Gaining a patient's trust, or the trust of a patient's family, may seem to be a given, but achieving trust is a fragile, individual, hazardous endeavour. In an era of distrust of institutions and professions, the patient must trust the staff of doctors, nurses, and therapists before a working therapeutic relationship can be established. In recent decades, coping with angry and difficult people produced numerous books, consultants, and seminars. This book approaches the issue from the standpoint of developing a working, trusting relationship with patients and families, and the pitfalls that one may encounter. The author discovers that the individuals -- patients, family members, visitors -- behave in circumstance of illness in the same manner they behave in other aspects of their lives: at home, at the grocery store, at the airport, etc. While most people are reasonable, given their trying circumstances, a small number are distrustful, difficult, and consume inordinate time and energy of the staff. The book outlines situations and problem individuals encountered and how to cope with them. Trust is not an academic study, but a practical guide. The recommendations presented developed from trial and implementation in daily practice. Trust concentrates on behaviour and its management in a medical setting with no attempt at analysis.

Captain Noon is in his last year at college. He sleeps till noon, he dreams of being a pilot. Time and opportunities slip away in procrastination. The narrator, his father, recalls his own father's instructions, "play for keeps," and the head of his high school "hoe-out your row." Get on with it. Finish what you do. A distant cousin Nora put off life and never got around to it. A thorn in the side of members of the family, Nora lives alone and has a stroke. She is the family historian collecting clippings about members of the family in her Death Bible. The comfortable Berkeley liberals, a man in an electric wheelchair takes a 'pitch' in the rain, a pitcher for the Giants, neighbors, Berkeley's contraband dog hair, and the fancy of the Triple Z Squadron, the Triple Z Airlines in peacetime, fill out the story. Thomas De Quincey says: "If once a man indulges himself in murder, very soon he comes to think of robbing, and from robbing he comes next to drinking and Sabbath-breaking, and from that to incivility and procrastination."

When Dr. Browne's partner retires, his practice is taken over by Dr. Forbes Q. Hazzig, who becomes a zealot for a 'managed care revolution' of 'marketplace medicine.' Browne and his associate Dr. Kennes receive irrational, discordant information from healthcare experts, consultants and economists. Browne learns that rhetoric of a mass movement must be as erroneous as possible promising a vague, glorious future. Hazzig grows immensely rich and gains enormous power relying on intimidation and coercion.

Joanna Browne's exhibition of J.M.W. Turner becomes a thrilling success, yet Hazzig's wife succeeds in eliminating Joanna's position at East Valley Museum of Art. Joanna must accept a position at a distant university; her absence devastates Browne.

Browne and Kennes discover managed care was based on a Washington bureau hoax, the 'health maintenance strategy' of 1973: an irrational mass movement, a mass hysteria. Hazzig plots to humiliate and ruin the two doctors; each threat goes awry. Hazzig is discredited; his illusory wealth collapses.

Reunited with Joanna, Dr. Browne receives a disturbing invitation to return to East Valley to be recognized with Dr. Kennes for their efforts to expose the folly of managed care. Browne is reluctant to relive his lonely, troubled, distressed past.

Trust in a Medical Setting

If you're one of the millions who use computers at work or at home, the hours you spend in front of the monitor could be giving you a pain in the neck, back, hand, wrist, or arm. If so, you may be suffering from CRS.
Tightness, stiffness, and pain of the upper extremities are common complaints of writers and computer users. Carpal tunnel pain, repetitive strain injuries, occupational disorders of the upper extremities, and other problems related to heavy keyboard and computer use have spread across the nation as computers become indispensable at work and at home. Classified under the rubric "computer-related syndrome," or CRS for short, these injuries have caused a work slowdown, while creating a whole field of medical exploration.
CRS: The Prevention & Treatment of Computer-Related Injuries by rheumatologist Dr. Richard Dean Smith and physical therapist Steve Garske calls attention to the common problems of computer use and offers practical advice and helpful hints intended to lessen the risk of sustaining injuries related to posture, rapid movements, and positional errors common to writers, computer users, and other occupations. Everyone needs to be informed of the dangers involved, as well as successful prevention techniques and helpful remedies when injury does occur. The book includes a history of CRS, information on symptoms, clinical findings, effects on work, and where to get help.