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April 11, 1980

Anatomy of an Illness as Perceived by the Patient

Author Affiliations

American Medical Association Chicago

JAMA. 1980;243(14):1471. doi:10.1001/jama.1980.03300400055038

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Just before Christmas 1976, a report of the diagnosis and treatment of an illness appeared in a medical journal. There is, of course, nothing unusual about that, except that this report dealt with just one patient and was written by the patient himself— Norman Cousins, for more than 30 years an editor of Saturday Review magazine.

As an intelligent, well-educated layman with a strong determination to overcome his illness, Cousins was disinclined to accept hospitalization and treatment unquestioningly. Some might consider him a "difficult" patient in that he refused to let technicians draw blood more frequently than once every three days and challenged the hospital diet as poorly balanced.

But he also studied his own illness, speculated on its possible causes, and—in a kind of partnership with his physician—undertook some unusual approaches to overcoming it. Among these was the medicine of laughter, resulting from the reading of amusing books and