The patient not the disease

Heroes Not Zombies

Eric Cassell has a new book out. The Nature of Clinical Medicine. Maybe not a title which grabs your imagination but I was very influenced by two of his earlier works – The Healer’s Art, and The Nature of Suffering. In particular, I appreciated the way he articulated the difference between “disease” and “illness”. It seemed to me that the patient’s illness could only be understood by including their story, their reports of the invisible, subjective experiences we call symptoms.

When I studied Medicine in Edinburgh, the first three years of the six year degree course had a curriculum of “medical sciences” and so my first degree was a BSc in Medical Sciences. It was only when we entered into Year 4 that we were introduced to patients and to a curriculum of “clinical medicine”. So, the first time I saw “cirrhosis of the liver” it was in a…

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