Transcript
Page 1: Captain, my captain, who shall be captain?

member of a pi'ofession's personalneeds for' self-satisfaction, or' status inlife, makes him eligible for' such member-ship. Moreover there's rio questionthat some patients could be greatlyhelped by various well-wishers if theywere given the opportunity. The pr'incipal problem is: who is the to!) responsible pel'son in the patient-pr'ofessionalrelationship? Whether' we like it or' not,all group activity needs one final to!)individual to make the ultimate decision—--a captain. Who shall be the captain? Who shall be the patient's to!)professional adviser in sickness or injury?

In cancer', the patient-physician r'elationship is of extreme impor'tancebecause it is so often a life-or-deathstruggle which extends over a long penod of time. Cancer' patients have oftensaid that they could riot have sur-vivedthe stress and terror of the disease ifthey had not had the constant, faithfulsupport of their' own physician. Nomatter how many specialists participate in the tr'eatment, patients tendto depend on the one physician withover--all r'esponsibility for' their' totalmedical management. Those who wouldincrease the size of the “¿�healthteam,―or' tamper- with the patient-physicianrelationship, should remember' thateven within the medical profession itself, the l)r'Oblem has arisen of the oversegmented, over'-compar'tmentalized patient, who rio longer' is considered awhole being but mer'ely a parcel ofl)arts. Shall the patient now be foughtover not only foi his par'ts, but for' hisparts—parts? Shall rnultidisciplinar'yr'ivalr'ies over status, “¿�peckorder,― or“¿�r'ights―be allowed to determine thecourse of events in his illness, whichitself takes no sides in the total attackon him?

Captain, my captain, who shall becaptain ?

Because cancer is a disease of suchmai'ked diversification, its managementhas challenged many scientific disciplines. The response has been so energetic that the patient often findshimself in the midst of an active battleground between the par'amedical profess ions.

For the nioi'e orderly and coordinatedfunctioning of the var'ious health professions, a “¿�healthteam― concept hasbeen pr'oposed for' patient management.What the “¿�healthteam― is, who inviteswhom to become nienibers, and who has“¿�i'ights―as team member's, etc., wasdiscussed in a scholarly special cornmunication published in the J.4MA[October' 7, 1961]. The author' of thearticle decries any “¿�peckorder― whichmay exist among the various member'sof the “¿�team―and appeals for their'voluntar'y coor'dinated cooper'at ion. Hestates that the medical professionshould be magnanimous in yielding tothe other' health pr-ofessions in the“¿�peckor'der― for' patient i-esponsihility.He points out that unless such niagnan im ity is spontaneously displayed,government r'egulations will bring itabout. The threat of govermment control is riot a new appr'oach to the physician, but pr'esenting it under- the titleof “¿�voluntar'ycoor'dination― is unique.

One of the r'easons for- admission tothe “¿�healthteam,― according to thearticle, “¿�isto obtain satisfaction fr'omour day-to-day activities.― It may hethat a law will he passed to give a memher' of a profession “¿�i'ights―on the“¿�healthteam.― It may even be that a

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