Patient Doctor Quotes

You say you felt a presence, but I only sensed an absence. A vague pain without a source. I was like a patient who cannot tell the doctor where it hurts, only that it does.

The doctor of the future will give no medication, but will interest his patients in the care of the human frame, diet and in the cause and prevention of disease. ~

It’s true that AI can mimic the human brain, but it can also outperform us mere humans by discovering complex patterns that no human being could ever process and identify.

Cognitive robotics can integrate information from pre-operation medical records with real-time operating metrics to guide and enhance the precision of physicians’ instruments. By processing data from genuine surgical experiences, they’re able to provide new and improved insights and techniques. These kinds of improvements can improve patient outcomes and boost trust in AI throughout the surgery. Robotics can lead to a 21% reduction in length of stay.

Each patient carries his own doctor inside him.

When I arrived, I did the job of six people and worked over one hundred hours per week for more than a year until I collapsed in my yard and nearly died!

The reality is that the lives of the smallest patients are in our hands, and their clinical condition can change in an instant. No matter how many times you are involved in situations such as this, the physical stress and anxiety as well as the emotional and psychological effects of being immersed in that environment are dramatic and lasting on the human body, mind, and central nervous system. These effects are severe, and I firmly believe that they are cumulative over your lifetime.

In short, physicians are getting more and more data, which requires more sophisticated interpretation and which takes more time. AI is the solution, enhancing every stage of patient care from research and discovery to diagnosis and therapy selection. As a result, clinical practice will become more efficient, convenient, personalized, and effective.

One of the greatest realizations that I clumsily stumbled upon during this process, was that these people didn’t need someone like me to tell them what to do; they needed someone like me to show them what can be done, together.

It’s estimated that AI could free up to 25% of clinician time across different specialties. This increased amount of time could mean less hurried encounters and more humane interactions, including more empathy from happier doctors. This is important because empathy has been shown to improve outcomes by boosting patient adherence to the prescribed treatments, increasing motivation, and reducing anxiety and stress.

Do not work primarily for money; do your duty to patients first and let the money follow; our life is short, we don't live twice; the whirlwind will pick up the leaves and spin them, but then it will drop them and they will form a pile.

I will love you if I never see you again, and I will love you if I see you every Tuesday. I will love you as the starfish loves a coral reef and as kudzu loves trees, even if the oceans turn to sawdust and the trees fall in the forest without anyone around to hear them. I will love you as the pesto loves the fettuccini and ats the horseradish loves the miyagi, and the pepperoni loves the pizza. I will love you as the manatee loves the head of lettuce and as the dark spot loves the leopard, as the leech loves the ankle of a wader and as a corpse loves the beak of the vulture. I will love you as the doctor loves his sickest patient and a lake loves its thirstiest swimmer. I will love you as the beard loves the chin, and the crumbs love the beard, and the damp napkin loves the crumbs, and the precious document loves the dampness of the napkin, and the squinting eye of the reader loves the smudged document, and the tears of sadness love the squinting eye as it misreads what is written. I will love you as the iceberg loves the ship, and the passengers love the lifeboat, and the lifeboat loves the teeth of the sperm whale, and the sperm whale loves the flavor of naval uniforms. I will love you as a drawer loves a secret compartment, and as a secret compartment loves a secret, and as a secret loves to make a person gasp... I will love you until all such compartments are discovered and opened, and all the secrets have gone gasping into the world. I will love you until all the codes and hearts have been broken and until every anagram and egg has been unscrambled. I will love you until every fire is extinguished and rebuilt from the handsomest and most susceptible of woods. I will love you until the bird hates a nest and the worm hates an apple. I will love you as we find ourselves farther and farther from one another, where once we were so close... I will love you until your face is fogged by distant memory. I will love you no matter where you go and who you see, I will love you if you don't marry me. I will love you if you marry someone else--and i will love you if you never marry at all, and spend your years wishing you had married me after all. That is how I will love you even as the world goes on its wicked way.

AI-powered passive monitoring is taking off and has huge advantages over the traditional way of monitoring patients. The advantage of passive monitoring, as opposed to data collected from wearables, is that it doesn’t require patients or seniors to actively wear a device at all times. Used in a hospital setting, the tech reduces healthcare workers’ risk of exposure to COVID-19 by limiting their contact with patients and automating data collection for vital signs. Also, camera-based monitoring is unpopular for the simple reason that a lot of people don’t like being watched by a camera.

Much of clinician burnout is due to spending time writing notes, placing orders, generating referrals, writing prior authorization letters, and creating patient communication. In other words, burnout is caused by physicians having to generate output! With the emergence of large language models that are used to train generative AI solutions, these use cases will be at the frontier of AI’s applications in healthcare.

An algorithm that expedites care to a stroke patient in a chaotic emergency room (ER) has a good chance of adoption. An algorithm that reads a routine scan and provides some quantification of what the physicians can already estimate won’t be in as much demand. There are good reasons for algorithms to parse patient records to look for signs of rare diseases, but there are fewer good reasons for using them to evaluate clinical symptoms. It’s cool that AI tools can make diagnoses from scratch, but for most clinical encounters doctors are already pretty good at it.

How does your patient, doctor? Doctor: Not so sick, my lord, as she is troubled with thick-coming fancies that keep her from rest. Macbeth: Cure her of that! Canst thou not minister to a mind diseased, pluck from the memory a rooted sorrow, raze out the written troubles of the brain, and with some sweet oblivious antidote cleanse the stuffed bosom of that perilous stuff which weighs upon her heart. Doctor: Therein the patient must minister to himself.

I was able to shake off the near-death experience, and whether it was true or not, I was able to use it as some sort of moral validation as to the importance of my existence, or at least the importance of me completing this job, because clearly God, the universe or whoever understood that there was no other human being alive on this earth stupid enough to take this job.

The purpose of a doctor or any human in general should not be to simply delay the death of the patient, but to increase the person's quality of life.

The issue of reimbursement by payers is an important factor that should be discussed. Is it possible that if radiologists use AI to read scans, they’ll receive less reimbursement? Or to approach this from the other angle, if payers are reimbursing for the use of AI, will they pay radiologists less as a result? My discussions with insurance executives have shown that they don’t think this is likely. If the use of these technologies will improve patient outcomes and lead to fewer errors, there are benefits to them that will motivate executives to pay for them in addition to radiologists’ reading fees.

