And that's everybody's loss.

Yes. The doctor's as much as the patient's. What I would encourage the young person interested in being a health worker to do is not to start medical school until he or she has lived in community with people, and established some sense of his or her ability to relate in human terms. It would be very good to have already developed a warmth and affection for a particular community before going to medical school, to have had a chance to engage in a wide range of community activities and involvements. Then if he or she does go on to medical school, to go through it with eyes open, critically, and with the plan of taking back to the community what will be of use to it.

You were saying that you thought a turn toward self-care in this country would have a beneficial effect on other countries, too.

Yes. As it is now, when students from undeveloped countries come here for medical training, we train them to depend on our highly technological way of medicine, and we socialize them to want to make a lot of money. As a result, they're not trained to practice the kind of medicine their countries need, and they end up staying here or going to some other rich country.

When we support medical programs in these countries, we tend to build costly, elaborate hospitals in big cities, serving the elite, ignoring the majority of the people. We support programs to force birth control on the poor when they are so poor that they desperately need a big family to survive. What we should do is help them get a better standard of living, and they'll regulate the size of their own families.

The health decisions we make in America will have a terrific impact on the health of people in the poorer countries. I don't think we can afford to think of our health as something separate from the health of the rest.