Sometimes, alone at night at my mountainside clinic, as I sit on the stone bench beneath the huge Royal Pine in the patio and look up through its black silhouette at the vast and muted sky, I, like the moon, find the needed distance and stillness to reflect. I cud such thoughts as daylight has little time for. Sometimes I ask . . .

What is the justification of an endeavor like Project Piaxtla? What right have we—intruders from another culture and in some respects from another age—to descend upon an isolated, tradition-oriented, impoverished but relatively stable society such as inhabits this beautiful and wild Sierra Madre Occidental, and attempt to improve the standard of health and medical care? True, the campesinos express appreciation. But are they ready for such “improvements”? And. are such “improvements” really for the best? What will be the long range consequences of our efforts?

Who can say for sure? . . . Not I. Nor the moon. Nor any of us.

In our defense, it can be argued that disease is no longer as rampant or as crippling as it was before we came, that infant and maternal mortality have dropped to less than half what they were six years ago . . .

And so? . . . So we have saved scores of babies' lives. Saved them for what? Have we really done the babies or mankind any service? . . .

The moon holds her silence.

A baby is born . . . and begins to fail shortly after birth. An urge deep within us, almost as basic as hunger or lust, demands we do our utmost to save that baby’s life.

But why? Is such an urge justifiable? Certainly the ecologists, as well as the Hindus, have amply demonstrated that “reverence for life” by itself is not enough, that it can even prove life-impoverishing. Is there, then, any justification whatever for saving that sick baby’s life?

The moon, full to overflowing, bursts out:

YES! And a thousand times over, YES! The infant deserves to be saved, not because it is living but because it is loved! Love is the ultimate and the only justification for all life and any life, for any and all action. There is no other. None.

Silent again and reflective, the moon slips slowly westward, brushing the pine boughs.

It dawns on me that the ultimate value of Project Piaxtla, or any human effort, depends not so much on what we do, as how we feel about doing it. What is done is done, but the spirit in which it is done lives on and can grow and engender.

It is not enough, then, to “set an example” by “doing good”; for unless we do so lovingly, eagerly, joyfully (I might even say selfishly) who would want to follow our example? To do good on a completely rational and objective basis —guided, perhaps, by some higher moral love, but without the joy and suffering of dynamic personal love —is like taking a baby from its mother and putting it in a sunless orphanage on the theory that the babe is better cared for. Charity without love can only breed resentment.

We have all been taught the merits of taking an “objective approach”. We take pride that medicine —which once was considered an art —is becoming, more and more, an “exact science”, for controlled methods and instrumental precision have added tremendously to its efficient practice.

Yet there is a danger in becoming too objective.

Human love is, after all, subjective . . . and irrevocably so. It cannot be sterilized, plotted or stored on a shelf. Even in its highest form, it is full of impurities. Like the mythical hoop-snake that takes its tail in its mouth and rolls along, love advances through the circular meeting of paradoxical opposites. It is the hungry embrace where joy and suffering, giving and receiving, selfishness and selflessness, impatience and forbearance, weakness and strength, blindness and the greatest human vision, all converge. And enigmatic and subjective though it be, that passionate convergence has been the point of departure for every memorable step mankind has ever made.

If in our relations with the villagers, we can get across some sense of the personal satisfaction that comes from giving of oneself, of the pleasure in responding to another person’s need, of the fulfillment in helping promote harmony, this has more meaning than the many babies we save or children we vaccinate. For surely, in the barrancas as anywhere else on this verdant footstool, the awakening in man of responsible concern for his fellow man is more important to his ultimate welfare than all the wonders of medicine and science put together.

The difference between giving a handout and giving a hand is that the latter involves a part of oneself.

With the last newsletter I felt discontented —as I am sure did many friends —insofaras it was far too prosaic and businesslike for a venture which was conceived of and still functions on so personal a level.

Project Piaxtla has, indeed, grown and become more organized, a fact for which I frankly have mixed feeling. When a child grows up to become a “responsible adult” much is gained, but also much is lost . . . The services our project now renders are far more consistent and effective than in its early days. Yet at times I feel that something of the freshness and overwhelming sense of wonder has diminished . . . though in truth, it is perhaps not so much the project as its conceiver that is growing up . . . (or old?)

Fortunately, many of our volunteers, and particularly the youthful, “self-made” medics such as Allison Akana, Bill Gonda and Phil Mease, through their deep dedication and endless capacity to marvel at the intricate mesh of beauty and tragedy in village life, have kept our venture young and vital. The bond of trust and respect which our young medics have established with the villagers goes far beyond my furthest hopes.

As for myself, my initial excitement has quieted down. Not everything is new anymore. Yet for all that, there can be no excuse for a newsletter as prosaic as the last. There still occur in the barrancas such events as stagger and awe the senses, such beauty as never grows stale, such friendship as grows and is self-renewing.

This newsletter, which I hope may balance the last, is perhaps more personal and subjective than is appropriate in the report of a village aid program to its friends. Much of what follows was written through the need to “get out” some of my own responses to one of the most disturbing events that has occurred in my six years in the Sierra Madre. There will doubtless be readers who take exception to my conclusions—or lack of conclusions—or who feel that a newsletter is the wrong place to air such personal thoughts. To these friends I apologize and say no more than that I have tried to give my best.