perm filename DOCDIL.LIT[ESS,JMC]1 blob sn#005479 filedate 1971-08-15 generic text, type T, neo UTF8
00100	                        THE DOCTOR'S DILEMMA
00200	
00300		Suspend  your  natural  skepticism  and imagine the following
00400	miracle to have occurred:  A  young  doctor  working  in  a  hospital
00500	discovers  that  he  has  the  power  to cure anyone under the age of
00600	seventy of any sickness or injury simply  by  touching  the  patient.
00700	Any contact, however brief, between any part of his skin and the skin
00800	of the patient will cure the disease.
00900	
01000		He has always been devoted to his work, and he wants  to  use
01100	his  gift to benefit humanity as much as possible.  However, he knows
01200	that he gift is absolutely non-transferable (This  was  explained  by
01300	the angel or flying saucerite who gave it to him.), will last for his
01400	lifetime only, and will not persist  in  tissue  separated  from  his
01500	body.
01600	
01700		What will happen if he uses his gift?
01800	
01900		What should he try to do and how should he go about it?
02000	
02100		What is the most favorable result that can be expected?
02200	
02300		I  consider myself a member of the scientific rather than the
02400	literary culture, and my idea of the  correct  answer  to  the  above
02500	questions  reflects  this.  However, in order to mislead the reader I
02600	shall give a number  of  pessimistic  scenarios  together  with  some
02700	related literary exercises.
     

00100	                 EXERCISES IN PESSIMISM AND PARANOIA
00200	
00300		1.  The doctor uses his gift, the other doctors  are  jealous
00400	and  disbelieving  and drive him from the hospital. He cures patients
00500	outside, they get him for quackery and put him in jail where he can't
00600	practice.   Even  in jail, he cures people, and the prison doctor has
00700	him put in solitary confinement.   Even there he  cures  a  guard  of
00800	cancer and then the little daughter of the warden of the prison. This
00900	arouses the fears of the  insecure,  narrow  minded,  brutalized  and
01000	bureaucratized  prison  doctors to the extent that they have him sent
01100	to a hospital for the criminally insane to be cured of his  delusion.
01200	There, they lobotomize him.  Write scenes in which doctors disbelieve
01300	cures taking place before their eyes,  self  justifying  speeches  by
01400	people  who  decide to imprison him even though they know better, and
01500	the report justifying his commitment to the mental hospital.
01600	
01700		2.  His gift is judged sacreligious by  the  church  of  your
01800	choice.   Fanatics are aroused by preachers and our hero is burned at
01900	the stake.  Write a speech justifying burning the doctor as a  lesser
02000	evil  compared to letting him go on violating God's law that man must
02100	suffer disease and death.
02200	
02300		3. His gift is judged holy by a religion that gets control of
02400	him,  and  its use is surrounded by so much ritual that hardly anyone
02500	gets cured.  Describe the ritual.
02600	
02700		4. People keep coming to him until he is exhausted, but there
02800	is  always  an  emergency  case more touching than all that have gone
02900	before and eventually he dies of exhaustion.  Write his speech saying
03000	that  he  realizes he can cure more people if he gets some sleep, but
03100	true morality requires him to treat the immediate emergency.
03200	
03300		5.  He forms an organization for curing people and  at  first
03400	works  very  hard but gradually gets lazy, is corrupted by desire for
03500	money, power, fame and women, requires more  and  more  flattery  and
03600	obsequiousness,   eventually   strives   single-mindedly  for  power,
03700	develops cruel tastes, comes to dominate the country, and is  finally
03800	assassinated.     Write  speeches  for  him  justifying his increased
03900	demands at various stages.  Write the self-justifying speech  of  the
04000	assassin.
04100	
04200		6. He is taken over by the U.S. government which either:
04300	
04400		a.      keeps   him   to   cure   members   of   the   ruling
04500	military-industrial  complex  and  to co-opt  leaders  of the people.
04600	Describe  the  subtle way in which a revolutionary is co-opted in the
04700	guise of being given a say in how the gift shall be used.  Write  the
04800	speech  of  a  revolutionary refusing to be cured of his wounds after
04900	unsuccessfully trying to blow up the doctor.
