One year after caring for Pope John Paul II, following the assassination attempt that almost ended his life in 1981, he asked that I travel to war torn Lebanon as his personal representative. I tried to capture in this article the individual trauma and determination I experienced there – a determination that is evident in the streets of Beirut more than twenty years later. The article elicited many, some quite hostile, letters.

The article about Libya was chosen by a foreign policy association as one of the best journalistic pieces of that particular year. It raises questions concerning honesty and integrity...

These articles reflect a forty-plus year love affair with the people and land of a now “failed state.” I was present at the birth of the Somali Republic, a birth of joy and hope and promise. Thirty years later, I was also present when the government of Somalia imploded, a death of a nation caused by corruption, incompetence, and international politics. I collected my technical papers documenting medical and epidemiological studies in a small textbook,Health on the Horn of Africa, a volume I was once told had “one of the lowest sales records in publishing history,” and in a...

I still own a home in Nicaragua, a commitment made in 1985 during the Contra-Sandinista War. As these articles indicate, my early service there was in an earthquake shattered city, living with the then president. As I came to know the country I grew very sympathetic to the aspirations of the oppressed, and during the 1980s spent much time there with my wife trying to establish a health service and using the credibility of medicine to foster peace. In retrospect, my efforts failed to change the course of events, but these articles remain my testament to the rights of a...

Thirty six years ago, I was appointed Professor and Chairman of a Department in an Irish medical school and began a transatlantic commute that anchored our family life in Dublin as well as New York. I have also served for over three decades as the President-General of the American Irish Historical Society, and have used that platform to extend my arguments for freedom from the Middle East, Africa, and Latin America to the land of my ancestors. These articles were written in reaction to the armed conflict that I personally observed in Northern Ireland in the late 1960s, 1970s and...

It was not too many years ago that I sat at just such a graduation, here at my alma mater, eager for the ceremony to be over, eager to shed the student’s shackles. I left this great university and hospital complex with a healthy trepidation for the future and a sailor’s respect for those sudden gusts of wind that so often alter the expected course of our lives.

Although there were the normal fears of an undergraduate about to assume the responsibilities of a physician, I recall leaving Cornell more with a sense of wonder and expectation, an almost irrepressible...

This address was modified for scores of different universities and hospitals, but the principles which guided my actions and, therefore, my words remained much the same in different locations.

In the long haul of life, it is the philosophy - in this instance of an administration - that may make it memorable. The details of specific bills or the relentless activities of a bureaucracy are easily forgotten. It is so easy to lose the peculiar élan of an era and let sheer size - whether it be in business or academia or government - crush the individual flair and approach....

Universities reflect the societies they serve. At all times, universities try to teach the young to learn and to accept the burden of leadership; they prepare a new generation to take the torch of responsibility and educate those who must expand society’s vision while preserving its traditions. In times of political stability, the university, the repository of historical and cultural wisdom, becomes the focus for the refinement of all that makes a civilization. During times of national debate, as in the United States during the Vietnam War, the university can become the center for dissent, coalescing the philosophic concerns of...

After the Sandinista government had been overthrown, and the goals of the revolution crushed, I gave this talk at a Convocation at the National Autonomous University of Nicaragua, 1990.

Several years ago, in an address at your neighboring college here in Managua (The University of Central America, 1987), I suggested that “a university reflects the society it serves,” that if academia was to thrive in the throes of a revolution it must assert its relevance by crossing the campus gates, temporarily forsaking the privileged protection of lecture halls and immersing itself in the struggles of the oppressed.

Time has passed,...

It is a privilege to be asked to share in this memorial service at Pace University but also, and just as important, to be present at your time of renewal. These emotions - grief, approaching despair, and overwhelming, abiding hope are not contradictory or mutually exclusive. Particularly for the young, hope for a better future is a fundamental part of your being. It is why you study at a university. To learn, to expand your minds so that you can contribute to others, and maybe, just maybe, make a saner world for your children and their children.

Today, it is...

Throughout the centuries, those who survive disasters have offered memorials to the dead, and they have done so with different tools and different skills: Picasso did it for the victims of Guernica with oil paints. Verdi mourned the poet/patriot Manzoni with a musical masterpiece. Graveyards and public squares are full of sculpture and architecture dedicated to those we loved and those we honor as fallen heroes. Many of us, however, still record our losses and deepest sorrows with words.

