THE DOCTOR'S DILEMMA

	Suspend  your  natural  skepticism  and imagine the following
miracle to have occurred:  A  young  doctor  working  in  a  hospital
discovers  that  he  has  the  power  to cure anyone under the age of
seventy of any sickness or injury simply  by  touching  the  patient.
Any contact, however brief, between any part of his skin and the skin
of the patient will cure the disease.

	He has always been devoted to his work, and he wants  to  use
his  gift to benefit humanity as much as possible.  However, he knows
that the gift is absolutely non-transferable (This was  explained  by
the angel or flying saucerite who gave it to him.), will last for his
lifetime only, and will not persist  in  tissue  separated  from  his
body.

	What will happen if he uses his gift?

	What should he try to do and how should he go about it?

	What is the most favorable result that can be expected?

	I  consider myself a member of the scientific rather than the
literary culture, and my idea of the  correct  answers to  the  above
questions  reflects this.  However, in order to mislead the reader, I
shall give some pessimistic scenarios and related literary exercises.
 LITERARY EXERCISES IN PESSIMISM AND PARANOIA

	1.  The doctor  uses his gift, the other  doctors are jealous
and disbelieving  and drive him from the  hospital. He cures patients
outside, they get him for quackery and put him in jail where he can't
practice.  Even  in jail, he cures people, and  the prison doctor has
him  put in  solitary confinement.   Even there  he cures  a guard of
cancer and then the little daughter of the warden of the prison. This
arouses the  fears of the insecure,   narrow minded,   brutalized and
bureaucratized prison doctors to the  extent that they have him  sent
to a hospital for the criminally insane to  be cured of his delusion.
There, they lobotomize him.  Write scenes in which doctors disbelieve
cures taking place  before their eyes,   self justifying speeches  by
people who decide  to imprison him even though they  know better, and
the report justifying his commitment to the mental hospital.

	2.   His gift  is judged  sacrilegious by the  church of your
choice.  Fanatics are aroused by preachers, and our hero is burned at
the stake.  Write a  speech justifying burning the doctor as a lesser
evil compared to letting him go on violating God's law that man  must
suffer disease and death.

	3. His gift is judged holy by a religion that gets control of
him,  and its  use is surrounded by so much ritual that hardly anyone
gets cured.  Describe the ritual; make it beautiful.

	4. People keep coming to him until he is exhausted, but there
is always  an emergency case  more touching  than all that  have gone
before and eventually he dies of exhaustion.  Write his speech saying
that he realizes he can  cure more people if he gets some  sleep, but
true morality requires him to treat the immediate emergency.

	5.  He  forms an organization for curing  people and at first
works very hard but gradually gets  lazy, is corrupted by desire  for
money, power,  fame and women,  requires more  and more flattery  and
obsequiousness,     eventually  strives  single-mindedly  for  power,
develops cruel tastes, comes to dominate the country, and  is finally
assassinated.    Write  speeches  for him  justifying  his  increased
demands  at various stages.  Write  the self-justifying speech of the
assassin.

	6. He is taken over by the U.S. government which either:

	a.      keeps   him   to   cure   members   of   the   ruling
military-industrial  complex and  to  co-opt leaders  of  the people.
Describe the subtle way in which  a revolutionary is co-opted in  the
guise of being given a say in how the gift  shall be used.  Write the
speech  of a revolutionary refusing  to be cured of  his wounds after
unsuccessfully trying to blow up the doctor.

	b.  devises  a system of  boards to allocate  the use of  his
ability in the fairest possible  way, but its operation is frustrated
by injunctions  and demonstrations by paranoid groups (your choice as
to whether  the groups are  left,   right or  center) that cannot  be
convinced  that  his services  are  being  allocated  fairly.   Write
speeches charging that any  of the following  groups are not  getting
their fair share: Blacks, veterans, the poor, Southerners, policemen.
Make up lists of demands on behalf of these groups.

	c.   creates  a vast bureaucracy  to administer  that bungles
hideously but amusingly.  Write a description of the  computer bungle
that requires  him to cure the  same person 103 times  and 102 people
zero  times each.  Describe  the questionnaire that  has to be filled
out even by the dying in order to be cured.   Describe humorously how
a dying man completes the  form in the nick of time, but is prevented
from being cured at the last  minute because he has written "same  as
the above" in  a space where he  should have written his  address for
the third time.

	d.  gets into a dispute with the Russians who want the doctor
to cure their leaders too.  This  leads to a nuclear war.  Write  the
dialog at the  final negotiating session casting the  Russians as the
villains  rejecting a reasonable American offer.   Rewrite it casting
the Americans as villains trying  to use their control of  the doctor
to rule  the world.  Write  the dialog with neither  side as villains
but just as paranoid and stupid.  Rewrite it so as to admit all three
of the above interpretations.  Describe a scene in which  the sly and
wicked  Russians swindle  the gullible  Americans with  the aid  of a
woolly-minded pinko homosexual  American professor  into letting  the
Russians get their hands on the doctor.   Write the speech of the KGB
chief  sending the agent on his mission in  the style of a James Bond
novel and also  in the style of  Colonel Abel's memoirs.   Describe a
CIA attempt  to use  the doctor to  blackmail a Cuban  diplomat whose
little daughter  is  dying  of leukemia  into  assassinating  Castro.
Describe  the death  scene  of  the little  girl  who,   even  dying,
understands why  she must die in order  to defeat imperialism.  Write
suitable speeches for the dying little  girl and for the head of  the
CIA  justifying the  blackmail to  a squeamish  agent.   Describe the
scene  after the  bombs have  fallen with  the doctor  running around
curing a few radiation injuries in a scene of vast devastation.  Also
write a  repentant speech for  him refusing to  cure any more  or the
reproachful speech of a dying person refusing to be cured.

