What Richard Selzer, M.D. once wrote of surgery is true of therapy: only human love keeps this from being the act of two madmen.

Survival, in the cool economics of biology, means simply the persistence of one's own genes in the generations to follow.

We live in a dancing matrix of viruses; they dart, rather like bees, from organism to organism, from plant to insect to mammal to me and back again, and into the sea, tugging along pieces of this genome, strings of genes from that, transplanting grafts of DNA, passing around heredity as though at a great party.

Given the opportunity, under the right conditions, two cells from wildly different sources, a yeast cell, say, and a chicken erythrocyte, will touch, fuse, and the two nuclei will then fuse as well, and the new hybrid cell will now divide into monstrous progeny. Naked cells, lacking self-respect, do not seem to have any sense of self.

We are not made up, as we had always supposed, of successively enriched packets of our own parts. We are shared, rented, occupied. At the interior of our cells, driving them, providing the oxidative energy that sends us out for the improvement of each shining day, are the mitochondria, and in a strict sense they are not ours.

Doctors, dressed up in one professional costume or another, have been in busy practice since the earliest records of every culture on earth. It is hard to think of a more dependable or enduring occupation, harder still to imagine any future events leading to its extinction.