In a perfect world, organ systems would not fail and when they did, their repair would either be managed by nature or by a benevolent health care delivery system. However, in the very real world, medical costs, career progression and survival of the family are quite often impacted by health care costs. The costs of health care are impressive, and the abuse of those charges are legendary. Careers, if not families, are destroyed by overwhelming costs.
Complicating the financial threats are the interpersonal/familial issues which predated the onset of the physical symptoms. The frail marriage, the tenuously held career, the dysfunctional family and the poorly conceived and maintained social system may readily falter and fail in response to the onset of symptoms and their attendant financial burden.
When the threat to integrity of the family and career emerge, the impact upon the patient and the way in which symptoms are perceived become distorted. The patient may begin to minimize symptoms in order to stave off the dissolution of the family or become overwhelmed by the symptoms due to the threat they imply.
Important questions which can be addressed are those associated with the threatening and acute impact of the disease or injury process:
a.What will happen to the family if your symptoms do not resolve; if this problem becomes chronic and refractory to change?
b.Can your career be maintained with these symptoms or in the aftermath of having missed work as a result of the symptoms?
c.What family problems existed prior to the onset of your symptoms (or occurrence of this accident) and how will those problems be impacted as a result of your current disability?
d.Are there dangers you anticipate from members of your family or coworkers who will be intolerant of your complaints?