The Touch of Life
The daughter of American missionaries, who teas taken to China at an early age. PEARL S. BUCK made her first appearance in print in the Atlantic for January, 1923. Since then she has contributed to us as the spirit prompted and we were particularly proud of her a when in 1938 she received the Nobel Prize for Literature. The paper which follows is drawn from her new book, My Several Worlds, autobiographical in nature, touching on her life in China, Japan, and in this country. It will be published in early November by John Day.
by PEARL S. BUCK
1
THE modern lay mind is secretly troubled by the rise of power of the professional over our lives. The lay person today does not go as readily even to the doctor as he used to, though he knows that go he must or he may die. Why is this? I can remember twenty years ago, when I first came to live in my own rural region, our country doctor was trusted far more than any doctor is today. Our people sent for him as they sent for no one else. He was at their beck and call at all hours and he enjoyed a confidence that was astounding and touching.
People trusted not only his skills: they trusted him. He could talk to them about their minds affecting their bodies and making them ill and they believed him as they do not today believe the doctor or the psychiatrist, separately or in combination, although the skills in both these professions have developed enormously. The lay person, while he realizes the development, is nevertheless more troubled than ever. Because he does not trust either professional as much as he did that old country doctor, his general confidence in human beings is shaken, and because his confidence is shaken he does not get well as fast as he ought to.
What has caused the change from confidence to doubt? The development of the specialist — and the specialist is the professional in essence — has something to do with it. The division of the profession into specialties has greatly increased costs, for one t hing. A call from the doctor in our country region used to cost two dollars. Now it is three or four times that amount and so high that a poor farmer or factory worker will often let illness develop too long before he undertakes the expense of being treated. Health insurance societies as yet are too full of jokers to provide the help they should. For example, some of the best known will give no further help when a disease is pronounced chronic. Yet the person with a chronic illness is the very one who must have continuing help. So far, health insurance has not built up much confidence in the medical profession among laymen.
Another development in professionalism is that the doctor, even in the country, usually demands nowadays that a sick person come to him at his office, even though this may mean a journey of many miles. I myself have had to say firmly that I will not take a sick child with a temperature out of the house, and I will change my doctor before I do so. The decision costs me money, of course, and I am tolerated to an extent that is perhaps unfair. I do sec the doctor’s point of view. He is a human being, too. Yet somehow our old country doctor did get, around; he did comfort people as well as heal them; and his fees were small in relation to fees today.
Modern doctors live at a far higher standard than our old country doctor did. I have no objection to anyone living as well as he can, but it must be recognized that when the lay mind sees the high average income and living standards of today’s doctors, compared with the simplicity and devotion of the old country doctor, it is inevitable that people do not trust this new doctor as they did ihe old. I am against socialized medicine, 1 shall always prefer our system of personal and private doctors, and yet I feel concern because though I can pay ray doctors’ bills, thanks to chance, I know that. some of my neighbors often put off getting medical attention because they are too poor to pay and too proud to take charity,and medical charity is no sweeter than any other. Few doctors can or do treat a charity patient as they treat one who pays well.
I deplore the increasing loss of trust in the idealism of the professional, especially in the medical field. The lay person is so helpless when lie falls ill, so pathetic in his need of confidence. His wretched body is all that he possesses, and he clings to it in the face of death and extinction. I understand, of course, that the physician cannot allow himself to be torn daily by emotions or he could not do his work.
Yet I believe the professional is mistaken when he declares that he must be detached, must be removed from personal interest, must be unsharing and remote, in order that he not be destroyed. I think he destroys himself by his very emotional detachment. If I am to commil my body to a man or woman to cut up while I am unconscious, be sure that I shall search not only for the skillful surgeon, but for the surgeon who is first a feeling human being. As a lay person, I do not want a surgeon, however expert, who never comes back to see how I am, who turns me over to another automaton house doctor, who in turn leaves me with an automaton nurse.
I once had my life saved, many years ago, by a surgeon who not only performed a skillful operation, but who, coming back often to see for himself how I was, delivered me out of the hands of a nurse under whose oppression I would surely have died, so cruel was she when left alone with me. I was at that, desperate point between life and death when the slightest discouragement could and very nearly did push me over the brink. The surgeon understood instantly that this nurse had the touch of deal h and not of life.
The touch of life! That is what I mean. Some professionals have it and some do nol have it; but when the lay person feels the touch of life in a professional, he willingly entrusts himself to the superior knowledge, the perfected skill. And what is this touch of life, this life-giving force, except the fruit, of rich emotional understanding, the fruit of experience richly shared? Those professionals who do not have t lie emotional understanding of those whom they are supposed to serve do hasten the death of many.
2
BUT it is not only the medical profession that the lay mind may distrust. For it is the peculiar power of the professional that he is needed at the crises of human life, and there are other crises than that of illness and threatening death. Lei me lake an (example from another profession* that of the social worker, especially in the field of child adoption.
