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DISCUSSION: Dr. Cornelis Heijn, Jr., presented a case of a thirty-eight-year-old woman who developed a life-threatening ventricular arrythmia upon attempting to mail a letter that would take her away from her mother. Since she was away from her father when he died, the letter was, in primary process terms, her mother's death warrant. Dr. Heijn agreed with Dr. Silverman's basic premises, although he expressed the wish for some clarification of aspects of the paper. "Is stress always present before physical illness, or is Dr. Silverman implying it is a necessary but not sufficient condition?" He also wondered about the prospective nature of Dr. Silverman's predictors. Were these discovered upon reviewing the clinical data? Dr. Heijn then focused on the need for verification of Dr. Silverman's hypotheses. He proposed the following basic requirements: (1) "definitions need to be operationalized"; (2) "data would need to be adequate"; and (3) "the full data needs to be evaluated by neutral observers of equal sophistication." When validation becomes more effective, we, and medicine in general, will be able to rely on Dr. Silverman's findings more fully. Dr.