The clown wanted to bypass all medical care and cure his cancer with a naturopathic doctor. What a fool, right?” ... Karver’s smirk widened a little. “That’s right, my good man. They shouldn’t even be able to call themselves doctors. Making people eat roots, tree bark, dirt and whatnot. If they stopped trying to peddle their snake oil, maybe they’d stop mysteriously dying or disappearing.” Karver paused for a few seconds, grinning at Frank in silence, creating an awkward moment ...

I will love you with no regard to the actions of our enemies or the jealousies of actors. I will love you with no regard to the outrage of certain parents or the boredom of certain friends. I will love you no matter what is served in the world’s cafeterias or what game is played at each and every recess. I will love you no matter how many fire drills we are all forced to endure, and no matter what is drawn upon the blackboard in blurry, boring chalk. I will love you no matter how many mistakes I make when trying to reduce fractions, and no matter how difficult it is to memorize the periodic table. I will love you no matter what your locker combination was, or how you decided to spend your time during study hall. I will love you no matter how your soccer team performed in the tournament or how many stains I received on my cheerleading uniform. I will love you if I never see you again, and I will love you if I see you every Tuesday. I will love you if you cut your hair and I will love you if you cut the hair of others. I will love you if you abandon your baticeering, and I will love you if you if you retire from the theater to take up some other, less dangerous occupation. I will love you if you drop your raincoat on the floor instead of hanging it up and I will love you if you betray your father. I will love you even if you announce that the poetry of Edgar Guest is the best in the world and even if you announce that the work of Zilpha Keatley Snyder is unbearably tedious. I will love you if you abandon the theremin and take up the harmonica and I will love you if you donate your marmosets to the zoo and your tree frogs to M. I will love you as a starfish loves a coral reef and as a kudzu loves trees, even if the oceans turn to sawdust and the trees fall in the forest without anyone around to hear them. I will love you as the pesto loves the fettuccini and as the horseradish loves the miyagi, as the tempura loves the ikura and the pepperoni loves the pizza. I will love you as the manatee loves the head of lettuce and as the dark spot loves the leopard, as the leech loves the ankle of a wader and as a corpse loves the beak of the vulture. I will love you as the doctor loves his sickest patient and a lake loves its thirstiest swimmer. I will love you as the beard loves the chin, and the crumbs love the beard, and the damp napkin loves the crumbs, and the precious document loves the dampness in the napkin, and the squinting eye of the reader loves the smudged print of the document, and the tears of sadness love the squinting eye as it misreads what is written. I will love you as the iceberg loves the ship, and the passengers love the lifeboat, and the lifeboat loves the teeth of the sperm whale, and the sperm whale loves the flavor of naval uniforms. i will love you as a child loves to overhear the conversations of its parents, and the parents love the sound of their own arguing voices, and as the pen loves to write down the words these voices utter in a notebook for safekeeping. I will love you as a shingle loves falling off a house on a windy day and striking a grumpy person across the chin, and as an oven loves malfunctioning in the middle of roasting a turkey. I will love you as an airplane loves to fall from a clear blue sky and as an escalator loves to entangle expensive scarves in its mechanisms. I will love you as a wet paper towel loves to be crumpled into a ball and thrown at a bathroom ceiling and as an eraser loves to leave dust in the hairdos of people who talk too much. I will love you as a cufflink loves to drop from its shirt and explore the party for itself and as a pair of white gloves loves to slip delicately into the punchbowl. I will love you as the taxi loves the muddy splash of a puddle and as a library loves the patient tick of a clock.

Few things a doctor does are more important than relieving pain. . . pain is soul destroying. No patient should have to endure intense pain unnecessarily. The quality of mercy is essential to the practice of medicine; here, of all places, it should not be strained.

First lesson taught to doctors in medical college: "Be emotional about the disease, not the patient.

Doctors are great--as long as you don't need them.

Doctors always think anybody doing something they aren't is a quack; also they think all patients are idiots.

Doctors put a wall up between themselves and their patients; nurses broke it down.

The illness of a doctor is always worse than the illnesses of his patients.The patients only feel, but the doctor, as well as feeling, has a pretty good idea of the destructive effect of the disease on his constitution.This is a case in which knowledge brings death nearer.

The doctor of the future will give no medicine, but will interest his (sic)patient in the care of the human frame, in diet and in the cause and prevention of disease

I notice that every patient on the ward has a pulse of 60 recorded in their observation chart so I surreptitiously inspect the healthcare assistant’s measurement technique. He feels the patient’s pulse, looks at his watch and meticulously counts the number of seconds per minute.

If you have one wish, wish for everything to be exactly as it is. Then wait patiently for your wish to come true.

Canst thou not minister to a mind diseas'd, Pluck from the memory a rooted sorrow, Raze out the written troubles of the brain, And with some sweet oblivious antidote Cleanse the stuff'd bosom of the perilous stuff Which weighs upon the heart? DOCTOR: Therein the patient Must minister to himself.

Moist was sure doctors keep skeletons around to cow patients. Nyer, nyer, we know what you look underneath ...

Personally, I have always felt that the best doctor in the world is the Veterinarian. He can't ask his patients what is the matter...he's just got to know.

The nurses, I have already learned, are the ones who give us the answers we’re desperate for. Unlike the doctors, who fidget like they need to be somewhere else, the nurses patiently answer us as if we are the first set of parents to ever have this kind of meeting with them, instead of the thousandth.

An oncology ward is a battlefield, and there are definite hierarchies of command. The patients, they're the ones doing the tour of duty. The doctors breeze in and out like conquering heroes, but they need to read your child's chart to remember where they've left off from the previous visit. It is the nurses who are the seasoned sergeants -- the ones who are there when your baby is shaking with such a high fever she needs to be bathed in ice, the ones who can teach you how to flush a central venous catheter, or suggest which patient floor might still have Popsicles left to be stolen, or tell you which dry cleaners know how to remove the stains of blood and chemotherapies from clothing. The nurses know the name of your daughter's stuffed walrus and show her how to make tissue paper flowers to twine around her IV stand. The doctors may be mapping out the war games, but it is the nurses who make the conflict bearable.

Hello, old friend. And here we are. You and me, on the last page. By the time you read these words, Rory and I will be long gone. So know that we lived well and were very happy. And above all else, know that we will love you always. Sometimes I do worry about you though. I think once we're gone you won't be coming back here for awhile. And you might be alone. Which you should never be. Don't be alone, Doctor. And do one more thing for me. There's a little girl waiting in a garden. She's going to wait a long while, so she's going to need a lot of hope. Go to her. Tell her a story. Tell her that if she's patient, the days are coming that she'll never forget. Tell her she'll go to see and fight pirates. She'll fall in love with a man who'll wait two thousand years to keep her safe. Tell her she'll give hope to the greatest painter who ever lived. And save a whale in outer space. Tell her, this is the story of Amelia Pond. And this is how it ends.

