We invite you to embark on a journey with us to explore some fascinating perspectives that shed a light on our relationship with sound and music.

Dr. Jeffrey Thompson, the Founder and Director of the Center for Neuroacoustic Research in California (www.neuroacoustic.com), is recognized as a worldwide expert in the field of acoustic pacing frequencies that are incorporated into musical sound tracks. A consummate musician and composer in his own right, he has established a method for using modulated sound-pulses that change states of consciousness for optimal “Mind-Body” healing. Dr. Thompson believes that the sounds in nature resonate with us because they take us back to the beginning of our journey and our primary senses.

Matter&Beyond: Why are sound and music so central for us, both culturally and personally?

I don’t think I’ve found a single culture on earth which at some point hasn’t used sound as a prominent technique in healing, in religious rites, or as a means of attaining a change of consciousness in one way or another. I think the tradition probably dates back to the first use of sound as a soothing or healing means for mothers; that is lullabies for babies.

M&B: Is this our earliest experience with sound? Is this what you call primordial sounds?

If you go back to before the lullabies, we’re talking about womb experiences and it’s one of the primal things we all share; this is what I call primordial sounds. Certain type of sounds have the same influence on anyone who hears it, no matter what age you are, what sex you are, what culture you were brought up in, what language you speak; womb sounds fit that criteria.

M&B: Why is it sound, but not the vision?

Because at 16 weeks, when the fetus is very small, the nervous system is developed enough that all the senses are functioning; however it is dark, so the eyes aren’t working, no information is being received and the nose and the mouth are filled with fluids, so there is no tasting or smelling, but sound travels through water five times better than it does through air; therefore the ears are working but amplified by five times, and the largest sense organ we have, the skin, is a huge sense organ for vibrations. Thus, we’re experiencing vibration and sound for nine months in the womb and that sound environment is a very specific type of environment; the amniotic fluid sounds, the watery bubbly sounds, the mother’s heartbeat through the placental artery, respiratory sounds from the diaphragm, noises of the internal organ; it’s a rich complex, three-dimensional sound environment that is exactly the same for everyone of us; we all experienced this in the same way.

M&B: How does the fetus perceive this sound?

Remember the fetus is small and the ear is small; the eardrum is extremely small. If the eardrum was blown up to the size of my eardrum and the mother’s heart was blown up in proportion it would fill this room. So what kind of sound would such a heart make? It wouldn’t be the sound that you would expect it to be listening to the adult’s heart with a stethoscope from the outside; it would be a very large, slow sound, a large thumping sound.

M&B: How is this related to the use of sound in therapy or for relaxation?

Most of us who have gone on vacations and have explored nature feel a peaceful, beautiful return to nature; why?

Because if you take the sounds of the amniotic fluid and you slow those sounds down, they sound a lot like the ocean. The size of the sound waves compared to the eardrum would make these watery sounds sound like they have also slowed down. So many of the watery sounds in the womb sound like other sounds that we can hear later in nature. This can spark a similar kind of primordial recognition which is beyond the control of the rational thinking mind.

So when we build up these kinds of sounds on a soundtrack you can then push the button and the body will automatically go back to what it felt like to have a natural experience; when we combine the sounds of nature with music this makes a relaxation tape. So I would say that the sounds of nature provide secondary primordial sounds, as not all of us would have heard the same natural sounds in our lives.

The idea is to extend the power of the primordial recognizable components of sound in order to create a physical response. The technique is to connect with a primal recognition at a subconscious level; this will tap into experiences that you have had in the womb and at other times.

M&B: You not only use sound for relaxation, but also in order to combat stress. Could you please talk about this?

When a person has a fight-or-flight response, a stress response, we know very precisely what happens physiologically. The very first thing, the most sensitive organ, to respond to stress is the heart and thus when we look at the heart waves we can gain important information.

M&B: Why the heart and not the brain?

The reason for this is that the heart is the perfect system in the nervous system; it is called the autonomic nervous system or the automatic functioning nervous system; it knows how to organize and control my organs and glands and body chemistry and perform biomechanics that I’m not aware of and can’t control.