05000	
05100		b.  devises a system of boards to allocate  the  use  of  his
05200	ability  in the fairest possible way, but its operation is frustrated
05300	by injunctions and demonstrations by paranoid groups (your choice  as
05400	to  whether  the  groups  are  left,  right or center) that cannot be
05500	convinced that his  services  are  being  allocated  fairly.    Write
05600	speeches  charging  that  any of the following groups are not getting
05700	their fair share: Blacks, veterans, the poor, Southerners, policemen.
05800	Make up lists of demands on behalf of these groups.
05900	
06000		c.    creates  a  vast bureaucracy to administer that bungles
06100	hideously but amusingly.  Write a description of the computer  bungle
06200	that  requires  him  to cure the same person 103 times and 102 people
06300	zero times each.  Describe the questionnaire that has  to  be  filled
06400	out  even by the dying in order to be cured.  Describe humorously how
06500	a dying man completes the form in the nick of time, but is  prevented
06600	from  being  cured at the last minute because he has written "same as
06700	the above" in a space where he should have written  his  address  for
06800	the third time.
06900	
07000		d.  gets into a dispute with the Russians who want the doctor
07100	to cure their leaders too.  This leads to a nuclear war.   Write  the
07200	dialog  at  the final negotiating session casting the Russians as the
07300	villains rejecting a reasonable American offer.    Rewrite it casting
07400	the  Americans  as villains trying to use their control of the doctor
07500	to rule the world.  Write the dialog with neither  side  as  villains
07600	but  just  as  paranoid  and  stupid.   Rewrite it so as to admit all
07700	three of the above interpretations. Describe a scene in which the sly
07800	and  wicked Russians swindle the gullible Americans with the aid of a
07900	woolly-minded pinko homosexual American professor  into  letting  the
08000	Russians  get their hands on the doctor.  Write the speech of the KGB
08100	chief sending the agent on his mission in the style of a  James  Bond
08200	novel  and also in the style of Colonel Abel's memoirs.    Describe a
08300	CIA attempt to use the doctor to blackmail  a  Cuban  diplomat  whose
08400	little  daughter  is  dying  of  leukemia  into assassinating Castro.
08500	Describe the  death  scene  of  the  little  girl  who,  even  dying,
08600	understands why she must die in order to defeat imperialism.    Write
08700	suitable speeches for the dying little girl and for the head  of  the
08800	CIA  justifying  the  blackmail to a squeamish agent.    Describe the
08900	scene after the bombs have fallen  with  the  doctor  running  around
09000	curing a few radiation injuries in a scene of vast devastation.  Also
09100	write a repentant speech for him refusing to cure  any  more  or  the
09200	reproachful speech of a dying person refusing to be cured.
09300	
09400		7.    The  scientists  insist  on  studying  his  gift to the
09500	exclusion of letting him use it.  Ever more dangerous experiments are
09600	tried until he is killed.  Describe how the scientist become more and
09700	more neurotic in the face of this miracle unexplainable by their puny
09800	materialistic  minds.    Describe  some  of  their silly experiments.
09900	Describe one of their inhuman experiments in which people are  killed
10000	in  order  to determine the exact moment when someone is dead and can
10100	no longer be revived by the doctor.   Write  a  scene  in  which  the
10200	doctor discovers what is being done and the chief scientist justifies
10300	it to him.
10400	
10500		8. The Mafia or the Weathermen kidnap the doctor and threaten
10600	to  kill  him  unless  some  outrageous  demand is met.     Write the
10700	threatening letters from the two groups.
10800	
10900		9.   The doctor is taken over by technocrats  who  drug  him,
11000	confine  him,  and  rule  his  life  in order to get the last iota of
11100	productivity out of him.  Describe a scene in which a high  executive
11200	demands  more  productivity and threatens to replace the psychiatrist
11300	in charge of  him.      His  many  attempts  to  commit  suicide  are
11400	frustrated  by  the clever technocrats.  Eventually, a nurse falls in
11500	love with him and helps him commit suicide.   Give  their  dialog  as
11600	they die in each others arms.
11700	
11800		10.   A wrangle about what to do goes on until he dies of old
11900	age.  Write a speech saying, "Stop this endless debate and start some
12000	action." that has the effect of delaying action further.
12100	
12200		11.   The  doctor  has  a  visitation from a second angel who
12300	explains that the apparent first angel was really the devil who  gave
12400	him  this  gift in order to bring him into sin.  Expound the theology
12500	of this.