I first came to know professional social workers through the adopt ion of four children nearly twenty vears ago. My husband and I, loving children, decided to adopt a family, since nature had denied us the joy of children by birth. We went to a reputable agency, made ourselves known, and began the process necessary to prove ourselves good parents. It did not take too long in those days; the process was courteous and civilized. In due course our big third-floor bedroom became a nursery, but without a nurse, for we wanted to take care of the two lively babies ourselves. A year and a half later they were joined by an equally lively boy and a girl, each a few weeks old.
In the rich years bet ween the day they came home and today, I have kept myself abreast of developing adoptive practices as well as a layman can, and have taken an active part as a member on the boards of three adoptive agencies. My interest in this subject is far more than personal. I doubt that I am a good mother in the old-fashioned “mom" sense. I love people from the moment they are born until they die of old age on their way to a hundred. The newborn child is to me first a human being and only second a baby. 1 am not a peasant mother — that is, not an instinctive one. I do not wish to mother the world. I am not infinitely maternal. Hut I have deeply enjoyed being a mother to my children.
Aside from this, my firm belief is that all human creatures deserve a happy childhood as a right and as a prerequisite to normal adulthood, and that the first essential to happiness is love. I have observed that if a child does not have a wholehearted love from and for someone before he is five years old, he is emotionally stunted perhaps for the rest of his life. That is, he is unable to love anyone wholeheartedly and is to that extent deprived of a full life. This loving and beloved person is ideally father or mother or both, but lacking these, a kindhearted maid or nurse or grandmother will do. It should be someone who has the permanent physical care of him, so that through the daily washing and dressing and feeding and play he feels the pervading and continuing presence of love. It has to he real love. The professional coddling that a trained nurse or attendant gives a baby in a foundling home or hospital does not fool even the baby. It takes more than a clock-watching employee to make a child feel secure.
It is amazing how discerning a baby can be. A child in the care of a good but unloving foster mother soon sinks into impassivity and begins to fade. Love is the sunshine of his growing soul, and when there is no sun, the soul stops and body and mind begin to lag. That is why children in orphanage’s and boarding homes look dull and are either too silent or too noisy. Babies used to be kept in hordes in orphanages until it was discovered how quickly they died of nothing at all, apparently. Of course they died for lack of true love.
What about the professional adoption agencies? Their function is to get children adopted. Alas, they are too often so involved in their professional standards, their lists of questions, their vested interest in the job of homeless child and impatient adoptive parents, that sometimes I fear more children are prevented from finding homes than are ever placed by them.
Children ought to go as quickly as possible from natural mother to adoptive parents. Let us admit that sometimes this speed would mean a mistake. Even so, I believe, the total damage would not amount to that which the long delay now causes. There is a fearful lag in the average adoptive agency. Workers put in their eight hours a day faithfully enough, I daresay, but far too much of their time is spent at paper work, filing, and red tape. This is made necessary to some extent, I know, by the differing laws of the individual states. A child is often limited to one state or one area in his chances for adoption, each agency serving only one area, without possibility of interchange between areas. Again the child bears the brunt of his sad exclusion. He continues to wait upon laws and professionalism and bureaucracy.
And the prospective adoptive parents wait, eating their hearts out, anxious lest the delay mean that they do not measure up to some perfectionist demand of the professional, that the “matching" in religion or race is not perfect, that the house is not quite big enough, that one bathroom is insufficient, that the father is not a college graduate or that he is a college graduate, that their marriage is not perfect in its adjustment and security, that they themselves are not perfect but only ordinary human beings.
And the boarding home where the baby waits? There he is probably one of several children, all waiting for adoption or else a mixture of the family’s own children and the boarding children. Let us bear in mind the significant fact that boarding mothers are paid for caring for homeless children. It is true that usually they are kind, good women, but many times they are ignorant women, not at all suitable for adoptive mothers, and the professional would not consider them so. Yet the social worker leaves the child there for an indefinite period, seeming to think that because the boarding home is an approved and licensed one, the child is doing well. Meanwhile, during the first months of a child’s life, the allimportant months, he is without real parents. For no boarding mother can take the place of the true mother.
Moreover, I have often found that while an agency may be an excellent one, its supervisor enlightened and well-meaning, the social workers all graduates of the best, schools, and the psychologist and pediatrician skilled, none of this guarantees the child anything. The child has to live in the boarding home alone without any of these professionals present. The boarding mother receives from the doctor, for example, a diet list and instructions. More likely than not, she puts the list in a drawer, saying that she reckons she knows how to take care of a kid. And the child is fed noodles and macaroni instead of meat and vegetables and fresh fruits. It is only human nature to save money if possible. And starch fattens a baby and makes a nice show, does it not?
Many professional social workers know little about children. They do not seem able to see the difference between firm, healthy, muscular flesh and flabby fat. Too many social workers have never married and have no children of their own to teach them. To my thinking, one who works with babies or little children should not be without experience in the daily care of a baby. Even being married is not always enough. There has to be the loving heart.
