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Biomedical subjects

B Hontschik

Publications and source records attributed to B Hontschik.

4 recordsLinked to original sources
PubMed1999

[Psychological aspects in surgery--surgical aspects in psychology: psychosomatic medicine in routine practice?].

Medicine appears to have reached a standstill, in particular surgery: While progress in apparative diagnostics and therapy, e.g. by ultrasound, endoscopy, laparoscopy, and arthroscopy, has reached in some areas "breathtaking speed", the parties concerned-surgeons and patients-lose in reserve air to breathe: no time for any profound consideration, no chance for in-depth talking before surgical procedures are performed, no training for giving real support after surgery. Do we see a brand of surgery which feels responsible only for a human machine without soul? Meanwhile discussions have begun inside medicine in general about a change of paradigms, ways of thinking, the model of the world. Surgery can even make substantial contributions to this change of paradigms. Surgery for the human machine? Psychosomatic ways of thinking are first seen not applicable for surgery. Substantial anxiety exists to take notice of each other. Three concrete examples from everyday practice in surgery demonstrate, how psychosomatic thinking can change and enrich surgical practice: From the area of indications reflections about appendectomy, from the operative-surgical area the phenomenon of self-destructive behaviour, from the restitutive area experiences in treatment of osteomyelitis. Back to the interpersonal area! Psychosomatics must be recognised as a way of thinking and be integrated as such into surgery. A so-called "integrated surgery" will arise. The examples demonstrate also, that it is not some anonymous surgical medicine, which must and can change, but that only the individual surgeon as a concrete person can bring back his work into the interpersonal area.

Adaptation, Psychological↗
PubMed1995

[Life crisis and surgical intervention. Significance of interfamiliar crisis for indication for appendectomy].

Psychosomatic thinking leads a shadowy existence in surgery. That this is not justified is shown here by using the example of erroneous indications for appendectomies. Historical analysis revealed that the idea of 'chronic recurrent' appendicitis was erroneous from the very beginning. It can only be understood in the context of the particular medico-scientific conditions in the early 20th century. Statistical analysis identifies primarily girls and young women as the group predominantly affected by this erroneous diagnosis: mostly women have been and are operated, whereas true (= acute) appendicitis is a disease predominating in males. By means of a psychodynamically oriented look at stereotypically occurring individual cases in a heuristic manner, links to statistic results were found, permitting a restrictive concept for indications which was new for our hospital but had already been realized for a long time in the Anglo-American countries. Within three years daily surgical practice could be modeled, so that the number of appendectomies decreased to one fourth of the original number, while the frequency of acute appendicitis and of cases with perforated appendix remained unchanged. For the first time more male than female patients have been appendectomized, in accordance with the epidemiology of the disease. Altogether, this qualitative success was only possible, because the psychosomatic way of thinking by the involved physicians has been accepted for daily surgical routine on all hierarchic levels. It is therefore stressed that surgeons, too, should participate regularly in Balint groups, above all during specialization.

Adolescent↗