I was like the patient who cannot explain to the doctor where it hurts, only that it does.

In quixotically trying to conquer death doctors all too frequently do no good for their patients’ “ease” but at the same time they do harm instead by prolonguing and even magnifying patients’ dis-ease.

The American Academy of Nutrition and Dietetics is sponsored by Coca-Cola.

Every patient carries her or his own doctor inside.

[The doctor] peeked into the trauma room and saw the situation: the clerk - that is, me - standing next to the orderly, Georgie, both of us on drugs, looking down at a patient with a knife sticking up out of his face. 'What seems to be the trouble?' he asked.

THE MAXIMS OF MEDICINE Before you examine the body of a patient, Be patient to learn his story. For once you learn his story, You will also come to know His body. Before you diagnose any sickness, Make sure there is no sickness in the mind or heart. For the emotions in a man’s moon or sun, Can point to the sickness in Any one of his other parts. Before you treat a man with a condition, Know that not all cures can heal all people. For the chemistry that works on one patient, May not work for the next, Because even medicine has its own Conditions. Before asserting a prognosis on any patient, Always be objective and never subjective. For telling a man that he will win the treasure of life, But then later discovering that he will lose, Will harm him more than by telling him That he may lose, But then he wins. THE MAXIMS OF MEDICINE by Suzy Kassem

Because the brain mediates our experience of the world, any neurosurgical problem forces a patient and family, ideally with a doctor as a guide, to answer this question: What makes life meaningful enough to go on living?

There is something about the presence of a cat that seems to take the bite out of being alone.

But the story of leukemia--the story of cancer--isn't the story of doctors who struggle and survive, moving from institution to another. It is the story of patients who struggle and survive, moving from on embankment of illness to another. Resilience, inventiveness, and survivorship--qualities often ascribed to great physicians--are reflected qualities, emanating first from those who struggle with illness and only then mirrored by those who treat them. If the history of medicine is told through the stories of doctors, it is because their contributions stand in place of the more substantive heroism of their patients.

And so it is a truth universally acknowledged that a young woman in possession of vague symptoms like fatigue and pain will be in search of a doctor who believes she is actually sick.

Those who have the strength and the love to sit with a dying patient in the silence that goes beyond words will know that this moment is neither frightening nor painful, but a peaceful cessation of the functioning of the body. Watching a peaceful death of a human being reminds us of a falling star; one of a million lights in a vast sky that flares up for a brief moment

Look at your life as a patient and a doctor!

Doctor’s recommendation to patient. Underneath that was scrawled: Don’t do cocaine.

Tuesday, 9th Novermber 2004 Bleeped awake at 3AM from my first half hour shut-eye in three shifts to prescribe a sleeping pill to a patient whose sleep is evidently much more important than mine. My powers are greater than I realised; I arrive on the ward to find the patient is asleep.

Doctors of ancient times used to recommend reading to their patients as a physical exercise on an equal level as walking, running, or ball-playing.

The doctor who treats himself has a fool for a patient.

Tuesday, 5 July 2005 Trying to work out a seventy-year-old lady’s alcohol consumption to record in the notes. I’ve established that wine is her poison. Me: ‘And how much wine do you drink per day, would you say?’ Patient: ‘About three bottles on a good day.’ Me: ‘OK . . . And on a bad day?’ Patient: ‘On a bad day I only manage one.

Why are you so afraid of the word ‘Fascism,’ Doremus? Just a word—just a word! And might not be so bad, with all the lazy bums we got panhandling relief nowadays, and living on my income tax and yours—not so worse to have a real Strong Man, like Hitler or Mussolini—like Napoleon or Bismarck in the good old days—and have ‘em really run the country and make it efficient and prosperous again. ‘Nother words, have a doctor who won’t take any back-chat, but really boss the patient and make him get well whether he likes it or not!

Most medical students go through a brief period when they develop all manner of imaginary illnesses – I myself had leukaemia for at least four days – until they learn, as a matter of self-preservation, that illnesses happen to patients, not to doctors.

I liked that in obstetrics you end up with twice the number of patients you started with, which is an unusually good batting average compared to other specialties. (I’m looking at you, geriatrics.)

What patients seek is not scientific knowledge that doctors hide but existential authenticity each person must find on her own. Getting too deeply into statistics is like trying to quench a thirst with salty water. The angst of facing mortality has no remedy in probability.

In the end, it cannot be doubted that each of us can see only a part of the picture. The doctor sees one, the patient another, the engineer a third, the economist a fourth, the pearl diver a fifth, the alcoholic a sixth, the cable guy a seventh, the sheep farmer an eighth, the Indian beggar a ninth, the pastor a tenth. Human knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still it is never complete. And Truth comes somewhere above all of them, where,

Most people live in fear of some terrible event changing their lives, the death of a loved one or a serious illness. For the chronically ill, this terrible event has already happened, and we have been let in on an amazing secret: You survive. You adapt, and your life changes, but in the end you go on, with whatever compromises you have been forced to make, whatever losses you have been forced to endure. You learn to balance your fears with the simple truth that you must go on living.

He thinks I’m having trouble expressing my feelings, which is why he suggested I write in a journal—to get it out, he said, like in the old days when physicians used to bleed their patients in order to drain the mysterious poisons. Which almost always ended up killing them in spite of the doctors’ good intentions, I might point out.

