Long before there were effective treatments, physicians dispensed prognoses, hope, and, above all, meaning. When something terrible happens-and serious disease is always terrible-people want to know why. In a pantheistic world, the explanation was simple-one god had caused the problem, another could cure it. In the time since people have been trying to get along with only one God, explaining disease and evil has become more difficult. Generations of theologians have wrestled with the problem of theodicy-how can a good God allow such bad things to happen to good people? Darwinian medicine can't offer a substitute for such explanations. It can't provide a universe in which events are part of a divine plan, much less one in which individual illness reflects individual sins. It can only show us why we are the way we are, why we are vulnerable to certain diseases. A Darwinian view of medicine simultaneously makes disease less and more meaningful. Diseases do not result from random or malevolent forces, they arise ultimately from past natural selection. Paradoxically, the same capacities that make us vulnerable to disease often confer benefits. The capacity for suffering is a useful defense. Autoimmune disease is a price of our remarkable ability to attack invaders. Cancer is the price of tissues that can repair themselves. Menopause may protect the interests of our genes in existing children. Even senescence and death are not random, but compromises struck by natural selection as it inexorably shaped out bodies to maximize the transmission of our genes. In such paradoxical benefits, some may find a gentle satisfaction, even a bit of meaning-at least the sort of meaning Dobzhansky recognized. After all, nothing in medicine makes sense except in the light of evolution.

As Mollie said to Dailey in the 1890s: "I am told that there are five other Mollie Fanchers, who together, make the whole of the one Mollie Fancher, known to the world; who they are and what they are I cannot tell or explain, I can only conjecture." Dailey described five distinct Mollies, each with a different name, each of whom he met (as did Aunt Susan and a family friend, George Sargent). According to Susan Crosby, the first additional personality appeared some three years after the after the nine-year trance, or around 1878. The dominant Mollie, the one who functioned most of the time and was known to everyone as Mollie Fancher, was designated Sunbeam (the names were devised by Sargent, as he met each of the personalities). The four other personalities came out only at night, after eleven, when Mollie would have her usual spasm and trance. The first to appear was always Idol, who shared Sunbeam's memories of childhood and adolescence but had no memory of the horsecar accident. Idol was very jealous of Sunbeam's accomplishments, and would sometimes unravel her embroidery or hide her work. Idol and Sunbeam wrote with different handwriting, and at times penned letters to each other.The next personality Sargent named Rosebud: "It was the sweetest little child's face," he described, "the voice and accent that of a little child." Rosebud said she was seven years old, and had Mollie's memories of early childhood: her first teacher's name, the streets on which she had lived, children's songs. She wrote with a child's handwriting, upper- and lowercase letters mixed. When Dailey questioned Rosebud about her mother, she answered that she was sick and had gone away, and that she did not know when she would be coming back. As to where she lived, she answered "Fulton Street," where the Fanchers had lived before moving to Gates Avenue.Pearl, the fourth personality, was evidently in her late teens. Sargent described her as very spiritual, sweet in expression, cultured and agreeable: "She remembers Professor West [principal of Brooklyn Heights Seminary], and her school days and friends up to about the sixteenth year in the life of Mollie Fancher. She pronounces her words with an accent peculiar to young ladies of about 1865." Ruby, the last Mollie, was vivacious, humorous, bright, witty. "She does everything with a dash," said Sargent. "What mystifies me about 'Ruby,' and distinguishes her from the others, is that she does not, in her conversations with me, go much into the life of Mollie Fancher. She has the air of knowing a good deal more than she tells.

وسمع في رأسه صدى كلام استاذه الكندي د/تومسون الذي كان يردد دائما (الكلام مع المريض علم وفن، يحتاج الى الكثير من الخبرة والمهارة ؛ولذلك يتفاوت الأطباء فيه.عليك اولا ان تتفهم المريض وعائلته ،مامستوى التعليم عندهم ؟كيف ترابطهم في الأسره؟هل هم من النوع القلق ؟هل هم من النوع الذي يحب التفاصيل؟وبعد جمع أكبر قدر من المعلومات عمن امامك،تفصّل له جرعة المعلومات التي تعطيه إياها وطريقة اعطاء المعلومات وكأنك تكتب له جرعة الدواء الذي تعطيه وطريقة اعطائه)

Применение противозачаточных средств иногда критикуют как «противоестественное». Да, это так — очень противоестественное. Беда в том, что противоестественно и всеобщее благосостояние. Я думаю, что большинство из нас считает всеобщее благосостояние в высшей степени желательным. Невозможно, однако, добиться противоестественного всеобщего благосостояния, если не пойти при этом также на противоестественную регуляцию рождаемости, так как это приведет к еще большим невзгодам, чем существующие в природе.

The night before brain surgery, I thought about death. I searched out my larger values, and I asked myself, if I was going to die, did I want to do it fighting and clawing or in peaceful surrender? What sort of character did I hope to show? Was I content with myself and what I had done with my life so far? I decided that I was essentially a good person, although I could have been better--but at the same time I understood that the cancer didn't care.I asked myself what I believed. I had never prayed a lot. I hoped hard, I wished hard, but I didn't pray. I had developed a certain distrust of organized religion growing up, but I felt I had the capacity to be a spiritual person, and to hold some fervent beliefs. Quite simply, I believed I had a responsibility to be a good person, and that meant fair, honest, hardworking, and honorable. If I did that, if I was good to my family, true to my friends, if I gave back to my community or to some cause, if I wasn't a liar, a cheat, or a thief, then I believed that should be enough. At the end of the day, if there was indeed some Body or presence standing there to judge me, I hoped I would be judged on whether I had lived a true life, not on whether I believed in a certain book, or whether I'd been baptized. If there was indeed a God at the end of my days, I hoped he didn't say, 'But you were never a Christian, so you're going the other way from heaven.' If so, I was going to reply, 'You know what? You're right. Fine.'I believed, too, in the doctors and the medicine and the surgeries--I believed in that. I believed in them. A person like Dr. Einhorn [his oncologist], that's someone to believe in, I thought, a person with the mind to develop an experimental treatment 20 years ago that now could save my life. I believed in the hard currency of his intelligence and his research.Beyond that, I had no idea where to draw the line between spiritual belief and science. But I knew this much: I believed in belief, for its own shining sake. To believe in the face of utter hopelessness, every article of evidence to the contrary, to ignore apparent catastrophe--what other choice was there? We do it every day, I realized. We are so much stronger than we imagine, and belief is one of the most valiant and long-lived human characteristics. To believe, when all along we humans know that nothing can cure the briefness of this life, that there is no remedy for our basic mortality, that is a form of bravery.To continue believing in yourself, believing in the doctors, believing in the treatment, believing in whatever I chose to believe in, that was the most important thing, I decided. It had to be.Without belief, we would be left with nothing but an overwhelming doom, every single day. And it will beat you. I didn't fully see, until the cancer, how we fight every day against the creeping negatives of the world, how we struggle daily against the slow lapping of cynicism. Dispiritedness and disappointment, these were the real perils of life, not some sudden illness or cataclysmic millennium doomsday. I knew now why people fear cancer: because it is a slow and inevitable death, it is the very definition of cynicism and loss of spirit.So, I believed.