Physicians And Patients Quotes

The physician’s duty is not to stave off death or return patients to their old lives, but to take into our arms a patient and family whose lives have disintegrated and work until they can stand back up and face, and make sense of, their own existence.

It’s true that AI can mimic the human brain, but it can also outperform us mere humans by discovering complex patterns that no human being could ever process and identify.

Cognitive robotics can integrate information from pre-operation medical records with real-time operating metrics to guide and enhance the precision of physicians’ instruments. By processing data from genuine surgical experiences, they’re able to provide new and improved insights and techniques. These kinds of improvements can improve patient outcomes and boost trust in AI throughout the surgery. Robotics can lead to a 21% reduction in length of stay.

The physician should not treat the disease but the patient who is suffering from it

In short, physicians are getting more and more data, which requires more sophisticated interpretation and which takes more time. AI is the solution, enhancing every stage of patient care from research and discovery to diagnosis and therapy selection. As a result, clinical practice will become more efficient, convenient, personalized, and effective.

Falsehood flies, and truth comes limping after it, so that when men come to be undeceived, it is too late; the jest is over, and the tale hath had its effect: like a man, who hath thought of a good repartee when the discourse is changed, or the company parted; or like a physician, who hath found out an infallible medicine, after the patient is dead.

Do not work primarily for money; do your duty to patients first and let the money follow; our life is short, we don't live twice; the whirlwind will pick up the leaves and spin them, but then it will drop them and they will form a pile.

An algorithm that expedites care to a stroke patient in a chaotic emergency room (ER) has a good chance of adoption. An algorithm that reads a routine scan and provides some quantification of what the physicians can already estimate won’t be in as much demand. There are good reasons for algorithms to parse patient records to look for signs of rare diseases, but there are fewer good reasons for using them to evaluate clinical symptoms. It’s cool that AI tools can make diagnoses from scratch, but for most clinical encounters doctors are already pretty good at it.

Much of clinician burnout is due to spending time writing notes, placing orders, generating referrals, writing prior authorization letters, and creating patient communication. In other words, burnout is caused by physicians having to generate output! With the emergence of large language models that are used to train generative AI solutions, these use cases will be at the frontier of AI’s applications in healthcare.

It has oft been said that physicians make the worst patients, but it is the opinion of This Author that any man makes a terrible patient. One might say it takes patience to be a patient, and heaven knows, the males of our species lack an abundance of patience.

The good physician treats the disease; the great physician treats the patient who has the disease.

The erosion of an effective patient-physician relationship has no place when dealing with chronic pain. Worst of all, dismissing the patient's pain is as devastating as crushing a patient's hope.

THE MAXIMS OF MEDICINE Before you examine the body of a patient, Be patient to learn his story. For once you learn his story, You will also come to know His body. Before you diagnose any sickness, Make sure there is no sickness in the mind or heart. For the emotions in a man’s moon or sun, Can point to the sickness in Any one of his other parts. Before you treat a man with a condition, Know that not all cures can heal all people. For the chemistry that works on one patient, May not work for the next, Because even medicine has its own Conditions. Before asserting a prognosis on any patient, Always be objective and never subjective. For telling a man that he will win the treasure of life, But then later discovering that he will lose, Will harm him more than by telling him That he may lose, But then he wins. THE MAXIMS OF MEDICINE by Suzy Kassem

But the story of leukemia--the story of cancer--isn't the story of doctors who struggle and survive, moving from institution to another. It is the story of patients who struggle and survive, moving from on embankment of illness to another. Resilience, inventiveness, and survivorship--qualities often ascribed to great physicians--are reflected qualities, emanating first from those who struggle with illness and only then mirrored by those who treat them. If the history of medicine is told through the stories of doctors, it is because their contributions stand in place of the more substantive heroism of their patients.

A physician is not angry at the intemperance of a mad patient; nor does he take it ill to be railed at by a man in a fever. Just so should a wise man treat all mankind, as a physician does his patient; and looking upon them only as sick and extravagant.

Before you examine the body of a patient, be patient to learn his story. For once you learn his story, you will also come to know his body.

He thinks I’m having trouble expressing my feelings, which is why he suggested I write in a journal—to get it out, he said, like in the old days when physicians used to bleed their patients in order to drain the mysterious poisons. Which almost always ended up killing them in spite of the doctors’ good intentions, I might point out.

Before you treat a man with a condition, know that not all cures can heal all people. For the chemistry that works on one patient may not work for the next, because even medicine has its own conditions.

I guessed that he was one of those ambitious young physicians who more and more fill the profession, opportunists with a fashionable hoodlum image, openly hostile to their patients. My brief stay at the hospital had already convinced me that the medical profession was an open door to anyone nursing a grudge against the human race.

I had learned something, something not found in Hippocrates, Maimonides, or Osler: the physician's duty is not to stave off death or return patients to their old lives, but to take into our arms a patient and family whose lives have disintegrated and work until they can stand back up and face, and make sense of, their own existence.

Physicians, patients, and ethicists must also understand that acknowledging abuse and encouraging African Americans to participate in research are compatible goals. History and today's deplorable African American health profile tell us clearly that black Americans need both more research and more vigilance.

Greed is the world's greatest illness, love is the world's greatest physician, the soul is the world's greatest patient, and benevolence is the world's greatest remedy.

Physician, heal thyself: then wilt thou also heal thy patient. Let it be his best cure to see with his eyes him who maketh himself whole.

Before you diagnose any sickness, make sure there is no sickness in the mind or heart. For the emotions in a man's moon or sun, can point to the sickness in any one of his other parts.

Before asserting a prognosis on any patient, always be objective and never subjective. For telling a man that he will win the treasure of life, but then later discovering that he will lose, will harm him more than by telling him that he may lose, but then he wins.

Physicians don’t do the best for their patients because they: practice defensive medicine (Self-defense), do not understand health statistics (Innumeracy), or pursue profit instead of virtue (Conflicts of interest).

love, n. A temporary insanity curable by marriage of by removal of the patient from the influences under which he/she incurred the disorder. This disease, like Caries and many other ailments, is prevalent only among civilized races living under artificial conditions; barbarous nations breathing pure air and eating simple food enjoy immunity from its ravages. It is sometimes fatal, but more frequently to the physician than the patient.

This book carries the urgency of racing against time, of having important things to say. Paul confronted death—examined it, wrestled with it, accepted it—as a physician and a patient. He wanted to help people understand death and face their mortality.

long-term survivors had poor relationships with their physicians—as judged by the physicians. They asked a lot of questions and expressed their emotions freely.

I don't think you can be a physician and not see yourself reflected in your patient's illness. How would I deal with the kind of news I'd given Mr. Walters?

