THE PHYSICIAN, THE PENDULUM, AND THE WAR CHANDLER SMITH, M.D.* A responsibility ofgrowing urgency looms on the medical horizon. It is due to the conjunction of two facts. The first is that America is now engaged in war, and the violence is escalating. The possibility of nuclear exchange cannot be foreclosed. The second is that the physician is a keeper ofthehumane traditionin society. Itishewho thwartstheepidemic and seeks the avoidance offamine. The scope ofhis responsibilities reaches out to all mankind. As expressed in the Hippocratic oath, his life is pledged to the service ofhumanity. The conjunction oftraditionalhumanism with incalculable danger places on him especially the responsibility for seeking ways in which war may be avoided. Furthermore, he is aware that unless the advancing trend ofviolence is stopped, all the accomplishments of the past, grand as they have been, and all the hopes for the future, sanguine as they may be, not only for the present generation but for all who follow as well, face the growing prospect ofcoming to naught. The avoidance ofwar is essentially a political question, and it may be contended that the physician is not prepared to cope with it. His abilities may be underestimated. At issue is the balance between conscience and practicaljudgment. In matters ofconscience no group is especially skilled, and in questions ofjudgment the physician is more capable than most. He is accustomed to the rigors ofclose reasoning and is dedicated to the welfare ofsociety. Thus intellectual discipline and professional responsibility prepare him to meet the problems of society as well as the problems of individuals. From the physician especially, wisdom and good judgment may be expected. There is no magic recipe for peace. But violence has certain features, the * Professor ofpathology, George Washington University School ofMedicine, 1335 H St., NW Washington, D.C. 20005. ??? responses to violence have certain consequences, and the physician is obliged to comprehend these so that the elements ofthe problem may be understood and the search for resolution may be taken up. It is not that his opinion ofa military tactic is needed; his province is rather the larger questions oftheplace ofviolence inhuman affairs, and theplace ofhumanism is the resolution ofcontentious issues. The problem is not the winning of a battle; it is not less than the survival of the human race. Medicine, having accomplished so much to improve the human condition, can scarcely overlook the gravest crisis that society has yet faced. Any nation is free to initiate violence. That is a sovereign option and cannot be precluded. The central question is how violence can be prevented , or, once begun, how it shall be met so that it will diminish rather than expand. That is thepressing immediate question. There is no escaping it; response must be made, and the incineration ofcities, perhaps the demise ofcivilization, is not an acceptable result ofpolicy. The problem is real and urgent. The reasons for responding to violence are twofold: first, to preserve principle, second, to restore goodwill. Principle is essential; its abandonment is the equivalent ofsurrender. Neither victory nor resolution can be expected without it. Goodwill is essential. If arms are used to preserve principle, goodwill is abandoned and might prevails. Might stimulates hate, anger, vengeance, and retaliation. These responses preclude peace; as soon as the vanquished regroup, the contest is reopened and war recurs. History givesevidence ofthis. Therefore, the maintenance ofprinciple and the restoration ofgoodwill are the objectives ofthe response to violence. Both must be achieved at once, for neither succeeds alone. Principle without goodwill leads to naked violence that cannot fail to recur, while goodwill without principle is vacuous submission devoid ofbenefit. Only the dual condition succeeds. Only three different responses to violence are possible: surrender, retaliation , and nonviolence. Ofcourse variations and combinations may be seen. Running away avoids the question, and appeasement is a form ofsurrender . Retaliation has several forms that range from sabotage to guerilla warfare to "flexible firepower" to massive retaliation. They are all variations of the use of force to counter force. Even stalemate is a form of counterviolence in which the action is held in abeyance. Regardless ofthe varieties, the central fact is that only three different responses are possible; 102 Chandler Smith · The Physician...
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Dec 31, 2023
C.A Faraone 
Open Access
