PSYCHOLOGICAL HANDLING OF THE CHRONICALLY INCAPACITATED PATIENT

• Epilepsy, hemiplegia, cerebral palsy, and paralysis after poliomyelitis are a few examples of the chronically incapacitating conditions in which the physician's knowledge of the disease needs to be supplemented by his understanding of the patient. The fears of death, of pain, and of disability need to be recognized and overcome. A family facing bereavement should be put into action; a physician who knows their circumstances is aware of many important things that need to be done. Working in line with a patient's existing motivations, the physician can induce him to use residual powers to best advantage. The patient identifies himself with a physician whom he respects and likes; suggestion can then be effectively used, the patient can be educated as to his condition, and group therapy can sometimes be employed. The gains that have been made by the science should be paralleled by more emphasis on the art of medicine.