Foreword to the Paperback Edition
Two classic medical quotations provide the context and set the
stage for this book: "The physician is obligated to consider more
than a diseased organ, more even than the whole man-he must
view the man in his world" (Harvey Cushing); and "One of the
essential qualities of the clinician is interest in humanity, for the
secret of the care of the patient is in caring for the patient"
(Francis Weld Peabody).
A stormy debate surrounds the delivery of health care at this
time. Anxious questions are being asked about the fact that
millions of Americans have no insurance coverage, the costs of
medical care are soaring, and the quality of care is often unac-
ceptable. Hardly visible in all this turmoil are the human beings
who are presumably the center and beneficiaries of all this at-
tention. This book is about them.
One of the distinguishing characteristics of our society is the
prodigious growth of scientific knowledge and technology.
While this has undoubtedly improved material conditions, the
brilliance of technical achievement has not necessarily made us
happier, or more humane, or satisfied with our medical care. We
have in many ways been dehumanized. Much of this is due to
this growth of scientific knowledge and the consequent need for
professionals to become specialists, or even sub specialists. This
leads us to focus more and more on smaller and smaller aspects
of human behavior and welfare. As a corrective to reductionism
the need for acting with the total person in mind becomes stron-
ger. The first step in doing this is having an interest in and caring
for the patient, as Peabody wrote in 1927.