xt7fn29p3x4h https://exploreuk.uky.edu/dips/xt7fn29p3x4h/data/mets.xml The Frontier Nursing Service, Inc. 1980 bulletins  English The Frontier Nursing Service, Inc. Contact the Special Collections Research Center for information regarding rights and use of this collection. Frontier Nursing Service Quarterly Bulletins Frontier Nursing Service Quarterly Bulletin, Vol. 56, No. 2, Autumn 1980 text Frontier Nursing Service Quarterly Bulletin, Vol. 56, No. 2, Autumn 1980 1980 2014 true xt7fn29p3x4h section xt7fn29p3x4h VOLUME 56 AUTUMN, 1980 NUMBER 2
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US ISSN 0016-2116 I  
Cover: Nativity Scene arranged with creche figures from Bogota,  
in the mountains of Columbia. Many graduates of the I il,
Frontier School of Midwifery and Family Nursing have  
gone all over the world to practice what they have learned QQ
here, and of those who have gone overseas, several are still  
working in South and Central America. ‘
—Ph0t0 by Gabrielle Beasley
  s i
US ISSN 0016-2116 _, .
Published at thc end of each quarter by the Frontier Nursing Service, Inc. it , i
Wendover, Kentucky 41775 2 `
Subscription Price $2.00 a Year i  
Edit0r`s Office, Wendover, Kentucky 41775  
Second-class postage paid at Wendover, Ky. 41775 and at additional mailing offices  
Send Form 3579 to Frontier Nursing Service, Wendover, Ky. 41775 I
Copyright 1980, Frontier Nursing Service, Inc. I
J ,

5  `.l I
 ll French, Flemish, or Fake? 2 `
  ENT Clinic Sally Rogers 10
 _— Perspectives in i
E; ` Humanistic Medicine Tim Carey, MD. 12 ,
 lv  Molly’s Thanksgiving Tradition Patti Rogers, FNP 17 l
    Cancer: A Demonstration of Hope Alice Basch, M.S.N 19 ·
  The Work of a Midwife Marian Barrett 22 I
  · Old Staff News 26
f Old Courier News 27  
` Student News 28
  Frederick Zerzavy, M.D. 29
{ Dr. Brandon 30
‘ Recollections of Winter Dale Deaton and Lynn Lady 31
  Memorial Gifts 39 l 
 . In Memoriam 41 _
§ Ambulance Service ‘
. In Leslie County Bill Chamberlain 42
) Urgent Needs 44
Y The Big House Restoration Dale Deaton 45 `
1 Beyond The Mountains Kate Ireland 47
Q Field Notes 49
l Staff Opportunities 52
 A Statement of Ownership 58

 2 Faomxmz Nmzsmo smavics ~
St. Christopher’s Chapel, located on Hospital Hill, looks out '
over the small but busy town of Hyden. It was constructed in 1960- .
61 with walls of local stone, chairs, and woodwork crafted by local
men, ironwork for the door, candlesticks, and the cross also of  
local craftsmanship. The kneeler, which spreads the length of the  
altar space, was designed in Boston and worked by many hands, NX
one of whom was Courier Fanny Mcllvain. The cross was `¥
designed by Dr. Beasley and the ironwork by Courier Virginia R
Branham. Eugene Dixon did the ironwork, George Bowling set *< i
the sixteen inch walls, and Oscar Bowling, who did many projects Q
for the FNS over the years, crafted the chairs and other wood .3
work. The first service was held in the not-quite-complete ; 
‘ Chapel on Christmas Eve, 1960, and a midnight service on  
Christmas Eve has been held annually ever since. The Chapel  
was dedicated on April, 22, 1961 and was consecrated by the *
Bishop of Lexington on May 11, 1961.  
The window was thought to be 14th or 15th century French. It  i
was given to Mrs. Breckinridge in 1938 or ’39 by her cousin, Dr. 2 
Preston Pope Satterwhite of New York, who had the window in his  Q
home. Mrs. Breckinridge said she asked him for it every time she  
visited him because St. Christopher was the patron saint of the  
FNS nurses. He finally gave it to her, she said, "to get rid of me". A  
stained glass expert from Cincinnati supervised the installation  
of the window and chose the colored glass for the side windows. ri 
In an effort to {ind out the value of the window (for insurance  
purposes), correspondence with the expert from Cincinnati was  
resumed in June, 1979. A color photo was forwarded to the -* 
Riordan Stained Glass Studio to speed the process of the  
appraisal. When the pictures were forwarded to Mr. Walter _,
Bambach, new owner of the Riordan Stained Glass Studio, in W
Covington, Peggy Elmore, who had been conducting assiduous _ 
research on the window, noticed from the photographs that there . `
appeared to have been some damage to the side panels at one time, (
now no longer in evidence. Perhaps they had been repaired
between 1939 and 1960. At the time of the installation, Mr.
Riordan had commented on the side panels, which seemed to be of
a later date than the central panel (or lancet). Things dragged on.

