||3 CHASE N. PETERSON 1960. We have never had so many answers or solutions. This expenditure has paid off. With public health sanitation, immunizations, and better nutrition, not to mention modern surgery, cancer :hemotherapy, blood pressure control, and antibiotics, there is no question that we have reduced the level of sickness and disability in :>ur population. Why then, if we are doing better, should we be feeling worse? In a poll by Yankolovich10 in 1979, 70 percent of adults were reported to be more concerned about their health than :hey had been in the past. Forty-four percent found it harder to cope with everyday living. Eighty-two percent felt they needed reduced iaily stress. Forty-two percent worried a lot that someone will get a :errible disease in their family. And 80 percent felt that with all the advances in medicine, almost all serious illnesses are curable if you :ould just catch them at an early stage. How does one explain the vast expenditure of time on television and money at the drug store for reatment of headache, constipation, sunburn, anxiety, depression, md mood changes if we are, in fact, in better health? Something has aot yet explained our general sense of dis-ease. We never had so riuch health care and we have never been so ill-at-ease. Dr. Lewis Thomas writes, "As a people, we have become obsessed with Health. There is something fundamentally, radically unhealthy about all his. We do not seem to be seeking more exuberance in living as nuch as staving off failure, putting off dying. We have lost all :onfidence in the human body."11 In part, we suffer from what Wildavsky calls the "Paradox of Time." Past successes lead to future ailures â€" yesterday's victims of tuberculosis are today's geriatric :ases. The Paradox of Time is that success lies in the past, and possibly) the future, but never in the present."12 To find out how we have gotten this way, let us look briefly at the listory of medicine. We have gone through two phases of medicine md now find ourselves in a third. The first phase of medicine tretches from the dawn of man to the first decades of this century. It vas an age characterized by the art of medicine, heavily overlaid with juackery. There was litde anyone could do to alter disease states, but he doctor often brought comfort and the nurse surely did by their ittendance at disease and their provision for some degree of diag-lostic predictability. Purgatives, leeching, blood letting and every >ther good and more often bad idea of mankind has at one time >een an offering of the medical establishment in the pre-scientific >eriod. It is generally conceded that only by well into the Twentieth Century did a random patient seeing a random doctor have a better han 50/50 chance of being improved by the encounter.