THE PIMPLE ON
ADONIS' NOSE
or
Some Thoughts on the
Distribution of Educational Resources
in
The United States Today
by
Robert
Paul Wolff
Last summer, having finished the
revisions for a new edition of a textbook on Introductory Philosophy and
finding myself with enough money in my bank account for a brief overseas
vacation, I asked an agent at the local Travel Bureau to find me someplace completely
new, untraveled, and out of the way. He
sifted through a dusty pile of brochures shoved to the back of a drawer and
came up with the tiny Republic of Invertia, almost exactly half way around the
world.
An island nation with a population
of slightly more than four million, Invertia has no history, art, music, or
natural landmarks of any note, and hence has been virtually ignored in the
travel boom of the past twenty years. I
agreed forthwith, and told him to book me as inexpensive a round‑trip flight as
he could manage, together with reservations at what appeared, from the
brochure, to be Invertia's sole tourist hotel.
Three days later, I was on my way.
We touched down in the capital city
of Invertia shortly after nine a.m., local time; by ten we were through customs, and at ten‑thirty,
I had checked into my hotel, and realized that I had four days to fill and no
idea what there was to do in Invertia.
Fortunately, the National Tourist
Bureau, such as it was, occupied the building next to the hotel, so after a
quick lunch, I presented myself at the information desk and asked the clerk
what Invertia had to offer the interested tourist with several days on his
hands.
"You must surely visit our
national hospital, and also our national university," he said. "We in Invertia are enormously proud of
both institutions, and no visitor to our island should fail to see them. I will telephone the Ministries of Health and
Education and arrange the entire matter."
When I returned to
my hotel at dinner time, I found a message from the Travel Agent. The next day at one in the afternoon, I would
be given a tour of the leading hospital of Invertia. The following day, I would see the
university.
As I came down to
the lobby of my hotel on my second day in Invertia, promptly at one p.m., I
found the Minister of Health herself waiting for me. Apparently visitors were rare enough to
warrant the red carpet treatment no matter how unimportant they might be. We got into the official limousine at the
curb, and set out for the National Invertian Center for Health, or NICH as the
Minister referred to it.
Approaching the NICH, I was
powerfully impressed by the size and elegance of the building, gleaming with
marble facade and surrounded by carefully maintained lawns and gardens. Clearly, the government of Invertia put
health care very high on its agenda. I
assumed I would be driven to the rather imposing front entrance for an
official tour, but instead the Minister directed the driver to pull up in
front of the Emergency Room. As she
explained to me, the ER was the heart of any hospital, and I would get the best
possible idea of how Invertians handled their medical services by observing its
activities for a while.
Walking through the automatic
sliding doors into the Emergency Room of the Invertian National Hospital, I
was struck immediately by how quiet, clean, and orderly everything was. My own experience of hospital emergency rooms
-- not to mention the images from countless movies and television serials ‑ had
led me to expect a busy, seemingly chaotic swirl of patients, nurses, and
Interns, with weary family members slumped in chairs along the wall staring
blankly at out‑of‑date magazines.
Instead, I could easily have mistaken the ER for the reception area of a
big law office or corporation.
For a moment, I simply stood and looked
around, trying to adjust my perceptions to my expectations. Then the sliding doors opened again and two
men came into the Emergency Room. The
first was a man about my age, shabbily dressed and in obvious distress. He staggered more than walked into the ER,
calling out in pain as he lurched toward the reception desk. "Please," he said in a gasping,
feeble voice, "help me! I think I
am having a heart attack!" With
that he slumped to the ground, clutching his chest.
The second man was a tall, handsome
youth ‑ a veritable Adonis ‑ who walked with an easy, athletic stride. He wore an elegant suit and tie, had smoothly
tanned features, and appeared to me to be in perfect health. These impressions, I must admit, are somewhat
reconstructed from subsequent reflection, because my attention was entirely
seized by the poor man writhing on the floor.
As I stood there frozen, watching
what seemed to be the last moments of a dying man, the ER erupted into
movement. The attendant behind the
reception desk spoke a few quick words into the phone at his elbow, and moments
later the swinging doors flew open as an Intern hurried into the room pushing a
wheel chair. I prayed that they would be
in time to save the man on the floor, who was now straining for breath with
great raking gasps.
To my astonishment, the Intern
rushed past the stricken man and instead approached the young Adonis, whom he
gently guided into the wheel chair.
