Correspondence

The Last Well Person

N Engl J Med 1994; 331:206July 21, 1994

Article

To the Editor:

I share Meador's concern (Feb. 10 issue) about the extinction of well people1. This is not, however, a recent phenomenon.

In 1923, the French writer Jules Romains addressed this issue in his comedy, “Knock, ou le Triomphe de la Medecine.”2 Dr. Knock purchased the unprofitable practice of a country physician. He then diagnosed almost everyone in the village with an illness and prescribed cures whose costs were matched to the incomes of his patients. Dr. Knock's thesis was entitled, “Sur les Pretendus Etats de Sante” (On the Supposed Condition of Good Health). The epigraph of the thesis read, “Les gens bien portants sont des malades qui s'ignorent” (The healthy are ill people who are unaware they are ill). This is the sentiment expressed in the quotation that headed Meador's article: “A well person is a patient who has not been completely worked up.”

Apparently, well people began to disappear from the world long before bone densitometry or cholesterol screening tests were used in clinical medicine.

Javier Galovart, M.D.
Calle Lopez Mora 5, 36211 Vigo, Spain

2 References

1
Meador CK. The last well person. N Engl J Med 1994;330:440-441
Full Text | Web of Science | Medline

2
Romains J. Knock, ou le triomphe de la medecine. Paris: Gallimard, 1924.

Author/Editor Response

Dr. Meador replies:

To the Editor: I thank Galovart for calling attention to the play by Romains from the 1920s. Art does portend reality.

Just imagine what Dr. Knock could have done had he been equipped with skinny needles, ultrasound devices, flexible endoscopes, free-standing ambulatory care centers, and television advertisements. If he had been funded by Medicare, first-dollar health insurance, disability insurance, worker's compensation, and all the third-party agencies that demand specificity even when there is none to record, Dr. Knock undoubtedly would have extended himself across France, even all of Europe. The last well person might never have seen World War II.

Clifton K. Meador, M.D.
Saint Thomas Hospital, Nashville, TN 37202

Citing Articles (1)