On facing human suffering

Abstract

Suffering is an intrinsic part of the human condition, in accord with our fragility and contingency, and as such, needs to be faced. Early medical tradition addressed the issue, and contemporary clinicians continue to grapple with it. Cassell contributed richly to our understanding with his definition that suffering maybe defined, operationally at least, as a sense of impending personal disintegration, which may be, in common parlance, a sense of being about to go to pieces. It is the particular responsibility of clinicians not merely to try to understand but also to relieve human suffering (at least that attributable to disease), and view of human person and of the means are evident. Cassell analyses the reasons for the manifest failure, even in centres of excellence. An adequate view of what we mean by 'person' and the sources of personal coherence, remains essential and elusive. A relational view of person and deliberate attention to the restoration, maintenance and strengthening of constitutive relationships-to other persons, personal history, place and cultural inheritance-may be a fruitful direction for action, together with care to encourage articulation of realistic hope. Clinical science is surely a human not a natural science.