Sherwin B. Nuland
22 quotes
Biography
Sherwin Bernard Nuland was an American surgeon and writer who taught bioethics, history of medicine, and medicine at the Yale School of Medicine, and occasionally bioethics and history of medicine at Yale College. His 1994 book How We Die: Reflections on Life's Final Chapter was a New York Times Best Seller and won the National Book Award for Nonfiction, as well as being a finalist for the Pulitzer Prize.
"If there is one operation for a disease, you know it works. If there are fifteen operations, you know that none of them work."
"Tradition is a persuasive teacher, even when what it teaches is erroneous."
"Long after the theories on which they were based had been debunked, Galen's concepts of sickness and its treatment continued to have a pervasive influence on the daily practice of medicine. Indeed, it is a measure of medicine's progress over the past fifty years that a goodly number of his remedies were still being used until well into the twentieth century."
"Poets, essayists, chroniclers, wags, and wise men write often about death but have rarely seem it. Physicians and nurses, who see it often, rarely write about it."
"Of hundreds of known diseases and their predisposing characteristics, some 85% of our aging population will succumb to the complications of one of only seven major entities: atherosclerosis, hypertension, adult-onset diabetes, obesity, mental depressing states such as Alzheimer's and other dementias, cancer, and decreased resistance to infection. Many of those elderly who die will have several of them. And not only that; the personnel of any large hospital's intensive care unit can confirm the everyday observation that terminally ill people are not infrequently victims of all seven."
"With deep sedation or the blessed respite of terminal coma that comes to some at the end of a difficult struggle, the actual hour when the heart stops is indeed often tranquil. Many do, in this way, avoid a tormented passage; but many others are in physical and mental distress till nearly the last moment, or even at the last moment."
"The tendency toward mysticism is ingrained in human nature. Superstition, religion, and medicine have made their long journey together, and even now are unable to let go of one another's hands."
"In its own unhurried way, age soundlessly and with persistence treads ever closer behind us on slippered feet, catches up, and finally blends itself into us—all while we are still denying its nearness."
"The later decades of a life become the time for our capabliites to find an unscattered focus, and in this way increase the force of their concentraled worth."
"My mother died of colon cancer one week after my eleventh birthday, and that fact has shaped my life. All that I have become and much that I have not become, I trace directly or indirectly to her death. ... In my professional and personal life, I have lived with the awareness of death's imminence for more than half a century, and labored in its constant presence for all but the first decade of that time."
"Not death but disease is the real enemy; disease, the malign force that requires confrontation. Death is the surcease that comes when the exhausting battle has been lost."
"Cancer cells are fixed at an age where they are still too young to have learned the rules of the society in which they live. As with so many immature individuals of all living kinds, everything they do is excessive and uncoordinated with the needs or constraints of their neighbors... they are reproductive but not productive."
"Long regarded as central to the contemporary understanding of medical ethics are four principles that must be satisfied in order to fulfill the requirements of moral decision-making. These principles are autonomy, justice, beneficence, and non-maleficence."
"Medical judgment can be taught - laboriously, in long periods of training - but it cannot be neatly handed over as the occasion demands it. It is the irreplaceable and untransferable contribution that the healer makes to the suffering individual who would be healed."
"The writings and the recommendations of the earliest medical scientists and the new breed of clinicians between the mid-fifteenth and early seventeenth centuries were based on the supposition that sufficient study and experimentation would elucidate not only the origins of disease, but its treatment as well."
"By the time of my ninth birthday, I had become a bit of a socialist, as I am said by conservative colleagues to be to this day. I went on within the next few years to volunteer as an envelope stuffer for the American Labor Party, and my political thinking has not shifted measurably since that time."
"Moths and flames, mankind and death--there is little difference."
"I never had a conscious fear of death, but I did have a conscious fear of sickness. By the time I completed medical school, that fear was gone."
"Even putting aside the Judeo-Christian morality upon which the Constitution and our nation's culture are based, the notion of forced euthanasia would contradict the long-held body of medical ethics to which all American doctors must adhere."
"The growing professional disciplines of medical ethics and bioethics have had a profound impact on researchers, bedside doctors, associations of physicians, and government."
"Every hope of successive generations of scholars that order might be constructed from the chaotic mess of medical nomenclature has been frustrated. Even diseases recognized in the same historical period have been given names based on characteristics that have no relation to one another, and thus no common criteria."
"We have had a rewarding relationship, the belly and I."