My rational-thinking brain can control physical body movements and thinking processes, but there’s another section that controls the automatic functioning of how my body runs. There is another control of this autonomic nervous system, which has two large branches of nerves that innervate all the organs and glands; these two branches of the nerves are the sympathetic and the parasympathetic nervous system.

While the sympathetic nervous system switches on, the parasympathetic switches off and mobilizes energy from the higher brain centers, from my digestive system, from my elimination system and from my immune system, it pulls that energy into my muscles to fight for my life.

This is when the brain freezes when you take an exam. You’re frightened about the exam; it is your final exam and you’re frightened that you’re not going to pass it or that you’re not going to do well. That fright causes the sympathetic system to switch on and drain the energy out of your brain; this is a self-fulfilling prophecy. You don’t have a brain left, because all the energy has gone to your muscles. At the moment the sympathetic system switches on, it mobilizes the pituitary which signals the adrenal glands; these fires adrenaline, the adrenaline starts the heart and the respiration and a number of other things. At the same time it suppresses the pancreas and lets loose extra glucose so you can fight for your life more and so what you end up with is the very first thing that happens.

M&B: What is the normal stress response and how do we return to a normal state?

When a person is required to carry out special tasks, like running or fighting for one’s life, then the sympathetic nervous system has to switch on, mobilize the energy from various places and send it to my muscles. If I am injured, but I survive and win, then the parasympathetic system is going to switch on and build up; that energy will be sent to my immune system, healing centers and recuperation areas for my muscles; when this is finished these are basically switched off, because we don’t need this energy anymore. This is certainly the normal way of functioning.

Thus, there are certain normal ways in which the body should function when a person is okay and normal. When the patient comes in and lies down on their back we hook them up and look at what’s happening in the autonomic nervous system. Normally when you lay down for three to five minutes your system should relax. Gravity isn’t affecting you, your heart doesn’t have to do extra work to pump the blood up to your brain; as a result the muscles relax and the sympathetic system and parasympathetic nervous systems should be at a level playing field. Now they can conserve their energy and this state of balance in the autonomic nervous system is known as homeostasis. The best state of health you can have is in homeostasis, where you’re not using energy in an unnecessary way. Homeo means unity, one, within my body, while stasis is a perfect state of rest.

M&B: What are the results of your studies to date? How many of us return back to homeostasis in three to five minutes?

Clinically what I see is maybe two patients with a normal response; I’ve been checking every patient with the real time heart rate variability system now for 7 years. This means thousands of patients; in all of that time I have seen one, maybe two patients with a normal response. I hook the patient up, and see what the response is. Most people’s response is abnormal; what this abnormality says is that after five minutes they have not attained a balance, and they have a good strong, healthy, dominant sympathetic stress response which never stops.

M&B: What do you think is the reason for this?

This state is constant because of the artificial, extremely stressful world that we have artificially created for ourselves. It wasn’t supposed to be like this; you are supposed to wake up in the morning and grab your spear and go catch a rabbit and that’s your workday; when you get there and you see that rabbit the sympathetic system turns on and the heart rates increase, the same thing happens with the rabbit, and it’s all going to be over in a couple of minutes. You’re going to catch the rabbit or he’s going to get away and then everything goes back, the clutch pushes in. Let’s say you get the rabbit, and the clutch pushes in; everything is fine and you are going to go home. Now you hear a growl behind you and there’s a saber tooth tiger looking at you, thinking about dinner; now the sympathetic system switches on, the heart rate is up, and you are running and he is running. It is all going to be over in a couple of minutes and either you are going to get away or you’re not.

But what I’m talking about here is that the nervous system, at its core, and its stress response are both designed for a sprint and not a marathon; but what we have had in the twenty-first century and throughout the twentieth century is a marathon of stress; but these are the kind of stresses that we can’t see, i.e. invisible stresses. They’re electromagnetic frequencies; the walls in this room, television channel frequencies, military frequencies, microwave frequencies, air pollution, food pollution and traffic jams when going to work to a job that doesn’t pay enough money for a boss who has the emotional development of a three-year old are all problems for us. The stress goes and then it’s back again; it’s time to get dinner for the kids and watching 7:00 news. This doesn’t stop; the nervous system’s solution to surviving this is to invent a mechanism of merely stepping on the gas, switching on the emergency sympathetic system on and bulldozing your way through the stress for the rest of your life with great momentum; but at nighttime, when it’s time to go to bed the nervous system doesn’t want to let go of this momentum that it has built up to get through the day.

