PubMed · 2737849
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R M Caplan. 1989. Craftsmanship.. https://pubmed.ncbi.nlm.nih.gov/2737849/
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This is the speech delivered by Bernardino Piñera MD, a catholic bishop, at the time of his incorporation as an Honorary Member of the Chilean Academy of Medicine. Medicine, health, and life, suffering and death are endowed with marvelous elements of reenchantment; turn pain into well-being, anxiety into serenity, fear into confidence; give sense to life and death, live and make men feel their human dignity. Many a patient miss the times when the doctor was a friend who knew him, not through biochemical or imaging diagnosis but through intimate conversation; when he was familiar with his character, his family and environment; when he could die in peace at home, surrounded by his family and thinking of God according to his religious beliefs. A profound change in medical conscience is needed, a philosophical and cultural change, allowing "high touch" to dominate and use "high tech". Let us transform the words sick or patient into "sick man" or "suffering man". Let us think of death as a culminating moment of life on earth, not as a failure of Medicine, but as the joyful acceptance of human destiny.
This is and address delivered by the author on being elected Member of the Chilean Academy of Letters. It develops the notion of medicine as a metatext composed by different "texts": the physiological, the introspective and the behavioral. Each of these narratives derives its meaning from the "context" provided by the others and is articulated differently according to the social roles allotted to the participants in communicative transactions. Medicine, as communicative praxis, is a science of actions rather than objects which can be understood as process, procedure and product. In the light of these concept the distinction between illness, disease and sickness receives a new emphasis.