Through all this, patients were getting used to demanding drugs for treatment. They did not, however, have to accept the idea that they might, say, eat better and exercise more, and that this might help them lose weight and feel better. Doctors, of course, couldn’t insist. As the defenestration of the physician’s authority and clinical experience was under way, patients didn’t have to take accountability for their own behavior.

Certainly the primary imperative of a physician is to be skilled in medical science, but if he or she does not probe a patient's soul, then the doctor's care is given without caring, and part of the sacred mission of healing is missing.

We have all heard such stories of expert intuition: the chess master who walks past a street game and announces “White mates in three” without stopping, or the physician who makes a complex diagnosis after a single glance at a patient. Expert intuition strikes us as magical, but it is not. Indeed, each of us performs feats of intuitive expertise many times each day. Most of us are pitch-perfect in detecting anger in the first word of a telephone call, recognize as we enter a room that we were the subject of the conversation, and quickly react to subtle signs that the driver of the car in the next lane is dangerous. Our everyday intuitive abilities are no less marvelous than the striking insights of an experienced firefighter or physician—only more common. The psychology of accurate intuition involves no magic. Perhaps the best short statement of it is by the great Herbert Simon, who studied chess masters and showed that after thousands of hours of practice they come to see the pieces on the board differently from the rest of us. You can feel Simon’s impatience with the mythologizing of expert intuition when he writes: “The situation has provided a cue; this cue has given the expert access to information stored in memory, and the information provides the answer. Intuition is nothing more and nothing less than recognition.

A note for physicians: if you listen carefully to what patients say, they will often tell you not only what is wrong with them but also what is wrong with you.

Such is the demographic paradox of a junior physician's relationship with his patients: I worry about how to extend their lives. This anxiety inevitably shortens my own.

These drugs were advertised mostly to primary care physicians, who had little pain-management training and were making their money by churning patients through their offices at a thirteen-minute clip.

A physician violates his duty to his patient and subjects himself to liability if he withholds any facts which are necessary to form the basis of an intelligent consent by the patient to the proposed treatment.” He wrote that there needed to be “full disclosure of facts necessary to an informed consent.

To the person who has anything to conceal—to the person who wants to lose his identity as one leaf among the leaves of a forest—to the person who asks no more than to pass by and be forgotten, there is one name above others which promises a haven of safety and oblivion. London. Where no one knows his neighbour. Where shops do not know their customers. Where physicians are suddenly called to unknown patients whom they never see again. Where you may lie dead in your house for months together unmissed and unnoticed till the gas-inspector comes to look at the meter. Where strangers are friendly and friends are casual. London, whose rather untidy and grubby bosom is the repository of so many odd secrets. Discreet, incurious and all-enfolding London.

The physician of the soul is aware that his patient will receive no nourishment unless he has been cleaned out; and the soul of the Great King himself, if he has not undergone this purification, is unclean and impure.

Somatic Symptoms: People with Complex PTSD often have medical unexplained physical symptoms such as abdominal pains, headaches, joint and muscle pain, stomach problems, and elimination problems. These people are sometimes most unfortunately mislabeled as hypochondriacs or as exaggerating their physical problems. But these problems are real, even though they may not be related to a specific physical diagnosis. Some dissociative parts are stuck in the past experiences that involved pain may intrude such that a person experiences unexplained pain or other physical symptoms. And more generally, chronic stress affects the body in all kinds of ways, just as it does the mind. In fact, the mind and body cannot be separated. Unfortunately, the connection between current physical symptoms and past traumatizing events is not always so clear to either the individual or the physician, at least for a while. At the same time we know that people who have suffered from serious medical, problems. It is therefore very important that you have physical problems checked out, to make sure you do not have a problem from which you need medical help.

As a doctor I constantly have to ask myself what kind of message the patient is bringing me. What does he mean to me? If he means nothing, I have no point of attack. The doctor is effective only when he himself is affected. 'Only the wounded physician heals.' But when the doctor wears his personality like a coat of armor, he has no effect.

Prescription, n.: A physician's guess at what will best prolong the situation with least harm to the patient.

Families, in some ways, became our second set of patients. They needed time and attention, and if you failed to provide that, things could deteriorate quickly.

A Medical Affair is more than compelling fiction. It also is a powerful narrative about how relationships between physicians and patients can evolve in unethical, even unlawful ways. And as a medical ethicist and educator, I was delighted to see Strauss deftly weave important information about sexual misconduct by physicians into her story line.” David Orentlicher Professor of law, medicine and ethics at Indiana University. Oversaw drafting of American Medical Association's ethical guidelines on intimate relationships between physicians and their patients

Remember. You are a physician. You are not a policeman nor are you a minister of religion. You must take people as they come. Remember, too that though you will generally know more about the condition than the patient, it is the patient who has the condition and this if nothing else bestows on him or her a kind of wisdom. You have the knowledge but that does not entitle you to be superior. Knowledge makes you the servant not the master.

So Medicare decided to pay hospitals like ours for internship and residency training programs, get it? It’s a win-win, as they say—the hospital gets patients cared for by interns and residents around the clock,people like us who live on site, and whose stipend is a bloody fraction of what the hospital would pay full-time physicians. And Medicare delivers health care to the poor.

Government agencies are trying to get doctors to cut back on prescribing opioids. I understand that they need to do something about the epidemic of overdoses. However, labeling everyone as addicts, including those who responsibly take opioids for chronic pain, is not the answer. If the proposed changes take effect, they would force physicians to neglect their patients. Moreover, legitimate pain patients, like myself, would be left in agony on a daily basis.

One might have complained about the soot and ashes or about the pipes and curtain rods that hung crazily from the ceiling, but patients never lived in a hospital ward so nearly free of bacteria as this one that was sterilized by fire.

Our essential connection with animals is ancient, and it runs deep. It extends from body to behavior, from psychology to society—forming the basis of our daily journey of survival. This calls for physicians and patients to think beyond the human bedside to barnyards, jungles, oceans, and skies. Because the fate of our world’s health doesn’t depend solely on how we humans fare. Rather it will be determined by how all the patients on the planet live, grow, get sick, and heal.

The important question isn't how to keep bad physicians from harming patient; it's how to keep good physicians from harming patients. Medical malpractice suits are a remarkably ineffective remedy. (In reference to a Harvard Medical Practice Study)... fewer than 2 percent of the patients who had received substandard care ever filed suit. Conversely, only a small minority among patients who did sue had in fact been victims of negligent care. And a patient's likelihood of winning a suit depended primarily on how poor his or her outcome was, regardless of whether that outcome was caused by disease or unavoidable risks of care. The deeper problem with medical malpractice is that by demonizing errors they prevent doctors from acknowledging & discussing them publicly. The tort system makes adversaries of patient & physician, and pushes each other to offer a heavily slanted version of events.