Then, solicitously settling a blanket about the young man's feet, he
made a detour around the body on the floor, glancing at it somewhat
irritatedly, and carefully pushed his new patient to the reception desk. As I watched, too horrified as yet even to
speak, the man on the floor gave a last cry, and died.
Throughout these events, the
Minister of Health stood beside me calm, unperturbed, a satisfied smile on her
face as if to say, "Well, that is how things are done here. Isn't that splendid?" Meanwhile, the receiving attendant was taking
the young man's medical history and inquiring as to his needs. Mesmerized, I drew closer to listen to the
interview.
So far as I could make out, this
was the first time he had ever found it necessary to seek medical
assistance. What had brought him to the
hospital was a small pimple on his nose, just to the right of center. He was greatly concerned that the pimple
spoiled his otherwise exquisite profile, and he wanted to know whether there
were specialists in the hospital who could remove it without leaving an
unsightly scar.
As he said this, the Minister of
Health, with a great air of self‑satisfaction, held up her hand, as though to
say to me, "Watch this!" The
attendant spoke again into the phone, and immediately a distinguished looking
doctor appeared who introduced herself as a plastic surgeon. She assured the young man that every facility
of the hospital would be put at his disposal, and she expressed herself as
absolutely confident that her team could remove the pimple with no visible scar
whatsoever. She had removed many such pimples,
she said, and had never lost a patient.
With that, the Intern rolled him through the swinging doors, and
followed by the surgeon, he disappeared.
A short while later, two orderlies brought in a large waste bin, pushed
the dead body roughly into it, and exited again.
I was so appalled by what I had
witnessed that I had trouble finding the words with which to give voice to my
thoughts. During my first few hours in
Invertia, I had felt quite comfortable and at home. The people all spoke English, and the
manners, the facial expressions, even the body language of the men and women I
had met seemed so much like those of my own home town of Amherst, Massachusetts
that I had begun to believe that I understood the Invertians quite well
indeed. Yet the utter incongruity of the
reactions in the Emergency Room to the two men who had presented themselves as
patients made me vertiginous.
Most mysterious of all was the
obvious satisfaction with which the Minister of Health had observed the
events. Her pride at the treatment of
the young man's pimple, and her utter unconcern for the dead man, bespoke an
attitude, a moral framework, a world view, so different from mine that I could
scarcely imagine where to begin my questions.
"Well," she said,
breaking into my troubled stream of thoughts, "now you have seen us at our
very best. What do you think of the
Invertian health care system? How does it compare with that of your own
country?"
Very quietly, with great self‑control
[for, truly, I feared that I had somehow stumbled into a madhouse, and could
not anticipate what those around me might do next], I undertook to
discover some explanation for what I had witnessed. "Let me start," I said, "with
the man who died of a heart attack on the floor before us. Why did no one try to help him? Why wasn't he immediately taken into an
examination room, given emergency treatment, put on oxygen, given drugs? Is your hospital not equipped to handle such
cases?"
"Oh, we are more than
adequately equipped to handle a heart attack, but what would have been the
point? He was clearly close to death
when he came through the doors of the ER."
"But with quick action, you
might have saved him! He died at our
feet!"
"Exactly," she said, as
though I had proved her point.
"Over a period of years, we have kept quite careful records of
patients admitted while suffering massive heart attacks, and our experience
shows that such patients have a very poor prognosis for recovery. A considerable number ‑ almost half, I
believe ‑ actually die during our efforts to save them or shortly thereafter,
and a majority of those who do live through the first days or weeks of
treatment emerge from the hospital in something less than perfect health. Many need further medical treatment, a
number have subsequent heart attacks, and taking all in all, the prospects of
heart attack patients for full recovery and healthy, happy post‑attack lives
are quite poor. So you see, it makes
very little sense to devote our splendid medical resources here at NICH to
treating what can only be considered marginal patients."
In order to grasp the utter
callousness of this speech, you must understand that it was delivered not
apologetically, or hesitantly, or with an embarrassed awareness of the inadequacies
in the Invertian health system thereby revealed, but with a sort of self‑satisfied
assurance, not to say smugness. The
Minister of Health clearly was a woman supremely pleased with the performance
of those under her command, and confident that I would share her pleasure once
I understood the marvelous efficiency of NICH.
"Do you never treat anyone
suffering from a heart attack?" I asked.