What was she thinking?” muttered Alexander, closing his eyes and imagining his Tania. “She was determined. It was like some kind of a personal crusade with her,” Ina said. “She gave the doctor a liter of blood for you—” “Where did she get it from?” “Herself, of course.” Ina smiled. “Lucky for you, Major, our Nurse Metanova is a universal donor.” Of course she is, thought Alexander, keeping his eyes tightly shut. Ina continued. “The doctor told her she couldn’t give any more, and she said a liter wasn’t enough, and he said, ‘Yes, but you don’t have more to give,’ and she said, ‘I’ll make more,’ and he said, ‘No,’ and she said, ‘Yes,’ and in four hours, she gave him another half-liter of blood.” Alexander lay on his stomach and listened intently while Ina wrapped fresh gauze on his wound. He was barely breathing. “The doctor told her, ‘Tania, you’re wasting your time. Look at his burn. It’s going to get infected.’ There wasn’t enough penicillin to give to you, especially since your blood count was so low.” Alexander heard Ina chuckle in disbelief. “So I’m making my rounds late that night, and who do I find next to your bed? Tatiana. She’s sitting with a syringe in her arm, hooked up to a catheter, and I watch her, and I swear to God, you won’t believe it when I tell you, Major, but I see that the catheter is attached to the entry drip in your IV.” Ina’s eyes bulged. “I watch her draining blood from the radial artery in her arm into your IV. I ran in and said, ‘Are you crazy? Are you out of your mind? You’re siphoning blood from yourself into him?’ She said to me in her calm, I-won’t-stand-for-any-argument voice, ‘Ina, if I don’t, he will die.’ I yelled at her. I said, ‘There are thirty soldiers in the critical wing who need sutures and bandages and their wounds cleaned. Why don’t you take care of them and let God take care of the dead?’ And she said, ‘He’s not dead. He is still alive, and while he is alive, he is mine.’ Can you believe it, Major? But that’s what she said. ‘Oh, for God’s sake,’ I said to her. ‘Fine, die yourself. I don’t care.’ But the next morning I went to complain to Dr. Sayers that she wasn’t following procedure, told him what she had done, and he ran to yell at her.” Ina lowered her voice to a sibilant, incredulous whisper. “We found her unconscious on the floor by your bed. She was in a dead faint, but you had taken a turn for the better. All your vital signs were up. And Tatiana got up from the floor, white as death itself, and said to the doctor coldly, ‘Maybe now you can give him the penicillin he needs?’ I could see the doctor was stunned. But he did. Gave you penicillin and more plasma and extra morphine. Then he operated on you, to get bits of the shell fragment out of you, and saved your kidney. And stitched you. And all that time she never left his side, or yours. He told her your bandages needed to be changed every three hours to help with drainage, to prevent infection. We had only two nurses in the terminal wing, me and her. I had to take care of all the other patients, while all she did was take care of you. For fifteen days and nights she unwrapped you and cleaned you and changed your dressings. Every three hours. She was a ghost by the end. But you made it. That’s when we moved you to critical care. I said to her, ‘Tania, this man ought to marry you for what you did for him,’ and she said, ‘You think so?’ ” Ina tutted again. Paused. “Are you all right, Major? Why are you crying?

Doctor(to patient): Give me your parent's number so that we can tell them what a bad boy you have been. Patient(Confused, unwilling): You don't need to. Doctor:Hospital Rules!!! And no matter how much i hate dead people, I hate Unpaid bills more

Did any of you ever see Doctor Tetrazzini perform? I say perform advisedly because his operations were performances. He would start by throwing a scalpel across the room into the patient and then make his entrance as a ballet dancer. His speed was incredible: "I don't give them time to die", he would say. Tumors put him in a frenzy of rage. "Fucking undisciplined cells!" he would snarl, advancing on the tumor like a knife-fighter.

The street to my left was backed up with traffic and I watched the people waiting patiently in the cars. There was almost always a man and a women, staring straight ahead, not talking. It was, finally, for everyone, a matter of waiting. You waited and you waited- for the hospital, the doctor, the plumber, the madhouse, the jail, papa death himself. First the signal red, then the signal was green. The citizens of the world ate food and watched t.v. and worried about their jobs or lack of the same, while they waited.

Because doctors can’t name the illness, everyone—the patient's family, friends, health insurance, and in many cases the patient—comes to think of the patient as not really sick and not really suffering. What the patient comes to require in these circumstances, in the absence of help, are facts—tests and studies that show that they might “in fact” have something.

It’s funny – you don’t think of doctors getting ill.’ It’s true, and I think it’s part of something bigger: patients don’t actually think of doctors as being human. It’s why they’re so quick to complain if we make a mistake or if we get cross. It’s why they’ll bite our heads off when we finally call them into our over-running clinic room at 7 p.m., not thinking that we also have homes we’d rather be at. But it’s the flip side of not wanting your doctor to be fallible, capable of getting your diagnosis wrong. They don’t want to think of medicine as a subject that anyone on the planet can learn, a career choice their mouth-breathing cousin could have made.

I guessed that he was one of those ambitious young physicians who more and more fill the profession, opportunists with a fashionable hoodlum image, openly hostile to their patients. My brief stay at the hospital had already convinced me that the medical profession was an open door to anyone nursing a grudge against the human race.

Healthy people, I have concluded, including myself, do not understand how everything changes once you have been diagnosed with a fatal illness. How you cling to hope, however false, however slight, and how reluctant most doctors are to deprive patients of that fragile beam of light in so much darkness. Indeed, many people develop what psychiatrists call ‘dissociation’ and a doctor can find himself talking to two people – they know that they are dying and yet still hope that they will live. I had noticed the same phenomenon with my mother during the last few days of her life. When faced by people who are dying you are no longer dealing with the rational consumers assumed by economic model-builders, if they ever existed in the first place.

Why is it that God gets all the credit for the good stuff, but it's the doctor's fault when shit happens? When the patient comes through, it's always 'Thank God,' and when the patient dies, it's always blame the doctor. Just once in my life, just for the sheer fucking novelty of it, it would be nice if somebody blamed God when the patient dies, instead of me.

In these days before antiseptics, doctors themselves also suffered high mortality rates. Florence Nightingale, a nurse during the Crimean War (1853-1856), watched one particularly inept surgeon cut both himself and, somehow, a bystander while blundering about during an amputation. Both men contracted an infection and died, as did the patient. Nightingale commented that it was the only surgery she'd ever seen with 300 percent mortality.

While all doctors treat diseases, neurosurgeons work in the crucible of identity: every operation on the brain is, by necessity, a manipulation of the substance of our selves, and every conversation with a patient undergoing brain surgery cannot help but confront this fact. In addition, to the patient and family, the brain surgery is usually the most dramatic event they have ever faced and, as such, has the impact of any major life event. At those critical junctures, the question is not simply whether to live or die but what kind of life is worth living. Would you trade your ability - or your mother's - to talk for a few extra months of mute life? The expansion of your visual blind spot in exchange for eliminating the small possibility of a fatal brain hemorrhage? Your right hand's function to stop seizures? How much neurologic suffering would you let your child endure before saying that death is preferable? Because the brain mediates our experience of the world, any neurosurgical problem forces a patient and family, ideally with a doctor as a guide, to answer this question: What makes life meaningful enough to go on living?

When a human doctor, after much bleeding and cupping, finds that a patient has died out of sheer desperation, he can always say, "Dear me, will of the gods, that will be thirty dollars please," and walk away a free man. This is because human beings are not, technically, worth anything. A good racehorse, on the other hand, may be worth twenty thousand dollars. A doctor who lets one hurry off too soon to that great paddock in the sky may well expect to hear, out of some dark alley, a voice saying something on the lines of "Mr. Chrysoprase is very upset," and find the brief remainder of his life full of incident.