QUARTERLY summu a ?
The verdict, given in October, 1979, from Mr. Bambach was that
J the window was a copy, probably reproduced by G. Owen Bonawit
, Studio of New York, dating, most likely, from the early 1900s.
i Never before had any doubt been expressed about the authen-
Q ticity of the St. Christopher’s window. We needed a second ·
I opinion. Peggy wrote to Barbara Wriston, a Trustee who had
, expressed some interest in the window on a visit to Hyden, and she
_ wrote to the Speed Museum in Louisville where most of Dr. I
  Satterwhite’s collection is housed. A reply from the Speed Y
?f__r Museum seemed to hold out little hope: the museum had had a
· V difficult time trying to establish the authenticity of several of the
l pieces in the Satterwhite collection, and the most it could do was to
x ~ suggest getting in contact with French and Company in New
; York, through whom Dr. Satterwhite had purchased most of his
  collection. A letter was sent off. Peggy noted that the window had A
  a similarity to a St. Christopher and Christ Child in All-Hallows’
 _ in North Street in York, England. A response from Mr. Samuel,
if formerly with French & Co., brought discouraging news: he
  thought the window a probable fake, and for two reasons. One, it
  was the vogue in the early 1900s to have a stained glass window
  somewhere in one’s home or apartment, and few were authentic.
’  Two, much of Dr. Satterwhite’s apartment and its contents were
I  reproductions or fakes. What to do? It was now January, 1980. _
  Peggy got in contact with a friend at the College of Nursing at
Zi the University of Kentucky, Pam Keogh, who studies medieval
  stained glass as a hobby. After much research, (as the following
  essay below will show,) Pam believed the window to be an original
  piece of work — or at least part of it was. Then, two months later a
 i note from the Curator of American Decorative Arts at the
  Metropolitan Museum of Fine Arts, who had been contacted by
  our Trustee Barbara Wriston, Mr. Heckscher had contacted a
  colleague at the Cloisters branch, Jane Hayward, who confirmed:
I "The window is: a) medieval; b) English; c) fifteenth century. It l
Q. looks to be a very good one and I hope it will be properly taken care
of." The problem seemed solved. French, Flemish, or fake? None
_’ ’ - of the above, thank you. It seems to be the real McCoy, or at least
 y the consensus is no better — and no worse — than fifty/fifty.
"The St. Christopher’s window welcomes the visitor to the
Chapel. Its soft light holds the colors and charges the tracery of
figure and design with a transcendental luminosity. Rich ruby; a

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shading of blue; yellow warmed by the golden flicker of candles  
above the altar. h
"The window consists of three lancets (or panels). The center T
shows the figure of St. Christopher in a canopied niche bearing
the Christ Child on his left shoulder as he wades through the -
‘ water (from right to left). The infant Saviour has two fingers of the
  right hand up in blessing. In His left hand is the orb and cross and
 ` behind His head, a petal-shaped nimbus (lacking the usual ~
_: attribute of the cross). The glass is white, the design painted in I
T? brown with touches of yellow marking the edge ofthe nimbus, the
Q curls of the hair, the orb and cross, and forming an ornate square
pattern inset with a small flower shape on the robe. St.
$· Christopher wears a toga or cloak of white with flowing lines
marked in brown. Bordering the sleeves and edges is a richly
’ patterned motif in yellow. His legs are characteristically bare to `
if  the knee with the ties or linen bands forming pendant ends over
j the waves. The water is drawn in waves in which two fish are
— clearly discernable swimming about his bare feet.
"Paint is used to delineate the waves about the feet and the
l fish, to give features to the face and details to the hands and to the
  folds of drapery. There is some modeling of the figure. The artist
 ’· has coated the glass a thin brown in places and then dabbed to
  produce a stippled surface that could be softened to give the effect
 · of natural form.
 _ "The background varies from very dark to the palest dispersal
  of blue. In it are placed patterned pieces (diapering) which do not
  appear to ‘match’ .
 . "The staff is of interest. Legend tells how it blossomed with
 Q flowers and fruit after the crossing. Here, it consists of a slender
I  tree trunk shape from which the branches have been cut. The
  whole is in yellow; at the top a large bunched rosette, at the foot a
  spray of roots, both highly stylized. A smaller branch jutting out
  at the left, also in yellow, bears four smaller rosettes. l
,  "The elaborate architectural canopy in white glass is set
l   against a ruby background. It has three fretted pinnacles and two
A i side piers. The center pinnacle is topped with a cinque-foil emblem
. and breaks through the surrounding border. Brown paint
delineates the ornate yellow decorations on the crockets. The side
I piers which support the canopy are made up of a variety of
wreathed and scrolled designs.

