From the Introduction
'That's it, I definitely won't get there in time for my first patient now. I'm in so much trouble. She was cross with me last time I was 20 minutes late for her appointment. This time she'll be incandescent with rage when I don't turn up for goodness knows how long.' The object of my fear was Ethel, a formidable Surrey housewife who fed on errant workmen and tardy psychiatrists. 'But she'll hang on, just for the hell of it, so I'll never catch up and all the rest of my patients will be kept waiting too, even longer probably while she gives me what for. How could I have been so stupid as to come out without my mobile? I can't even let them know. If I try to get to the payphone the train will leave for sure. I'm such a fool, I knew this would happen. I could kick myself.'
My head sagged, my brow furrowed and my hands fidgeted, mirroring the posture of half of my fellow would-be passengers. The other half sat slumped, looking hopeless, defeated and miserable. I was sitting on the 4:15 at a London terminal, stationary, with no idea if we would move before doomsday, and if not why not. It was ten to five. The one exception in this sorry crew was my friend Steve, a New Yorker who has lived here for a while. He was hopping mad. 'Why don't any of you guys do anything? If this happened at Grand Central there would be a baying mob at the station manager's door threatening to string him up by his balls; that gets them moving. Anyway stuff like this doesn't happen there. People tell you what's going on, 'cuz if they don't, they know they'll get their asses kicked. You guys are so passive.' Then he was off to find the station manager. As he disappeared into the crowd, the train pulled away.
Two stressed nations divided by a common emotion, anger/fear/ recrimination/self-recrimination/stress. Whatever you want to call it. It's all the same thing. It's only how we express it and then what we do with it that's different. Steve and I were both very stressed that day, and we exhibited why stress-related illness is so common in both our cultures. It's a near-inevitable emotion, but many factors influence how we experience it.
Stress is cultural. It isn't what is happening that causes stress. It's what we fear is going to happen in the future. What is most feared varies between cultures, because fear is a conditioned response. That is, we learn what to fear. Most of this learning happens early in our lives, a lot of it at the hands of our parents, though I learned fear from a horrid schoolteacher who thought children should be dealt with like army recruits. Steve, like many New Yorkers, has been taught to fear not being in control. Most of my fellow Englishmen, like me, fear being punished. Our culture favors punishment and many of us spend much of our lives fearing the loss that punishment is. In the past this loss of comfort involved being hit with a stick. Now it is the discomfort of being harangued by Ethel. When my mind is at its most catastrophic, I imagine that, in her rage, she will complain about my sloppy time-keeping to the General Medical Council and I'll lose my license, ending my days in poverty and degradation. This hypothetical future may be extremely unlikely, but if we hear a story just once of someone suffering a fate that has any vague similarity to our situation, we can convince ourselves that it is going to happen to us. Then we spend our whole lives running from this imaginary fear.
When bad things do happen, repeatedly, and we fail to influence the events, the result isn't fear, or stress, it is despair and resignation. That was the response of some of the occupants of my train. They had learned that trains are often late and nobody cares enough to tell you why or how long you may have to wait. It's not fair that these innocent would-be travelers should be the ones blamed by their spouse/children/boss/partner while the train operator worries not a jot, but tha