H. Speidel – författare

The Surgeon as a Humanist Medicine is the most humane of the sciences and the most scientific of the humanities. Cardiac surgery today provides a most natural confluence for the high technology of medicine and the humanistic values traditional in the practice of medicine. The cardiac surgeon must, of necessity, be knowledgeable in physiology and cardio­ logy, and must also possess consummate surgical technical skill. The attainment of these skills over long years of training leads many of these surgeons to believe or per­ ceive this long struggle as an apotheosis of their position in life, rather than as an education in bringing the latest scientific advances to the care of patients. The problem lies not only with the cardiac surgeon; it is also contributed to by the patients'' perception of heart surgery, heart disease, and the mystery of the science and physiology involved. The patient with heart disease expecting surgery may, for the first time, be facing the finiteness of his existence. The low risk of cardiac surgery to­ day not withstanding, the coronary surgery patients, most likely a type A personality, is faced with a perceived threat to his invulnerability, his self-image, his family, his independence, his control of situations, and his very existence.

The Surgeon as a Humanist Medicine is the most humane of the sciences and the most scientific of the humanities. Cardiac surgery today provides a most natural confluence for the high technology of medicine and the humanistic values traditional in the practice of medicine. The cardiac surgeon must, of necessity, be knowledgeable in physiology and cardio­ logy, and must also possess consummate surgical technical skill. The attainment of these skills over long years of training leads many of these surgeons to believe or per­ ceive this long struggle as an apotheosis of their position in life, rather than as an education in bringing the latest scientific advances to the care of patients. The problem lies not only with the cardiac surgeon; it is also contributed to by the patients' perception of heart surgery, heart disease, and the mystery of the science and physiology involved. The patient with heart disease expecting surgery may, for the first time, be facing the finiteness of his existence. The low risk of cardiac surgery to­ day not withstanding, the coronary surgery patients, most likely a type A personality, is faced with a perceived threat to his invulnerability, his self-image, his family, his independence, his control of situations, and his very existence.

Dieses Buch informiert umfassend über physiologische, psycho­ logische, soziale, technische und organisatorische Fragen, die im Zusammenhang mit der Dialyse auftreten. Es unterrichtet dar­ über hinaus über die komplexen Probleme, welche eine chroni­ sche Krankheit, die für den Kranken eine ständige, nur durch unausgesetzte medizinische Betreuung und Überwachung ab­ wendbare Todesdrohung bedeutet, für die Interaktion zwischen Kranken, Ärzten, Pflegepersonal und Angehörigen aufwirft. Da­ mit wird das Buch zum Dokument für eine bemerkenswerte Etappe in der Entwicklung der modernen Medizin, die zwei für sie vitale Probleme lösen muß: Die Einführung des Kranken als Subjekt in die Heilkunde, die Viktor von Weizsäcker forderte, und die Integration der sich ständig vermehrenden Spezialdiszi­ plinen zu einem einheitlichen System. Zu dem ersten Problem dokumentiert das Buch die schein­ bar paradoxe Tatsache, daß die Einführung des Kranken als Subjekt, die der Psychologie bisher trotz aller Anstrengungen nicht gelungen ist, von der Perfektion der Technik - gegen deren eigentliche Intention - erzwungen wird. Der Grund dafür ist die Erfahrung, daß die Subjektivität des Kranken zu einem Hinder­ nis für den technischen Fortschritt in der Medizin wird, das durch weitere Perfektionierung der Technik nicht überwunden werden kann.