I’ve always been fascinated by words, by the challenge of trying to capture an essence in a well formed phrase, an...

A number of years ago, after I had accepted the invitation to give my first commencement address, I thought back to my own graduation, and, for the life of me, could not remember who the speaker was or what he had said. At first blush, I thought that this sort of academic amnesia might be peculiar to myself. But an informal poll that I conducted among friends assuaged my guilt. Very few of them - less than one percent, I would say - could recall a single phrase or thought from their baccalaureate addresses. In the face of such statistics,...

When a middle aged Jewish farmer in rural Wales experienced spiritual visions - the Paraclete twice appearing with instructions to “Become A Doctor” - it was fortunate that Harry O’Flanagan was Dean and Registrar of The Royal College of Surgeons in Ireland. It is difficult to imagine a more bizarre basis for applying to medical school, and the admissions interview must have been memorable. Flexibility, instinctive insights, and a bit of intellectual daring were characteristics of the O’Flanagan era at the College, and Asia, as well as Ireland, were the beneficiaries of this decision. Jack Preger, the farmer with the...

In 1729, the Dean of St. Patrick’s Cathedral in Dublin, Jonathan Swift, in “A Modest Proposal for Preventing the Children of Poor People from Being a Burthen to Their Parents,” suggested that the poverty stricken, famine threatened, and economically exploited Irish peasantry, who nonetheless produced such beautiful infants, could resolve the troubling specter of recurrent starvation by eating their own babies. In doing so, he argued, they might simultaneously address the complex, but related, social issues of overpopulation and undernutrition.

Maybe Swift’s technique of proposing outlandish and obscene solutions in order to accentuate reality and subtly emphasize the need for...

I was one of eight children raised in a loving but slightly dysfunctional home dominated by my Jesuit trained father, a physician who recited Latin and Greek poetry as bedtime lullabies. He insisted, if we wanted his attention on any serious matter, that we “put it on paper” declaring that “if it’s important enough to you then write it down.” I never forgot that lesson.

I have written or edited thirty three books and well over two hundred medical and other articles on a wide range of topics, all important to me. My first book on clinical tropical medicine was...

The eastern Horn of Africa is the land of the Somalis. It is a harsh, arid land whose culture reflects an existence geared to an eternal struggle for survival. All aspects of life revolve today, as they have for centuries, around the semiannual monsoon seasons and the success or failure of the rains.

Water is the crux of the economy, the synonym for beauty, the common thread of all cultural expression, and the greatest single factor influencing health on the Horn. In the dry savannah and semidesert plains that cover almost 80 percent of Somalia, men and their herds migrate...

Medicine is one of the last, and certainly the most promising, untapped resources in contemporary international diplomacy. That is the unqualified contention of this book, published at a critical time. The future of foreign assistance programs is being debated. Alternatives to unsuccessful approaches in international relations are being sought. Funds for international medical research are diminishing. A “new” diplomacy is emerging in an era of instant communications. It is to be hoped that we in the developed countries have the maturity, the wisdom, and, if necessary, the courage to jettison the standard, rigidly pursued, and often unsuccessful practices of past...

My father was a physician who, not incidentally, knew more poetry - and could recite it with more intense passion and feeling - than anyone I have ever met. Undoubtedly, I absorbed his view of the world, if not by osmosis then surely by forced participation, while traveling on medical house calls in the Irish immigrant neighborhoods of the Bronx.

Family and clan were all important then, for one turned inward (in that pre-television era) for support, love, entertainment, and solace. When one finally emerged from that beautiful shelter, it was with a broad interest in almost every human activity...

This collection of speeches is culled from several hundred addresses I delivered during an intense six year period of public service when I directed New York State’s health and human services departments. Conceived, written, and delivered in the heat of battle, they reflected the crises of the moment and were often geared to defend a particular policy or deflect an opposing argument. To accomplish this with philosophy, perspective, and a bit of poetry is the unique challenge that public speeches pose to a writer.

These are not leisurely essays, polished for publication; neither are they technical talks, replete with charts...