Physicians, though they put their patients to much pain, will not destroy their nature, but will raise it up by degrees. Surgeons will pierce and cut but not mutilate. A mother who has a sick and self-willed child will not cast it away for this reason. And shall there be more mercy in the stream than there is in the spring? Shall we think there is more mercy in ourselves than in God, who plants the feeling of mercy in us?

Six witnesses affirmed that Jacoba had cured them, even after numerous doctors had given up, and one patient declared that she was wiser in the art of surgery and medicine than any master physician or surgeon in Paris. But these testimonials were used against her, for the charge was not that she was incompetent, but that—as a woman—she dared to cure at all.

But if I did not know what I wanted, I had learned something, something not found in Hippocrates, Maimonides, or Osler: the physician’s duty is not to stave off death or return patients to their old lives, but to take into our arms a patient and family whose lives have disintegrated and work until they can stand back up and face, and make sense of, their own existence.

I speak as a planetary physician whose patient, the living Earth, complains of fever; I see the Earth's declining health as our most important concern, our very lives depending upon a healthy Earth. Our concern for it must come first, because the welfare of the burgeoning mass of humanity demands a healthy planet.

A modern hospital is like Grand Central Station—all noise and hubbub, and is filled with smoking physicians, nurses, orderlies, patients and visitors. Soft drinks are sold on each floor and everybody guzzles these popular poisons. The stench of chemicals offends the nose, while tranquillizers substitute for quietness.

Hippocrates, who lived about 400 years before Jesus, often wrote about how physicians should ethically interact with patients. But Hippocrates never mentioned children. That’s because children were property, no different than slaves. But Jesus stood up for children, cared about them, when those around him typically didn’t.

The liquor, that is, the rye, was all about the same: most people bought drug store rye on prescriptions (the physicians who were club members saved 'scrips' for their patients), and cut it with alcohol and colored water. It was not poisonous, and it got you tight, which was all that was required of it and all that could be said for it.

I didn't know. But if I did not know what I wanted, I had learned something, something not found in Hippocrates, Maimonides, or Osler: the physician's duty is not to stave off death or return patients to their old lives, but to take into our arms a patient and family whose lives have disintegrated and work until they can stand back up and face, and make sense of, their own existence.

I didn’t know. But if I did not know what I wanted, I had learned something, something not found in Hippocrates, Maimonides, or Osler: the physician’s duty is not to stave off death or return patients to their old lives, but to take into our arms a patient and family whose lives have disintegrated and work until they can stand back up and face, and make sense of, their own existence.

The freedom of patient speech is necessary if the doctor is to get clues about the medical enigma before him. If the patient is inhibited, or cut off prematurely, or constrained into one path of discussion, then the doctor may not be told something vital. Observers have noted that, on average, physicians interrupt patients within eighteen seconds of when they begin telling their story.

Where there were once several competing approaches to medicine, there is now only one that matters to most hospitals, insurers, and the vast majority of the public. One that has been shaped to a great degree by the successful development of potent cures that followed the discovery of sulfa drugs. Aspiring caregivers today are chosen as much (or more) for their scientific abilities, their talent for mastering these manifold technological and pharmaceutical advances as for their interpersonal skills. A century ago most physicians were careful, conservative observers who provided comfort to patients and their families. Today they act: They prescribe, they treat, they cure. They routinely perform what were once considered miracles. The result, in the view of some, has been a shift in the profession from caregiver to technician. The powerful new drugs changed how care was given as well as who gave it.

We should make it a rule not to seek to impose hypnotic treatment on any patient. A prejudice is widespread among the public (actually supported by some eminent, but in this matter inexperienced, physicians) that hypnosis is a dangerous operation. If we sought to impose hypnosis on someone who believed this assertion, we should probably be interrupted, after no more than a few minutes, by disagreeable occurrences, which would arise from the patient's anxiety and his distressing feeling of garded as results of hypnosis.

Our world is in turmoil. It is aging toward senility. It is very ill. Long ago it was born with brilliant prospects. It was baptized by water, and its sins were washed away. It was never baptized by fire, for that is still to come. It has had shorter periods of good health, but longer ones of ailing. Most of the time there have been pains and aches in some parts of its anatomy, but now that it is growing old, complications have set in, and all the ailments seem to be everywhere. The world has been ‘cliniced,’ and the complex diseases have been catalogued. The physicians have had summit consultations, and temporary salve has been rubbed on afflicted parts, but it has only postponed the fatal day and never cured it. It seems that while remedies have been applied, staph infection has set in, and the patient’s suffering intensified. His mind is wandering. It cannot remember its previous illnesses nor the cure which was applied. The political physicians through the ages have rejected suggested remedies as unprofessional since they came from lowly prophets. Man being what he is with tendencies such as he has, results can be prognosticated with some degree of accuracy.

As for the prayers, I suppose they can’t hurt. I’ve never found much good in them, I’ll confess that here, though I keep such thoughts private when in public company. Who would confide in a physician who claimed no affiliation with God? I still must feed myself, and keep my house. I still need my patients. But too many people believe with too much conviction in what amounts to, at best, a superstition. I’ve seen science change a patient’s diagnosis, but I’ve never heard a prayer that changed God’s mind about a damn thing..

Logotherapy bases its technique called “paradoxical intention” on the twofold fact that fear brings about that which one is afraid of, and that hyper-intention makes impossible what one wishes. In German I described paradoxical intention as early as 1939.11 In this approach the phobic patient is invited to intend, even if only for a moment, precisely that which he fears. Let me recall a case. A young physician consulted me because of his fear of perspiring. Whenever he expected an outbreak of perspiration, this anticipatory anxiety was enough to precipitate excessive sweating. In order to cut this circle formation I advised the patient, in the event that sweating should recur, to resolve deliberately to show people how much he could sweat. A week later he returned to report that whenever he met anyone who triggered his anticipatory anxiety, he said to himself, “I only sweated out a quart before, but now I’m going to pour at least ten quarts!” The result was that, after suffering from his phobia for four years, he was able, after a single session, to free himself permanently of it within one week. The reader will note that this procedure consists of a reversal of the patient’s attitude, inasmuch as his fear is replaced by a paradoxical wish. By this treatment, the wind is taken out of the sails of the anxiety. Such a procedure, however, must make use of the specifically human capacity for self-detachment inherent in a sense of humor. This basic capacity to detach one from oneself is actualized whenever the logotherapeutic technique called paradoxical intention is applied. At the same time, the patient is enabled to put himself at a distance from his own neurosis. A statement consistent with this is found in Gordon W. Allport’s book, The Individual and His Religion: “The neurotic who learns to laugh at himself may be on the way to self-management, perhaps to cure.”12 Paradoxical intention is the empirical validation and clinical application of Allport’s statement.

