On Balance. (Address to the 1998 M.D. graduates, Faculty of Medicine, University of Toronto.) 1998.

This 'Pre-convocation Ceremony' is unique, I believe, to the Faculty of Medicine. By celebrating your graduation twice, they are able to acknowledge what we all know, which is that you are twice as good as anyone else.

Today's paper quotes Dr. John Bonn responding to accusations that your College of Physicians and Surgeons is secret and self-serving. This is a clear advance since the last century when an editorial in 'The Lancet' described the Royal College of Surgeons in the United Kingdom as

" This sink of infamy and corruption, this receptacle of all that is avaricious, base, worthless and detestable..."

My instructions today are that I should inspire you. This quotation should inspire you with the desire to write similarly clear English.

As a step toward greater inspiration, I offer you a more kindly quotation due to J. Paul Getty. Getty's formula for success was: "rise early, work hard, strike oil".

To appreciate the depth of that insight you need to look at Getty's ways more closely. He bought a large country house in England in which to entertain his friends, since the rich have a lot of friends. What was remarkable about Getty's country house was that it had, at intervals along its corridors, pay telephones. For Getty realized that in addition to striking oil, one must strike a balance. In his case it was a balance between generosity and extravagance. I want to talk about this question of balance, both as it affects our professional lives and our lives as citizens.

In science the crucial balance is between seeing things whole and seeing them in part. Nature deals in forests, scientists seldom even in trees. For we decompose what we see, to the level of atoms and molecules. By putting on blinkers and seeing only a part of a complex phenomenon we reveal connections previously hidden from view. Tree molecules, we find, turn up in a wide variety of organisms. These linkages are the stuff of science. But in the process of delving for hidden patterns the larger pattern called a forest can be lost to view. Then the strength of science, which lies in its sharp but narrow focus, becomes its weakness.

Since there is no right solution to this problem of balance between viewing the whole and the part-one finds different 'styles' in science, as one does in art. Some practitioners paint brilliantly with a fine brush, others with a broad one. Though there is no right style, there is a wrong one which is to abandon the problem of balance and neglect the whole in favour of its details. When we do that, we abandon art for illustration. If that distinction presents problems, let me characterise it as the difference between writing a novel, and making a shopping list. Only the first tells a story, and consequently only the first resembles science.

The question of balance between the picture and its details is as central to your profession as it is to mine. The medical arts in their eagerness to be accepted as science have striven for precision. You are awash at this moment in an ocean of measurables. If type 11 blood-hobgoblin exceeds 6.8, you are told, prescribe anti-phlogiston. This is valuable advice, so long as one is reminded, for example by looking in the mirror, that the patient is not an equation.

"But how could we forget it?", you may ask. I can only say that it happens. Tomorrow when you look in the mirror you may not see a person, but a physician. To understand the difference you might try listening from some hiding place in a hospital to the tones of your colleagues addressing one another, and then to them addressing a patient. There is nothing easier, in your field or mine, than to sink into narrow professionalism

"Ironically, the first price we pay is to function poorly as professionals. That wonderfully subtle term 'clinician' describes the ability of the great physician to pay attention to a conflicting body of detail, and then subordinate it to an assessment of the patient as a whole. In the physical sciences (as in the medical) what marks the outstanding practitioners is that they know which experiments (or symptoms) to ignore. They know this because they see the larger picture.

There is a second hazard from too narrow attention to detail - a second way in which we cut ourselves off from the wider picture. This is in the abrogation of our responsibility as citizens.

That we are tempted to cut ourselves off, is not surprising. Our professions make preposterous demands. They demand obsessive attention. When Isaac Newton was asked how he arrived at his theory of gravity, he replied: "by constantly thinking on it". To give a more recent example, in the 1930's, as the events that would lead to the death of 100 million people were taking shape in Europe, one of Americas leading nuclear physicists, Robert Oppenheimer, read no newspaper. How could world news concern him?

A few years later he was director of the Manhattan Project charged with constructing an atom bomb, and was a witness to the first nuclear explosion. He turned away from the awesome sight, saying "the scientists have known sin". He was not expressing regret at having engineered the bomb. What he was saying was that the physicists and chemists would now have to look beyond their science to the complex question of human survival. It would no longer be possible for a scientist or physicians to withdraw from the world. In today's world for an educated professional to plead ignorance and remain silent, is to be guilty of complicity in the worlds ills.

Far better, like Albert Einstein, to accept one's responsibility and participate as a citizen, even though that involves "knowing sin". Einstein was, as you will recall, a lifelong pacifist. Yet in 1939 he felt bound to write to President Roosevelt to recommend that the United States build the most terrible weapon in history, the atomic bomb. There are some who would conclude that he was a better scientist than statesman. They forget that science offer solutions, whereas politics demands that we chose the lesser evil.

No wonder then, that when I began work as a scientist, the various professional associations to which I belonged discouraged debate on political matters. Such debate, it was felt, would discredit science. Since then the world has changed, and we have come to understand that it is the failure to debate these questions that damages science. How can one care about truth in science, or healing, and yet not care about the fate of humankind? In fact we exist in a closed loop; through caring about the truth we discover it and by knowing the truth we are led to care.

Let me illustrate that statement by recalling an occasion two weeks ago, in this hall. I had been asked to welcome the heroic Chinese dissident Wang Dan. Wang was released not long ago from jail in China, where he had spent the better part of nine years for his role as the foremost organizer of the Tiananmen Square pro-democracy rally of 1989.

What is the link, you may ask, between a democracy rally and the worlds of science and medicine that you and I inhabit? The link is straight-forward enough, though we seldom think about it. You and I belong to an international community dedicated to open discussion and to the tolerance of dissent. We scientists do not grant a monopoly of the truth to any nationality, or religion, or ethnicity. We are in conscience bound, therefore to combat any regime that stifles free debate and victimises people for their beliefs. We are the natural allies of all who demand democracy and respect for human rights.

That, grandiloquently stated, is why any member of your profession or mine would be proud to be associated with a democracy movement, and why I was so pleased to be part of the Convocation Hall welcome for Wang Dan. The hall was packed. The majority of the audience had strong personal connections with China. All watched in grave silence as a film was shown of the young people, a million strong, milling around in Tiananmen Square. But the link between knowing and caring was made evident through the fact that only one member of the audience - and not I assure you the least stalwart - had tears streaming down his face; that was Wang Dan.

It is because of this link between knowledge and compassion that we prize your education so highly. And it is because of this link that we can realistically hope that this age, which is an age of education, will lead to a more humane world.

A final word to our graduands. Recently, I visited the office of a physician who is at the pinnacle of his profession. We met in the middle of his working day. His face showed the signs of strain, as well it might. Knowing that I was detaining him, and conscious of his secretary's eyes burning into my back, I nonetheless asked him what I should say today to a distinguished bevy of near - M.D.s. At this he leaned back in his -chair with a smile, the mask of fatigue falling away, and said; ""Tell them that, despite everything, I simply cannot think of a more rewarding existence". And so I tell you, and wish you well.

Dr. John Polanyi, Nobel Lareate, Professor of Chemistry, Faculty of Arts & Science, University of Toronto

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