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personal gratification. Although a number of totalitarian secular countries have also placed a higher value
on societal needs than on individual ones, the secular Western democracies have failed miserably in these
goals and usually have not even made the attempt.
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11.Accompanying the transition from a religious to a secular society changes have occurred in the goals
and behavior of its citizens. Think for a moment of a child who is reared in a permissive environment,
150 who is accustomed to getting what he wants when he wants it, who lives in relative affluence, and who is
taught to strive for happiness and selffuffillment as his ultimate goals. Is it reasonable to expect that such a
child will develop into a moral and ethical adult giving his energies for the betterment of society — even if
he chooses medicine as his ultimate calling?
155 12.The crisis of humane medicine is the result of the failure of secular democratic societies to inculcate
moral and ethical values into their educational systems.
13. Paul Goodman has said that science rose in the 20th century because it worked better than any other
160 endeavor. Science, he says, defeated religion in a frank and fair contest of miracles and wonders. «Science
worked better against plagues, and it has proved to be immensely better at Hying and distant
communication». There can be little argument with these observations. The question that must be asked,
165 however, is whether science is also better than religion in training for moral behavior. I believe that the
answer is obvious. It is no accident that some of the prime examples of humane medicine in the West are to
170 be found in hospitals run by religious groups, because the people working in these institutions have been
imbued from infancy with a respect for the sanctity of life and for the dignity of human beings, and with
service to humanity ranked as a higher priority than personal gratification. If we are to train humane
175 physicians, we must begin to address ourselves as a society to the basic general education toward ethical
and moral values from infancy onward. For those who are comfortable with training that is rooted in
traditional religious values, the solution is relatively easy, although all too often formalistic religion slights
180 ethics. For the large proportion of Western society that is secular, a substitute for religion in ethical training
is an urgent societal need. Much of the ethical behavior of even our secular societies is still rooted in the
religious heritage of a generation or two ago. As each generation moves further away from these traditional
185 habits and mores, many of the basic axioms of societal morality are held up for critical inquiry and often
rejected. We are too frequently left adrift without an accepted ethical consensus, and we witness in our
youth what sociologists call alienation. Our societies must come to grips with this problem because the
190 problem transcends medicine; it threatens the very fabric of Western societal structure and its future.
From: The New England Journal of Medicine, Vol. 304, No. 17 (April 23, 1981).
HANDS: A CASE STUDY
by Oliver Sacks
(1)
Madelaine J. Was admitted to St. Benedict’s Hospital near New York City in 1980, her sixtieth
year, a congenially blind woman with cerebral palsy, who had been «looked after» by her family at home
5
throughout her life. Given this history and her pathetic condition — with spasticity and athetosis, i.e.
involuntary movements of both hands, to which was added a failure of the eyes to develop — I expected to
find her both retarded and regressed.
2
(2) She was neither. Quite the contrary: she spoke freely, indeed eloquently (her speech, mercifully, was
scarcely affected by spasticity), revealing herself to be a highspirited woman of exceptional intelligence
and literacy.
2
«You’ve read a tremendous amount», I said. «You must be really at home with Braille».
15
(4) «No, I’m not», she said. «All my reading has been done for me — by talking books or other people.
I can’t read Braille, not a single word. I can'’ do anything with my hands they are completely useless».
(5) She held them up, derisively. «Useless Godforsaken lumps of dough — they don’t even feel a part of
me».
20
(6) I found this very startling. The hands are not usually affected by cerebral palsy; at least, not
essentially affected: they may be somewhat spastic, or weak, or deformed, but are generally of
considerable use
25
(unlike the legs, which may be completely paralysed — in that variant called Little’s disease, or cerebral
diplegia) .