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more information about their genetic parent(s), and that very fewabuse this privilege. They argue that adopted people have a needand a right to know about their origins, and that developmentalmaturity often depends on a clear sense of identity, which is

inextricably linked with an understanding of their heritage.Being open and honest is accepted as being a good thing in

adoption, yet those who adopt children find it the most difficultpart. For many the difficulty in "telling" is entangled partly withtheir feeling of shame and sense of failure about their childlessnessand infertility. In this context, it is easier to see that the question ofidentity is not just about human and personal rights but also aboutsocial attitudes to infertility, childlessness, and non-natural families.The authors claim that, unlike parents who adopt, those who

have a child through artificial means are unlikely to tell the child thetruth later. They cite one commentator who goes so far as to say thata child who does not know that he was born through artificialinsemination by donor "will be as certain of its origins as any otherchild. The fact that it is mistaken about the origin of half its genes isto my mind of no importance whatsoever".Adoptive practices and human fertilisation programmes differ in

that the primary concern for adoption agencies is the welfare of thechild, whereas the latter is essentially a service for adults. With thisin mind, the authors still argue that some aspects of adoption andhuman fertilisation programmes are analogous, and that therelevance of adoption experience and research could help to protectthe welfare of future generations.

1. Walby C, Symons B. Who am I?: identity, adoption and human fertilisation. 1990. Pp128. London: Bnnsh Agencies for Adoption and Fostering, 11 Southwark Street,London SE1 1RQ. ISBN 0-903534878.

WHO on low-dose oral interferon-alpha forAIDS

Considerable media coverage was given to reports from the KenyaMedical Research Institute and published in July (East AfricanMedical Journal 1990; 67 [suppI2]: SS64--86) of a beneficial effect oflow doses of oral human interferon-alpha (’Kemron’) in the

management of patients with HIV infection or AIDS. On Sept 3-4,the World Health Organisation convened a meeting to examine thedata; the conclusion was that the beneficial effects are as yetunproven. Recommendations for the design of studies with oralinterferons were made and will be circulated to national drugregulatory authorities. Emphasis was put on importance of havingthe interferon prepared in accordance with prevailing norms forquality control by competent research-based pharmaceuticalmanufacturers, who have been urged to supply preparations onlyfor prospective clinical trials, until more conclusive data areavailable.

Nobel prizeThis year’s Nobel prize for medicine has been awarded to DrJoseph E. Murray, of Brigham and Women’s Hospital, Boston, andDr E. Donnall Thomas, of the Fred Hutchinson Cancer Center,Seattle. Dr Murray carried out the first successful transplantation ofa kidney from a living donor, in December, 1954. Dr Thomasdemonstrated that methotrexate could reduce the graft-versus-hostreaction in bone-marrow transplantation.

In England Now

- My first patient, in my first house job, was an old Italian who spokeno English. Put to bed, he developed acute retention and I advancedupon him with a catheter. He was frightened; so was I. "Perche?Perche?" he begged to know, but I had no Italian. Or had I? Amaster in junior school had made us learn a foreign tag each week.So it was that I could repeat in Italian the first stanza of the Inferno,and I knew the English ran: "In the middle of the journey of life I

found myself lost in a dark wood, because the straight way wasblocked." I duly recited the original and a smile of contentmentspread over the patient’s face. His doctor not only explained whatwas going on but quoted Dante to do so!My very last patient, a week ago, had an extremely paranoid

personality; she was almost a vexatious litigant. At the end of theinterview, to which the students had listened spellbound, sheintimated her intention to sue me. "What about?" "You’re refusingto give me advice." This was a bit hard since for the last half hourshe had been resisting everything that I suggested. "What advicehaven’t I given you?" "You won’t tell me whether I should sue theother doctor!"

So my work for the NHS, from close on its beginning to close toits end, began and finished on high notes. Moreover, in the practiceof psychiatry over the last thirty-five years I have never come acrossa boring patient. In what other specialty can one say that?

* * *

The British Post Office is this year celebrating the 150th

anniversary of the first adhesive postage stamp, the Penny Black. Itmay not be known to many that following the introduction of thisnew "invention" there was concern among the public that lickingthe back of the stamp might lead to cancer of the tongue. The healthscare prompted one reader to write to The Lancet (1840-41; i: 524):"Having seen in the papers that moistening with the tongue theglutinous matter on the postage labels will produce a cancer, I beg toask if any such thing is to be feared from the practice."The editor allayed his reader’s fears:"The alleged calamity is a hoax, designed to frighten silly people.

However, the comer of the letter, and not of the back of the label,should be moistened."

* * *

When Dadie’s husband died, she had to retreat to shelteredaccommodation in a block of flats. We visited her there. Her flat was

cramped but reasonably comfortable. I asked to go to the toilet. Itwas dusk so I tried to pull the light switch but nothing happened.When I came out I told Dadie, who threw up her hands and said"Heavens, that’s the pull cord to summon the warden. But not toworry. Fortunately-and that’s what we all think in this building-he’s never been known to come. And a good thing too!"

International Diary

A meeting on Cracking Gallbladder and Bile Duct Problems will takeplace in London on Thursday, Oct 18: Conference Office, British Institute ofRadiology, 36 Portland Place, London WIN 4AT, UK (071-580 4085).

A conference entitled Medical Aspects of Emotional Abuse is to be heldin Torquay on Friday, Nov 9: Janet Brosnan, British Agencies for Adoptionand Fostering, South West Centre, 9 Stokes Croft, Bristol BS1 3PL, UK(0272-425881).

An international symposium on Metabolism in Drug Research andDevelopment will be held in Milan on Nov 26-27: Prof Albeno Fngerio,Italian Group for Scientific Research and Study, Viale Lombardia 8, 20131Milan, Italy (02-266 53 30).

4th DPHM-INSERM conference entitled Drugs and Europe-Realityand Ambition is to take place m Pans on Nov 26-29: Mme DanielleGolinelli, General Secretary, IPR International, 12 rue des Halles, 75001Paris, France (1-42 33 95 41).

A conference entitled Cardiology’91 is to be held in California, USA, on Jan24-26: Janice R Turner, Conference Management Associates, PO Box 2586,La Jolla, Ca 92038, USA (619-459 1564).

A list of symposia on Molecular and Cellular Biology can be obtainedfrom Keystone Symposia, 2032 Armacost Avenue, Los Angeles, California90025, USA (tel 213-207-2397, fax 213-207-5042).