The Ailment

This classic paper was written by Tom Main in 1957. Main, who worked at the Cassell Hospital in Richmond, South West London, for 30 years, set up a twice-weekly work discussion group after a number of staff began to show signs of stress. Its purpose was to make a retrospective study of those patients whose treatment could be considered a serious failure. What emerged was that each of these individuals had managed to form a “special” relationship with a member of staff. Over time, the group came to recognise how this had happened, and to understand better the evasions and distortions in their team working that had led to this situation developing.

When a patient gets better it is a most reassuring event for his doctor or nurse. The nature of this reassurance could be examined at different levels, beginning with that of personal potency, and ending perhaps with that of the creative as against the primitive sadistic wishes of the therapist; but without any such survey it might be taken for granted that cured patients do great service to their attendants.
Last updated on: Monday, 16 April 2012

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