Objective To quantify James Bond’s consumption of alcohol as detailed in the series of novels by Ian Fleming.
Design Retrospective literature review.
Setting The study authors’ homes, in a comfy chair.
Participants Commander James Bond, 007; Mr Ian Lancaster Fleming.
Main outcome measures Weekly alcohol consumption by Commander Bond.
Methods All 14 James Bond books were read by two of the authors. Contemporaneous notes were taken detailing every alcoholic drink taken. Predefined alcohol unit levels were used to calculate consumption. Days when Bond was unable to consume alcohol (such as through incarceration) were noted.
Results After exclusion of days when Bond was unable to drink, his weekly alcohol consumption was 92 units a week, over four times the recommended amount. His maximum daily consumption was 49.8 units. He had only 12.5 alcohol free days out of 87.5 days on which he was able to drink.
Conclusions James Bond’s level of alcohol intake puts him at high risk of multiple alcohol related diseases and an early death. The level of functioning as displayed in the books is inconsistent with the physical, mental, and indeed sexual functioning expected from someone drinking this much alcohol. We advise an immediate referral for further assessment and treatment, a reduction in alcohol consumption to safe levels, and suspect that the famous catchphrase “shaken, not stirred” could be because of alcohol induced tremor affecting his hands...
Connoisseur or alcoholic?
A commonly used screening tool to identify alcohol dependence is the “CAGE” questionnaire, where two yes responses should prompt further investigation:
-Have you ever felt you needed to Cut down on your drinking?
-Have people Annoyed you by criticising your drinking?
-Have you ever felt Guilty about drinking?
-Have you ever felt you needed a drink first thing in the morning (Eye opener) to steady your nerves or to get rid of a hangover?
Applying these to Bond, the authors would score him 3 out of 4. In “Thunderball” he recognises his high alcohol intake and that he feels better drinking less. He also admits to having an eye opener on some mornings (the “Prairie Oyster”). Also in Thunderball, together with the Living Daylights, he becomes annoyed when challenged about his drinking by his boss “M”. It is likely that an international spy and assassin cannot spend too much time worrying about remorse, so we are not surprised that there are no documented instances of alcohol associated guilt.
The most common cause of tremor is essential tremor. This is typically postural and will most commonly affect the upper limbs, although lower limb involvement is recognised. The role of alcohol is somewhat uncertain, with some evidence that in lower doses it can be beneficial in essential tremor, while others propose that those with high alcohol consumption are four times more likely to suffer with essential tremor.
Cerebellar lesions are well known to cause an intention tremor and cerebellar tremor is considered a distinct clinical entity. While strokes are a more common cause of cerebellar lesions (of which Bond is at increased risk), chronic exposure to toxins, such as alcohol, that cause more generalised damage to the cerebellum can also cause a cerebellar tremor. We have shown that Bond’s alcohol intake is of sufficiently high frequency and duration to cause such cerebellar damage.
- Graham Johnson, ST5 emergency medicine,
- Indra Neil Guha, clinical associate professor of hepatology,
- Patrick Davies, consultant paediatric intensive care