"Hanging in front of the canopy is a shield of arms. Such  
shields normally identify the donor of the window. It is yellow and
bears a ship painted a dark russet brown. Itis surrounded by light
brown scrolls or ribbons and is set in a wreath of green laurel or _
ivy leaves indented with six of the cinque—foil emblems. [
"The three-sided pedestal upon which St. Christopher stands  
would normally top the niched vault that would house the donors.  
What is visible is richly emblazoned with the cinque—foil emblems  
repeated throughout the lancet.  
"There are five tracery outlines in blue on each of the side .
lancets. They are linked with each other by circles of red and each
center quarry bears a single medallion or motif. Grisaille patterns
each one: brown lines, lightly etched, are enriched with yellow. l
Readily recognized among the motifs is the letter ‘R’ topped with a i
crown, the rose, a bunch of hazel nuts with oak leaves, a set of  
crossed keys. `
"A border of grisaille foliated ornament surrounds the window  
on three sides. The row of triangles is interrupted by the tallest  
pinnacle in the canopy.  
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  _ QUARTERLY Rurrmru v
V  “Stained glass is glass which is colored with pigment during Q
  its molten phase. Pieces are then cut according to the design and .
Q are bound together by pieces of lead. In painted glass the color is I
;_ not in the glass itself but upon it. The design is painted on before
  the firing. The earlier the glass the less there is of painting upon it,
 _ and the more the burden of design upon the artist. Drawings,
  called cartoons, were executed and used as designs upon which to
if base the window, its color, traceries, lead lines. These cartoons
‘ were often used more than once and were frequently copied.
q` "The origin of stained glass is obscure, but it seems probable
K that the development began in the Middle East. By the late
  fourteenth and early fifteenth centuries, color, lead lines, and the
Pl pattern of paint were arranged to balance in a flow of light that
I ‘ made the window speak to the assembled congregation in the
  emotional terms of the day. Some experts will argue that this
}  period represents the apogee of ecclesiastical stained glass in
y Europe.
6  "When I last talked with Peggy Elmore we returned again to
  the authenticity of the window. Her correspondence pointed to the
P  feasibility of a reproduction. Itis general knowledge that copies of
  fifteenth century English windows were apparently very popular
 2 late in the nineteenth and early twentieth centuries and graced a
 , number of churches in America at that time. But I stayed with the
 ; hunch that it was fifteenth century English from the city of York. I
i  took photographs and returned to examine in greater detail. There
 . were undoubted features which appeared to point to its originality
i  — albeit much repaired and incomplete. The center lancet ends
ij just below the three—sided base or pedestal upon which St.
  Christopher stands. The vaults, barely visible, are cut off at the
1 point below which they would normally house the donors who
frequently occupy this unique architectural niche. Such figures
if would thus extend the lancet to a size more in keeping with the I
yy proportions of base, figure and canopy, and would add a further
I * pair of medallions to the side lancets (making six on each side
i Q instead of five). This loss would explain the absence of the lower
 A border which would normally "frame" the window and which is
  present on the other three sides.
V "A look at the side lancets indicates that they are leaded
i together in a way so counter to the unified demands ofthe original
_. tracery design that it must be supposed that a considerable