In actual fact. The manifold sexualities - those which appear with the different ages (sexualities of the infant or the child), those which become fixated on particular tastes or practices (the sexuality of the invert, the gerontophile, the fetishist), those which, in a diffuse manner, invest relationships (the sexuality of doctor and patient, teacher and student, psychiatrist and mental patient), those which haunt spaces (the sexuality of the home, the school, the prison)- all form the correlate of exact procedures of power.

I'm glad you came here and got the help you needed," Neil says, and he shakes my hand in that way that people do in here to remind themselves that you're the patient and they're the doctor/volunteer/ employee. They like you, and they genuinely want you to do better, but when they shake your hand you feel that distance, that slight disconnect because they know that you're still broken somewhere, that you might snap at any moment.

This was my wake-up call. I opened my eyes to the depressing fact that there are other forces at work in medicine besides science. The U.S. health care system runs on a fee-for-service model in which doctors get paid for the pills and procedures they prescribe, rewarding quantity over quality. We don’t get reimbursed for time spent counseling our patients about the benefits of healthy eating. If doctors were instead paid for performance, there would be a financial incentive to treat the lifestyle causes of disease. Until the model of reimbursement changes, I don’t expect great changes in medical care or medical education.5

In the year of the sun was sun eclipse, the sun of piety, knowledge and divinity. The establisher of the path of Tijaniyya, the reviver of the traditions of the chocest of Adnan. The servant of Allah, the Imam of the Maliki law, and affairs are for Allah for he is the possessor. He added that Sufism is a spritual clinic with doctors who have knowledge of attending to ailments of the soul. For a sick patient who requires cure and dosses of medicine from the clinic, there is the need for him to make declaration of his sickness and acceptance of patienthood.

The core predicament of medicine - the thing that makes being a patient so wrenching, being a doctor so difficult, and being a part of society that pays the bills they run up so vexing - is uncertainty. With all that we know nowadays about people and diseases and how to diagnose and treat them, it can be hard to see this, hard to grasp how deeply uncertainty runs. As a doctor, you come to find, however, that the struggle in caring for people is more often with what you do not know than what you do. Medicine's ground state is uncertainty. And wisdom - for both the patients and doctors - is defined by how one copes with it.

Really, awfully, terribly, I had a sudden attack of hiccups. I was staring at the Doctor, murderously angry with him. And hiccuping... 'That's it. I'm going down there. I'm offering myself to them instead. If you're too much of a coward.' The Doctor winced at that last word. I hiccuped again. 'Amy Pond,' he said. 'Try holding your breath.' 'I will not hold my breath! This is important! Rory is having his mind vacuumed and we're just standing here-' 'Hiccuping.' 'Yes.' We stood, glaring at each other. I hiccuped again. 'Seriously,' said the Doctor, patiently. 'I know it's not the best time, but really, try holding your breath.' I stood there. Hiccuping and scowling at him.

the top reason doctors give for not counseling patients with high cholesterol to eat healthier is that they think patients may “fear privations related to dietary advice.”65 In other words, doctors perceive that patients would feel deprived of all the junk they’re eating. Can you imagine a doctor saying, “Yeah, I’d like to tell my patients to stop smoking, but I know how much they love it”?

In the spring of 2009, I was the 217th person ever to be diagnosed with anti-NMDA-receptor autoimmune encephalitis. Just a year later, that figure had doubled. Now the number is in the thousands. Yet Dr. Bailey, considered one of the best neurologists in the country, had never heard of it. When we live in a time when the rate of misdiagnoses has shown no improvement since the 1930s, the lesson here is that it’s important to always get a second opinion. While he may be an excellent doctor in many respects, Dr. Bailey is also, in some ways, a perfect example of what is wrong with medicine. I was just a number to him (and if he saw thirty-five patients a day, as he told me, that means I was one of a very large number). He is a by-product of a defective system that forces neurologists to spend five minutes with X number of patients a day to maintain their bottom line. It’s a bad system. Dr. Bailey is not the exception to the rule. He is the rule.

Why do you want to persecute yourself with the question of where all this is coming from and where it is going? Since you know, after all, that you are in the midst of transitions and you wished for nothing so much as to change. If there is anything unhealthy in your reactions, just bear in mind that sickness is the means by which an organism frees itself from what is alien; so one must simply help it to be sick, to have its whole sickness and to break out with it, since that is the way it gets better. In you, dear Mr. Kappus, so much is happening now; you must be patient like someone who is sick, and confident like some one who is recovering; for perhaps you are both. And more: you are also the doctor, who has to watch over himself. But in every sickness there are many days when the doctor can do nothing but wait. And that is what you, insofar as you are your own doctor, must now do, more than anything else.

Of the thousands of patients I have seen, only two or three have ever claimed to be unhappy: all the rest have said that they were depressed. This semantic shift is deeply significant, for it implies that dissatisfaction with life is itself pathological, a medical condition, which it is the responsibility of the doctor to alleviate by medical means. Everyone has a right to health; depression is unhealthy; therefore everyone has a right to be happy (the opposite of being depressed). This idea in turn implies that one’s state of mind, or one’s mood, is or should be independent of the way that one lives one’s life, a belief that must deprive human existence of all meaning, radically disconnecting reward from conduct. A ridiculous pas de deux between doctor and patient ensues: the patient pretends to be ill, and the doctor pretends to cure him. In the process, the patient is wilfully blinded to the conduct that inevitably causes his misery in the first place.

At those critical junctures, the question is not simply whether to live or die but what kind of life is worth living. Would you trade your ability--or your mother's--to talk for a few extra months of mute life? The expansion of your visual blind spot in exchange for the small possibility of a fatal brain hemorrhage? Your right hand's function to stop seizures? How much neurological suffering would you let your child endure before saying that death is preferable? Because the brain mediates our experience of the world, any neurosurgical problem forces a patient, and family, ideally with a doctor as a guide, to answer this question: What makes life meaningful enough to go on living?

What if, ladies and gentlemen, today I told you that anyone here who was born on a Monday, Tuesday, or Wednesday was free to leave right now? Also, they'd be given the most central parking spots in the city, and the biggest houses. They would get job interviews before others who were born later in the week, and they'd be taken first at the doctor's office, no matter how many patients were waiting in line. If you were born from Thursday to Sunday, you might try to catch up – but because you were straggling behind, the press would always point to how inefficient you are. And if you complained, you'd be dismissed for playing the birth-day card.” I shrug. “Seems silly, right? But what if on top of these arbitrary systems that inhibited your chances for success, everyone kept telling you that things were actually pretty equal?

