Full Description
The old-fashioned doctor, whose departure from the modern medical scene is so greatly lamented, was amply aware of each patient's per sonality, 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, phys ical examination, and "personal profile," together with a limited number of generally ineffectual therapeutic agents. A doctor today deals with an enormous array of additional new information, which comes from X-rays, biopsies, cytology, electrographic tracings, and the phantas magoria 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.
Contents
I. On Becoming a Patient: Psychosocial Considerations.- 1. Illness and Help-Seeking Behavior.- 2. The Sick Role.- 3. Expectations in the Consulting Room.- II. On Being a Patient: Psychophysiological Considerations.- 4. Anxiety.- 5. Psychological Defense Mechanisms.- 6. Depression, Mania, and Suicide: Affective Disorders.- 7. Psychosis.- 8. Confusion, Delirium, and Dementia: Organic Brain Syndromes and the Elderly Patient.- 9. Pain.- 10. Sleep and Dreaming.- III. On Assessing a Patient: A Clinical Systems Approach.- 11. Approach to a Patient: The Patient Evaluation Grid.- 12. Current Context.- 13. Recent Context.- 14. Background Context.- IV. On Managing a Patient.- 15. The Case of the "Sick Tarzan": A Challenging Case History.- 16. The Doctor-Patient Relationship.- 17. The Patient's Personality.- 18. The Hospitalized Patient.- 19. Therapeutic Dimensions.- 20. Drugs That Affect Behavior.- 21. Some Illustrative Patients.- 22. Summary and Perspectives.
