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" I was, in the 1960s, in a marriage. To use the word 'bad' would be perhaps the understatement of the year. It was dreadful. "

Sherwin B. Nuland

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" At times, morality can be dismissed as a matter of personal conscience, no matter how widespread its acceptance. Ethics, on the other hand, arises from societal or group commitments to principia of behavior. "

Sherwin B. Nuland

" Being someone who had had a very difficult childhood, a very difficult adolescence - it had to do with not quite poverty, but close. It had to do with being brought up in a family where no one spoke English, no one could read or write English. It had to do with death and disease and lots of other things. I was a little prone to depression. "

Sherwin B. Nuland

" Where nothing in a person's earlier years lends itself to an old age devoted to continuing intellectual and physical pursuits, a late-life interest in Tolstoy or even crossword puzzles is unlikely to appear, no matter the urging by well-intentioned social workers or people like me who write books about it. "

Sherwin B. Nuland

" Nosology (from the Greek 'nosos,' meaning 'disease,' and 'logos,' referring to 'study') is not a sport for the timid, and certainly not for those so scrupulous about rules and order that they demand consistency in all things. "

Sherwin B. Nuland

" I've seen so many patients, particularly elderly patients, over the years who become debilitated and changed by the process by which I cure them or another doctor cures them. And has it really been worth it? "

Sherwin B. Nuland

" Cancer cells are fixed at an age where they are still too young to have learned the rules of the society in which they live. As with so many immature individuals of all living kinds, everything they do is excessive and uncoordinated with the needs or constraints of their neighbors... they are reproductive but not productive. "

Sherwin B. Nuland

" If there's one operation for a disease, you know it works. If there are 15 operations, you know that none of them work. "

Sherwin B. Nuland

" To become comfortable with uncertainty is one of the primary goals in the training of a physician. "

Sherwin B. Nuland

" Both individual fulfillment and the ecological balance of life on this planet are best served by dying when our inherent biology decrees that we do. "

Sherwin B. Nuland

" Though President George W. Bush made some small noises about his intention to present some form of improved health coverage, nothing grew out of them. "

Sherwin B. Nuland

" Even putting aside the Judeo-Christian morality upon which the Constitution and our nation's culture are based, the notion of forced euthanasia would contradict the long-held body of medical ethics to which all American doctors must adhere. "

Sherwin B. Nuland

" The dignity we seek in dying must be found in the dignity with which we have lived our lives. "

Sherwin B. Nuland

" It's unnatural to believe death usually has a beauty and a concordance and is usually a coming together of your life's work. It leads to frustration for the patient. And it leaves grieving families convinced they did something wrong. "

Sherwin B. Nuland

" I think when you think of death as being part of the life cycle and recognize that death is an inevitability for our species because the world has to be renewed with each death, then the hope becomes when it is renewed it will be renewed by people on whom I have had some influence for good. "

Sherwin B. Nuland

" The writings and the recommendations of the earliest medical scientists and the new breed of clinicians between the mid-fifteenth and early seventeenth centuries were based on the supposition that sufficient study and experimentation would elucidate not only the origins of disease, but its treatment as well. "

Sherwin B. Nuland

" I have been following the attempt to initiate or revamp federal involvement in the health of Americans since it was a major topic for my high school debating team in 1947. "

Sherwin B. Nuland

" You know, ever since man had any notion that some of his other people, his colleagues, could be different, could be strange, could be severely depressed or what we now recognize as schizophrenia, he was certain that this kind of illness had to come from evil spirits getting into the body. "

Sherwin B. Nuland

" Every hope of successive generations of scholars that order might be constructed from the chaotic mess of medical nomenclature has been frustrated. Even diseases recognized in the same historical period have been given names based on characteristics that have no relation to one another, and thus no common criteria. "

Sherwin B. Nuland

" Do you know what the world will be saved by? I'll tell you. It'll be saved by the human spirit. And by the human spirit, I don't mean anything divine, I don't mean anything supernatural - certainly not coming from this skeptic. "

Sherwin B. Nuland

" Not death but disease is the real enemy; disease, the malign force that requires confrontation. Death is the surcease that comes when the exhausting battle has been lost. "

Sherwin B. Nuland

" Long regarded as central to the contemporary understanding of medical ethics are four principles that must be satisfied in order to fulfill the requirements of moral decision-making. These principles are autonomy, justice, beneficence, and non-maleficence. "

Sherwin B. Nuland

" The growing professional disciplines of medical ethics and bioethics have had a profound impact on researchers, bedside doctors, associations of physicians, and government. "

Sherwin B. Nuland

" There are resurrection themes in every society that has ever been studied, and it is because not just only do we fantasize about the possibility of resurrection and recovery, but it actually happens. And it happens a lot. "

Sherwin B. Nuland

" I never had a conscious fear of death, but I did have a conscious fear of sickness. By the time I completed medical school, that fear was gone. "

Sherwin B. Nuland

" Only the emerging specialty of psychoanalysis seemed to understand that mental maladies are not fully analogous to physical disease. They resist classification, and might better be known by their symptoms and the individualized sufferings of patients than by assigned names. "

Sherwin B. Nuland

" There is, to be sure, sometimes only a small difference between being alert to possible danger and allowing oneself to become terrified to the point of paralysis by seeming or imagined portents. "

Sherwin B. Nuland

" The final disease that nature inflicts on us will determine the atmosphere in which we take our leave of life, but our own choices should be allowed, insofar as possible, to be the decisive factor in the manner of our going. "

Sherwin B. Nuland

" Death belongs to the dying and those who love them. "

Sherwin B. Nuland

" 'Death with dignity' is our society's expression of the universal yearning to achieve a graceful triumph over the stark and often repugnant finality of life's last sputterings. But the fact is, death is not a confrontation. It is simply an event in the sequence of nature's ongoing rhythms. "

Sherwin B. Nuland

" Where the despair of loneliness and poverty haunts every hour, the optimism to embark on new projects cannot find a place to alight on the brain's cortex. Poverty itself is an enormous obstacle to an enlightened and enlightening - not to say healthy - old age. "

Sherwin B. Nuland