If this is a man: No one has the right to rob the voiceless of a voice

A GROUP of friends of mine got together a while ago and invested money we didn’t have to make a pilot TV programme that didn’t sell. But, because the programme was about bestsellers, we got to meet famous writers.

Best of all, we got to meet Ed McBain.

Ed McBain, creator of the phenomenally successful 87th Precinct series of police procedurals. More than 50 of them. Ed McBain, the modern Graham Greene, writes 'entertainments' but also (as Evan Hunter) serious literature, starting with The BlackBoard Jungle when he was in his 20s.

Ed McBain/Evan Hunter gave us the run of his home in Connecticut for our filming and got the hell out of our way while the gear was set up. He used the time to answer letters from readers, of which he got and still gets considerable tonnage every day, although it now comes mostly as email.

McBain's readers are addicts, hooked on characters he created, like Carella, Meyer Meyer and Fat Ollie, who notice their every idiosyncrasy or changing attitude, write to the author about it and get a response.

When McBain said this as we filmed, the camera operator came out from behind the viewfinder in surprise. The author had to be kidding, right? What world-famous writer writes back to every headbanger who lashes off a letter to them?

Answer: the busiest writer alive does. He may indeed has published three novels in one year, quite apart from film work (he wrote the screenplay for Hitchcock's The Birds) but still finds time to thank readers who write to him.

On camera, McBain was a big handsome man who looked to be in his 40s and who knew exactly how good he was at his trade. Better still, for a documentary, he was a great storyteller, getting furious all over again at a remembered insult or blood-chillingly acerbic about a criticism. A man capable of suffering fools, but not gladly. Oh, never gladly. A subtle man, comfortably keeping his distance while creating (in person and in his books) the illusion of shared intimacy. A man in control of his life.

Since then, he has published perhaps 15 books. When I've written to him commenting on the latest Hunter or McBain novel, within days an answer has arrived that is thoughtful and witty. All carry a casual reference to the encounter in his home which must have been such a tiny irrelevancy in the scheme of things.

In that same period, he was going through a divorce, marrying again, and trekking from one doctor to another to see what could be done about the hoarseness in his throat, undoubtedly caused by smoking cigarettes from the age of 15, but given the media and public appearances required to publicise each of his many books causing him serious inconvenience.

The hoarseness was the outward and audible sign of what eventually turned out to be cancer. He had surgery. A prosthesis went into his throat. He's working again. In the last couple of weeks, his mordant account of the experience, Let's Talk, was published on this side of the Atlantic by Orion.

On the cover of the book, he's smiling, one beautifully manicured hand covering the hole in his throat, as it must be covered, to let him produce the synthetic voice modern technology has given him in place of his own.

He's smiling, even though the synthetic voice machine forces him to plan each communication. Instant repartee belongs to those with real live larynxes.

"That's the major part of it, of course, the inability to display my wit," he says. "The inability to flare up in anger. The inability to talk myself out of any given situation, threatening or otherwise. Without a real voice, I feel disenfranchised. I feel powerless. I feel frightened."

McBain's fear comes from the realisation that, without the capacity to make oneself instantly, unmistakably clear, one is projected ruthlessly into extreme old age, one's boundaries overthrown, one's individuality, even humanity, compromised.

A CONFUSED elderly patient in a TV expose of an Irish nursing home, flailing helplessly at a strange-accented man ostensibly there to assist her is one personification of the problem. Ed McBain is another. The difference being that he can testify, in the written word, to how it feels to be disrespected by those who deliver 'care'.

"The aide wheeled me into a basement corridor teeming with hospital personnel and patients, where she left me facing a blank wall," he writes of one post-surgical encounter.

"I sat in that wheelchair, staring at the wall in that basement corridor and wondered why the aide might have thought I'd actually prefer facing a wall instead of watching the passing scene. Sitting there in an invalid's wheelchair, wearing an invalid's short striped hospital gown, looking at the wall and hearing behind me people using their voices the way I would never again be able to use mine."

Ed McBain is not poor. But modern health care treats rich and poor with equal disregard. It's not deliberate, of course. Putting patients (particularly the old or voiceless) in public places where those who talk to them are uniformed and standing, while they are of necessity seated and wearing humiliating non-clothes, is a purely accidental version of what Hitler's Germany did with malice aforethought.

Laurence Rees's history of Auschwitz points out that this was "one of the reasons Dr Mengele appeared on the ramp at Auschwitz immaculately dressed in his SS uniform, his boots shining like mirrors."

For, just as the Germans wanted to create a self-fulfilling prophecy that those whom they fought were inferior, so by dressing and acting as if they were members of a master race they wanted to force their enemies to subscribe to the belief that the Nazis were indeed their superiors."

The voiceless and the elderly go through that process every day. Not just in nursing homes. Not just in Ireland. Lack of empathy with and respect for this growing group is endemic in the developed world, with the possible exception of Japan, where the elderly still have perceived value.

In Ireland, the Medical Council ensures doctors stay current with medical science. Nobody ensures those caring for older or voiceless people stay current with the humanity thing. Nobody anywhere helps nurses, nurse's aides and paramedics to realise that a silent 77-year-old in ridiculous paper slippers, shrunken by illness and radiation, might be a man of ideas and achievement, who has reached, informed and amused millions, who loves and is loved.

"I do not feel like an old man," Ed McBain says, "I hope I do not look like an old man, and I certainly do not THINK like an old man, however an old man is supposed to think."

In common with his peers in every hospital and nursing home in the world, he does not want to be treated like an old man. Because to be treated as an old man or woman is to be treated as something less than human.

What a grievous irony that is.