To day I conclude my essay, The Pimple on Adonis' Nose. Tomorrow I shall tell you about its reception, and discuss some of the questions it raises.
On my last day in
Invertia, I met as promised with the Minister of Health, the Minister of
Education, and members of their staffs.
We sat on the porch of my hotel, in the late summer sun, and talked for more
than three hours.
I spoke at length about
my puzzlement and distress at what I had witnessed, both at NICH and at the
university. I told them I was appalled
by the callous disregard of the man who had died in the ER of the hospital. Invertians, I said, seemed to be friendly,
sensitive, caring people, and yet the staff of the hospital exhibited no anger
at what had happened. I went on to talk
about the mystifying events at the university, and confessed myself utterly
unable to understand why the brilliant young student of Mathematical Physics
had been summarily turned away while a barely literate young man, manifestly
unready for university work, had been so solicitously received and admitted.
When I had finished, both
Ministers sat quietly for a while, stunned, I think, by the vehemence of my
remarks. Finally, the Minister of
Education made a gesture deferring to his colleague, and she began their reply.
She started with a
"Tell me," she
said, "since you clearly find our Invertian medical policies so alien, how
such things are managed in the United States.
Had we visited the Emergency Room of an American hospital, what would we
" In the emergency
room of any American hospital, "I replied, “the response to that
desperately ill man who staggered into the ER of the NICH would be the
same. He would be given immediate
emergency medical attention, and every effort would be made to keep him alive.
Specialists would be called to the ER;
if necessary the patient would be hurried into an operating room; the entire medical team ‑ specialists,
residents, interns, nurses, technicians ‑ would work together to arrest the
heart attack, stabilize the patient, and give him the best possible chance for
"If, at the same
time, a healthy young man were to present himself with a pimple and ask for
treatment, he would be told to wait until someone could see him. In all likelihood, he would be sent packing
with a warning not to waste the time of the ER with cosmetic problems and some
sardonic advice about over‑the‑counter skin creams. Were the doctors in the ER actually to
examine him, they would quickly conclude that he was not in need of medical
care, and he would be advised to go home.
"And how do these
meticulously cared‑for patients fare?" the Minister of Health asked
me. "Do they all recover and go on
to lead long healthy productive lives?"
not," I replied. "Many of them
die despite the best efforts of the hospital, and even those who do recover are
required to follow a careful regimen of diet, exercise, and periodic check‑ups. The point is that the American medical
profession considers its job to be the saving and prolonging of life, not the
cosmetic improvement of those who already enjoy excellent health."
your educational system?" the Minister of Education asked, breaking into
the discussion. "Does it operate on
these same principles? Are the neediest
attended to first, as in our Invertian university? I was, I confess, very puzzled by your
reaction to our admissions procedures, in light of the reports I had heard of
your concern about the operation of our National Hospital." At this point, I became aware of a certain
uneasiness. In retrospect, I realized it
had been growing in a corner of my mind since my visit to the university the
previous day, and my conversation there with the Minister of Education. As I answered his question about the American
higher educational system, I began to feel more and more that there was some
sort of incompatibility between my reactions on the first and second days of my
visit. But all of this, as I say, became
clear to me only in retrospect. When the
Minister asked me about American higher education, I plunged into my reply with
"To begin," I
said, "I must explain that higher education in the United States is not
under the unified control of the central government, as it is in so many
European, Asian, and African nations, and as it appears to be here in Invertia. There are, taking all in all, almost four thousand institutions of higher education in
America, including private universities and liberal arts colleges, state
universities and colleges, community colleges, junior colleges, and so forth. These institutions vary dramatically in size,
in quality, in cost, in level of funding, and in mission. Some are vocationally oriented; some were
founded, and are still run, by religious sects;
some are devoted as much to research as to teaching; and others are
entirely teaching institutions.
"The very best
colleges and universities have many times as many applicants as they have room
for. Their admissions policies are
highly selective; such institutions spend hundreds of thousands of dollars a
year processing applications, interviewing applicants, and making sure that
they select the most qualified young men and women who wish to enter. But there are also a considerable number of
colleges that have trouble filling their classrooms, and they, despite their
best efforts to be selective, may be forced to admit students who are not a
great deal more qualified than the young man we saw yesterday.
"The system has
serious defects, needless to say ‑ defects of which I am a harsh critic.
Nevertheless, I really think it is fair to say that the overwhelming majority
of professors, admissions personnel, and academic administrators genuinely seek
to select, for their institutions, applicants who are well‑prepared for higher
education and capable of benefiting from the faculty assembled there.