 a momma mmsmo smwxcia
reconstruction process was undertaken at one time. A closer look
at the blue glass in the center lancet leads to the notion that .
certain pieces have been incorporated from an earlier firing. Such
tactics were quite common. It was the custom in early stained ‘
glass to hang on to leftover pieces, particularly of blue, and utilize
them in later works.
"Such features, while not tantamount to saying that the A
window is an original, certainly make it seem rather unlikely that  -
it could be a reproduction, particularly in terms of the end result of  r
the reconstruction of the side panels. Such careful piecing does not ’g·
smack of staightforward reproduction. But, what happened to the  
donors, and whether the window was shortened as a whole or in
parts to accomodate what was already existing, is open to  
conjecture. The development of the canopy of white glass is seen
in England during the fifteenth century. The extension of the .
canopy into the grisaille border, breaking the horizontal line is a
feature of York, a key city in the history of stained glass in the -
fifteenth century. There is also the essential proportion of base,
canopy and figure in York stained glass at that time. This
consideration is lost in our St. Christopher window. By the ‘
sixteenth century the canopies had lost this quality and were
highly perpendicular with many crazed pinnacles.
"The York artists appear to have been influenced by the art
movement of Flanders. This is not surprising when much of their
glass was imported from Bruges and Antwerp. What can be
conjectured is that the mid-fifteenth century woodcut known as
the Buxheim St. Christopher may have had its cartoon copied.
T This would account for the fact that while the Buxheim St.
Christopher is crossing from left to right, the York figures =
necessarily cross from right to left, with the infant Christ born on
the opposite shoulder. Another feature of the St. Christophers in
the York context refers to the guild of which St. Christopher was a  
patron. The guilds of St. George and St. Christopher, at one time lr
distinct, were united in 1447. Unlike the Corpus Christi Guild at  `L
York, which had the high clergy and most of the wealthy classes  
as members, the Guild of St. George and St. Christopher was more Y 
civil and democratic in nature. Lancets of St. Christopher and St. i_
George are so frequently to be seen in the stained glass ofthe area
as to be almost a hallmark of York work. Donors who wished to _
commerate their allegiance to both church and guild com-
missioned to have their likenesses placed under the vaulted .

 i QUARTERLY Burrmiu 9
 ‘ pedestal with their shield carried upon the canopy. Such com-
 I memorations may be seen in St. Johns, Mickelgate; St. Martin-le-
 = Belfrey; the Holy Trinity, Goodramsgate; and All Hallows’.
I "A study of ecclesiastical heraldry will no doubt further clues
I  with respect to the medallions. The rose is a York motif. Two keys
appear in York as the modern arms of the see in the mid-fifteenth
I century.
_ "Although it appears promising and highly likely that the
{ window is a York original of the fifteenth century, what
’ vicissitudes it has undergone are still open to conjecture. Perhaps
  experts will deny its place. Whatever is decided, Ithink I speak for
  all who visit the Chapel when I repeat that it is a love offering to
r` God — an offering given in the true spirit of stained glass — glass
— for light and color, lead for line; the whole an emotional appeal to
transcend everyday existence."
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by Sally Rogers, Courier
During the third week of October, Danna Larson, Coodinator .
of Couriers and Volunteers, and I were reminded by Mrs.
Pendleton that the semi-annual Ears, Nose, and Throat Clinic .
would take place at the Mary Breckinridge Hospital on November I
3 through 7. Dr. Bratcher, his assistant Dr. Kaplin, and their ,_
team of audiologists and nurses from the University of Cincinnati Q.
were scheduled to screen patients and then perform approximate-  
ly twenty-four tonsilectomies on children ranging in age from 5 to  
16. Dr. Bratcher and his specialists have been coming down from  
Cincinnati for over ten years for these specialty clinics at their
own expense. Dr. Bratcher believes so strongly in the FNS that he
takes a week twice a year to volunteer his services — and his
abundant good cheer. We are extremely grateful and fortunate to
have this ‘angel over our shoulders.’
Danna and I were relieved to hear that Patty Adams and Eva
Pace, both administrative secretaries, planned to dress up as V
clowns and masquerade in the Primary Care Clinic and on the
Med-Surg floor in order to liven up the hectic, daytime screening .
hours. Danna and I, however, had to entertain the tonsilectomy
patients on the Wednesday evening before their surgery the
following day. We knew that most of the children would be
apprehensive about Thursday’s operation and spending the
night in the strange environment of a hospital, and we wanted to ‘
throw a party that would take their minds off these justified fears.
But the idea of acting out skits and singing songs didn’t appeal to
us. I have the singing voice of a cow and I knew Danna would
refuse to play the piano in public. Danna, however, had a _
brainstorm. What better way for the children to eleviate their g
fears and tensions than to bash them out on pinatas?  
The evenings prior to November ‘5 were spent cutting old yi
newspapers into strips, dunking strips into a messy concoction of
flour and water and applying them over balloon molds. By K
November 4, we had completed three animal pinatas: a rabbit, a  
pig, and a spider, and all were stuffed with candy and toys.  =
Barbara Post, Coordinator of Wendover, had also suggested we `
wrap surprise balls because she believed it was always fun for
someone to unwrap an endless stream of colored crepe-paper and

