I cannot pretend I am without fear. But my predominant feeling is one of gratitude. I have loved and been loved; I have been given much and I have given something in return; I have read and traveled and thought and written. I have had an intercourse with the world, the special intercourse of writers and readers.Above all, I have been a sentient being, a thinking animal, on this beautiful planet, and that in itself has been an enormous privilege and adventure.

But the saddest difference between them was that Zazetsky, as Luria said, 'fought to regain his lost faculties with the indomitable tenacity of the damned,' whereas Dr P. was not fighting, did not know what was lost. But who was more tragic, or who was more damned -- the man who knew it, or the man who did not?

When people die, they cannot be replaced. They leave holes that cannot be filled, for it is the fate--the genetic and neural fate--of every human being to be a unique individual, to find his own path, to live his own life, to die his own death.

But it must be said from the outset that a disease is never a mere loss or excess— that there is always a reaction, on the part of the affected organism or individual, to restore, to replace, to compensate for and to preserve its identity, however strange the means may be: and to study or influence these means, no less than the primary insult to the nervous system, is an essential part of our role as physicians.