"Of course we do," she
replied, "but only when we determine that the patient has a very good
chance of complete recovery. Before we
will admit a heart attack patient, we require an extensive physical
examination, a complete medical history, and letters from the patient's
previous physicians explaining why they believe that the patient's heart
condition is not an accurate indication of his or her general health. If, in light of the entire medical dossier,
we decide that the patient can reasonably be expected to recover from the heart
condition quickly and live a long, healthy, productive life without further
medical intervention, then we are quite prepared to make an exception. Indeed, our admitting attendants are
specifically instructed to keep an eye out for promising patients who might in
the ordinary course of events be overlooked because of apparently contra‑indicated
previous conditions." This entire
speech, you understand, delivered in that patronizing tone so often used by
experts, especially medical experts, when explaining things to lay people who
cannot be expected to grasp the most elementary matters.
"And the handsome young man
with the pimple on his nose?" I asked.
"He does not seem to have gone through an elaborate background
check or a series of admissions tests."
"Quite true," she
replied. "Ordinarily, any patient seeking admission to the hospital must
go through the entire procedure of medical evaluation, but every so often, we
see a patient who is obviously bursting with good health ‑ fit, vigorous,
strikingly attractive. When such a
patient comes along, needing only the very slightest medical adjustment to
emerge in perfect condition, a patient with whom our chance of success is
virtually 100%, we are prepared to waive the normal procedures and speed the
admission process. That young man was
one of the most promising patients I have ever seen. Our Cosmetic Surgery Department's success
with superficial pimples is close to perfect.
As soon as I saw him, I was sure he deserved admission to the
hospital. When he is released, he will
be an outstanding specimen of Invertian youth.
I would hazard the guess that he will never need medical attention
again."
I was struggling to find my
bearings in what seemed more and more to be a Kafka‑esque hall of mirrors. "Let me be absolutely sure I understand
what you are saying," I said, in one last effort to make sense out of this
nightmare. "You operate this
hospital on the general principle that patients will be admitted only if they
have relatively minor ailments which you can be virtually sure of curing. When someone is desperately in need of
medical attention, such as the man who died here only a few minutes ago, you
deny it on the grounds that such people have a poor chance of being totally and
completely cured. But when young
Adonises or Venuses present themselves to have a pimple removed, a hang nail
trimmed, or a slight headache treated symptomatically ‑ in short, when patients
appear who do not need medical care in order to survive, but merely want
it so as to become even healthier and more attractive than they already are,
then you lavish the full resources of this magnificent modern hospital on
them. Do I have that right?"
"Just so," she said. "I think you are now beginning to
understand how the Invertian medical system works."
"But men and women are dying
every day, some of whom could be saved by your hospital. And in return, all you get is the
satisfaction of knowing that your healthiest, most attractive young men and
women are pimple and hang nail free! How
can you possibly justify devoting all your medical resources to such frivolous
ends?"
Oh, dear," she replied,
obviously distressed that I understood so little of what she had been
saying. "I am afraid you have
things quite upside down. If we were to
do as you suggest, and admit to our hospital patients with heart attacks,
cancer, internal injuries from automobile accidents, and heaven knows what
else, we should be swamped! We might
manage to handle a few, though it would mean turning away thoroughly qualified
patients like that young man who was just admitted. But to let them all in would be impossible!
"Indeed," she went on,
"we couldn't do it even if we wanted to.
Our medical staff is not trained to deal with life‑threatening ailments,
save for a handful of specialists in the Trauma Center. What would all our supremely well‑trained Plastic
Surgeons, Podiatrists, and Dermatologists do to keep busy? Besides, we haven't the physical facilities
to treat such patients. In this
hospital, there are four entire wards of Plastic Surgery, each completely
staffed and outfitted, including a Nasal Reconstruction center. But there are only two physicians with any
experience of major heart ailments, and neither of them has the capacity to
treat more than three or four patients at a time.
"All that is entirely
secondary, however, for what is at stake here is a matter of fundamental
principle. Invertian society has need of
an elite core of superbly healthy men and women whose every last imperfection
or blemish has been meticulously removed by the most modern techniques of
medical science. In an ideal world,
where there are infinite resources, we could, I suppose, build endless
hospitals to treat those suffering from heart disease, cancer, severe internal
injuries, and other life‑threatening physical problems. But resources very definitely are not
infinite, and as I am sure you will recognize, it takes much more in the way of
those resources to treat each dying patient than it does to correct the minor
imperfections of healthy patients. When
you consider that many of the really sick patients simply die despite our best
efforts, you will concede that it would be utterly quixotic of us to turn our
entire medical system upside down, all for the purpose of trying to save the
lives of men and women who, even if they do live, will never play a set of competitive
tennis, run a respectable marathon, or grace our city with their good
looks."