M&B: And this has devastating effects on our health?

You can’t keep running in high gear for the rest of your life without some horrible consequences; the body’s not designed for it. You can only do this for a few decades before your heart or your brain blows up, the two biggest killers in Western society are heart attacks and strokes – there is also high blood pressure and diabetes. But what can we expect if our sympathetic nervous system is all the time working, which means by definition that our heart pressure is up and the pancreas is suppressed, so there is extra glucose being sent out? So people who don’t have the constitution to handle the stress blow a fuse; they have no way to handle the stress and as a result they have immune system problems, digestive problems, and problems that come from that colon cancer, irritable bowel syndrome, autoimmune diseases, allergies.

M&B: You are using sound in order to help people return to their normal healthy state. How does this work?

I’ve come up with a way to use sound to force the autonomic nervous system to push in the clutch, removing us from a place of high stress from which you can leave by using sound; we do this by using the heart-rate variability to see how bad the heart rate is and then explore various precisely tuned sound frequencies which will actually force the nervous system to push in the clutch. There will be a very specific tone for every person; this is like a glass vibrating if I sing the right note. An opera singer can sing the right note to make the glass vibrate. Well, now let’s imagine that your autonomic nervous system is the glass and we’re going to explore various sound frequencies that are very precisely tuned to find out which one affects your autonomic nervous system function; when we find it the response will be like pushing in the clutch and sending it into a state of relaxation. So we hit the right note and we get the response; this is what I’ve been looking for. Now we can see this phenomenon clinically. Once we’ve got the tone that’s associated with the pushing in of the clutch of the autonomic nervous system we can use that therapeutically through a specially designed sound table that I have made; this consists of low-frequency sound components which drive the low frequencies right into your cells via headphones. This relaxation mode is introduced to your nervous system over an extended period of time. We can burn this sound onto a CD and you can take it home and work with it at home on your stereo; it is like an internal training program. Every time your nervous system pushes in the clutch, the ability to push in the clutch grows, just like working a muscle in a gym.

This is a kind of high-tech stress reduction training program for the nervous system with sound. This is one of the three components I mentioned earlier; there are three parallel processes using sound for healing. This one is the idea of using the physical resonance to cause an effect on the nervous system to relax people.

M&B: This is what is called a sound table, right?

Yes, the sound table I needed had to have specific requirements, which is why I had to make my own to attain the exact clinical results I wanted. The power in the table actually delivered more power to your body than I wanted to be delivered. Therefore, I had to be able to have the sound that was coming from the table split into the right and left speakers, but none of those that were available on the market could do that. So I had to have it specially designed. As a composer, musician and audio engineer I was able to design the sounding board of that table and the transducers so that a lot of free sound could be delivered and spread out, therefore it is much more effective and delivers the sound to your body via headphones. Thus there is a lot going on in that table that you cannot see and this is what makes it work properly.

Interview conducted by Mustafa Tabanli for Ebru TV for the Emmy Award winning television series Matter and Beyond.

Who are gifted students?

Gifted students display distinctive qualities in many ways. They usually think differently than their friends; they can come up with extraordinary ideas and self-developed thoughts; details are important for them; they have the ability to learn quickly and progress in academic and intellectual fields; they display high performance in one or more type of art. However, these talented people only make up 2% of the society. These individuals do not like to overexert themselves to increase their grades in education, nor do they study in a systematic manner or do homework. They tend to choose practical solutions, produce new ideas, and try to develop these ideas. They analyze and question whatever they learn, but nevertheless they can still be disorganized. They are often the students who cause problems at school. Awkward and disruptive in the classroom, they can be argumentative or uninvolved in activities. Research into the lives of many people who throughout history have caused great change has discovered that the outstanding talent of these famous people usually passed unnoticed by their teachers, and they were actually problematic children in their early years as students. Edison, for example, was taught at home by his mother, an experienced teacher, because he could not conform to or thrive in school life.