Seeing modern health care from the other side, I can say that it is clearly not set up for the patient. It is frequently a poor arrangement for doctors as well, but that does not mitigate how little the system accounts for the patient's best interest. Just when you are at your weakest and least able to make all the phone calls, traverse the maze of insurance, and plead for health-care referrals is that one time when you have to — your life may depend on it.

We evolved haphazardly within a random universe; no purpose underpins us, no God watches over us, and no assured glorious future awaits us. We are saddled with a dualistic consciousness that weighs us down and plays tricks on us. We have built and seem unable to dismantle a dehumanizing and destructive civilization and mindset that perpetuates deceit and greed. We can make ourselves as comfortable as possible, as doctors tell their terminally ill patients, but we are sadly incurable.

The scientific study of suffering inevitably raises questions of causation, and with these, issues of blame and responsibility. Historically, doctors have highlighted predisposing vulnerability factors for developing PTSD, at the expense of recognizing the reality of their patients' experiences… This search for predisposing factors probably had its origins in the need to deny that all people can be stressed beyond endurance, rather than in solid scientific data; until recently such data were simply not available… When the issue of causation becomes a legitimate area of investigation, one is inevitably confronted with issues of man's inhumanity to man, with carelessness and callousness, with abrogation of responsibility, with manipulation and with failures to protect.

no disease suffered by a live man can be known, for every living person has his own peculiarities and always has his own peculiar, personal, novel, complicated disease, unknown to medicine -- not a disease of the lungs, liver, skin, heart, nerves, and so on mentioned in medical books, but a disease consisting of one of the innumerable combinations of the maladies of those organs. This simple thought could not occur to the doctors (as it cannot occur to a wizard that he is unable to work his charms) because the business of their lives was to cure, and they received money for it and had spent the best years of their lives on that business. But above all that thought was kept out of their minds by the fact that they saw they were really useful [...] Their usefulness did not depend on making the patient swallow substances for the most part harmful (the harm was scarcely perceptible because they were given in small doses) but they were useful, necessary, and indispensable because they satisfied a mental need of the invalid and those who loved her -- and that is why there are, and always will be, pseudo-healers, wise women, homoeopaths, and allopaths. They satisfied that eternal human need for hope of relief, for sympathy, and that something should be done, which is felt by those who are suffering.

In psychology it is very important that the doctor should not strive to heal at all costs. One has to be exceedingly careful not to impose one's own will and conviction on the patient. You have to give him a certain amount of freedom. You can't wrest people away from their fate, just as in medicine you cannot cure a patient if nature means him to die. Sometimes it is really a question whether you are allowed to rescue a man from the fate he must undergo for the sake of his further development.

When I went on my first antidepressant it had the side effect of making me fixated on suicide (which is sort of the opposite of what you want). It’s a rare side effect so I switched to something else that did work. Lots of concerned friends and family felt that the first medication’s failure was a clear sign that drugs were not the answer; if they were I would have been fixed. Clearly I wasn’t as sick as I said I was if the medication didn’t work for me. And that sort of makes sense, because when you have cancer the doctor gives you the best medicine and if it doesn’t shrink the tumor immediately then that’s a pretty clear sign you were just faking it for attention. I mean, cancer is a serious, often fatal disease we’ve spent billions of dollars studying and treating so obviously a patient would never have to try multiple drugs, surgeries, radiation, etc., to find what will work specifically for them. And once the cancer sufferer is in remission they’re set for life because once they’ve learned how to not have cancer they should be good. And if they let themselves get cancer again they can just do whatever they did last time. Once you find the right cancer medication you’re pretty much immune from that disease forever. And if you get it again it’s probably just a reaction to too much gluten or not praying correctly. Righ

Struggle toward the capital-T Truth, but recognize that the task is impossible—or that if a correct answer is possible, verification certainly is impossible. In the end, it cannot be doubted that each of us can see only part of the picture. The doctor sees one, the patient another, the engineer a third, the economist a fourth, the pearl diver a fifth, the alcoholic a sixth, the cable guy a seventh, the sheep farmer an eighth, the Indian beggar a ninth, the pastor a tenth. Human knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still it is never complete. And truth comes somewhere above all of them, where, as at the end of that Sunday’s reading: the sower and reaper can rejoice together. For here the saying is verified that “One sows and another reaps.” I sent you to reap what you have not worked for; others have done the work, and you are sharing the fruits of that work.

Alongside the ledger of atrocity, I keep another. The Palestinian doctor who would not abandon his patients, even as the bombs closed in. The Icelandic writer who raised money to get the displaced out of Gaza. The American doctors and nurses who risked their lives to go treat the wounded in the middle of a killing field. The puppet-maker who, injured and driven from his home, kept making dolls to entertain the children. The congresswoman who stood her ground in the face of censure, of constant vitriol, of her own colleagues’ indifference. The protesters, the ones who gave up their privilege, their jobs, who risked something, to speak out. The people who filmed and photographed and documented all this, even as it happened to them, even as they buried their dead. It is not so hard to believe, even during the worst of things, that courage is the more potent contagion. That there are more invested in solidarity than annihilation. That just as it has always been possible to look away, it is always possible to stop looking away. None of this evil was ever necessary. Some carriages are gilded and others lacquered in blood, but the same engine pulls us all. We dismantle it now, build another thing entirely, or we hurtle toward the cliff, safe in the certainty that, when the time comes, we’ll learn to lay tracks on air.

Dr. Bone Specialist came in, made me stand up and hobble across the room, checked my reflexes, and then made me lie down on the table. He bent my right knee this way and that, up and down, all the way out to the side and in. Then he did the same with my left leg. He ordered X rays then started to leave the room. I panicked. I MUST GET DRUGS. "What can I take for the pain?" I asked him before he got out the door. "You can take some over the counter ibuprofen," he suggested. "But I wouldn't take more than nine a day." I choked. Nine a day? I'd been popping forty. Nine a day? Like hell. I couldn't even go to the bathroom on my own, I hadn't slept in three weeks, and my normally sunny cheery disposition had turned into that of a very rabid dog. If I didn't get good drugs and get them now, it was straight to Shooter's World and then Walgreens pharmacy for me. "I don't think you understand," I explained. "I can't go to work. I have spent the last four days with my mother who is addicted to QVC, watching jewelry shows, doll shows and make-up shows. I almost ordered a beef-jerky maker! Give me something, or I'm going to use your calf muscles to make the first batch!" Without further ado, he hastily scribbled out a prescription for some codeine and was gone. I was happy. My mother, however, had lost the ability to speak.

