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As I scribble these words on a train to London, I’m wearing a lightweight Italian wool suit, a shirt from Gieves & Hawkes, a silk spotty tie and a pair of Church’s suede brogues. You might mistake me for a prosperous Neapolitan gentleman of a certain age. But in fact, I’m a charity-shop dandy – my outfit came to less than £60. That’s less than a pair of new trainers for my teenage daughter. I’m particularly pleased with the shoes, which I picked up locally for £30. A new pair would set you back £700. If you’re not too grand to buy secondhand, it’s actually far easier and cheaper for men to dress smartly than to be slovenly. I learned this important fact in my early twenties.

The Spectator was there at the founding of America. George Washington had six copies of the original, 18th-century Spectator at his Mount Vernon estate and read them often. He shared with Joseph Addison, The Spectator’s co-publisher, an interest in how to educate ideal citizens: men and women with wit and grit. Young Washington read The Spectator in the hope of bettering himself, too. Both of his older half-brothers had been educated in England and he wished also for the manners and polish of an English gentleman. For the pioneering, self-improving men who would go on to create an independent America, the 18th-century Spectator was both an education and a guide. “I bought it, read it over and over, and was much delighted with it,” wrote Benjamin Franklin in his Autobiography.

“You are going to die before me and leave me to deal with this, and I will curse your soul for all eternity,” I once said half-jokingly to my husband over a glass of wine. We were having one of our regular conversations about what he was going to do about his late uncle’s possessions, which had arrived at our house in lorry-loads about a year after we had married. “Why don’t you do half an hour of sorting every weekend? I will help you,” I would suggest in reference to the multiple barns, basements and attics at our farm, which were now piled high with three generations’ worth of male hoarding. But with an increasing number of children in the house and no sense of urgency, progress was slow.

“Where are all my favorite parts?” Arnold Schoenberg asked, on being presented with a severe academic analysis of the Eroica symphony. “Oh, there they are. In the tiny notes.” The tendency of many people, presented with the overwhelming abundance of an art form, is to exclude as much as possible. Reduce the wonderful life of incidental invention to the tiny notes; erect walls excluding the fascinating curiosity, the eccentric, the madly idiosyncratic. Produce a list of the 100 Best Books, sticking to declared Greatness. People have been producing lists of the Best Books for a hell of a long time. When copyright law was reformed in 1774, it enabled publishers to produce collections of novels for the first time.

Sam Altman, the co-founder of OpenAI, which launched ChatGPT, is not overweight. Gay tech billionaires rarely are. Even so, as he explained in a recent interview, he was keen to try a GLP-1, one of those drugs that have revolutionized weight loss in the past five years. You can understand why he was curious. Ozempic and Mounjaro might appear to have nothing in common with artificial intelligence, but both phenomena have helped to create the sensation that we’re entering an era of accelerating and uncontrollable change. Alas, he screwed it up. He had someone inject him with a megadose, puked all night and then lay in bed for days "staring at a white ceiling thinking nothing," not only feeling no urge to eat but also no "desire for anything.

There’s a question I’ve started being asked at work. Given I’m a psychiatrist, it isn’t one I’d ever expected to hear: “Do I have cancer?” A young woman with anxiety wants to know whether the lump on her neck is sinister; she has been watching a great deal of TikTok. A man in his late thirties, in for a routine review, mentions in passing that his sister has been referred for a colonoscopy and wonders whether he should be too. At a dinner party a few weeks ago, a friend leant across halfway through her low-alcohol natural wine and asked me, in a small voice, whether it was true her generation was getting cancer in their thirties. Yes, I said, perhaps a little too bluntly. She looked rather panicked for the rest of her evening.