Just as city-bred people find themselves surprised and alarmed by the intensity of natural darkness in the countryside, so many young people now feel uneasy, almost to the point of agitation, when confronted with silence. Without an incessant background din of music, radio, or television, they cannot (or say they cannot) concentrate. It is as if their own unaided thoughts alarmed them, and they suffered an addiction to distraction.

It is hardly surprising, then, if many people now gain their sense of reality not by contact with reality itself, but through television. What happens on the screen is more real to them than what happens all around them. Reality and virtual reality have changed their order of importance in their mental economy.

Last week, I was teaching a medical student when the police brought into our ward a man who that morning had stabbed his girlfriend to death and then had taken an overdose. He still had his girlfriend’s blood on his feet.

The killer was not a habitual criminal. Indeed, he had never been in trouble with the police before in his 30 years. An immigrant who came to Britain four years previously, he had gone to live with his girlfriend at her invitation, but she had soon tired of him and began to taunt him unmercifully about his lack of sexual prowess. He became intensely jealous of her former lovers. That morning, they had had a violent quarrel, and she threatened him with a kitchen knife. He grabbed it from her, but still she taunted him. He stabbed her once, non-fatally, but still she continued her stream of insults. Then he stabbed her two or three times, and she died. He took his overdose and called the police.

His account of the events was of the greatest lucidity. Evidently, he felt compelled to speak. He appeared to have the gift of narrative. When he came to the fatal stabbing, he began to cry. “I’ve committed the biggest sin there is,” he said. “I’ve taken the life of another, and now I must pay the price.”

When the patient left my room, the medical student, a middle-class 22-year-old, was visibly shaken. He had never heard anything like this confession before. He struggled to put his thoughts into words.

“Phew!” he said, shaking his head. “It’s just like on TV.”

And you can’t get more real than that.

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