Randolph M. Nesse Quotes

“I can’t prove it, but I’m pretty sure that people gain a selective advantage from believing in things they can’t prove.”

“If you could make male mortality rates the same as female rates, you would do more good than curing cancer.”

“All organisms are shaped to behave in ways that increase fitness even if that decreases health and happiness. Did you ever desperately want to have sex with someone even though you knew that could lead to disaster? Most people have, with sometimes dire consequences. Then there are the rest of our desires and the inevitable suffering because they cannot all be fulfilled. We want so badly to be important, rich, loved, admired, attractive, and powerful. For what? the good feelings from succeeding are just about balanced by the bad feelings from failure. Our emotions benefit our genes far more than they do us.”

“Caffeine seems innocuous, but a single coffee bean can kill a mouse.”

“Like fever and pain, anxiety and low mood are useful normal responses to some situations.”

“Most behavior is in pursuit of a goal. Some efforts are attempts to get something, others to escape or prevent something. Either way, an individual is usually trying to make progress toward some goal. High and low moods are aroused by situations that arise during goal pursuit. What situations? A generic but useful answer is: high and low moods were shaped to cope with propitious and unpropitious situations.”

“Selection shapes brains that maximize the number of offspring who survive to reproduce themselves. This is very different from maximizing health or longevity. It is also different from maximizing matings. That is why organisms do things other than having sex. Especially humans. Having the most offspring requires allocating plenty of thought and action to getting resources other than mates and matings, especially social resources, such as friends and status. Everyone else is doing the same thing, creating constant conflict, cooperation, and vast social complexity whose comprehension requires a huge brain.”

“Some clinicians skip asking about personal details. They check symptoms on a list, put patients into diagnostic categories, and then recommend whatever treatment has been shown to help patients with that diagnosis. This nomothetic approach saves time, effort, and the emotional entanglements that ensue from creating relationships with individuals. Fewer midnight phone calls.”

“Strong selection for extreme mental capacities may have given us all minds like the legs of racehorses, fast but vulnerable to catastrophic failures.”

“The greatest boon of modern life is also the greatest villain: the availability of plentiful food.”

“The mechanisms our minds use to anticipate the results of our actions are inadequate for coping with modern media.”

“A Darwinian view of medicine simultaneously makes disease less and more meaningful. Diseases do not result from random or malevolent forces, they arise ultimately from past natural selection. Paradoxically, the same capacities that make us vulnerable to disease often confer benefits. The capacity for suffering is a useful defense.”

“Autoimmune disease is a price of our remarkable ability to attack invaders. Cancer is the price of tissues that can repair themselves. Menopause may protect the interests of our genes in existing children. Even senescence and death are not random, but compromises struck by natural selection as it inexorably shaped out bodies to maximize the transmission of our genes. In such paradoxical benefits, some may find a gentle satisfaction, even a bit of meaning-at least the sort of meaning Dobzhansky recognized. After all, nothing in medicine makes sense except in the light of evolution.”

“Chlamydia, today´s most common cause of venereal disease, does the equivalent of hiding in the police station.
Schistosomes of the mansoni type go a step further and essentially steal police uniforms. These parasites, a serious cause of liver disease in Asia, pick up blood-group antigens so that they may look to the immune system like our own normal blood cells.”

“Darwinism gives no moral guidelines about how we should live or how doctors should practice medicine. A Darwinian perspective on medicine can, however, help us to understand the evolutionary origins of disease, and this knowledge will prove profoundly useful in achieving the legitimate goals of medicine.”

“Every textbook description of a disease should have, in our opinion, a section devoted to its evolutionary aspects. This section should address the following questions:

1. Which aspects of the syndrome are direct manifestations of the disease, and which are actually defenses?

2. If the disease has a genetic component, why do the responsible genes persist?

3. Do novel environmental factors contribute to the disease?”

“Long before there were effective treatments, physicians dispensed prognoses, hope, and, above all, meaning. When something terrible happens-and serious disease is always terrible-people want to know why. In a pantheistic world, the explanation was simple - one god had caused the problem, another could cure it. In the time since people have been trying to get along with only one God, explaining disease and evil has become more difficult. Generations of theologians have wrestled with the problem of theodicy-how can a good God allow such bad things to happen to good people?

Darwinian medicine can't offer a substitute for such explanations. It can't provide a universe in which events are part of a divine plan, much less one in which individual illness reflects individual sins. It can only show us why we are the way we are, why we are vulnerable to certain diseases.”

“Natural selection involves no plan, no goal, and no direction – just genes increasing and decreasing in frequency depending on whether individuals with those genes have, relative to other individuals, greater or lesser reproductive success.”

“Our behavior and emotions seem to have been shaped by a prankster.”

“The body is a bundle of careful compromises.”

“The design of our bodies is simultaneously extraordinarily precise and unbelievably slipshod. It is as if the best engineers in the universe took every seventh day off and turned the work over to bumbling amateurs.”

“Why are male and female sexual responses so uncoordinated, instead of being shaped for maximum mutual satisfaction?”

“Why are so many of us constantly anxious, spending our lives, as Mark Twain said, suffering from tragedies that never occur?”

“Why do we crave the very foods that are bad for us but have less desire for pure grains and vegetables?”

“Why do we find happiness so elusive, with the achievement of each long-pursued goal yielding not contentment, but only a new desire for something still less attainable?”

“Why do we keep eating when we know we are too fat?”

“Why has the medical profession not taken advantage of the help available from evolutionary biology, a well-developed branch of science with great potential for providing medical insights? One reason is surely the pervasive neglect of this branch of science at all educational levels. Religious and other sorts of opposition have minimized the impact in general education of Darwin's contributions to our understanding of ourselves and the world we live in.”

“Why is our willpower so weak in its attempts to restrain our desires?”