Hippocrates, the father of modern medicine, had described the body’s ability to heal itself, which he called veriditas (green life force). He believed that the physician’s job was to identify which forces were keeping the patient from healing himself and then remove them.

With the managed care movement of the 1980s and 1990s, insurance companies cut costs and reduced what services they’d pay for. They required that patients give up their longtime physicians for those on a list of approved providers. They negotiated lower fees with doctors. To make up the difference, primary care docs had to fit more patients into a day. (A Newsweek story claimed that to do a good job a primary care doctor ought to have a roster of eighteen hundred patients. The average load today is twenty-three hundred, with some seeing up to three thousand.)

The United States spends more than twice as much per capita on health care as other rich capitalist countries —around $9,400 compared to around $3,600—and for that money its citizens can expect lives that are three years shorter. The United States spends more per capita on health care than any other country in the world, but 39 countries have longer life expectancies. [...] Under the current US system, rich, insured patients visit doctors more than they need, running up costs, while poor patients cannot afford even simple, inexpensive treatments and die younger than they should. Doctors spend time that could be used to save lives or treat illness by providing unnecessary, meaningless care. What a tragic waste of physician care.

Several years ago, researchers at the University of Minnesota identified 568 men and women over the age of seventy who were living independently but were at high risk of becoming disabled because of chronic health problems, recent illness, or cognitive changes. With their permission, the researchers randomly assigned half of them to see a team of geriatric nurses and doctors—a team dedicated to the art and science of managing old age. The others were asked to see their usual physician, who was notified of their high-risk status. Within eighteen months, 10 percent of the patients in both groups had died. But the patients who had seen a geriatrics team were a quarter less likely to become disabled and half as likely to develop depression. They were 40 percent less likely to require home health services. These were stunning results. If scientists came up with a device—call it an automatic defrailer—that wouldn’t extend your life but would slash the likelihood you’d end up in a nursing home or miserable with depression, we’d be clamoring for it. We wouldn’t care if doctors had to open up your chest and plug the thing into your heart. We’d have pink-ribbon campaigns to get one for every person over seventy-five. Congress would be holding hearings demanding to know why forty-year-olds couldn’t get them installed. Medical students would be jockeying to become defrailulation specialists, and Wall Street would be bidding up company stock prices. Instead, it was just geriatrics. The geriatric teams weren’t doing lung biopsies or back surgery or insertion of automatic defrailers. What they did was to simplify medications. They saw that arthritis was controlled. They made sure toenails were trimmed and meals were square. They looked for worrisome signs of isolation and had a social worker check that the patient’s home was safe. How do we reward this kind of work? Chad Boult, the geriatrician who was the lead investigator of the University of Minnesota study, can tell you. A few months after he published the results, demonstrating how much better people’s lives were with specialized geriatric care, the university closed the division of geriatrics.

This book carries the urgency of racing against time, of having important things to say. Paul confronted death—examined it, wrestled with it, accepted it—as a physician and a patient. He wanted to help people understand death and face their mortality. Dying in one’s fourth decade is unusual now, but dying is not.

physicians, Drs. Bill Castelli, Bill Roberts and Caldwell Esselstyn, Jr., that in their long careers they had never seen a heart disease fatality among their patients who had blood cholesterol levels below 150 mg/dL. Dr. Castelli was the long-time director of the famous Framingham Heart Study of NIH; Dr. Esselstyn was a renowned surgeon at the Cleveland Clinic who did a remarkable study reversing heart disease (chapter five); Dr. Roberts has long been editor of the prestigious medical journal Cardiology. BLOOD CHOLESTEROL AND DIET

These six forget those who have bestowed obligations on them, viz., educated disciples, their preceptors; married persons, their mothers; persons whose desires have been gratified, women; they who have achieved success, they who had rendered aid; they who have crossed a river, the boat (that carried them over); and patients that have been cured, their physicians.

Imagine another scene, one that occurred when he was twenty years older. At an academic symposium on Ellen West, a heavily studied patient who committed suicide several decades before, Rogers startled the audience by the depth and intensity of his reaction. He spoke about Ellen West as though he knew her well, as though it were only yesterday that she had poisoned herself. Not only did Rogers express his sorrow about her tragically wasted life, but also his anger at her physicians and psychiatrists who, through their impersonality and preoccupation with precise diagnosis, had transformed her into an object. How could they have? Rogers asked.

In a sense, everything is magic: magic, for example, is the science of herbs and metals, which allows the physician to influence both malady and patient; magical, too, is illness itself, which imposes itself upon a body like a demonical possession of which sometimes the body is unwilling to be healed. The power of sounds, high or low, is magic, disturbing the soul, or possibly soothing it. Magic, above all, is the virulent force of words, which are almost always stronger than the things for which they stand; their power justifies what is said about them in the Sepher Yetsira, not to mention between us the Gospel According to Saint John. Magical is the prestige which surrounds a monarch, and which emanates from the ceremonies of the Church; and magical in their effect, likewise, are the scaffolds draped in black and the lugubrious roll of drums at executions; all such trappings transfix and terrify the gaping onlookers even more than they awe the victims. And finally, love is magic, as is hatred, too, imprinting as they do upon the brain the image of a being whom we allow to haunt us.

There are cancers so insidious in their nature that their very pulsation is invisible. Such cancers leave the ivory whiteness of the skin untouched, and marble not the firm, fair flesh, with their blue tints; the physician who bends over the patient's chest hears not, through he listens, the insatiable teeth of the disease grinding its onward progress through the muscles, as the blood flows freely on; the knife has never been able to destroy, and rarely even, temporarily, to discern the rage of these mortal scourges; their home is in the mind, which they corrupt; they fill the whole heart until it breaks. Such, madame, are the cancers, fatal to queens; are you, too, free from their scourge?

