The Patient: "Biological, Psychological, And Social Dimensions Of Medical Practice"

The old-fashioned doctor, whose departure from the modem medical scene is so greatly lamented, was amply aware of each patient's personality, family, work, and way of life. Today, we often blame a doctor's absence of that awareness on moral or ethical deficiency either in medical education or in the character of people who become physicians. An alternative explanation, however, is that doctors are just as moral, ethical, and concerned as ever before, but that a vast amount of additional new information has won the competition for attention. The data available to the old-fashioned doctor were a patient's history, physical examination, and "per­ sonal profile," together with a limited number of generally ineffectual therapeu­ tic agents. A doctor today deals with an enormous array of additional new information, which comes from X rays, biopsies, cytology, electrographic tracings, and the phantasmagoria of contemporary laboratory tests; and the doctor must also be aware of a list of therapeutic possibilities that are both far more effective and far more extensive than ever before. Front Matter....Pages i-xxvi Front Matter....Pages 1-1 Illness and Help-Seeking Behavior....Pages 3-14 The Sick Role....Pages 15-22 Expectations in the Consulting Room....Pages 23-35 Front Matter....Pages 37-37 Anxiety....Pages 39-69 Psychological Defense Mechanisms....Pages 71-89 Depression....Pages 91-127 Pain....Pages 129-156 Sleep and Dreaming....Pages 157-182 Front Matter....Pages 183-183 Approach to Patients: The Systems-Contextual Framework and the Patient Evaluation Grid....Pages 185-200 The Current Context of Help-Seeking Behavior....Pages 201-217 The Recent Context of Help-Seeking Behavior....Pages 219-226 The Background Context of Help-Seeking Behavior....Pages 227-240 Front Matter....Pages 241-241 The Case of the “Sick Tarzan”: A Challenging Case History....Pages 243-246 The Doctor-Patient Relationship....Pages 247-252 The Patient’s Personality....Pages 253-269 The Hospitalized Patient....Pages 271-288 Therapeutic Dimensions....Pages 289-302 Drugs Affecting Behavior....Pages 303-318 Some Illustrative Patients....Pages 319-334 Summary and Perspectives....Pages 335-341 Back Matter....Pages 343-351