I am a philosopher by profession,
and argument is my stock in trade, but the image of that poor man dying in
agony at my feet blotted out all thought of logical by‑play. I listened to the Minister's arguments with
a heavier and heavier heart. When she
had finished, I asked meekly whether we could leave, and without seeing
anything more of the NICH, I returned to my hotel. The next day, I was slated to visit the university. I could not even imagine what I would find
there. Nazi‑style experimentation on
human subjects, perhaps. Lock‑step
courses in Invertian ideology. A
Department of Astrology and Dianetics.
I spent a troubled night.
The next afternoon, it was the
Minister of Education who appeared at my hotel to conduct me on a tour of the
Invertian National University. The
Minister was a short, fat, energetic man who perspired freely in the warm
midday sun. My mind was still filled
with the images of that poor man, dying on the floor of the ER, utterly ignored
by Doctors, Orderlies, and the Minister of Health herself. I am afraid I was only half listening as the
Minister of Education poured out statistics on the way to the University. I did manage to gather that the University
had a full complement of departments in the Arts, Humanities, Social Sciences,
and Natural Sciences, as well as small but well‑staffed Law, Medical,
Engineering, and Business Schools. Even
before we arrived at the university, I began to feel more at home.
The Central Administration Building
was a large, nondescript, functional structure ‑ the sort of building one could
see on any of a thousand American campuses.
After parking in a place especially reserved for the Minister's car, we
entered and went first to the Student Admission Office. The Minister explained that this was the best
place to get a feel for how the University operated.
The Admissions Office looked just
like any college admissions office in America.
There were wall racks with copies of application forms, class schedules,
literature promoting one or another of the various degrees offered at the
university. A bulletin board had
sprouted with the usual hand‑printed notices of rooms to share, typing
services, furniture for sale, secondhand
textbooks. There were several Admissions
Officers waiting to greet prospective students.
All rather familiar and comforting, I thought to myself, especially
after the disorienting visit to the hospital.
As I stood there with the Minister
and his aide, looking about the large room, the door opened behind us and two
young people walked in. First through
the door was a neatly dressed young woman whose face and manner bespoke a
quite attractive intelligence and self‑confidence. As she approached the desk of one of the
Admissions Officers, I edged closer in order to overhear their conversation.
She introduced herself
forthrightly, in a cultivated voice, and said that she wished to enter the
university to pursue a degree in Mathematical Physics. She explained that she had a straight‑A grade
record at her secondary school, had achieved perfect scores on the Invertian
equivalent of the Scholastic Aptitude Test, and in fact had already published
several original papers on a rather recondite branch of Mathematical Physics
in Invertian and foreign journals. She
was, she added, a champion swimmer and tennis player, and also had given public
concerts as a pianist. In her spare
time, she said, she worked with learning‑disabled children, and took inner‑city
girls on nature walks. Needless to say,
I was tremendously impressed. This was
just the sort of outstanding student I had encountered at Harvard, Yale,
Princeton, Swarthmore, and the other top colleges and universities in America. She had that pulled‑together look of someone
who knows her own abilities, has worked hard to develop them, and has acquired
thereby a justifiably high sense of self‑worth.
As she spoke, the Admissions
Officer grew visibly more impatient, fidgeting with his pencil and rather
ostentatiously leafing through some paperwork on his desk. When the young woman had finished, he looked
up. "Well," he said, in a
perfunctory tone of voice, "take an application form and fill it out. We will contact you if we can find room for
you." With that, he dismissed her
and turned his attention to the second applicant.
My first thought was that the young
woman had stumbled on a small‑minded bureaucrat who resented young people
manifestly more talented and accomplished than he. I had known a few such in America, even, I
reflected, among the senior professoriate.
Then too, it occurred to me that because there could be no question
about her being admitted, he might simply have sent her off so that he could
attend to more difficult cases. But as I
stood there, wondering what might happen next in this topsy‑turvy country, I
heard the young woman saying to an older couple who were apparently her
parents, "I knew I wouldn't get in."
The looks on their faces confirmed that she had would be denied
admission to the university.
The Minister of Education had
observed all this with apparent approval.
