By some singularity of reasoning, his role as healer is disparaged, and the words 'care, not cure' are becoming as tiresome as 'death with dignity'" (p. Ingelfinger, in a classic editorial in the New England Journal of Medicine, rebukes those who would expand medical treatment to include families, not just individuals: "The curious idea is abroad that the doctor should be a factotum of health. The attempt by physicians such as Pellegrino to enlarge the boundaries of what counts as healing has often produced frustration and anger.
Rather, it has enabled the profession of medicine to set very definite limits to the boundaries of healing and thereby to maintain control over the responsibilities that physicians take upon themselves as healers. However, this concentration on facts and diseases does not result from simple, unreflective traditionalism. In taking a medical history, physicians have traditionally tended to restrict the province of illness to the facts of diseases, leaving unexplored the fact of illness-that is, the physical, psychological, and moral vulnerability the patient suffers in the attack on his or her very being that Pellegrino calls "the ontological assault of illness" (1982). How extensive that common ground must be to constitute a right and good healing action is open to question. This requires that a dialogue be established between healer and patient whose goal is the creation of a common ground of meaning shared by the healer and the patient. It follows that for an action of someone who professes to heal to be a right and good healing action, it must be situated in the context of a personal history so as to restore the direction of a personal project. As such, healing must be based on an authentic perception of the experience of illness in the particular person. Healing, according to this definition of health, occurs when a new equilibrium is found between one's hopes and one's failures that can be incorporated into one's personal project. This means that health cannot be understood apart from a person's life history, or to use José Ortega y Gasset's phrase, one's "personal project" (p. We feel healthy, he says, when we have found an equilibrium between our already-experienced shortcomings and our aspirations and have adjusted our goals to the gap between them. A less formal starting point than Kass's from which to examine the relationship between health and medicine is Pellegrino's definition of health as a state of accommodation, defined in different terms by each person. Kass states the problem this way: Health and only health is the doctor's proper business but health, understood as well-working wholeness, is not the business only of doctors. Unlike the Greek, the English language sets up a relationship between medicine, whose business is healing, and health that is problematic. Howard Brody (1987) calls medicine a craft in which scientific knowledge is applied to particular patients for the purpose of "a right and good healing action," employing the now-classic phrase of Edmund Pellegrino (1982). The work of healing in Western culture is the proper activity of the profession of medicine. It is the well-working of the organism as a whole, an activity of the living body in accordance with its specific excellences. Kass sums up this Greek understanding of health by defining it as a natural as opposed to a moral norm that reveals itself in activity as a standard of bodily excellence or fitness. The Greek terms, in contrast, stress the functioning of the whole, and not only its working but its working well. The English emphasis on wholeness, Kass also notes, is comparatively static and structural, implying a whole distinct from all else and complete in itself and connoting self-sufficiency and independence. Health for the ancient Greeks was a state or condition unrelated to, and prior to, both illness and healers.
In addition, the Greek terms for health, unlike the English, are unrelated to all the verbs for healing. This is also true for German, Latin, and Hebrew. Ancient Greek had two words generally translated as "health": hygieia, meaning "a well way of living," and euexia, meaning "good habit of body." Leon Kass (1985) notes that the English and both Greek words for health are totally unrelated to all the words for disease, illness, and sickness. The English word health literally means wholeness and to heal means to make whole. Healing is an action whose goal is the restoration of health.
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