The place of community in medical encounters

Disease and injury creates a break between the individual and the community which compromises the individual's status within the community as well as the integrity of the self as a "product" of social interaction. Our "everyday" activities are called into question since our ability to fulfill obligations and to achieve many of our ends is diminished through the weakening of our bodies. In light of this account of disease, healing is about restoring the individual to a state of vital functioning, and vital functioning entails communal participation. As John Dewey points out, health as "living healthily" can be understood only in context of each patient's pursuits which are always social and communal. But, if living in community with others is the end-in-view for medical encounters, it too must be implicated in the means to that end. A patient who is given the opportunity to participate as a member of the health care community has already begun within the medical encounter itself to live healthily. It follows, then, that we must work to promote new attitudes within health care towards aiding in the effective agency and participation of patients in their healing process -- i.e., we must see community as healing.