Then if any one at all is to have the privilege of lying, the rulers of the State should be the persons; and they, in their dealings either with enemies or with their own citizens, may be allowed to lie for the public good. But nobody else should meddle with anything of the kind; and although the rulers have this privilege, for a private man to lie to them in return is to be deemed a more heinous fault than for the patient or the pupil of a gymnasium not to speak the truth about his own bodily illnesses to the physician or to the trainer, or for a sailor not to tell the captain what is happening about the ship and the rest of the crew, and how things are going with himself or his fellow sailors. Most

Over the years I have had much occasion to ponder this word, the intelligentsia. We are all very fond of including ourselves in it—but you see not all of us belong. In the Soviet Union this word has acquired a completely distorted meaning. They began to classify among the intelligentsia all those who don't work (and are afraid to) with their hands. All the Party, government, military, and trade union bureaucrats have been included. All bookkeepers and accountants—the mechanical slaves of Debit. All office employees. And with even greater ease we include here all teachers (even those who are no more than talking textbooks and have neither independent knowledge nor an independent view of education). All physicians, including those capable only of making doodles on the patients' case histories. And without the slightest hesitation all those who are only in the vicinity of editorial offices, publishing houses, cinema studios, and philharmonic orchestras are included here, not even to mention those who actually get published, make films, or pull a fiddle bow. And yet the truth is that not one of these criteria permits a person to be classified in the intelligentsia. If we do not want to lose this concept, we must not devalue it. The intellectual is not defined by professional pursuit and type of occupation. Nor are good upbringing and good family enough in themselves to produce and intellectual. An intellectual is a person whose interests in and preoccupation with the spiritual side of life are insistent and constant and not forced by external circumstances, even flying in the face of them. An intellectual is a person whose thought is nonimitative.

Discounting mental behavior as a factor of sickness definitely sounds irrational, much less so than myths. Every practitioner knows that the will of the patient to recover plays a vital part in his treatment. Wedded to "strong" treatment, most physicians can nevertheless accept the idea that mentality, conviction and feelings do not play their part. At the dawn of Western medicine, Hippocrates claimed that "a patient who is mortally ill may yet recover from his doctor's confidence in the goodness." This has been corroborated by several modern studies, showing that people who trust their doctor and yield to his care are more likely to recover than those who treat treatment with distrust, anxiety and antagonism.

After hearing much from his patients about alleged faith-healing, a Minnesota physician named William Nolen spent a year and a half trying to track down the most striking cases. Was there clear medical evidence that the disease was really present before the ‘cure’? If so, had the disease actually disappeared after the cure, or did we just have the healer’s or the patient’s say-so? He uncovered many cases of fraud, including the first exposure in America of ‘psychic surgery’. But he found not one instance of cure of any serious organic (non-psychogenic) disease. There were no cases where gallstones or rheumatoid arthritis, say, were cured, much less cancer or cardiovascular disease. When a child’s spleen is ruptured, Nolen noted, perform a simple surgical operation and the child is completely better. But take that child to a faith-healer and she’s dead in a day.

Once I had been diagnosed with a terminal illness, I began to view the world through two perspectives; I was starting to see death as both doctor and patient. As a doctor, I knew not to declare “Cancer is a battle I’m going to win!” or ask “Why me?” (Answer: Why not me?) I knew a lot about medical care, complications, and treatment algorithms. I quickly learned from my oncologist and my own study that stage IV lung cancer today was a disease whose story might be changing, like AIDS in the late 1980s: still a rapidly fatal illness but with emerging therapies that were, for the first time, providing years of life. While being trained as a physician and scientist had helped me process the data and accept the limits of what that data could reveal about my prognosis, it didn’t help me as a patient. It didn’t tell Lucy and me whether we should go ahead and have a child, or what it meant to nurture a new life while mine faded. Nor did it tell me whether to fight for my career, to reclaim the ambitions I had single-mindedly pursued for so long, but without the surety of the time to complete them. Like my own patients, I had to face my mortality and try to understand what made my life worth living—and I needed Emma’s help to do so. Torn between being a doctor and being a patient, delving into medical science and turning back to literature for answers, I struggled, while facing my own death, to rebuild my old life—or perhaps find a new one. —

These reports from the IOM, AHRQ, and NIH demonstrate how much we have learned about ME/CFS and how much we still do not know. We do not understand its pathogenesis, and we do not have a diagnostic test or a cure. However, these recent reports, summarizing information from more than 9000 articles, should put the question of whether ME/CFS is a "real" illness to rest. When skeptical physicians, many of whom are unaware of this literature, tell patients with ME/CFS that "there is nothing wrong," they not only commit a diagnostic error: They also compound the patients' suffering.

During her time at Miss Porter’s School in Farmington she had often become depressed and was hobbled by fatigue. In 1887, when she was twenty, she wrote in her diary, “Tears come without any provocation. Headache all day.” The school’s headmistress and founder, Sarah Porter, offered therapeutic counsel. “Cheer up,” she told Theodate. “Always be happy.” It did not work. The next year, in March 1888, her parents sent her to Philadelphia, to be examined and cared for by Dr. Silas Weir Mitchell, a physician famous for treating patients, mainly women, suffering from neurasthenia, or nervous exhaustion. Mitchell’s solution for Theodate was his then-famous “Rest Cure,” a period of forced inactivity lasting up to two months. “At first, and in some cases for four or five weeks, I do not permit the patient to sit up or to sew or write or read,” Mitchell wrote, in his book Fat and Blood. “The only action allowed is that needed to clean the teeth.” He forbade some patients from rolling over on their own, insisting they do so only with the help of a nurse. “In such cases I arrange to have the bowels and water passed while lying down, and the patient is lifted on to a lounge at bedtime and sponged, and then lifted back again into the newly-made bed.” For stubborn cases, he reserved mild electrical shock, delivered while the patient was in a filled bathtub. His method reflected his own dim view of women. In his book Wear and Tear; or, Hints for the Overworked, he wrote that women “would do far better if the brain were very lightly tasked.

Nonviolent coercion always brings tension to the surface. This tension, however, must not be seen as destructive. There is a kind of tension that is both healthy and necessary for growth. Society needs nonviolent gadflies to bring its tensions into the open and force its citizens to confront the ugliness of their prejudices and the tragedy of their racism. It is important for the liberal to see that the oppressed person who agitates for his rights is not the creator of tension....How strange it would be to condemn a physician who, through persistent work and the ingenuity of his medical skills, discovered cancer in a patient. Would anyone be so ignorant as to say he caused the cancer? Through the skills and discipline of direct action we reveal that there is a dangerous cancer of hatred and racism in our society. We did not cause the cancer; we merely exposed it. Only through this kind of exposure will the cancer be cured.

