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By R. M. Shaw, R. A. Bowen, G. E. Paget

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Extra resources for All Heal. A Medical and Social Miscellany

Sample text

The few patients who by public propaganda are induced to seek early advice are as nothing to the many who do so and are not given it. Cancer: Patient's Viewpoint and Clinician s Problems 45 As a surgeon I would like to conclude this third NufField Lecture by quoting the remarks of that great British surgeon, eloquent of speech, broad in mind, kind in nature, skilful in execution and courageous in his approach to cancer surgery—Gordon-Taylor: . . 'the vision splendid', which for us is that long-desired day, perhaps not too far distant, when in the cure of cancer gross mechanical destruction and cruel mutilation of human tissues shall no longer be required, nor the scorching methods and machinery of Hephaestus the blacksmith god, or Prometheus who stole fire from heaven!

Sequence of events looms large in the patient's mind. ' And often retrospectively there is a recollection of some event, some injury perhaps trivial and vague. But the patient or his widow fastens on to this; hence the claims for industrial compensation or pension sometimes supported by medical opinions, although not supported by facts or by the known natural history of cancer. Most such claims are based on sequence of events : 'Post hoc, propter hoc\ Ί was well when I joined the Army or Navy or Air Force—I got my cancer in the Service', or Ί fell whilst at work', Ί sustained a knock or a blow on duty'.

G. declarative, interrogative, interjectional, hortatory. One and the same stereotype can serve now as an exclamation, now as a question, later as a proposition. 54 MACDONALD CRITCHLEY Non-verbal aids to communication, such as kinesics, soon become pressed into service. With his intact limb and facial musculature the patient will employ a rich pantomime in order to eke out the meaning he seeks to attach to his solitary utterance. At a later date, if and when the stereotypy becomes established as the sole articuleme, the patient may make an extraordinary adjustment.

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