"Every one of those
colleges and universities would be simply delighted to receive an application
from that young woman whom your university rejected. Indeed, if you will give me her name and
address, I think I can guarantee to arrange a full scholarship for her at any
one of scores of outstanding institutions in the United States."
"So," said the
Minister of Education, not as impressed as I might have hoped by this rather
effulgent speech, "your answer is, no.
The American university system does not operate on the same principles
as does our Invertian system. If I may
venture an observation, it would appear that you run your universities in just
about exactly the manner that the Minister of Health here runs our hospitals."
"What on earth are
you talking about?" I said, astonished by his remark, and stung by it as
well. "With all due respect to the
Minister, who is, I recognize, a dedicated public servant, your hospitals do cosmetic surgery
on fundamentally healthy young men and women while allowing heart attack victims
to die on the floor of the Emergency Room.
What possible connection is there between that bizarre distortion of
medical values and the way in which the American system of higher education
Minister replied, in a patient, measured tone, as though explaining things to a
child, "our medical system selects only the healthiest patients, on the
basis of the probability that they will respond positively to treatment and
leave our hospital as close to physical perfection as nature and medical
science combined can make them. We
reject patients who are too sick, too weak, whose general physical condition is
too poor, to make them promising candidates for treatment."
system selects students, by your own account, in exactly the same manner. The closer a student is to being in perfect
educational health, if I may speak in that fashion, the more eagerly your
colleges and universities compete to enroll that student in their entering class. You yourself told us that the young Invertian
woman with the extraordinary preparation in theoretical physics and the arts
could, without difficulty, secure a scholarship at any of your very best
colleges or universities. The young man
we saw yesterday, on the other hand, was, educationally speaking, the
equivalent of the heart attack victim at the hospital. He was desperately in need of immediate
educational help if his mind was to have the slightest chance to survive. So our most senior professors rushed to his
side, and took him into the university, where they are already beginning the
long process of remediation and development from which he may, I say may,
emerge a reasonably well‑educated, independent, literate, thoughtful
citizen. Your colleges and universities,
if I understand you correctly, would shrink from such an applicant, admitting
him only if forced to by a shortage of, as you put it, 'better qualified'
"Your colleges and
universities are engaged, educationally speaking, in the removal of pimples
from the faces of intellectually beautiful young people. The only visible difference between those
young men and women on their first and last days of college, I would imagine,
is a slightly higher sheen, a bit more of a glow of perfection. Judging by what I have read of your most
distinguished universities ‑ for, you see, we here in Invertia are aware of the
rest of the world ‑ many of the young people who enter those ivied walls are so
far advanced in their study of science, the arts, or society that they are better
thought of as junior colleagues than as students.
"Is it not the
proudest boast of such institutions that virtually all who enter their Freshman
classes graduate with distinguished records, and go on to achieve great success
in later years? How does that differ
from my colleague's claim that the Invertian medical system has produced a
small but select cadre of beautiful people who are free of every blemish and
in perfect physical health? You are
disturbed that this island of perfection is purchased at the price of a sea of
physical neglect. Your educational
system accomplishes the very same result.
Your Harvards and Yales and Amhersts graduate perfect educational Adonises
and Venuses, while all about them the minds of countless men and women are dying
for lack of educational care."
"You cannot expect Princeton or Chicago
to admit students who cannot properly read or write," I protested. "That is not their function. They do not have the resources for the
enormous task of remediation such an admissions policy would impose on
them. To set scholars of Renaissance
poetry or Quantum Physics the task of teaching remedial writing or math would
be an unconscionable waste of the extraordinary talent gathered in those centers
of learning. Their job is to take the
most promising, the brightest, the most talented young people in America,
regardless of race, creed, gender, or national origin, and bring them to a
pitch of intellectual excellence at which they will be able to extend the
scholarship, the exploration of nature, the cherishing and elaboration of the
arts beyond what previous generations have achieved."
"As for the absence,
at your best institutions, of appropriate resources for remediation," the
Minister responded, "that is precisely, as I understand it, the point made
by my colleague here with regard to the NICH.
The medical policies of Invertia being what they are, the NICH has over
the years built up a world‑class cosmetic surgery department, while neglecting
its coronary, oncology, and trauma departments.
Naturally, the NICH is not now well‑suited to treat heart attack
victims. If the policy were to be
changed, it would no doubt take some time and even a good deal of money to
convert the NICH into something resembling your Massachusetts General Hospital.
