The great secret, known to internists and learned early in marriage by internist’s wives, but still hidden from the general public, is that most things get better by themselves. Most things, in fact, are better by morning. Obviously, it is a great time-saver and money-saver for the physician’s family that anxiety about disease is not handled as though it were the disease itself; there is perhaps greater willingness to accept anxiety as a natural, often transient, phenomenon. And certainly there is much less ambition to deploy the full technology of medicine as a corrective for the human condition.
American physician, poet and educator (1913-1993)
Lewis Thomas (25 November 1913 - 3 December 1993) was a physician, author, administrator, educator, policy advisor and researcher. He served as a Dean of Yale Medical School, Dean of the New York University School of Medicine and President of Memorial Sloan-Kettering Institute.
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The need to make music, and to listen to it, is universally expressed by human beings. I cannot imagine, even in our most primitive times, the emergence of talented painters to make cave paintings without there having been, near at hand, equally creative people making song. It is, like speech, a dominant aspect of human biology.
Statistically the probability of any one of us being here is so small that you would think the mere fact of existence would keep us all in a contented dazzlement of surprise. We are alive against the stupendous odds of genetics, infinitely outnumbered by all the alternates who might, except for luck, be in our places.
Maybe altruism is our most primitive attribute out of reach, beyond our control. Or perhaps it is immediately at hand, waiting to be released, disguised now, in our kind of civilization as affection or friendship or attachment. I can’t see why it should be unreasonable for all human beings to have strands of DNA coiled up in chromosomes, coding out instincts for usefulness and helpfulness. Usefulness may turn out to be the hardest test of fitness for survival, more important than aggression, more effective, in the long run, than grabbiness.
I must mend the ways of my mind. This is a very big place, and I do not know how it works. I am a member of a fragile species, still new to the earth, the youngest creatures of any scale, here only a few moments as evolutionary time is measured, a juvenile species, a child of a species. We are only tentatively set in place, error prone, at risk of fumbling, in real danger at the moment of leaving behind only a thin layer of our fossils, radioactive at that.
The future is too interesting and dangerous to be entrusted to any predictable, reliable agency. We need all the fallibility we can get. Most of all, we need to preserve the absolute unpredictability and total improbability of our connected minds. That way we can keep open all the options, as we have in the past.
It is conceivable that we might be able to provide good medical care for everyone needing it, in a new system designed to assure equity, provided we can restrain ourselves, or our computers, from designing a system in which all 200 million of us are assumed to be in constant peril of failed health every day of our lives. In the same sense that our judicial system presumes us to be innocent until proven guilty, a medical care system may work best if it starts with the presumption that most people are healthy. Left to themselves, computers may try to do it in the opposite way, taking it as given that some sort of direct, continual, professional intervention is required all the time, in order to maintain the health of each citizen, and we will end up spending all our money on nothing but this.
Perhaps the safest thing to do at the outset, if technology permits, is to send music. This language may be the best we have for explaining what we are like to others in space, with least ambiguity. I would vote for Bach, all of Bach, streamed out into space, over and over again. We would be bragging of course, but it is surely excusable to put the best possible face on at the beginning of such an acquaintance. We can tell the harder truths later.
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We are endowed with genes which code out our reaction to beavers and otters, maybe our reaction to each other as well. We are stamped with stereotyped, unalterable patterns of response, ready to be released. And the behavior released in us, by such confrontations, is, essentially, a surprised affection. It is compulsory behavior and we can avoid it only by straining with the full power of our conscious minds, making up conscious excuses all the way. Left to ourselves, mechanistic and autonomic, we hanker for friends.