To help teachers to recognize gifted students, various tests have been introduced into the education systems of schools in the West. One of these exams is the IQ test. Some consider IQ tests as the most efficient way of discovering the abilities of students, while some other educationalists say that the only “skill” an IQ test indicates is the ability to take IQ tests; in fact the more you take, the higher you score.

In general, gifted students are recognized by the following qualities:

1. They are quick to learn; they understand and learn the topics in which they have greater ability more easily than other pupils, and they comment on or question the information provided.

2. They try to improvise on whatever they learn; they ask questions that will assist them in progressing in the topics they learn and constantly try to develop on these subjects.

3. They enjoy speaking with older people and usually choose the company of friends older than themselves. They obtain pleasure from discussing with older people, usually teachers.

4. They have the ability to judge and transform information.

5. They have extraordinary desire for intellectual activity.

6. As well as being energetic or overactive, they can also be introverted individuals who prefer their own company.

7. They absorb even the tiniest detail in subjects in which they have an interest.

8. They study only to satisfy their overwhelming desire to learn, and not to please their families or teachers.

9. They are curious, continually asking why and how and other similar questions.

10. They have very good memories.

11. They easily figure out complex objects and events.

Gifted individuals may have many more qualities than those listed above. Another aspect to consider is that if a child has one or a few of these qualities we should not come to the conclusion right away that he is a gifted child. A child could be talented in one certain topic. An individual who shows outstanding performance in mathematics could be completely unsuccessful in social studies and even worse in art, and a student who is successful in art may be very poor at physics. The understanding that an intelligent student must be successful in every field of education is misleading because this is not the case with all individuals. Further, methods of discovering a student’s ability in one field may not be suitable for other subjects.

Types of education for gifted students

In different countries of the world there are various kinds of education for gifted students. These can be categorized as separate education, combined education, and individual education.

1. Separate education: Separate education is grouping students to be educated according to the subjects in which they show higher performance. This kind of education is usually regarded as unsuitable in present-day understandings of schooling on the grounds that if not well balanced separate education may encourage selfishness, a sense of arrogance and unsound personality.

2. Combined education: This is a form of education where talented individuals continue studies in their usual environment among their friends in the five different formats noted below:

a) Education in special classes: Students known to have a higher rate of ability are taught in special classes in their own schools.

b) Early education: This is enrolling gifted children in schools earlier than the normal school age, usually a year earlier but in some cases maybe even two years, depending on a child’s general intellectual performance. This format is not advised because early education is said to have negative effects on the physical, emotional and psychological development of children.

c) Accelerated education: This is where children known to have outstanding intelligence are advanced to a higher class. This can be implemented two times at the most.

d) Groups of equal ability: This is a form of education where students with the same abilities in certain subjects are taught in specific, segregated classes and then encouraged to develop their skills in their topic of interest.

e) Enriched schedule: This is where a skilled individual is provided with special activities in his or her own classroom alongside the normal curriculum.

3. Individual education: A student with outstanding abilities is provided with a specific education in their own field of interest.

Recommended types of education

If we look at the various kinds of education, the most appropriate forms of learning seem to be groups of equal ability and the enriched schedule because separating children from their usual environment and friends can induce various problems.

Education of groups with equal ability

This is a method where students of equal ability are taught in one class. The ideal number of students per class is three, and a teacher is usually assigned to the class as a counselor.

After lessons the students research the topics relevant to their interests or abilities. This research begins with easier tasks, and while they are investigating the topic the students are actually learning and practicing different methods of learning. They learn in sequence how to research a topic and what to do when they are faced with a problem. The students learn study and learning methods without realizing that they are actually learning. This is a very effective method, and in this kind of education students gain the chance to learn and research, develop and innovate while remaining among their friends in their normal environment. Therefore, they are not subjected to the negative aspects of segregation, and gifted students in higher classes become an example for younger, outstandingly gifted students in lower classes.

Education with an enriched schedule

In the enriched schedule education program, the student continues his or her usual education in his or her own classroom guided by the teacher to perform research in the field in which he or she has greater ability. He or she then explains the research discoveries to classmates. Thus, while students are developing skills in explaining discoveries they are also teaching their friends and representing model students in the classroom. Teachers play a big role in this type of education. It is their duty to recognize the students’ fields of interest or abilities and arrange a program suitable to the students’ characters.

What the education of a gifted student entails

Gifted students should not be told of their superior capabilities because the word “superior” or “outstanding” could lead to arrogance in the student, which will cause problems with classmates. Students who think they are superior will begin to think that studying is unnecessary, which could lead to them abandoning their education completely. Nevertheless, their education can be customized according to their greater abilities.

Gifted students are individuals who need special education and trained, professional teachers, just like a student with hearing problems, a blind student or a student with a learning impairment.

Conclusion

The main differences between a student of normal learning capacity and one of outstanding abilities are that a gifted student can achieve what others think impossible. A ship being commanded from land, the discovery of electricity, the invention of motor vehicles, priceless classic paintings, music, literature and works of art are all the products of extraordinarily skilled people.

Outstanding talent is a gift from God, a great blessing. One who has a gift and the people responsible for discovering it and ensuring it develops, namely the mother, father, and teacher, must recognize it in the early stages and educate these children in a beneficial manner so that they will be able to do work which is of interest to them, work that ordinary people would not be able to do. In this way, they will be able to benefit others as well as themselves.

They must also develop in their character and spirituality. If a talented person does not have a good character, he or she could become more dangerous than a person of normal intelligence. Great responsibility lies with teachers and the education authorities.

The air that we breathe consists of 78% nitrogen, 21% oxygen and 1% other gases, such as water, carbon dioxide, and carbon monoxide. First of all, the level of oxygen in the air is of extreme importance; that is, if the air were to contain 40% oxygen instead of the normal 21%, then there would be no life on Earth. Most living organisms, if not all, would die due to oxygen poisoning. Their proteins and DNA would be oxidized and become non-functional. Metals would be corroded and trees would burn at slightly higher temperatures than normal.

Vertebrates have been equipped with two principal mechanisms to supply their cells with an adequate and continuous flow of oxygen. The first one is the circulatory system and the second one is oxygen-carrying molecules; hemoglobin in the red blood cells and myoglobin in the muscles. The air we breathe is filtered even before it reaches our lungs. Then, it dissolves in the mucus, a highly viscous material, which coats the inside of our lungs. Next, the dissolved oxygen diffuses into the blood through alveolar cells and the walls of the capillary vessels. Finally, the oxygen is picked up by the red blood cells; these are what make our blood red. The red color is due to a molecule called heme that is present in hemoglobin and myoglobin. Every heme molecule in hemoglobin can bind four oxygen molecules together. Every oxygen molecule bound to hemoglobin increases the affinity of hemoglobin to bind to another oxygen molecule. The hemoglobin becomes saturated if the dissolved oxygen is above a certain level; this can be seen in the lungs. If the level of dissolved oxygen drops below a certain level, as can be seen in tissues like the muscles, brain, and liver, then the oxygen molecules start to dissociate from the hemoglobin. Likewise, every dissociating oxygen molecule facilitates the dissociation of another oxygen molecule from the hemoglobin. This is one miraculous design that is known to us: a molecule devoid of any wisdom and intelligence grasps a very crucial cargo where it is abundant, carries it to a place where the cargo is most needed and less abundant, and releases it. The myoglobin in the muscle tissue then binds the oxygen and serves as an oxygen backup resource for times when there is inadequate oxygen supply during exertion.

Fetuses have their own specific hemoglobin, called hemoglobin-F, which is different from that of adult hemoglobin, hemoglobin-A. Before birth, the fetus gets its oxygen from the mother’s blood through the placenta. The higher affinity of hemoglobin-F than hemoglobin-A to oxygen makes the oxygen exchange between the maternal and fetal blood possible. It is interesting to note that right around the time of birth the fetus switches the production of hemoglobin-F to hemoglobin-A, as this is more efficient under normal breathing conditions. Our current knowledge is insufficient to completely understand how this switch-over occurs and how it is regulated. Future studies will shed light on this complex but magnificent mechanism of regulation and this superb design.

Why are we so dependent on oxygen? In fact, our energy metabolism is completely dependent on oxygen. The chemical breakdown of nutrients by a dozen enzymes releases energy, which as is cannot be stored or transferred to the places where it is required. We are equipped with a second mechanism, which involves another set of different proteins that converts the released chemical energy to a more useful and transferable molecular form, called ATP. ATP, which we can think of as small packages of energy, is the main form of energy within our cells that can be readily used by all reactions that require energy. The first set of enzymes abstracts electrons from the nutrients during their chemical breakdown. These so called high-energy electrons are transferred from one protein to the next by the second set of proteins that form the electron transport chain. The final acceptor of these electrons is molecular oxygen. If oxygen were not there to pick up the electrons at the end of this chain, the last protein (cytochrome oxidase) would lead to a dead end, as it would be rendered inactive with the electrons that it is carrying. This would make this superb design of complex mechanism useless and wasteful; the synthesis of every new and active cytochrome oxidase would require more energy than is produced in one cycle of an electron transfer in the absence of oxygen.

It has been known for some time that cells can sense the level of oxygen in their environment. They are equipped not only with a sensing mechanism, but also with a response mechanism, by which they can survive for a short period of time. In 1995, a protein called HIF (Hypoxia Inducible Factor) was identified and was shown to regulate cellular response to hypoxia, i.e., a reduced oxygen level. HIF is a transcription factor, which induces the expression of a set of genes that are required for survival under hypoxia. Several genes encoding glycolytic enzymes are regulated under hypoxia; this allows cells to produce ATP even without oxygen. Nevertheless, oxygen-independent energy generation is very inefficient and the yield is insufficient. Another set of genes induce angiogenesis (vascularization), or the making of new capillary vessels. VEGF (vascular endothelial growth factor) is one of the best known HIF target genes that induces the formation of new vessels where expressed.

One of the most remarkable aspects of HIF-based oxygen sensing is that under normal oxygen levels the HIF protein is simultaneously synthesized and degraded. Only under low levels of oxygen does HIF accumulate and induce its target genes. At first sight, this continuous production and degradation of HIF may look wasteful, whereas in reality it is a very well designed precautionary mechanism. The HIF protein is marked and sent for degradation by a class of enzymes called HPH/PHD. These enzymes also use the oxygen molecule to tag the HIF protein. If there were not enough oxygen around, HPH/PHD enzymes would not be able to tag HIF. As a result HIF accumulates and induces its target genes to ensure the adequate supply of oxygen. With this mechanism cells can quickly adapt and survive. Therefore, continuous production and degradation of HIF turns out to be a necessary precautionary measure which is taken against the risk of death arising from a low oxygen level.

This article is by no means a complete picture of the miraculous world of oxygen, perhaps it is no more than a brush stroke on the entire picture. Yet, even this incomplete glimpse is enough to help us realize how perfectly we have been created, and how well we are taken care of. We do not have even the slightest control over any of these aforementioned mechanisms. We breathe day and night, and every breath should be taken in gratitude to God, who created us as this masterpiece.

What is malformation? If a little girl, with six fingers on one hand, says she loves her sixth finger very much, how do we tell her she is malformed?

Blepharoptosis is a condition in which the upper eyelid droops in consequence of paralysis of muscles or nerves. But would we say that having drooping eyelids, eyes with short palpebral fissures, is a malformation? Would we not then have to say that most Chinese and Japanese have somewhat ‘malformed’ eyes?.

If the little girl’s sixth finger causes her no impediment, except for its appearance, would it be right to think of it as a ‘disability’ or a ‘problem’? On that criterion, obesity or anorexia nervosa could also be considered as disability. They are not only disagreeable in appearance but also impair physical and social function. Such impairment must surely be part of any definition of disability.

But this too raises a question. If an abnormality does not cause impairment of function, but only makes a person ugly, do we consider it a disability? Who will judge the level of ugliness, the individual or society? A schoolgirl with polydactylism – more than five fingers or five toes; a young man with alopecia universalis – absence at all hair, on the head and body; a teenage girl with ichthyosis vulgaris (xeroderma) – a severe skin disorder which causes an ugly appearance – if such conditions do not cause any impairment, if people have got used to seeing them, the individuals may not perceive themselves as ugly and therefore not feel distress. But if their appearance does disturb others and they feel distressed as a result, should we describe them as normal or disabled’? A little girl in a nursery school may be afraid of holding up a polydactyl hand; his co-workers may be upset by sharing a workplace with a man suffering from alopecia universalis; a hair dresser may not want to cut the hair or manicure the nails of a girl who suffers from ichthyosis vulgaris.

Plainly, clinical definitions do not define or cover disability. Sociological reflections are also important. Sometimes it is more important to ask how people around a particular individual perceive that individual, than to ask how medical science defines his or her condition.

There are situations where individuals do not feel handicapped and find their lives valuable and worth living, but people around them are upset by them and label them as disabled. In contrast to this, there are some cases, in which, the individual is considered medically ‘normal’, is perceived as ‘normal’ by society, and his or her condition does not cause any impairment, but that individual thinks that a particular part of his or her body is a problem and tries to find a ‘solution’ to it. These ‘solutions’ are an important part of the plastic surgeon’s workload. It is not easy to explain the circumstances which disturb people so much that they take the risk of surgery. But we may infer another factor to define disability namely the psychological state of the individual. The individual may not have any physical abnormality but psychologically he or she feels abnormal. Hospital records abound with such cases.

Among the most difficult ‘abnormalities’ are anomalies affecting the newborn and congenital malformations. There are 200 such ‘disabilities’ (see Goodman and Gorlin 1983). Among them are Downs Syndrome, Spina Bifida and Fetal Alcohol Syndrome. The distress caused by such illnesses has led to attempts to identify cases as early as possible. In order to do this, scientists have established new prenatal diagnostic methods such as USG (ultrasound), amniocentesis, CSV (cholonic villi sampling) and photocopy. 60-65% of malformations can be diagnosed with these methods (Goodman and Gorlin, 1983, p.83). However, we must define our aims clearly to protect humankind from being victims of these improvements. Goodman (1986, pp2l4-17) suggests that prenatal diagnosis is used for monitoring the pregnancy, to localize the placenta, to detect multiple pregnancies, to know fetal age correctly, to monitor probable congenital malformation and to make studies about the genetic, biochemical and chromosomal structure of the fetus. These are all aims which are innocent and for the benefit of humankind. But, like all other new technologies, they do raise moral questions.

Before 1977, prenatal diagnosis was rare in Sweden. The number of late terminations because of fetal abnormality was 34 in that year. By the end of the 1980s, this number had reached 100 per year. 40% of these terminations were because of Downs Syndrome and 15% because of NTD (Neural Tube Defect) (Reid, 1991, p.77). Introduction of the technologies to Portugal, Greece and Germany led to new legislation on the termination of pregnancies (Reid, 1991, p.9).

Despite all measures and methods of elimination, disabled babies continue to be born. Maybe attention should be turned to treatment and rehabilitation. Although it is not always possible to correct impairment completely, quality of life can be improved through a variety of rehabilitation methods.

Almost half of handicapped newborns die in the first year of life and 80% of the rest need corrective surgery or lifetime therapy. For this reason, treatment and rehabilitation are costly options. But after the improvement of surgical sciences, especially plastic surgery in recent years, the remediability of many conditions has increased.

Remediability or irremediability of disabilities is of crucial importance in determining the treatment offered to handicapped newborns. Decisions about remediability or irremediability are made by doctors. The reasoning and judgments of philosophers, theologians, sociologists, other experts (and, of course, parents) are informed by data supplied by doctors. The objectivity of that data is not unquestionable. Dr John Freeman (quoted in Kuhse and Singer 1985, p.63) observed: ‘It concerns me greatly that a given child born in Sheffield has a 75% chance of being dead; that the same child born in Baltimore…has a 95% chance of being alive. And yet this is a decision made by the parents on the advice of either Dr Lorber or myself. That is scary.’

In this discussion of the definition of ‘disability’, we have tried to show that it and related terms cannot be solely the domain of doctors. It is true that scientists are vital in this area but they need to be aware of societal and religious issues. We cannot leave decisions about ‘disability’ to scientists who worship only science.