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We meet here to discuss a subject of paramount significance to the medical profession. The cause, removal, and relief of suffering constitute the special province of the physician. of all subjective symptoms, it is suffering that brings most of our patients to us. It sets the stage and colors the initial mood of the doctor-patient relationship. Our conceptions and understanding of suffering, our attitudes and reactions toward it, will determine our efficacy as therapists.
The everyday physician and surgeon at first will not realize the profound implications of our subject here. For them the answer is simple. A patient complains of suffering, you search for the cause and remove it, and in the meantime you provide relief. When the patient complains of suffering for which no organic cause whatever can be found, then they come to realize that this subjective symptom of suffering has meanings that transcend the everyday frames of medical reference and they turn to psychiatry and psychoanalysis for elucidation and guidance. I am sure with this panel and with this audience, we can anticipate lively discussion and some worthwhile contributions.
To prepare you for some of the possible angle shots, we will have to consider the nature of the suffering. Is it suffering from fatigue, fear, guilt, pain, rejection, or self-effacement, or is it the paradoxical suffering from success and too much limelight? We must also keep in mind the function or purpose of the suffering. Add to this the extent and level of the suffering. For those oriented to a “self” psychology, is it the real or neurotic self that is suffering?
Just this morning, I happened to read a chapter of The Screw Tape Letters by C. S. Lewis, in which the author gives us an entertaining commentary on how man deceives himself and glorifies and perpetuates his neurotic suffering. Screw Tape, as the Devil's henchman, writes letters to his emissaries on Earth, instructing them how to bring about man's downfall. He says:
“The cha