So promises the title page of Leopard Men, an action-packed melodrama set in Northern Nigeria and first presented at the Crown Theatre in Eccles, Lancashire, in September 1924. It focuses on a group of Europeans struggling to survive the hell that is West Africa, as they seek to impose and maintain British rule and systems of commerce on the local population:

The main interest, however, centres on a native woman's obsessive desire for Jimmy, a dissolute white trader who, having previously seduced her, has now brought his wife over from England. The abandoned Fatuma Fulani is so distraught (‘brown woman got heart same – like white woman’) that she determines to take bloody revenge by adopting the garb and weapons of a local cult whose members disguise themselves in leopard skins and attack their enemies (‘She instantly grips his throat with claws fixed to her hands’). All ends happily.

INTRODUCTION

The incidence, clinical presentation, and outcome of transplant-associated malignant melanoma (MM) are discussed more fully in Chapter 26. Surveys on the incidence of transplant-associated MM are limited, but those available have described a range from no increased risk up to an 8-fold increase relative to the nontransplanted immunocompetent population. Donor-derived MM accounts for 28% of cases of donor-derived transplanted tumors, making this the most common type of transplanted metastatic disease in organ transplant recipients (OTR). Information on other forms of posttransplant MM is scarce, and data on the incidence, management, and course of metastatic MM in OTR are almost nonexistent (Figure 34.1). The staging of metastatic (stage IV) melanoma was revised in 2001, and is now delineated as summarized in Table 34.1. Treatment of posttransplant metastatic MM is directed by our experience in immunocompetent individuals, with the crucial added consideration of whether graft-preserving immunosuppression should be withdrawn or altered. Management of this difficult clinical problem is unlikely ever to be strictly protocol-driven given the current lack of a robust evidence base, but rather requires a careful balancing of many complex allograftand tumor-related factors, which is possible only through a multidisciplinary approach.

INCIDENCE AND PROGNOSIS OF METASTATIC MELANOMA IN OTR

Available literature suggests a very poor prognosis (62% mortality) for transplant recipients with a history of MM before transplantation who have a recurrence of MM after transplantation. Similarly, OTR with donor-derived MM have high mortality rates with a 5-year survival of only 5%.

In 1978, David Hare observed that 'It would be sad if this historical period had no chronicler', and one of the roles he has subsequently adopted has been to act as a witness of our times. Indeed, the theatre critic Michael Billington characterises Hare's work as demonstrating a 'sustained conviction that writers have a Balzacian duty to record what is going on around them', and Blake Morrison agrees that 'When future historians come to study the state of Britain in the late twentieth century, Hare will be the playwright they turn to first.' Hare's 'State of the Nation' trilogy of plays centring on the key public institutions of law, church and politics, which was staged at the National Theatre in the early 1990s, was significant in establishing his reputation in this respect; but some of his more recent work has also chimed with the rediscovery of 'documentary drama' and 'verbatim theatre', and the recognition of the potency of these forms as political theatre.

Britain came closer to outright class war in 1926 than at any other time in the twentieth century, and theatre, as one of the principal media through which ideas were disseminated, was a crucial battleground in the struggle. A few years earlier, a play called The Right to Strike had led to arguments and fighting in the auditorium, articles in the Times, polls by the Daily Mirror, extracts being performed in church, and the intervention of Buckingham Palace. ‘One feels’, wrote the Saturday Review, that the author, if he had liked to do so, might quite easily have provoked a riot’. It is only necessary to see how concerned the Censors were about licensing plays for public performance to realise how significant theatre was seen to be in preventing or encouraging class conflict. In 1925 a licence had been refused to Strindberg’s Miss Julie partly because of its ‘very questionable theme in these days of the relations between masters and servants’, and in 1926 Noel Coward’s This Was a Man suffered the same fate at the hands of the Lord Chamberlain and his Advisory Board: