1. A medical instrument comprising: a proximal control handle; a distal work member; a proximal movable member controlled from said proximal control handle; a distal movable member controlled from said proximal movable member to provide controlled movement of said distal work member from said proximal control handle; an instrument shaft that intercouples said proximal and distal movable members; and actuation means coupled between said movable members; said proximal movable member comprising a ball and socket assembly supported between said handle and instrument shaft and constructed and arranged for three dimensional motion.