Doctor and patient : $b Papers on the relationship of the physician to men and institutionsPeabody, Francis Weld
Science
Doctor and patient : $b Papers on the relationship of the physician to men and institutions
Peabody, Francis Weld
Medicine; Medicine -- Practice; Physicians
When a patient enters a hospital, the first thing that commonly happens
to him is that he loses his personal identity. He is generally referred
to, not as Henry Jones, but as “that case of mitral stenosis in the
second bed on the left.” There are plenty of reasons why this is so,
and the point is, in itself, relatively unimportant; but the trouble
is that it leads, more or less directly, to the patient being treated
as a case of mitral stenosis, and not as a sick man. The disease is
treated, but Henry Jones, lying awake nights while he worries about his
wife and children, represents a problem that is much more complex than
the pathologic physiology of mitral stenosis, and he is apt to improve
very slowly unless a discerning intern discovers why it is that even
large doses of digitalis fail to slow his heart rate. Henry happens to
have heart disease, but he is not disturbed so much by dyspnea as he is
by anxiety for the future, and a talk with an understanding physician
who tries to make the situation clear to him, and then gets the social
service worker to find a suitable occupation, does more to straighten
him out than a book full of drugs and diets. Henry has an excellent
example of a certain type of heart disease, and he is glad that all the
staff find him interesting, for it makes him feel that they will do
the best they can to cure him; but just because he is an interesting
case he does not cease to be a human being with very human hopes and
fears. Sickness produces an abnormally sensitive emotional state in
almost every one, and in many cases the emotional state repercusses,
as it were, on the organic disease. The pneumonia would probably run
its course in a week, regardless of treatment, but the experienced
physician knows that by quieting the cough, getting the patient to
sleep, and giving a bit of encouragement, he can save his patient’s
strength and lift him through many distressing hours. The institutional
eye tends to become focused on the lung, and it forgets that the lung
is only one member of the body.
But if teachers and students are inclined to take a limited point
of view even toward interesting cases of organic disease, they
fall into much more serious error in their attitude toward a large
group of patients who do not show objective, organic, pathologic,
conditions, and who are generally spoken of as having “nothing the
matter with them.” Up to a certain point, as long as they are regarded
as diagnostic problems, they command attention; but as soon as the
physician has assured himself that they do not have organic disease, he
passes them over lightly.
Public-domain text, read in full here on John Shaqi.
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