War crimes, you say? No matter how many policies you put on paper, in reality, there are no rights and wrongs in war. War itself is a crime. War cannot be justified. I believe, the only people, in this world, whose opinions matter, are the ones who go the extra mile to help other people expecting nothing in return. Soldiers who fight fiercely for their country, the doctors in Sri Lanka's public hospitals attending to hundreds of patients at a time for no extra pay , the nuns who voluntarily teach English and math to children of refugee camps in the north, the monks who collect food to feed entire villages during crises, they are the people worth listening to, their opinion matters. So find me one of them who will say: they wish the war didn't end in 2009, that they wish Sri Lanka was divided into two parts. Find me one of them who agrees with the international war crime allegations against Sri Lanka, and I will listen. But I will not listen to the opinions of those who are paid to find faults in a war they were never a part of, a war they never experienced themselves. I will not listen to the opinions of those who watched the war on tv or read about it on the internet or were moved by a documentary on Al Jazeera. The war is over. The damage is done. Let Sri Lanka move on. So our children will never have to see what we've seen.

Damn,” I said softly to myself. I had been fighting it for some time. Even before this ridiculous marriage, I had been more than conscious of his attraction. It had happened before, as it doubtless happens to almost everyone. A sudden sensitivity to the presence, the appearance, of a particular man—or woman, I suppose. The urge to follow him with my eyes, to arrange for small “inadvertent” meetings, to watch him unawares as he went about his work, an exquisite sensitivity to the small details of his body—the shoulder-blades beneath the cloth of his shirt, the lumpy bones of his wrists, the soft place underneath his jaw, where the first prickles of his beard begin to show. Infatuation. It was common, among the nurses and the doctors, the nurses and the patients, among any gathering of people thrown for long periods into one another’s company. Some acted on it, and brief, intense affairs were frequent. If they were lucky, the affair flamed out within a few months and nothing resulted from it. If they were not … well. Pregnancy, divorce, here and there the odd case of venereal disease. Dangerous thing, infatuation.

I remember going to the British Museum one day to read up the treatment for some slight ailment of which I had a touch – hay fever, I fancy it was. I got down the book, and read all I came to read; and then, in an unthinking moment, I idly turned the leaves, and began to indolently study diseases, generally. I forget which was the first distemper I plunged into – some fearful, devastating scourge, I know – and, before I had glanced half down the list of “premonitory symptoms,” it was borne in upon me that I had fairly got it. I sat for awhile, frozen with horror; and then, in the listlessness of despair, I again turned over the pages. I came to typhoid fever – read the symptoms – discovered that I had typhoid fever, must have had it for months without knowing it – wondered what else I had got; turned up St. Vitus’s Dance – found, as I expected, that I had that too, – began to get interested in my case, and determined to sift it to the bottom, and so started alphabetically – read up ague, and learnt that I was sickening for it, and that the acute stage would commence in about another fortnight. Bright’s disease, I was relieved to find, I had only in a modified form, and, so far as that was concerned, I might live for years. Cholera I had, with severe complications; and diphtheria I seemed to have been born with. I plodded conscientiously through the twenty-six letters, and the only malady I could conclude I had not got was housemaid’s knee. ... I had walked into that reading-room a happy, healthy man. I crawled out a decrepit wreck. I went to my medical man. He is an old chum of mine, and feels my pulse, and looks at my tongue, and talks about the weather, all for nothing, when I fancy I’m ill; so I thought I would do him a good turn by going to him now. “What a doctor wants,” I said, “is practice. He shall have me. He will get more practice out of me than out of seventeen hundred of your ordinary, commonplace patients, with only one or two diseases each.” So I went straight up and saw him, and he said: “Well, what’s the matter with you?” I said: “I will not take up your time, dear boy, with telling you what is the matter with me. Life is brief, and you might pass away before I had finished. But I will tell you what is NOT the matter with me. I have not got housemaid’s knee. Why I have not got housemaid’s knee, I cannot tell you; but the fact remains that I have not got it. Everything else, however, I HAVE got.” And I told him how I came to discover it all. Then he opened me and looked down me, and clutched hold of my wrist, and then he hit me over the chest when I wasn’t expecting it – a cowardly thing to do, I call it – and immediately afterwards butted me with the side of his head. After that, he sat down and wrote out a prescription, and folded it up and gave it me, and I put it in my pocket and went out. I did not open it. I took it to the nearest chemist’s, and handed it in. The man read it, and then handed it back. He said he didn’t keep it. I said: “You are a chemist?” He said: “I am a chemist. If I was a co-operative stores and family hotel combined, I might be able to oblige you. Being only a chemist hampers me.” I read the prescription. It ran: “1 lb. beefsteak, with 1 pt. bitter beer every 6 hours. 1 ten-mile walk every morning. 1 bed at 11 sharp every night. And don’t stuff up your head with things you don’t understand.” I followed the directions, with the happy result – speaking for myself – that my life was preserved, and is still going on.

Why say 'the world is complicated' and stop there? I say the world is complicated but not incomprehensible. Only you have to look at it steadily. Isn't it true a person's shoulder hurts sometimes because they've got a disorder in their stomach? And then what does a stupid doctor do? Order massages for the shoulder. What does a wise doctor do? He takes time to think about it, watches the patient carefully, gives him some medicine for his stomach, and the pain in his shoulder goes away. Better yet, he explains to his patients what they have to do to keep their stomach from getting out of order. One day his patient's going to get old and die, just like himself, just like us, and one day, incredible as it may seem, the Empire's going to die, and how foolish people are who whine about it, and whine about how complicated the world is. A seamstress's room is complicated too, but even at night, with the lights out, she can reach out in the darkness and find the yellow thread, the needles, the pincushion. We couldn't, because we don't know the order things are in, in the seamstress's room. And we can't see the order the world is in. But all the same it's there, right under our eyes.