Experts in diagnostic errors provided an answer to the puzzle that had been nagging me: How was it possible for missed diagnoses to be so common and yet not perceived by doctors as a major problem? The problem is that physicians, while generally aware that mistakes happen, greatly underestimate how often they make them. In his talks to doctors on the topic, Graber often asks how many have made a diagnostic error in the past year; typically, only about 1 percent of the hands go up. 'The concept that they, personally, could err at a significant rate is inconceivable to most physicians,' he writes. In short, they think it's the other guy. This overconfidence is not necessarily their fault: doctors simply do not get the feedback needed to gain an accurate sense of their batting average. They assume their diagnoses are correct until they hear otherwise. Since there are few, if any, health care organizations that systematically measure diagnostic error rates, they typically learn of their mistakes only from the patients themselves.

But I will tell you another misery that is not to be denied. In the common, natural course of events physicians, surgeons and apothecaries are faced with enormous demands for sympathy: they may come into immediate contact with half a dozen deeply distressing cases in a single day. Those who are not saints are in danger of running out of funds and becoming bankrupt; a state which deprives them of a great deal of their humanity. If the man is in private practice he is obliged to utter more or less appropriate words to preserve his connexion, his living;and the mere adoption of a compassionate face as you have no doubt observed goes some little way towards producing at least the ghost of pity. But our patients cannot leave us. They have no alternative. We are not required to put on a conciliating expression, for our inhumanity in no way affects our livelihood. We have a monopoly; and I believe that many of us pay a very ugly price for it in the long run. You must already have met a number of callous idle self-important self-indulgent hardhearted pragmatic brutes wherever the patients have no free choice.

The cure for HIV?” “In 2007, a man named Timothy Ray Brown, known later as the Berlin patient, was cured of HIV. Brown was diagnosed with acute myeloid leukemia. His HIV-positive status complicated his treatment. During chemotherapy, he battled sepsis, and his physicians had to explore less traditional approaches. His hematologist, Dr. Gero Hutter, decided on a stem cell therapy: a full bone marrow transplant. Hutter actually passed over the matched bone marrow donor for a donor with a specific genetic mutation: CCR5-Delta 32. CCR5-Delta 32 makes cells immune to HIV.” “Incredible.” “Yes. At first, we thought the Delta 32 mutation must have arisen during the Black Death in Europe—about four to sixteen percent of Europeans have at least one copy. But we’ve traced it back further. We thought perhaps smallpox, but we’ve found Bronze Age DNA samples that carry it. The mutation’s origins are a mystery, but one thing is certain: the bone marrow transplant with CCR5-Delta 32 cured both Brown’s leukemia and HIV. After the transplant, he stopped taking his antiretrovirals and has never again tested positive for HIV.

The physician had asked the patient to read aloud a paragraph from the statutes of Trinity College, Dublin. ‘It shall be in the power of the College to examine or not examine every Licentiate, previous to his admission to a fellowship, as they shall think fit.’ What the patient actually read was: ‘An the bee-what in the tee-mother of the trothodoodoo, to majoram or that emidrate, eni eni krastei, mestreit to ketra totombreidei, to ra from treido a that kekritest.’ Marvellous! Philip said to himself as he copied down the last word. What style! What majestic beauty! The richness and sonority of the opening phrase! ‘An the bee-what in the tee-mother of the trothodoodoo.’ He repeated it to himself. ‘I shall print it on the title page of my next novel,’ he wrote in his notebook.

If I show you, that you lack just what is most important and necessary to happiness, that hitherto your attention has been bestowed on everything rather than that which claims it most; and, to crown all, that you know neither what God nor Man is—neither what Good or Evil is: why, that you are ignorant of everything else, perhaps you may bear to be told; but to hear that you know nothing of yourself, how could you submit to that? How could you stand your ground and suffer that to be proved? Clearly not at all. You instantly turn away in wrath. Yet what harm have I done to you? Unless indeed the mirror harms the ill-favoured man by showing him to himself just as he is; unless the physician can be thought to insult his patient, when he tells him:—"Friend, do you suppose there is nothing wrong with you? why, you have a fever. Eat nothing to-day, and drink only water." Yet no one says, "What an insufferable insult!" Whereas if you say to a man, "Your desires are inflamed, your instincts of rejection are weak and low, your aims are inconsistent, your impulses are not in harmony with Nature, your opinions are rash and false," he forthwith goes away and complains that you have insulted him.

When I interviewed with the Chief of Family Medicine at a large medical corporation on the West Coast, he explained that, since he was part of a team of people who arranged for pharmaceutical companies to issue cash grants, he was in a position to offer me a particularly enticing salary. “What are the grants for?” I asked. “We have a quality improvement program that tracks physician prescribing patterns. We call it ‘quality’ but it’s really about money.” And that’s all it’s about. It works like this. In his organization, any patient with LDL cholesterol over 100 is put on a cholesterol-lowering medication. Any person with a blood pressure higher than 140/90 is put on a blood pressure medication. Any person with “low bone density” is put on a bone-remodeling inhibitor. And so on. The doctors who prescribe the most get big bonuses. Those who prescribe the least get fired. With a hint of incredulousness in his voice, he explained, “So far, every time we’ve asked for funding for our program, the drug companies give it to us.” If this is where healthcare is headed, then these hybrid physicians-executives will instinctively turn their gaze to our children and invent more creative methods to bulldoze an entire generation into the bottomless pit of chronic disease.

Before you examine the body of a patient, Be patient to learn his story. For once you learn his story, You will also come to know His body. Before you diagnose any sickness, Make sure there is no sickness in the mind or heart. For the emotions in a man's moon or sun, Can point to the sickness in Any one of his other parts. Before you treat a man with a condition, Know that not all cures can heal all people. For the chemistry that works on one patient, May not work for the next, Because even medicine has its own Conditions. Before asserting a prognosis on any patient, Always be objective and never subjective. For telling a man that he will win the treasure of life, But then later discovering that he will lose, Will harm him more than by telling him That he may lose, But then he wins. THE MAXIMS OF MEDICINE by Suzy Kassem Copyright 1993-1994 - THE SPRING FOR WISDOM

The conceptual problem at the center of contemporary healthcare is the confusion between disease processes and disease origins. Instead of asking why an illness occurs and trying to remove the conditions that led to it, medical researchers try to understand the mechanisms through which the disease operates, so that they can then interfere with them. These mechanisms, rather than the true origins, are seen as the causes of disease in current medical thinking. In the process of reducing illness to disease, the attention of physicians has moved away from the patient as a whole person. By concentrating on smaller and smaller fragments of the body – shifting its perspective from the study of bodily organs and their functions to that of cells and, finally, to the study of molecules – modern medicine often loses sight of the human being, and having reduced health to mechanical functioning, it is no longer able to deal with the phenomenon of healing. Over the past four decades, the dissatisfaction with the mechanistic approach to health and healthcare has grown rapidly both among healthcare professionals and the general public. At the same time, the emerging systems view of life has given rise to a corresponding systems view of health, as we discuss in Chapter 15, while health consciousness among the general population has increased dramatically in many countries. The

