mark Fisher (2009), famously made this point and noted how people could quite readily accommodate themselves to such a state of affairs, taking the neoliberal order for granted as something that has settled out as normal, rather than realizing the potential for resistance. Of course, resisting this deleterious, pathological social order is not only possible, it is urgent that such resistance is organized for; and that is the point of this short article. Various nursing activist-practitioners and scholars have formulated similar arguments (see Dillard-Wright et al., 2022). Perhaps, acknowledging and embracing incipient, emerging or full-blown Meldrewfication is one way to enter into a path to resistance. Furthermore, not doing so might actually be harmful for individual or collective well-being; if the psychic tensions of Medrewfication are not afforded some sort of positive outlet. Simply stewing in exasperation and frustration would be no good at all, but maybe we need to feel affronted, appalled, upset or angry about things in order to prompt action. Radical responses may be channelled into many forms of activism and organizing and can include situated, relational and, indeed, loving approaches (Collier-Sewell & Melino, 2023). Elsewhere, along with others, I have argued that nurses ought to become more active in movements for change (McKeown, 2019). This can start in the workplace, with membership of trade unions and associated political parties (though some of the democratic deficits of these can also provoke the Meldrew in me from time to time). Similarly, nurses can engage in wider community or health related activism in a range of community groups and new social movements, and these nurses may be able to forge progressive links and alliances back into workforce focused activism (Glascott & McKeown, 2022; McKeown & Spandler, 2015). Though a comedic character who may often just be thought of as an archetypal grumpy old man, it is plausible that Victor's frustrations and impatience with life's mundane vicissitudes actually reflect a deeper moral and humane concern for society and its perceived wrongs. Interestingly, Victor himself began his career as a curmudgeon on being made redundant from his job; a clear demonstration that Meldrewfication is arguably commensurate with acute sensitivity to injustice, and that realizing this can often begin within the workplace. That said, Victor's dissatisfaction with the world could tend to a fatalistic pessimism. In one scene he remarks: ‘one thing you can be sure about in life: just when you think that things are never ever going to get better, they suddenly get worse’. It is crucial that we resist such fatalism by embracing the optimism and hope for better futures that is inevitably bound up with actively seeking and organizing for change. Nurses might do well to begin this organizing imperative within their workplaces, noting the various injustices of their employment relations, and go on to imaginatively build upon recognition of other serial injustices that plague the social context they work in; not least the disempowerment and abuses heaped upon those who use, survive or refuse to use mental health services. We need to build peace and justice in the world and we need to pacify relations between staff and patients within more just mental health services. Can we as nurses achieve this? As Victor may have once said: ‘you better believe it!’ Data sharing not applicable to this article as no datasets were generated or analysed during the writing of this editorial.