Though blood may flow in both, there is a clear difference between a minor laceration and a hemorrhage. So, too, we must not confuse undernutrition or even hunger with famine. Famine is of a different scale, reflecting a prolonged total shortage of foods in a limited geographic area and leading to widespread disease and death from starvation.

Famines have occurred in all areas of the globe and in every period of recorded history. But the era in which we live has the odious distinction of being the period when more people will die of famine than in any previous century....

Several years ago, healthy young men began to die in large numbers from an unknown disease. As so often happens in the history of medicine, the early cases were considered isolated extremes in the normal spectrum of any illness, and there was, in retrospect, an inadequate appreciation by the health professions of a growing disaster. Slowly, but inexorably, the numbers afflicted grew until this insidious disease exploded into a frightening epidemic.

Persons who had been previously well developed rare tumors and unusual systemic infections. Studies indicated that these patients had suddenly and inexplicably lost their normal immunity to disease. They...

A bridge is a blend of poetry and practicality. By appreciating - and harnessing - tensions and forces man can span abysses, link separated lands, and create a thing of beauty. But soaring girders and graceful arches must be firmly anchored in a solid foundation, or even an expected load will cause collapse, destroying both bridge and travelers.

The imagery of a bridge seems appropriate for those who search for hope in a world where greed and arrogance abound. The prevalence of poverty and political oppression, hunger and disease, prejudice and ignorance can be denied only by the spiritually blind....

The metaphors of the human body come naturally to a physician as he views the ills that plague modern society. Just like patients, cities can rot from within until nothing remains but a hulk artificially maintained by emergency infusions. The signs and symptoms of serious disease are usually obvious, in medical as well as political life except to those who wish to deny the evidence of steady deterioration and the possibility of death. To those who indulge in such folly, the healing arts offer no immunity. While diagnosis is often quite easy, devising and administering an appropriate treatment plan can...

In a world where chaos and conflict are endemic, at a time when violence and votes are sweeping away the political contours we once thought permanent, in countries battered by economic collapse and internecine wars, when great nations are disintegrating into unworkable ethnic enclaves, and survival seems secure only in clan structures, when hatred and massacres, hunger, and epidemics run rampant, there is, nonetheless, a glimmer of hope in the growing recognition that, for better or worse, we are all neighbors on a finite globe, and that the oppression and starvation and illnesses of others are ultimately our own.

We...

In the fertile grazing grounds of Somaliland, mothers now tie toddlers to trees so that the young children cannot crawl, innocently but dangerously, out among the more than one million mines that have been haphazardly laid there over the last decade. Camels, and the youngsters and adolescents who tend them, are less fortunate, since, to survive in the Somali savannah, animals must endlessly search for water and nourishment. The fields are littered with animal carcasses, and stone mounds mark the graves of herders. The towns are crowded with amputees. Mine injuries have become one of the major health hazards in...

One of the supreme creations of the human spirit is the idea of prevention. Like liberty and equality, it is a seminal concept drawn from a reservoir of optimism that centuries of epidemics, famines, and wars have failed to deplete. It is an amalgam of hope and possibility which assumes that misery is not an undefiable mandate of fate, a punishment only redeemable in a later life, but a condition that can be treated like a disease and sometimes cured or even prevented.

During a lifetime in the practice of medicine - in Africa, Latin America, and Asia, as well...

Our most profound thoughts evolve, often very slowly, and coalesce, sometimes, into workable concepts only after prolonged gestation. Someone asked me at the conference that led to this book, “How long did it take you to plan and organize this?” I thought for a moment and answered, “About forty years.”

In the early 1960s, I worked for many months as a physician in the southern Sudan. It was a time of great social unrest and revolution in an area long isolated from the impact of modernity. The missionaries, who provided the only health and educational services available, were ejected shortly...

Hospitals, once charnel houses where the incurable and the contagious were isolated from contact with healthy society, and which then became holding pens to await the inevitability of death, are now centers of research and hope as well as service.

Physicians spend their day - every day - surrounded by the suffering of patients. To a degree, depending on the qualities of the varying doctors, the physician actually attempts to experience and share in that suffering so that comprehension of pain becomes an integral part of the healing process. Good physicians realize the privilege of their position - to be...