In 1994, Friedman wrote a memo marked “Very Confidential” to Raymond, Mortimer, and Richard Sackler. The market for cancer pain was significant, Friedman pointed out: four million prescriptions a year. In fact, there were three-quarters of a million prescriptions just for MS Contin. “We believe that the FDA will restrict our initial launch of OxyContin to the Cancer pain market,” Friedman wrote. But what if, over time, the drug extended beyond that? There was a much greater market for other types of pain: back pain, neck pain, arthritis, fibromyalgia. According to the wrestler turned pain doctor John Bonica, one in three Americans was suffering from untreated chronic pain. If that was even somewhat true, it represented an enormous untapped market. What if you could figure out a way to market this new drug, OxyContin, to all those patients? The plan would have to remain secret for the time being, but in his memo to the Sacklers, Friedman confirmed that the intention was “to expand the use of OxyContin beyond Cancer patients to chronic non-malignant pain.” This was a hugely audacious scheme. In the 1940s, Arthur Sackler had watched the introduction of Thorazine. It was a “major” tranquilizer that worked wonders on patients who were psychotic. But the way the Sackler family made its first great fortune was with Arthur’s involvement in marketing the “minor” tranquilizers Librium and Valium. Thorazine was perceived as a heavy-duty solution for a heavy-duty problem, but the market for the drug was naturally limited to people suffering from severe enough conditions to warrant a major tranquilizer. The beauty of the minor tranquilizers was that they were for everyone. The reason those drugs were such a success was that they were pills that you could pop to relieve an extraordinary range of common psychological and emotional ailments. Now Arthur’s brothers and his nephew Richard would make the same pivot with a painkiller: they had enjoyed great success with MS Contin, but it was perceived as a heavy-duty drug for cancer. And cancer was a limited market. If you could figure out a way to market OxyContin not just for cancer but for any sort of pain, the profits would be astronomical. It was “imperative,” Friedman told the Sacklers, “that we establish a literature” to support this kind of positioning. They would suggest OxyContin for “the broadest range of use.” Still, they faced one significant hurdle. Oxycodone is roughly twice as potent as morphine, and as a consequence OxyContin would be a much stronger drug than MS Contin. American doctors still tended to take great care in administering strong opioids because of long-established concerns about the addictiveness of these drugs. For years, proponents of MS Contin had argued that in an end-of-life situation, when someone is in a mortal fight with cancer, it was a bit silly to worry about the patient’s getting hooked on morphine. But if Purdue wanted to market a powerful opioid like OxyContin for less acute, more persistent types of pain, one challenge would be the perception, among physicians, that opioids could be very addictive. If OxyContin was going to achieve its full commercial potential, the Sacklers and Purdue would have to undo that perception.

Several years ago I was lecturing in British Columbia. Dr [Simon] Wessely was speaking and he gave a thoroughly enjoyable lecture on M.E. and CFS. He had the hundreds of staff physicians laughing themselves silly over the invented griefs of the M.E. and CFS patients who according to Dr Wessely had no physical illness what so ever but a lot of misguided imagination. I was appalled at his sheer effectiveness, the amazing control he had over the minds of the staid physicians….His message was very clear and very simple. If I can paraphrase him: “M.E. and CFS are non-existent illnesses with no pathology what-so-ever. There is no reason why they all cannot return to work tomorrow. The next morning I left by car with my crew and arrived in Kelowna British Columbia that afternoon. We were staying at a patient’s house who had severe M.E. with dysautanomia and was for all purposes bed ridden or house bound most of the day. That morning she had received a phone call from her insurance company in Toronto. (Toronto is approximately 2742 miles from Vancouver). The insurance call was as follows and again I paraphrase: “Physicians at a University of British Columbia University have demonstrated that there is no pathological or physiological basis for M.E. or CFS. Your disability benefits have been stopped as of this month. You will have to pay back the funds we have sent you previously. We will contact you shortly with the exact amount you owe us”. That night I spoke to several patients or their spouses came up to me and told me they had received the same message. They were in understandable fear. What is important about this story is that at that meeting it was only Dr Wessely who was speaking out against M.E. and CFS and how … were the insurance companies in Toronto and elsewhere able to obtain this information and get back to the patients within a 24 hour period if Simon Wessely was not working for the insurance industry… I understand that it was also the insurance industry who paid for Dr Wessely’s trip to Vancouver.

The next year, in March 1888, her parents sent her to Philadelphia, to be examined and cared for by Dr. Silas Weir Mitchell, a physician famous for treating patients, mainly women, suffering from neurasthenia, or nervous exhaustion. Mitchell’s solution for Theodate was his then-famous “Rest Cure,” a period of forced inactivity lasting up to two months. “At first, and in some cases for four or five weeks, I do not permit the patient to sit up or to sew or write or read,” Mitchell wrote, in his book Fat and Blood. “The only action allowed is that needed to clean the teeth.” He forbade some patients from rolling over on their own, insisting they do so only with the help of a nurse. “In such cases I arrange to have the bowels and water passed while lying down, and the patient is lifted on to a lounge at bedtime and sponged, and then lifted back again into the newly-made bed.” For stubborn cases, he reserved mild electrical shock, delivered while the patient was in a filled bathtub. His method reflected his own dim view of women. In his book Wear and Tear; or, Hints for the Overworked, he wrote that women “would do far better if the brain were very lightly tasked.

It seems obvious that throughout history, as one of the few professions open to women, midwifery must have attracted women of unusual intelligence, competence, and self-respect§. While acknowledging that many remedies used by the witches were “purely magical” and worked, if at all, by suggestion, Ehrenreich and English point out an important distinction between the witch-healer and the medical man of the late Middle Ages: . . . the witch was an empiricist; She relied on her senses rather than on faith or doctrine, she believed in trial and error, cause and effect. Her attitude was not religiously passive, but actively inquiring. She trusted her ability to find ways to deal with disease, pregnancy and childbirth—whether through medication or charms. In short, her magic was the science of her time. By contrast: There was nothing in late mediaeval medical training that conflicted with church doctrine, and little that we would recognize as “science”. Medical students . . . spent years studying Plato, Aristotle and Christian theology. . . . While a student, a doctor rarely saw any patients at all, and no experimentation of any kind was taught. . . . Confronted with a sick person, the university-trained physician had little to go on but superstition. . . . Such was the state of medical “science” at the time when witch-healers were persecuted for being practitioners of “magic”.15 Since asepsis and the transmission of disease through bacteria and unwashed hands was utterly unknown until the latter part of the nineteenth century, dirt was a presence in any medical situation—real dirt, not the misogynistic dirt associated by males with the female body. The midwife, who attended only women in labor, carried fewer disease bacteria with her than the physician.

