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January 1981

The Second Dimension

Author Affiliations

Department of Surgery University of Colorado Medical Center 4200 E Ninth Ave Denver, CO 80226

Arch Surg. 1981;116(1):11-13. doi:10.1001/archsurg.1981.01380130005001

As the art of surgery slowly develops into an applied clinical science, therapeutic decisions are increasingly made on the basis of numbers. Recently we summarized, in algorithmic form, data on which many surgical decisions are made.1 While assembling this data, it became evident that we were recording only one dimension of life, namely its length. Although this is obviously of importance, it alone is an incomplete scale for choosing among therapeutic options. Life has meaning (depth) as well as length; quality of life is its second dimension.

But how can a number value be assigned to the qualities of love, friendship, the appreciation of sound, color, touch, taste, physical excitement? There are those who, despite severe physical disabilities, live full and happy lives by any social, economic, philosophic, or emotional standards. Others are destroyed by a seemingly trivial handicap. One person may be perfectly content with a sedentary existence,

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