Didn't he care that so supremely well‑qualified an applicant had been
summarily turned away from the National University without so much as an
interview? How on earth could he explain
to the faculty of the university that the very best students were being denied
admission? At that moment, the second
potential student stepped up to the Admissions Officer's desk, and the
Minister, with much the same gesture that his colleague had used the day
before, motioned to me to watch how this applicant was treated.
Standing before the desk was a
young man who, in every conceivable way, contrasted totally with the young
woman who had just been so unaccountably sent packing. He was carelessly dressed, slouched rather
than stood, and seemed bewildered by his surroundings, as though a university
were entirely terra incognita to him.
Well, I thought, they shan't waste too much time on him.
Even before the young man started
to speak, the Admissions Officer's manner changed completely. He put down his pencil and visibly gave the
applicant his complete attention. "How
may I help you?" he asked solicitously, his voice friendly and inviting.
"I wanna go to school
here," the young man said, in a manner both belligerent and insecure. "I don't have no high school
diploma. I flunked out of 12th
grade."
"Can you read?" the
Admissions officer asked.
"Sure I can. Not books and stuff like that, but I can read
the sports pages well enough to know which team's ahead."
"And how
about writing. Have you ever written an
essay of, say, three pages in length?"
The young man
looked about suspiciously. "Say,
what's the idea of the Third Degree? I
just said I wanted to go to school here.
I didn't say I wanted to be one of the teachers."
"Of course, of course,"
the Admissions Officer answered in a tone intended to calm the young man's
anxieties. "We quite well
understand. Would you wait just one moment?"
With that, he picked up the phone
and said a few words too softly for the young man, or me, to hear. Almost at once, a door at the rear of the
reception room opened, and a group of distinguished‑looking men and women
entered, wearing full academic regalia, as though on their way to a
Commencement. They gathered around the
young man, took him gently in tow, and led him off through the rear door.
"What is going on?" I
asked the Minister, who throughout these events had been teetering back and
forth on his heels, hands in pockets, with a broad smile across his face. "Were those senior members of the
faculty? What are they doing here in the
Admissions Office? Where are they taking
that young man? And why on earth was
that extraordinary young woman denied admission to your university?"
The Minister was somewhat taken
aback by this rush of questions, but he motioned me to a chair, and undertook
to explain what I had just witnessed. He
sat down in a chair opposite me and gave a tug at his vest, as though to settle
himself for a lengthy discourse.
"Let us take your questions in
reverse order," he began, "inasmuch as the young lady's case was
dealt with before that of the young man.
The young lady was denied admission to our university because she is
highly intelligent, superbly well‑trained, already quite accomplished, and
powerfully motivated to continue her studies."
At about this time, I began to
wonder whether the Invertians really were speaking English. It certainly sounded as though they
were speaking English. But perhaps, I
thought, this is some curious dialect, derivative from English, in which
certain of the key logical connectives have had their meaning reversed. Could this be an obscure linguistic rebellion
against their former colonial rulers?
The problem here was with the Minister's use of the word
"because." The young lady had
been denied admission to the university because she was
intelligent, accomplished, and highly motivated. Did "because" in Invertian mean
"in spite of?" Did
"denied admission" perhaps mean "granted admission?" Or were the old sailor's yarns true about
everything at the antipodes standing on its head. I decided to try a bit of dialectical give‑and‑take
in an effort to get my bearings.
"You denied her admission because
she is intelligent, accomplished, and highly motivated. But surely she is an absolutely certainty to
do well at university. I would imagine
the probability that she will graduate, indeed graduate with honors, is just
about 100%."
"I'm glad you saw that,"
he replied, apparently pleased that I was catching on. "I thought perhaps, this being a
somewhat unfamiliar setting, that you might not have recognized it as soon as
we who are more practiced at the ins and outs of admissions. I was half‑sure before she even opened her
mouth, and as soon as she said she had published original papers in
Mathematical Physics, I knew there was no point in letting her in."
"But think how much she can
profit from a university education," I protested, feeling as I did so that
I was rapidly losing my grip on reality.
"With her background and preparation, a university education will
bring her to the very pitch of intellectual perfection. By the time she leaves, she will be virtually
at the same level as your most senior faculty.
And think what a delight it would be to them to have such a student in
their courses. Why, they could present
the very latest results of their own research for her consideration and critique,
instead of plodding through the elements of basic Physics and
Mathematics."