"In exactly the same
way, Harvard, having for more than a century labored hard to make itself the
very model of a modern German university, would be ill‑prepared indeed to deal
with an influx of genuinely needy students whose lack of skills and preparation
demand immediate, high‑quality remediation.
No doubt, it would cost Harvard some time, and some money, to
retool. But just as you seem unwilling
to accept such considerations as an excuse for allowing that poor man to die in
the ER, so, in all consistency, you can hardly accept the existing structure of
your institutions of higher education as an excuse for allowing potential
students like that young man in our admissions office yesterday to die, educationally
speaking, outside the walls of your most distinguished colleges and
"You are completely
ignoring the enormous social benefits that flow from the graduates of our very
best colleges and universities," I argued.
"It doesn't do Invertia as a whole any particular good to remove
pimples from the faces of otherwise beautiful young people. But that young woman, were she to receive the
benefits of an advanced university education, could do more than merely hold
down a job. She might make discoveries
that would lift all of Invertian society to a new height of material or
"Let me consider the
supposed benefits of a system of education designed to serve the least needy,
or, as you would prefer to put it, the best prepared, applicants," the Minister
responded. "Despite what I believe
to be a vast exaggeration of the effects of elite university education on
students who are already superbly well‑prepared, I am quite willing to grant
that lavishing the most expensive resources on those who need them least
results in some significant benefits that might otherwise fail to
materialize. But that hardly settles the
question, for we must still ask, as your economists like to do, what the
opportunity costs are of that educational policy. What is foregone, what is lost, when scarce
resources are concentrated on the least needy, rather than being allocated to
"Are you quite
prepared to insist that the total well‑being of American society would diminish
if some portion of the wealth devoted to the education of the best‑prepared students
were redirected into programs for remedial help to the educationally
neediest? If the students gathered at
Harvard, Yale, Berkeley, or Chicago were forced to attend the University of
Massachusetts, Dade County Community College, or Chico State, would the social
loss thereby inflicted on American really be greater than the benefit
resulting from bringing along to a higher level of educational accomplishment
all those young men and women who are now simply excluded from the entire
higher educational system?
"Perhaps you will
say yes. I don't know. But has the thought ever crossed your
mind? Has it even occurred to the
educational establishment in America to attempt a serious confrontation with
the question? Would the president of
Harvard consider such a question even relevant to his effort to actualize the
biblical injunction that to those that hath shall it be given?"
"This is simply
pointless," I burst out. "You
seem to have an answer ready to hand for every objection I raise. Let us stop arguing. You have been more than patient with a
newcomer to your land, and this is, after all, my vacation! Yet there is one final question I must
"By all means,"
the Minister of Education replied, not at all put out by my excitable
"I will not quarrel
with your educational policy," I said, " for all that it contradicts
everything to which I have devoted my adult life. But surely you can see, can you not, that
there is an extraordinary difference between Invertia's method of allocating
its educational budget and its method of allocating its medical budget. In the
one case, you treat the healthiest and let the neediest fall by the
wayside. In the other, you lavish
attention on the neediest, and force the ablest, best prepared to take whatever
is left over. And yet neither you, nor
your colleague here, seems to feel the least sense of inconsistency, to
experience the slightest mental cramp at this manifest contradiction. How on earth do you explain this strange
Minister responded with a smile, "that is a question you are as well
equipped to answer as I, for in your country, exactly the same contradiction
exists, for all that the incompatible policies are reversed. If you can explain why, in five decades of
university teaching, you have never felt the slightest discomfort at your
country's settled practice of devoting lavish resources to the education of
those least in need of them, while at the same time taking it for granted that
your country's medical resources should be concentrated on saving the lives of
your least healthy fellow Americans, then perhaps you will be able to
understand how we here in Invertia can live comfortably with the selfsame irrationality."
And with that, he and his
colleague rose, shook my hand, and departed, leaving me, as you will imagine,
In the first few hours
after this last conversation, I began to think that our way of doing things in
the United States was as utterly mad as the Invertian way. I even spent some restless hours that night
framing proposals for the reform of American higher education.
But the next day was
bright and sunny, and I was eager to return home. I paid my hotel bill, thanked
the man in the Travel Bureau for his help, and began the long trip home. The closer the airplane brought me to the
coast of North America, the less reasonable my feverish schemes for reform
appeared to me, and the more I recovered my old sense of the essential
rightness of the American way. By the
time I had landed at Logan Airport in Boston, there to be greeted by my wife,
I had entirely regained my senses, and was ready to treat my Invertian vacation
as nothing more than a good story.
Which, I hope you will
agree, I have done.