12600	
12700		12.   In order to destroy his gift  the  doctor  tricks  some
12800	scientists into skinning him alive.  Explain why he does this.
12900	
13000		13.   He  brings  about  universal  health and the population
13100	explodes.
13200	
13300		14.   Universal health is achieved, but when he dies medicine
13400	has been neglected, immunities are gone and plague wipes us out.
13500	
13600		15.  Write  a  great  American novel combining as many of the
13700	above catastrophes as possible.
13800	
13900		16. Write an impassioned letter to him urging him to keep his
14000	gift secret.
14100	
14200		I  believe that all the above catastrophes can be avoided and
14300	the gift made into a  great  benefit.   Those  readers  who  consider
14400	themselves  as  members of C. P. Snow's scientific culture should try
14500	to work out the best solution for a day or so before turning  to  the
14600	next page.
     

00100	            THE SOLUTION FROM COMMON SENSE AND TECHNOLOGY
00200	
00300		Clearly the gift is finite. The doctor will  eventually  die,
00400	and  his  patients  will  face disease again as they will anyway when
00500	they reach seventy.  This  is  no  reason  not  to  get  the  maximum
00600	benefit, however.
00700	
00800		It  turns  out  that  he can cure everyone in the world whose
00900	disease or injury can be diagnosed  in  time  to  bring  him  to  the
01000	doctor.  The solution is technological.
01100	
01200		Approximately  60,000,000 people under seventy die each year,
01300	i.e. two people die each second.  We build a machine that can move 12
01400	people  per second past him on each of ten moving belts.  A mechanism
01500	should be provided to stop the motion of the finger  of  the  patient
01600	momentarily  so  that  it  touches the doctor rather than brushes his
01700	skin.
01800	
01900		On the basis of the arithmetic the  doctor  need  only  spend
02000	1/60 th of his time curing people, i.e. 24 minutes per day.
02100	
02200		In order to reduce transportation costs it might be desirable
02300	to build a number of machines in different regions of the  world  and
02400	for  the doctor to make trips to these machines, say once a month, to
02500	get the slow diseases, and to fly the emergency cases to wherever  he
02600	happens to be.
02700	
02800		It  would  not  be  very difficult for the doctor to get this
02900	solution adopted given a reasonable degree of  persuasiveness  either
03000	on  his  own  part  or  on  the part of some former patients he could
03100	recruit to help him.   Doctors  are  often  skeptical,  but  we  have
03200	postulated  a  miracle  that  would  convince  almost  all  of  them.
03300	Politicians are often shortsighted and bureaucrats bumbling, but what
03400	would be required in this case is simple enough so that they could do
03500	it.   It is not possible to predict whether any important  opposition
03600	to  the  use of the gift would develop.  If so, it might be necessary
03700	to protect the doctor  from  assassination  and  the  equipment  from
03800	sabotage, and even then, there would be some risk of disaster.
03900	
04000		I have not postulated any mental or physical side effects but
04100	it would be necessary to watch for  them  as  well  as  for  possible
04200	adverse social side effects.
04300	
04400		The  use  of  this  gift  would  contribute to the population
04500	problem but not so much as one might think.  In the  U.S.   4,000,000
04600	people  are  born each year but less than 1,000,000 under 70 die each
04700	year and most of these are past the child-bearing age.    Elimination
04800	of  death  under 70 would require for stabilising the population that
04900	couples limit themselves to an average of  say  2.1  children  rather
05000	than the 2.2 children that might be allowable otherwise.
05100	
05200		In  countries  with  larger  death  rates of young people the
05300	population effect would be larger, but ordinary medicine  is  already
05400	having a similar effect.
05500	
05600		You  flunk  the  exam  if you propose not to cure people. Any
05700	attempt to cure as many as possible gets a B.  To get an A  you  must
05800	do the arithmetic and see that it is possible to cure everyone.
05900	
06000		Some  people  find  the  above  solution repulsive because it
06100	involves a big machine with moving  belts  which  would  probably  be
06200	noisy.   Maybe  they  don't like a technological solution to what has
06300	been conceived as a moral problem.
06400	
06500		Other people think that a  law  of  nature  is  surely  being
06600	violated  -  namely,  a  law that says that any apparently worthwhile
06700	innovation involving technology surely must have harmful side effects
06800	at least equal in magnitude to the apparent benefit.
06900	
07000	                                         John McCarthy