. eventually find a surprise at the end. Barbara, Danna, and I
 V wrapped and painted a total of fifteen, large surprise balls and
drastically depleted Keen’s Variety Store’s supply of primary
colored crepe-paper and candy.
On November 5 the party began promptly at seven o’clock.
I Nurse Carolyn White and approximately twenty pajama clad
` children piled into the hospital’s second floor elevator, rode up to
` the third floor, and then converged on the classroom. In addition
l to breaking open the pinatas, unwrapping the surprise balls and
1 untangling themselves from a spider web, the patients watched
cartoon film strips on loan from the Leslie County Public Library.
· Nurse Beverly Phelps also outlined all their questions about what
* was going to happen and when.
V By eight o’clock the festivities ended. Gabrielle Beasley had
‘ taped the party and we played back the film (after everyone had
left) to see if we had thrown a successful bash. Barbara, Gabrielle,
L Danna and I laughed at the footage on the pinatas and the antics
of some of the children who had clowned for the camera. I only
Q hope that the patients had a good time; I know we did.
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V M. Garrett tests hearing ofjerome Sizemore. Note the special fold-out on the ENT Clinic
in this issue of the Bulletin.

 iz Fnoimsn NURSING smwxcs
by Tim Carey, M.D.
Until the early twentieth century, the responsibility for an
individual’s health rested firmly with the individual. Physicians
were adept at certain surgical procedures, but medical therapy as
we know it today was essentially non-existent. Such advances as
were made, the development of asepsis, improvement in death j
rates from cholera and typhus, were more the result of basic 4.
sanitation than of advances in medical or surgical therapy.  
With the 1920s, however, the development of surgical tech-  
niques and pharmacologic therapy began which made an ap-  
preciable dent in mortality and morbidity from a number of  
diseases. Medicine, on the infectious disease model, began to look ~ 
as if it could conquer all worlds. The archetypal example is
syphyllis. A common infectious and psychiatric problem (GPI) _` 
could be cured by means of a single injection of penicillin. Would
other diseases be as easy to suppress? Medicine became ‘interven- q
tionist’, with many early successes, and lately, with spiralling _ 
costs and profound doubts on the part of the public as to the  
consequences of modern, reductionist medicine for the quality of  
life. A reductionist approach to medicine assumes that all aspects _i
of an organism can be best understood if it is broken up into its F
smallest parts. The flaws of such an approach to complex j
biological and ecological systems should be obvious. A reduc- Q
tionist approach inevitably leaves out data, and often winds up i
with a flawed result. The case against some of what modern ,
medicine does is reasonably clear, and I shall not belabor that Y
point. i
If the reductionist approach is not to be the saviour of modern { 
man, what then is one to do? More and more emphasis has  
recently been placed on ‘quality of life’, a vague term used to apply ?
to everything from care of the terminally ill (when to quit) to the ”
proper care of what are euphamistically termed "benign, self- 2, 
limited, or functional illnesses." Such issues lend themselves  :4
poorly to the traditional approach. I shall outline two basic ways I- ’
of approaching such problems. I
First, there are altemative methods of viewing health and .
disease, both traditional and modern. Methods such as acupunc-
ture and various meditation techniques have been practised