	7.   The  scientists  insist  on studying  his  gift  to  the
exclusion of letting him use it.  Ever more dangerous experiments are
tried until he is killed.  Describe how the scientist become more and
more neurotic in the face of this miracle unexplainable by their puny
materialistic  minds.   Describe  some  of  their silly  experiments.
Describe one  of their inhuman experiments in which people are killed
in order to determine the  exact moment when someone is dead  and can
no  longer be  revived by the  doctor.   Write a  scene in  which the
doctor discovers what is being done and the chief scientist justifies
it to him.

	8. The Mafia or the Weathermen kidnap the doctor and threaten
to kill him unless some demand is met.  Write the threatening letters
from the two  groups. Include justifications  of the most  outrageous
demands you can think of.

	9.   The doctor is  taken over  by technocrats who  drug him,
confine  him,  and  rule his  life in order  to get the  last iota of
productivity out of him.  Describe a scene in  which a high executive
demands more  productivity and threatens to  replace the psychiatrist
in charge of him.  His many attempts to commit suicide are frustrated
by the clever  technocrats.  Eventually,  a nurse falls in  love with
him and  helps him commit suicide.  Give their  dialog as they die in
each others arms.

	10.  A wrangle about what to do goes on until he dies  of old
age.  Write a speech saying, "Stop this endless debate and start some
action."  that has  the effect  of delaying  action further.  Write a
speech showing how  the third in  a series of  two year studies  will
save time in the long run.

	11.   The doctor  has a  visitation from  a second  angel who
explains that the apparent first angel was really the devil who  gave
him this gift in order  to bring him into sin.   Expound the theology
of this.

	12.   In  order to  destroy his gift  the doctor  tricks some
scientists into skinning him alive.  Explain why he does this.

	13.   He brings  about universal  health  and the  population
explodes.

	14.  Universal health is  achieved, but when he dies medicine
has been neglected, immunities are gone and plague wipes us out.

	15.   Write a great  American novel combining  as many of the
above catastrophes as possible.

	16. Write an impassioned letter to him urging him to keep his
gift secret.

	I believe that all  the above catastrophes can be avoided and
the gift  made into  a great  benefit.   Those readers  who  consider
themselves as members of  C. P. Snow's scientific culture  should try
to work  out the best solution for a day  or so before turning to the
next page.
SOLUTION:


	A solution requires morality, common sense, and technology.

	You  flunk on  moral  grounds  if  you propose  not  to  cure
anybody.

	Any attempt to cure  as many people as possible gets a B.  To
get an A, you must do the  arithmetic and see that it is possible  to
cure almost everybody for a while.

	Clearly the gift  is finite. The doctor  will eventually die,
and  his patients will  face disease  again as they  will anyway when
they reach  seventy.   This  is  no reason  not  to get  the  maximum
benefit.

	It turns  out that  he can cure  everyone in the  world whose
disease or  injury can  be diagnosed  in  time to  bring him  to  the
doctor.  The solution is technological.

	Approximately 60,000,000 people under seventy  die each year,
i.e. two people die each second.  We build a machine that can move 12
people per second past him on each of ten moving belts.   A mechanism
should be  provided to stop the  motion of the finger  of the patient
momentarily  so that  it touches the  doctor rather  than brushes his
skin.

	On the  basis of the  arithmetic the  doctor need only  spend
1/60 th of his time curing people, i.e. 24 minutes per day.

	In order to reduce transportation costs it might be desirable
to build a number of machines  in different regions of the world  and
for the doctor to make trips to these machines,  say once a month, to
get the slow diseases,  and to fly the emergency cases to wherever he
happens to be.

	It would not  be very difficult  for the  doctor to get  this
solution adopted  given a reasonable degree  of persuasiveness either
on  his own  part or  on the  part of  some former patients  he could
recruit to  help him.   Doctors  are often  skeptical,   but we  have
postulated  a  miracle  that  would  convince  almost  all  of  them.
Politicians are often shortsighted and bureaucrats bumbling, but what
would be required in this case is simple enough so that they could do
it.   It is not possible to  predict whether any important opposition
to the use of the gift would  develop.  If so, it might be  necessary
to  protect the  doctor  from assassination  and  the equipment  from
sabotage, and even then, there would be some risk of disaster.

	I have not postulated any mental or physical side effects but
it would  be necessary  to watch  for them  as well  as for  possible
adverse social side effects.

	The  use of  this  gift would  contribute  to the  population
problem but not so much as one  might think.  In the U.S.   4,000,000
people are born each  year but less than 1,000,000 under  70 die each
year and  most of these are past  the child-bearing age.  Elimination
of death under 70 would  require for stabilising the population  that
couples limit  themselves to  an average of  say 2.1  children rather
than the 2.2 children that might be allowable otherwise.

	In  countries with  larger  death rates  of young  people the
population effect would be  larger, but ordinary medicine  is already
having a similar effect.

	Some  people find  the  above solution  repulsive  because it
involves a  big machine  with moving  belts which  would probably  be
noisy.  Maybe  they don't like  a technological solution to  what has
been conceived as a moral problem.

	Other  people think  that  a law  of nature  is  surely being
violated - namely,   a law that  says that any apparently  worthwhile
innovation involving technology surely must have harmful side effects
at least equal in magnitude to the apparent benefit.

	There  remains,   however,   the  literary problem.   Namely,
imagine that the above analysis is correct and that the problem would
be solved. Imagine further  that the doctor, while posessing the gift
of healing, is not a super-organizer or super-hero of any sort.   How
could one make literature  of such a situation.   The pessimistic and
paranoid   fantasies  of  the  previous   section  make  much  better
literature at least by present literary standards.

 John McCarthy