PubMed · 7984444
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C A Anderson. The enemy within.. https://doi.org/10.1016/s0029-6554(09)91003-x
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A series of 4 schizophrenic patients is described. In 2 it was unequivocally shown that acute outbreaks of "positive" symptoms were expressions of intrapsychic conflicts and in 1, the result of a therapist's error. In the first case, when the conflict was resolved, symptoms disappeared. 2 other cases were in the chronic phase. In both, long-term dynamically oriented psychotherapy resulted in reappearance of "lost" cognitive and affective functions. Thus, "negative" symptoms (so-called post-psychotic defects) are amenable to psychotherapy and potentially reversible. Concern is expressed about the exclusive biological approach to the understanding and treatment of schizophrenia.
A local internist is in the process of ordering an intravenous pyelogram for a patient she suspects of having kidney problems, when a medical student shadowing her in clinic interrupts. The student wants to know why the physician is not ordering a low-osmolality contrast agent for the patient, having read that they are less likely to cause serious side effects than high-osmolality contrast agents. The physician realizes that the medical student is correct, but rejects the suggestion, telling the student that "low-osmolality contrast agents are the standard of care for low-risk patients."