ABSTRACT
Most of my training in health care was focused on the patient as an individual. We were taught about the specifics of physical health and illness in the form of an assessment of the patients’ symptoms, including their subjective descriptions of pain and stress. In some venues, mostly hospice/palliative care settings, the unit of care extended to the patient’s family. For the most part, however, the focus remained on individualized accounts of symptomatology and determining the appropriate diagnostic category followed by a decision regarding the appropriate technical/medical intervention, and then evaluating the outcome using the reports of physical indicators and subjective responses of individual patients. The assessment form we used at that time included specific bodily systems for us to document in our initial patient interview. At the bottom of the form, almost like an afterthought, a small space was allotted for “psychosocial concerns.” We listened compassionately and supported the patient and family members’ expressions of angst and anxiety as they related to the illness of the patient. We felt good about the care that we offered, and we did care deeply about our patients and their families. However, we rarely explored or even considered the social context of our patients and how their individual experiences were shaped and molded by forces other than just the disease process at hand.
