If this were true, we would expect there to have been an upsurge of lesser infringements of the former social code, and in minor acts of disorder, among the patients, particularly (in fact, almost exclusively) among the young, for it is they who act upon changing conceptions of appropriate or acceptable public behaviour. And this is precisely what has happened.

Needless to say, it is difficult to prove it by statistics, for no one gathers them. They would, in any case, be difficult to gather, especially over a period of time necessary to establish a secular trend. Still, statistics are not everything: no one needed to gather statistics of bombing during the Blitz to know that there was a war on. If social realities were knowable only through statistics, literature would be redundant.

There is a continuum of seriousness in the signs of a breakdown of social order in hospitals, as elsewhere. Some signs might be considered trivial, the harmless flouting of a former convention which, being a convention merely, had no deeper moral meaning or content. But in the social world, there is a dialectical relationship between serious and trivial infractions: if serious ones go unpunished, trivial ones are encouraged precisely because they are so trivial compared with the unpunished serious ones; on the other hand, unremarked trivial infractions encourage the commission of ever more serious ones, as the boundaries are extended.

An example of a 'trivial' sign is the continued wearing of hats by young men - in practice baseball caps, since no other headgear is now worn - inside the hospital building. Nobody thinks to remove his hat indoors, and certainly not to tip it in polite acknowledgement of someone he knows. The hat is worn not only in the hospital corridors and waiting rooms, but in the consulting room and even in the hospital bed itself (on the day on which I wrote this, I examined two young patients, one male, one female, who wore baseball caps in bed). Young men who wear such baseball caps never remove them when they enter the consulting room, and will do so only if the doctor needs physically to examine their scalp.

A considerable proportion of the visitors to a modern (or perhaps I should say contemporary) British hospital seem unable to go longer than a few minutes without refreshment of one kind or another. They eat and drink as they progress down the corridors, and do not necessarily stop once they are in the consulting room. A proportion of them discard the packaging of their snacks and drinks wherever they may happen to be when the packaging is empty or they have eaten and drunk as much as they want. Many young patients think that it is not only right to speak, but to consult a doctor, with their mouths full.