Dear Marion,

Thank you for your two letters,
yesterday's telling me that you were off to the farm
for the weekend, and then the letter that came just now,
inviting me to expand my comments about animals.

I felt unusually tired today, perhaps even a bit depressed,
embarrassed by my loquaciousness, by the poor quality of
my prose, and despairing, at least somewhat, of my ability
to explain what I have on my mind.

If I understand your letters correctly, and if my
understanding of myself is correct, our experiences
with governmental action and our interpretations are quite
similar. The differences between us: that you are more
prepared than am I, to be uncritical of the status quo,
and that you have a somewhat more conventional view of
your civic obligations. I am more sceptical, and harbor
less sympathy, not to mention enthusiasm, for political
causes.  I would like to think that I have been making
my contributions to the common good by the work that I
do as a physician, and by the legal positions that I stake
out in the litigation in which I am from time to time
involved.  It's probably vanity when I point out that
the practice of medicine would be much altered if ten
thousand physicians practiced medicine in the manner
in which I have practiced for the past fifty years;
and certainly the ambience of the courtrooms would be
very different, if ten thousand lawyers had presented
cases and arguments such as mine, whereas even if bumper
stickers on my automobiles swayed ten thousand voters
one way or the other, given the size of the electorate,
it's likely that the ten thousand votes changed by my
bumper stickers would make no practical difference at all.

My belief that regulations or practice guidelines or
the kind of thought control envisioned by the promoters
of computerized medical records are incompatible with
the way I have practiced and would like to practice
medicine, is grounded (sic) in my understanding of
what my knowldge consists of and what I know, i.e.
in my "epistemology." That's not a simple matter which
I can readily explain, but I'll try: can you imagine
learning a language by memorizing grammatical rules
and stylistic regulations, instead of listening and
trying to speak and responding to the melodies
perceived by your inward ear? Can you imagine taking
a hike through a wilderness, where in addition to a map,
you have specific regulations and guidelines directing
you how long each step should be, how many steps to
take per minute and exactly where to place each foot?
Can you imagine painting a landscape, where not only
all configurations and colors have been prescribed,
but also the size of the brushes, the number and
length of the strokes? My point is that men and women
are not machines and must not be regimented to 
become robots, and the opportunity to march to the
beat of a different drummer ought not to be
universally denied.

"If a man loses pace with his companions,
perhaps it is because he hears a different drummer.
Let him step to the music which he hears,
however measured, or far away." Thoreau, Walden

The consequence of the attempt to control the practice
of medicine with regulations and guidelines, will have
the consequence of creating a vapid scientific
scholasticism, both sterile and destructive.

Jochen