"Well," the Minister
answered, "you have just made the case for rejecting her ‑ as good a case
as I could have made myself. That young
woman is already so well developed intellectually that she does not need
what a university can offer. With or
without our university resources, she will do well in life. Indeed, she is already capable of securing a
position in one of our nuclear power plants, and with a bit of on‑the‑job
training, she will be a productive and successful member of society. To spend our scarce education funds on her
would be wasteful and inefficient."
"And that young man," I
said, rather more belligerently than I intended, for I was growing very
frustrated indeed. "You have
admitted him to the university despite the fact that he can barely read and
write. Judging from that flock of
professors who shepherded him out of here, he will be getting the most
expensive education Invertia has to offer.
Yet I will bet my airfare home that he won't make it through four years
of university education. Everything is
against him! He needs remedial reading,
remedial writing, no doubt remedial math as well. Out of every hundred such students you admit,
you probably won't see more than fifteen of them on Commencement Day."
"Oh, I agree with everything
you say," the Minister replied.
"But what would you have us do?
You saw him when he entered. Educationally
speaking, if I may put it this way, he was in extremis when he walked
in. If we had turned him away, I am absolutely confident that he would have
died intellectually before too long. At
this very moment, our team of professors is working with him, starting the
painful, difficult process of developing his intellect, challenging his mind,
helping him through the shame and self‑doubt of semi‑literacy. As you say, we lose quite a few young men and
women like him, but we save quite a few too.
Imagine the thrill we all feel when one of those young people, whose
mind had all but ceased to function, begins to read, to write, to think, to
argue, to question a world that has, until then, been closed to him or
her."
I have to admit that I was
beginning to feel just a trifle less sure of myself, but I decided to press on
nevertheless.
"Look," I said, trying
hard to find some common ground on which the Minister and I could achieve a
meeting of the minds. "Your motives
are no doubt admirable. I sympathize
entirely with what you are trying to accomplish. But how on earth can you use a university
faculty to do the most basic remedial education? Where do you find students able to take your
advanced courses in literature, philosophy, physics, or chemistry? How can students like that young man even
begin to handle the sophisticated intellectual materials presented in advanced
seminars?"
"Our faculty are capable of
helping the educationally most wounded of our students ‑ if I may put it that
way ‑ because we have for some time now been recruiting faculty specifically
for that purpose. We require that
professors in every department be trained in what I might call educational
emergency procedures. The handful of
advanced courses we offer are quite adequately enrolled, but we take care to
offer few enough of them so that there is no problem. All our facilities are designed to serve the
needs of the educationally disadvantaged.
We have even devised a system of icons to guide our poorer readers about
in the library.
"As for the drop‑outs, of
whom, as you suggest, there are many, you must not suppose that our efforts
with them are wasted. Not every student
who enters our university completes a degree or goes on to advanced study, but
even those who are with us for only a semester or two have clearly benefited
from the experience. Some who could
barely read leave able, for the first time, really to enjoy a daily
newspaper. Others have acquired numerical
skills that will earn them more challenging and rewarding jobs. Most, I think,
acquire some sense, however incomplete, of the life of the mind. And those with whom we completely fail ‑
whose minds die before we can save them ‑ well, they are the price we must pay
for the chance to help so many others.
"We could restrict our
university to that young lady and her sort.
There aren't many quite that promising, but Invertia has its share of
gifted young men and women. What would
we accomplish, were we to do so? Our
population would consist of a small number of superbly educated people whose
already magnificent talents and abilities had been brought to the pitch of
perfection by an expensive and exclusive education, and a large population of
inadequately educated men and women whose lives are stunted, whose perspectives
are narrowed, whose capacity for intelligent self‑government diminished,
because we denied them admission to our university."
I was by now thoroughly
confused. I felt an overwhelming need to
make sense out of the experiences of the past two days, to place my visits to
the NICH and to the Invertian National University into some sort of coherent
framework. Somewhat desperately, I proposed
a meeting at which the Ministers of Health and Education and I could talk
informally. The Minister of Education
immediately agreed, and assured me that it would be no trouble setting up such
a meeting for the following day, which was to be my last in Invertia. With that, we returned to my hotel, and he
left me until the next afternoon.
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 question.
"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
have seen?"
" 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
survival.
"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?"
"Of course 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."
"And 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
great self‑confidence.
"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 operates?"
"Well," the 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."
"Your university 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' candidates.
"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
universities."
"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
intellectual well‑being."
"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
the neediest?
"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
ask."
"By all means," the
Minister of Education replied, not at all put out by my excitable temperament.
"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
Invertian insensitivity?"
"Ah," the 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, sorely
troubled.
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.