Five Patients [antikvár]

ForewordThere has recently been a lot of foolish talk about something called "the new medicine." To the extent that it implies a distinction from some form of old medicine, the phrase has no meaning at all. Medicine has crossed no watershed; there has been no triumphant breakthrough, no quantum jump in science or technology or social application.Yet there is, within medicine itself, a sense that things are different. It is difficult to define, for it is not the consequence of change, but rather the fact of change itself.The first time I began to look at the Massachusetts General Hospital in the spring of 19691 had the uneasy feeling there was too much flux, too much instability in the system. I felt a little like an interviewer who has come upon his subject at a bad time. Only later did I realize that there would never be a "good" time, and that change is a constant feature of the hospital environment. The true figurehead of modern medicine is not Hippocrates but Heraclitus.To trace a history of change, one must go back about fifty years, to the time when organized research began to produce major new scientific and technological advances. Medicine has been revolutionized by those advances, but they have not stopped. Indeed, the pace of change has increased. Within the past ten years, social pressures have been added to those of science and tech-