Afterword
He who learns from children-what is he like?
One who eats sour grapes and drinks fresh wine.
And he who learns from an old man-what is he like?
He who eats ripe grapes and drinks vintage wine.
-Sayings of the Fathers
Looking back from what Ronald Blythe calls the view in winter,
I know that my early participation in the South African health
center movement made me an enthusiastic proponent of social
medicine and a doctor to underprivileged communities. In
America I continued on that path.
At medical school I was taught the importance of biology in
the causation of illness. In Umtata and in Durban I learned that
politics, economics, culture, and tradition are just as important.
In Boston and in North Carolina I discovered that self-esteem is
directly related to wellness. And, in every job I did, I saw that
medicine by itself can't control sickness due to poverty, bad
housing, lack of education, environmental hazards, and racial
and class discrimination.
Samuel Johnson once wrote: "We are all prompted by the
same motives, all deceived by the same fallacies, all animated
by hope, obstructed by danger, entangled by desire, and seduced
by pleasure." We doctors are a product of our society, true
enough, but we also belong
to'
a compassionate profession which
should be able to guard us from commercialization and help
us to retain our humanity.
It
is disgraceful that the least care
so often goes to those who need it most, but who cannot pay
their bills. And it is shameful that still today South Africa and
America are linked together as the only two industrialized
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