 A gomrsmy BULLETIN ra ·
Q successfully for centuries and compare favorably with western l
medicine in treating some conditions. Indeed, such techniques I
have been integrated with traditional medicine: acupuncture for I
anesthesia, and meditation for hypertension and tension related
ailments. Other approaches, however, are based on theories of
“ health and disease completely different from western medicine.
Iridology is based on the theory that physical diagnosis can be
. made from the color patterns of the iris. Reflexology is a massage
  treatment based on the supposed connections between the soles of
YI the feet and the visceral organs. Shiatsu, ‘touch for health’, and
  other massage treatments enjoy new popularity.
  Documentation of the efficacy of such treatments is scant, on
  the traditional "reproducable, double-blind" model of proof by
 · western medicine. Efficacy is generally found in the form of
testimonials and anecdotes, without investigation of the effec-
_  tiveness — or ineffectiveness — of these treatments. Nevertheless,
there does seem to be a cohort of patients who benefit from some
such treatments. Whether these patients benefit from biological
 i variability or from some form of placebo effect, their stories are
` often convincing for those diseases for which conventional
—- medicine has little to offer: headaches, back aches, undocumen-
  table pains, etc., but which in many practices make up over 50% of
_} outpatient primary care visits. How to choose patients, though,
l for such referrals? Those referring, and the practitioners involved,
· should assess whether or not the patient’s ailment is amenable to
  conventional therapy, especially in terms of reversible disease. A
k neurological exam is essential before referring a patient for
{ biofeedback for his daily headaches. There is little substitute for
¥ penicillin for pneumonia or surgery for a meningioma. In reality
F most patients at present ‘self-refer’ for alternative treatments.
. This tends to reinforce the gap between conventional medicine
 V and the alternative treatments, suggesting that one is necessarily I
4* a rejection of the other. Alternative treatments in some form are
 , unlikely to go away, and medicine will benefit by coming to terms
 dd with and understanding these treatments.
 -°~ What I have called ‘humanistic medicine’ is the other side of
`  the coin. I view humanistic medicine as an attitude towards our
l_ current form of medicine, something that can be compatible with
. CT scans, renal transplantation, and steel guiacs. Accepting that
modern medicine has a lot to offer, humanistic medicine attempts

 14 Fnourmn Nuasmo smavrcr  .
to transfer the responsibility for health back to the individual.
Thus, the emphasis is on patient education, complete communica-  ,
tion between physician and patient —— not the sham that often  ,
passes for talking to patients that we now see — and individual
self-care in recognizing causation of disease other than the
microbial and cures other than the pharmacologic. Areas such as I
the role of stress in disease, occupationally related disease,  ,
environmentally caused health problems, and the role of life  ?
changes in predisposing an individual to illness have been  `
burgeoning in the past few years. L;
Such a ‘humanistic’ approach can be liberating for the  
practitioner. No longer is every health or social problem ap-
propriate to be laid at the door of the office, the patient a passive ,; I
subject to be ‘cured’. "Patient, heal theyself" might be the maxim
for much of the philosphy of humanistic medicine. Thus,  
physicians no longer need set themselves up for failure by ,
attempting to treat problems medically which might be better  `
treated by changes in attitude or life style on the part of the  .
patient. T
During housestaff training in San Francisco, I had the =
opportunity to participate in a program that tried to put such  .
principles into practice. Regular, unselected ward patients were  
shown their charts and were invited to comment and contribute to I 
their medical charts. Through the use of consultants, an almost  ,
obsessive emphasis was placed on the physician-patient  
relationship. Factors such as the conduct of rounds, who was  
present, with whom communication took place, the bodily at- {
titudes of the physicians in reference to that of the patients all I
came into question and underwent modification. Seminars,  ‘
formal and informal, were held on a variety of problems, often ·
centering on the so-called "why me" syndrome which so many  
patients seem to have after initial hospitalization. Some, certainly “;
a distinct minority, were able to attain insight into causal aspects ii
of their health problems. `  
Insight seemed to follow a pattern which some of the  
humanistic health experts refer to as the "spiral of health." At the  ir
bottom of the spiral, a patient has a passive, accepting attitude  -_
toward illness, feeling that he has little to do with the cause or the  
cure. The second coil of the spiral seems to be one of intellectual  
awareness: the patient takes an interest, learns about his illness J 

‘ l
I and the cures for it. The third phase, one which relatively few l
’ patients in the study achieved, was one of control, where the .
» patient recognized that he might be able to influence the course of R
his disease or prevent future problems. Rather than a sense of
 _ cosmic innovation, such awareness often took the form of
recognition that susceptability to hepatitis, for example, might be
 I related to chronic stress and fatigue, and pneumonia to smoking.
Z  Thus, a period of hospitalization could be turned from a "time out" I
_ in a person’s life into a positive experience.
i*? There is a danger in such an approach which must be
  mentioned. By stressing personal responibility and personal
treatment for illness, one must avoid putting the blame for such
3 I an illness on the patient. Overemphasis on life-stress causation of
problems such as cancer has led some patients to blame
i· themselves for their tumors and has forced them into the hands of
, unproven quack therapists. Tragedies have occured through this.
i The results of the three year project in San Fancisco were
t mixed. No difference could be discerned between patient pop-
ulations who read their charts and those who did not. What end
< point should be used? Staff satisfaction, especially among nurses,
 _ was high, feeling that they were able to provide more complete
  care in such a setting. Physician housestaff, howe