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March 22, 1976

Is It Obvious Why Patients Ask Questions?

Author Affiliations

University of Rochester School of Medicine Rochester, NY
From the Medical-Psychiatric Liaison Unit, University of Rochester (NY) School of Medicine.

JAMA. 1976;235(12):1223-1224. doi:10.1001/jama.1976.03260380017018

THE QUESTIONS that patients put to their physicians are more than unilevel in meaning. On the one hand, they deal with the reality factors of being ill; on the other, they involve root problems of dependency, potency, shame, guilt, and self-awareness.

The question "Why did all this happen to me?" reiterated from the book of Job is often dismissed as a philosophical or theological dilemma. Nothing human is outside the scope of medicine. An analysis and attempt to answer this question is a useful introduction to the human process of becoming ill.

Complementary to the molecular disturbances involved in illness and aging, a similar homologous disruption is occurring at a psychological level. Stable psychic structures are called into question. Previous self-images are no longer coherent and consistent. Job was a righteous man and offered sacrifice daily to God, but still he lost his possessions and became ill with a skin