Harm reduction is often perceived as being inimical to the ultimate purpose of “curing” addiction—that is, of helping addicts transcend their habits and to heal. People regard it as “coddling” addicts, as enabling them to continue their destructive ways. It’s also considered to be the opposite of abstinence, which many regard as the only legitimate goal of addiction treatment. Such a distinction is artificial. The issue in medical practice is always how best to help a patient. If a cure is possible and probable without doing greater harm, then cure is the objective. When it isn’t — and in most chronic medical conditions cure is not the expected outcome — the physician’s role is to help the patient with the symptoms and to reduce the harm done by the disease process. In rheumatoid arthritis, for example, one aims to prevent joint inflammation and bone destruction and, in all events, to reduce pain. In incurable cancers we aim to prolong life, if that can be achieved without a loss of life quality, and also to control symptoms. In other words, harm reduction means making the lives of afflicted human beings more bearable, more worth living. That is also the goal of harm reduction in the context of addiction. Although hardcore drug addiction is much more than a disease, the harm reduction model is essential to its treatment. Given our lack of a systematic, evidencebased approach to addiction, in many cases it’s futile to dream of a cure. So long as society ostracizes the addict and the legal system does everything it can to heighten the drug problem, the welfare and medical systems can aim only to mitigate some of its effects. Sad to say, in our context harm reduction means reducing not only the harm caused by the disease of addiction, but also the harm caused by the social assault on drug addicts.

We were beginning to see that the medical profession, at the time still over 90 percent male, had transformed childbirth from a natural event into a surgical operation performed on an unconscious patient in what approximated a sterile environment. Routinely, the woman about to give birth was subjected to an enema, had her pubic hair shaved off, and was placed in the lithotomy position - on her back, with knees up and crotch spread wide open. As the baby began to emerge, the obstetrician performed an episiotomy, a surgical enlargement of the vaginal opening, which had to be stitched back together after birth. Each of these procedures came with a medical rationale: The enema was to prevent contamination with feces; the pubic hair was shaved because it might be unclean; the episiotomy was meant to ease the baby's exit. But each of these was also painful, both physically and otherwise, and some came with their own risks, Shaving produces small cuts and abrasions that are open to infection; episiotomy scars heal m ore slowly than natural tears and can make it difficult for the woman to walk or relieve herself for weeks afterward. The lithotomy position may be more congenial for the physician than kneeling before a sitting woman, but it impedes the baby's process through the birth canal and can lead to tailbone injuries in the mother.

Given the central place that technology holds in our lives, it is astonishing that technology companies have not put more resources into fixing this global problem. Advanced computer systems and artificial intelligence (AI) could play a much bigger role in shaping diagnosis and prescription. While the up-front costs of using such technology may be sizeable, the long-term benefits to the health-care system need to be factored into value assessments. We believe that AI platforms could improve on the empirical prescription approach. Physicians work long hours under stressful conditions and have to keep up to date on the latest medical research. To make this work more manageable, the health-care system encourages doctors to specialize. However, the vast majority of antibiotics are prescribed either by generalists (e.g., general practitioners or emergency physicians) or by specialists in fields other than infectious disease, largely because of the need to treat infections quickly. An AI system can process far more information than a single human, and, even more important, it can remember everything with perfect accuracy. Such a system could theoretically enable a generalist doctor to be as effective as, or even superior to, a specialist at prescribing. The system would guide doctors and patients to different treatment options, assigning each a probability of success based on real-world data. The physician could then consider which treatment was most appropriate.

While all of us dread being blamed, we all would wish to be more responsible—that is, to have the ability to respond with awareness to the circumstances of our lives rather than just reacting. We want to be the authoritative person in our own lives: in charge, able to make the authentic decisions that affect us. There is no true responsibility without awareness. One of the weaknesses of the Western medical approach is that we have made the physician the only authority, with the patient too often a mere recipient of the treatment or cure. People are deprived of the opportunity to become truly responsible. None of us are to be blamed if we succumb to illness and death. Any one of us might succumb at any time, but the more we can learn about ourselves, the less prone we are to become passive victims. Mind and body links have to be seen not only for our understanding of illness but also for our understanding of health. Dr. Robert Maunder, on the psychiatric faculty of the University of Toronto, has written about the mindbody interface in disease. “Trying to identify and to answer the question of stress,” he said to me in an interview, “is more likely to lead to health than ignoring the question.” In healing, every bit of information, every piece of the truth, may be crucial. If a link exists between emotions and physiology, not to inform people of it will deprive them of a powerful tool. And here we confront the inadequacy of language. Even to speak about links between mind and body is to imply that two discrete entities are somehow connected to each other. Yet in life there is no such separation; there is no body that is not mind, no mind that is not body. The word mindbody has been suggested to convey the real state of things. Not even in the West is mind-body thinking completely new. In one of Plato’s dialogues, Socrates quotes a Thracian doctor’s criticism of his Greek colleagues: “This is the reason why the cure of so many diseases is unknown to the physicians of Hellas; they are ignorant of the whole. For this is the great error of our day in the treatment of the human body, that physicians separate the mind from the body.” You cannot split mind from body, said Socrates—nearly two and a half millennia before the advent of psychoneuroimmunoendocrinology!

A 2016 study published in Proceedings of the National Academy of Sciences of the United States of America suggested that health care providers may underestimate black patients' pain in part due to a belief that they simply don't actually feel as much pain - a myth that dates all the way back to the days of slavery. For centuries, the claim that black people were biologically different from whites was 'championed by scientists, physicians, and slave owners alike to justify slavery and the inhumane treatment of black men and women in medical research,' the authors wrote. Black people were thought to have 'thicker skulls, less sensitive nervous systems,' and a super-human ability to 'tolerate surgical operations with little, if any, pain at all.' In the first phase of the study, over two hundred white medical students and residents were asked whether a series of statements about differences between black and white patients were true or false. Some of the statements were true, while others - for example, 'blacks' skin is thicker than whites' and 'blacks' nerve endings are less sensitive than whites' - were false. They found that a full half of the respondents thought that one or more the false statements - many of which were 'fantastical in nature' - were possibly, probably, or definitely true. Also, notably, many of them didn't agree with the statements that were actually true; only half of the residents knew that white patients are less likely to have heart disease than black patients are. When asked to read case studies of two patients complaining of pain, one white and one black, the respondents who had endorsed more false beliefs were more likely to believe that the black patient felt less pain, and undertreated them accordingly.