When I mention to someone that I suffer from gout - and I try hard not to bring it into the conversation too often - I can predict that they will respond in one of three ways. In response number one they say: "I thought gout was an 18th-century thing; I didn't know people got it nowadays." Response number two is to say: "Been drinking too much port, have you, old chap?" The third response is to laugh.
To which my own reactions go like this. First, you can bet your life that people still suffer from gout today, and in growing numbers. Second, I think I last had a glass of port at Christmas 1995 or thereabouts, and drink normally has very little to do with it. Third, when someone laughs about gout, I have to try hard not to hit them.
Until I had my first attack 18 months ago, I was one of the ignorant majority too. When the word gout cropped up, I thought of Dr Johnson and Pitt the Elder, not Tony Soprano or Harry Kewell (all gout sufferers). But then the gout crept silently into my foot in the night - a common initial assault - and my world changed. Ever since, I have become aware that ignorance about gout is normal. Like many mainly guy things, gout is rarely discussed. But it is one of the most excruciatingly painful things that it can ever be your misfortune to encounter. I'm also told it makes you irritable. Damn right it does.
When I say "one of" the most painful, this may be too modest. For the pain of gout may even be unmatched. It is no surprise to me that in a survey two-thirds of US gout sufferers ranked their attacks as "the worst pain possible". Some readers may bridle at this assertion. Right-thinking people have long accorded a unique status to childbirth as the most painful of all experiences. Yet, strapping on my tin-hat in anticipation of the response, it was a female GP of my acquaintance, who has had four children by natural delivery, who assured me that gout is indeed worse than childbirth. That is something I can never know, and I do not seek to make the worst the enemy of the bad but, please, reader, at least accept my assurance that gout is agonising.
Nevertheless, the idea that gout is a bit of a joke runs deep. Even the revered Guardian can treat it as a bit of a giggle. A month ago there was a revealing intro in this paper on a story about supposedly work-shy benefit claimants. "Tiredness, gout and acne," the story began, "are some of the illnesses cited by incapacity benefit claimants, according to a Department for Work and Pensions document." I don't think I am being paranoid in seeing the bracketing of those three conditions as implying that none of them is a legitimate reason for not working.
All I can say to that is that, if I hadn't been a journalist with a good employer, able to work from home in bare feet or wearing soft slippers for large parts of the past 18 months, there's no way I could have held down a regular job. Your life changes when you can't get your shoes on because your feet are periodically swollen and full of pain. If your job depends on your feet, as it does for dancers, postal workers or footballers, then gout means it's curtains for work until you recover. No police officer could walk the beat with gout. No bus driver could safely get behind the wheel. Everything alters, even in your everyday life. You can't nip out to the shops the way you used to. Queueing is a misery. Sitting in a theatre seat is uncomfortable. Long plane journeys can be excruciating.
So, whatever else there is to say about incapacity benefit abuse, there is no excuse for the idea that claimants suffering from gout are somehow on the skive. I'm prepared to bet that every one of the 3,000 people who claim the benefit because gout prevents them from working is telling God's truth. If I were work and pensions secretary, I wouldn't be trying to shove gout sufferers off the benefit rolls, that's for certain.
Earlier this year, a rather grand figure of my acquaintance actually congratulated me on getting gout. Such a distinguished disease, he assured me. Only the most interesting people get it. I retorted that you could say the same about syphilis. Anyway, the figures do not bear out this snobbery about gout being the patrician malady. Emperors and philosophers may indeed suffer from gout - as both Alexander the Great and Kant did. But so too do binmen and clerks. There was a piece in the paper the other day about a Heathrow security guard who started getting gout at 23. When he was diagnosed, he said exactly the same thing that we all say: "How have I got gout? That's a disease rich old folk get."
But it is not. Once you get gout, you soon realise that it is more common than you supposed. I know three Guardian colleagues with gout and I bet there are others. You soon see the world through fellow gout-sufferers' eyes too. Steve Bell pointed out to me an incisively brilliant 18th-century cartoon about gout by James Gillray - the devil is biting into the side of a man's toe joint. Only a sufferer could have done that drawing, just as only another sufferer, Ivan Turgenev, could have drawn for Pauline Viardot the witty little sketch of him climbing the stairs on his backside with his foot swathed in bandages stuck out in front of him. When I studied the 17th century, I never had any time for the Earl of Strafford, arguably the most dangerous over-mighty subject in English history. Yet I could feel even Strafford's pain when I read about his awful gout in John Adamson's recent book about the overthrow of Charles I.
The good news is that a combination of dietary watchfulness and modern medicine eventually equips you to overcome gout - or so I am told and hope. I can vouch for the fact that it isn't a quick process. Daily pills reduce the levels of uric acid that form the crystals which lodge in the joints to produce gout. Who knows, in 2008 I may even go on a walking holiday again. Provided I go easy on the port over Christmas, of course.