Yet it seems that the loving heart is the one possession which the professional is taught to avoid as the disqualifying possession, for a professional social worker must be “detached.” And this is the basic stupidity, for how can one have the right to care for children and place their destinies if one is “detached"? I understand very well what is meant by the term. Emotional clinging to a child is, we are told, the great sin. The professional must act like God, who pours down rain upon the just and the unjust with equal indifference. A child must therefore simply be a case, “a referral,” if you please, and it is very important to have just the right terminology, if you area professional, so that other professionals will know that you belong to the gang.
The profession is becoming a hiding place for small people, too timid to break petty rules and come out for the great principles of child life. And the greatest of these and the first commandment is love. Everybody who comes near a child, or who influences the life of a child in any way, must be capable of love — a love so generous that every child is dear and every child a valuable treasure.
This is not to say that social workers as a profession are insincere or wilfully cruel or even selfish. Not that at all! On the contrary, they are for the most part too conscientious, too careful, too critical — and too self-conscious. They are professional perfectionists in a far from perfect situation. They complain because doctors and friends and relatives place children for adoption; they give instances — true, I am sure — of misplacements, but they ignore the damage their own failure to solve the problem does to the waiting child or the “unadoptable” child. I believe there is no unadoptable child. There are parents to be found for every child.
The professional in the adoption field has, indeed, a power over human lives which demands a largeness seldom found. She — or he — sits in judgment. upon two people, weighing them, examining them, prying into their private fixes, and it is this professional who decides whether or not they shall have a baby.
3
IT IS an old war of mine, this war against professional perfectionism in an imperfect world. I used to wage it in China against the American doctors and the western-trained Chinese doctors. While millions of people died of preventable diseases and millions more went blind from trachoma, the doctors insisted that anyone who practiced medicine must be a graduate physician. But few could be graduates; it was too expensive and there were too few medical schools. To go abroad was prohibitive. 1 used to argue: Why do we need such high professional training for everybody? Why not train field workers who could give quinine for malaria, treat ulcers and wounds, swab eyelids for trachoma, yet who could be taught to realize when a malady was beyond their knowledge? The serious cases could be sent to a medical center, and if the illness was too grave for that they could be sent still further to a central hospital. It would mean that the time of highly paid professionals would not be spent upon familiar diseases, easily recognizable; and best of all, it would mean people were being helped.
But no, I was told, this was the absurd idea of a layman. I am now enduring considerable secret agony when I hear that the Communists in China are doing exactly what I had hoped could be done by our earlier professionals and are getting full credit for it. The manner in which a job is done is certainly very important, and the methods should be the best possible. I put only one aim above all this: to get the job done, for if one group fails to accomplish it in this needy world, another group will take over. Thus in the United States the black market in babies flourishes and will flourish, in spite of efforts to forbid it, until the supply meets the demand.
In our industrialized culture the professional mind is a necessity. The lay mind cannot function alone. In so complex a society as ours, which is in itself the product of professional science, the lay person is at the mercy of the professional, from the plumber who comes to fix the kitchen sink to the psychiatrist who tries to cure the schizophrenic adolescent. The lay person today feels he is only part of the great machine and that nothing can stop the machine. As he realizes his helplessness in this predicament, he will rebel blindly and desperately because he knows he must not yield his individuality.
There is the possibility of return to a healthier situation, and it lies within the power of the professional to bring about the change. How shall I express a truth at once simple and profound? It is only that the professional must be first of all a human being — not a scientist, not a physician, not a social worker, not a soldier, not a politician, but primarily a human being! For if he is first of all a human being, he will feel for other human beings; and feeling, he will know a cosmic love. Then all his work, his research, his teaching, his training, his skills, will serve the human individual as the supreme creation, before whom he must remain entirely humble. To save life and never to destroy it must be his single goal — not just to sav e life when it is already spoiled but when it is new and fresh and strong.
Such a professional mind will not accept the death of many human beings as relief to overpopulation, but will devise new sources of food and energy. Such a professional will think of the entire human race, for truly we are dependent upon one another, and if what is happening today in Asia has not taught us that, then we are backward indeed and unable to read history past and present. Such a professional, with such a spirit, will restore hope to the now despairing layman. For what the lay mind needs today is the professional mind that he can trust. He wants to believe in his specialists. He wants to have the inspiring faith that they are devoted to mankind through him, that they are honest and just plain good, in the ways in which he understands goodness. If his faith can be revived, his bitterness will fade away. What the human race needs today is not faith in some far-off future or even in some unknown god. What we all need above everything is faith in each other as human beings. We need to be able to trust one another, all countries, all races, all creeds, and this is the primary necessity not only for peace but for very existence upon this globe.
Upon the professional the burden lies for creating this trust, for he is the one who knows. The professional is continually telling the layman that only he, the professional, knows, and because it is his business to know. The burden is on the professional to prove that he can be trusted not only to wield his scalpel, but also to be true to the human being. He must not only treat with professional skills, he must serve. Create this faith honestly, and with continuing and relentless honesty, and you will see relief and comfort coming back to the human race.