I will love you with no regard to the actions of our enemies or the jealousies of actors. I will love you with no regard to the outrage of certain parents or the boredom of certain friends. I will love you no matter what is served in the world’s cafeterias or what game is played at each and every recess. I will love you no matter how many fire drills we are all forced to endure, and no matter what is drawn upon the blackboard in a blurring, boring chalk. I will love you no matter how many mistakes I make when trying to reduce fractions, and no matter how difficult it is to memorize the periodic table. I will love you no matter what your locker combination was, or how you decided to spend your time during study hall. I will love you no matter how your soccer team performed in the tournament or how many stains I received on my cheerleading uniform. I will love you if I never see you again, and I will love you if I see you every Tuesday. I will love you if you cut your hair and I will love you if you cut the hair of others. I will love you if you abandon your baticeering, and I will love you if you retire from the theater to take up some other, less dangerous occupation. I will love you if you drop your raincoat on the floor instead of hanging it up and I will love you if you betray your father. I will love you even if you announce that the poetry of Edgar Guest is the best in the world and even if you announce that the work of Zilpha Keatley Snyder is unbearably tedious. I will love you if you abandon the theremin and take up the harmonica and I will love you if you donate your marmosets to the zoo and your tree frogs to M. I will love you as the starfish loves a coral reef and as kudzu loves trees, even if the oceans turn to sawdust and the trees fall in the forest without anyone around to hear them. I will love you as the pesto loves the fetuccini and as the horseradish loves the miyagi, as the tempura loves the ikura and the pepperoni loves the pizza. I will love you as the manatee loves the head of lettuce and as the dark spot loves the leopard, as the leech loves the ankle of a wader and as a corpse loves the beak of the vulture. I will love you as the doctor loves his sickest patient and a lake loves its thirstiest swimmer. I will love you as the beard loves the chin, and the crumbs love the beard, and the damp napkin loves the crumbs, and the precious document loves the dampness in the napkin, and the squinting eye of the reader loves the smudged print of the document, and the tears of sadness love the squinting eye as it misreads what is written. I will love you as the iceberg loves the ship, and the passengers love the lifeboat, and the lifeboat loves the teeth of the sperm whale, and the sperm whale loves the flavor of naval uniforms. I will love you as a child loves to overhear the conversations of its parents, and the parents love the sound of their own arguing voices, and as the pen loves to write down the words these voices utter in a notebook for safekeeping. I will love you as a shingle loves falling off a house on a windy day and striking a grumpy person across the chin, and as an oven loves malfunctioning in the middle of roasting a turkey. I will love you as an airplane loves to fall from a clear blue sky and as an escalator loves to entangle expensive scarves in its mechanisms. I will love you as a wet paper towel loves to be crumpled into a ball and thrown at a bathroom ceiling and an eraser loves to leave dust in the hairdos of the people who talk too much. I will love you as a taxi loves the muddy splash of a puddle and as a library loves the patient tick of a clock. I will love you as a thief loves a gallery and as a crow loves a murder, as a cloud loves bats and as a range loves braes. I will love you as misfortune loves orphans, as fire loves innocence and as justice loves to sit and watch while everything goes wrong.

Several years ago, researchers at the University of Minnesota identified 568 men and women over the age of seventy who were living independently but were at high risk of becoming disabled because of chronic health problems, recent illness, or cognitive changes. With their permission, the researchers randomly assigned half of them to see a team of geriatric nurses and doctors—a team dedicated to the art and science of managing old age. The others were asked to see their usual physician, who was notified of their high-risk status. Within eighteen months, 10 percent of the patients in both groups had died. But the patients who had seen a geriatrics team were a quarter less likely to become disabled and half as likely to develop depression. They were 40 percent less likely to require home health services. These were stunning results. If scientists came up with a device—call it an automatic defrailer—that wouldn’t extend your life but would slash the likelihood you’d end up in a nursing home or miserable with depression, we’d be clamoring for it. We wouldn’t care if doctors had to open up your chest and plug the thing into your heart. We’d have pink-ribbon campaigns to get one for every person over seventy-five. Congress would be holding hearings demanding to know why forty-year-olds couldn’t get them installed. Medical students would be jockeying to become defrailulation specialists, and Wall Street would be bidding up company stock prices. Instead, it was just geriatrics. The geriatric teams weren’t doing lung biopsies or back surgery or insertion of automatic defrailers. What they did was to simplify medications. They saw that arthritis was controlled. They made sure toenails were trimmed and meals were square. They looked for worrisome signs of isolation and had a social worker check that the patient’s home was safe. How do we reward this kind of work? Chad Boult, the geriatrician who was the lead investigator of the University of Minnesota study, can tell you. A few months after he published the results, demonstrating how much better people’s lives were with specialized geriatric care, the university closed the division of geriatrics.

There was once a town in the heart of America where all life seemed to live in harmony with its surroundings. The town lay in the midst of a checkerboard of prosperous farms, with fields of grain and hillsides of orchards where, in spring, white clouds of bloom drifted above the green fields. In autumn, oak and maple and birch set up a blaze of color that flamed and flickered across a backdrop of pines. Then foxes barked in the hills and deer silently crossed the fields, half hidden in the mists of the fall mornings. Along the roads, laurel, viburnum, and alder, great ferns and wildflowers delighted the traveler's eye through much of the year. Even in winter the roadsides were places of beauty, where countless birds came to feed on the berries and on the seed heads of the dried weeds rising above the snow. The countryside was, in fact, famous for the abundance and variety of its bird life, and when the flood of migrants was pouring through in spring and fall people traveled from great distances to observe them. Others came to fish the streams, which flowed clear and cold out of the hills and contained shady pools where trout lay. So it had been from the days many years ago when the first settlers raised their homes, sank their wells, and built their barns. Then a strange blight crept over the area and everything began to change. Some evil spell had settled on the community: mysterious maladies swept the flocks of chickens, the cattle, and sheep sickened and died. Everywhere was a shadow of death. The farmers spoke of much illness among their families. In the town the doctors had become more and more puzzled by new kinds of sickness appearing among their patients. There had been sudden and unexplained deaths, not only among adults but even among children whoe would be stricken suddently while at play and die within a few hours. There was a strange stillness. The birds, for example--where had they gone? Many people spoke of them, puzzled and disturbed. The feeding stations in the backyards were deserted. The few birds seen anywhere were moribund; they trembled violently and could not fly. It was a spring without voices. On the mornings that had once throbbed with the dawn chorus of robins, catbirds, doves, jays, wrens, and scores of other bird voices there was no sound; only silence lay over the fields and woods and marsh. On the farms the hens brooded, but no chicks hatched. The farmers complained that they were unable to raise any pigs--the litters were small and the young survived only a few days. The apple trees were coming into bloom but no bees droned among the blossoms, so there was no pollination and there would be no fruit. The roadsides, once so attractive, were now lined with browned and withered vegetation as though swept by fire. These, too, were silent, deserted by all living things. Even the streams were not lifeless. Anglers no longer visited them, for all the fish had died. In the gutters under the eaves and between the shingles of the roofs, a white granular powder still showed a few patches; some weeks before it had fallen like snow upon the roofs and the lawns, the fields and streams. No witchcraft, no enemy action had silenced the rebirth of life in this stricken world. The people had done it to themselves.