Panel Discussion

M/O)DERATOR TLOiIs N. KATZ (Chicago, Ill.): Before I call upon my colleagues I wish to make a few introductory remarks. We as physicians must view heart disease in all its ramifications. Heart disease is primarily a chronic process. The problem is more than the immediate alleviation of acute exa(erbations of the disease, involving a temporary sojourn in the acute hospital, or its equivalent at home. The management of the acute phases of heart disease is so exciting to the layman, medical student, house officer, and headline writer and, unfortunately, to some physicians-that the chronic nature of Ithis disease may be overlooked. Care is required for the patient over months and years, care in which proper small things constantly repeated, surprisingly, have a great cumulative effect. In the last analysis, proper care means prevention of recurrences and ultimately of going to the normal population and preventing the disease from occurring in the first place. However, it is not enough merely to stop the advance of disease. One must endeavor to restore the patient to the full life. This is rehabilitation. This philosophy should be the credo of all physicians and of all the ancillary professionals dealing with a cardiac patient incapacitated by his disease. Man is a complex creature with a mind and emotions, and illness affects him in his totality-mind and body besides heart and blood vessels.