What they undertook to do

They brought to pass;

All things hang like a drop of dew

Upon a blade of grass.

W. B. Yeats,

As we gather to celebrate the bicentennial of this great university, its present leaders asked that I reflect on liberal education, human excellence, and classic texts, on our own evolution as the products of an academic tradition trained to draw from, and maybe even add to, that special body of literature that shapes our youthful dreams, encourages mature aspirations, and replenishes, over and over again, the spirit that struggles for integrity, purpose, and sometimes survival...

As an obviously compassionate fourteenth birthday gift, my parents gave me a book entitledShort Sports Heroes. Although I had participated fully in boyhood athletics, it was becoming physiologically clear that I would never bring a tall, well-formed body to the field. The book was clearly intended to encourage me to find role models in high diving, horse racing, and other competitive sports where the emphasis was on quick reflexes and agility. I should, it was subtly suggested, emulate the feats of the diver Sammy Lee or the great jockey Eddie Arcaro.

The book probably did help redirect my energies...

A physician’s view of suffering is tempered by constant exposure to pain. While philosophers and theologians may ponder the societal value of suffering, the medical doctor must deal daily with the evils of uncontrolled pain and help resolve in the individual patient the apparent tension between theological theory and clinical reality.

The control of pain is the fundamental mandate of medicine. The incredibly rich history of medicine - possibly the noblest record of human activity - is the tale of an endless search for the means to free the patient from the destructive impact of pain. One of the foundations...

These are introductory paragraphs from my first article in a medical journal which held, in retrospect, seeds for a future career in tropical medicine and international health.

The crowd had gathered slowly, and sheltering themselves from the 105 degree heat, the natives waited under mango tree. By noon, there were a few hundred people dressed in saris, dhotis, or nothing at all. From habit they grouped themselves so that all the lepers were under one tree, those with scabies were under another, and those with malnutrition and new complaints were under a third. They came, as they come each week,...

I have been the President-General of the American Irish Historical Society since 1974. Each year, according to the bylaws of the society, I must deliver an annual address. I include two examples since the society and my ethnicity have been important factors in the life of my family.

In Sliabh Luachra, in the shadow of the Paps of Dana, along the Kerry/Cork border, there are hills and vales of great beauty and many small, poor farms. From these remote hills came the great Gaelic poets Egan O’Rahilly and Owen Roe O’Sullivan. A harsher reality can be found in local statistics...

I begin this Presidential report on a personal note. Many of you - our members and regular guests - will note the absence of an elegant element at this banquet. My wife has set the tone of this dais for the past quarter century. Tonight, the Society misses the subtle direction she gave to our celebrations, one that seemed to elevate confusion and chaos into something magical.

A long, long time ago - and a very good time it was - when the world was much younger and more innocent, the land of our forebears was the playground of the...

I am grateful for the opportunity to honor the memory of a great surgeon and admired colleague who made a major contribution to Lenox Hill Hospital. Since I can contribute nothing to surgical knowledge, I was initially puzzled as to what should be the topic of this talk. As happens so often in life - or at least it has been true in my life - the solution came from a most unexpected source. I was listening to the George Gershwin opera,Porgy and Bess, and the classic song,It Ain’t Necessarily So,got me thinking.

I hope to develop...

Threads loosen and the patterns of the past unravel. Violence and neglect tear at the fabric of society, damaging the designs created by centuries of custom, shattering the dreams of those who find beauty and strength in the complex tapestry of life.

But the weaver cannot be discouraged merely because fools fail to appreciate tradition or deceive themselves by substituting colorful but weak fibers for the strong warp and weft of the craftsman’s loom. The weaver’s hands will not be stilled. With confidence he must continue interlacing yarns of different textures and hues. Experience teaches him to finish frazzled ends...

Shortly after completing emergency abdominal surgery on Pope John Paul II, following an assassination attempt in May 1981, his Vatican and hospital medical team asked six international specialists to come to Rome and serve as consultants. Two of those invited were from the United States, the senior Professor of Surgery at Harvard, and myself. The consultants met with the Italian doctors, examined the patient, reviewed the hospital records, and issued appropriate bulletins. Newspaper and television coverage made our participation part of the public record.

While most of the other consultants believed it appropriate to provide follow up interviews, I have...