Mayo Clin Proc, March 1987, Vol 62 BOOK REVIEWS 242

authors because many of the syndromes are pri-marily of histologic importance and cannot be depicted clinically.

The book has a helpful index, an attractive cover, and a pleasing page format.

The Man Behind the Syndrome provides enjoy-able reading, including information about many interesting personalities from many different fields of medicine. One cannot help but be im-pressed and inspired by the contributions of these eminent medical scientists.

Marc A. Shampo, Ph.D. Section of Publications

The Psychiatric Hospital: Context, Values, and Therapeutic Process, by Henry L. Len-nard, 221 pp, with illus, $24.95, New York, Human Sciences Press, 1986

The evolution of psychiatric practice has been punctuated by fits and starts, by detours into blind alleys, by controversies, and by quantum leaps forward. In this monograph, Dr. Lennard presents one evolutionary development in the treatment of patients with chronic, disabling mental illness. This book describes High Point Hospital with painstaking detail and obvious affection. This hospital and its milieu epitomize the social treat-ment of illnesses such as schizophrenia, in which a cardinal manifestation of the disorder itself is social morbidity.

High Point espouses an abiding principle: to improve the quality of life of the chronically mentally ill through addressing the social dys-function that typifies the disease. Attentional work, informational work, trust work, competence work, and attaining membership are all facets of the social therapies that are described in depth in this monograph. The reader is immersed in the therapeutic community of High Point and in-structed regarding the dosage of social therapies and the role of deuterolearning in that setting.

The Psychiatric Hospital is likely to be of inter-est and utility to mental health professionals who are particularly involved with program devel-opment and to psychotherapists of the social-theoretical persuasion. Those whose approach to the management of chronic mental illness is

traditionally psychodynamic or primarily phar-macologic may find the inherent bias of this presentation difficult. This book is also marred by invidious comparisons of High Point with "other" hospitals; these references are both unnecessary and distracting. No substantive data on outcome are presented that would invite meaningful com-parisons with other types of treatment.

This is an era when deinstitutionalization and the plight of the homeless mentally ill are chang-ing the complexion of psychiatry in the social arena. This is also an era when the mind is perceived as matter that can be treated apart from the social dimension of personality and illness. One wonders whether High Point is anachronistic in this era and how this species of psychiatric hospital will respond to evolutionary pressures. I recommend The Psychiatric Hospital to interested observers of this scene.

Jeffrey D. Rome, M.D. Department of Psychiatry

and Psychology

Hospice: Complete Care for the Terminally 111, 2nd ed, by Jack McKay Zimmerman, 311 pp, with illus, $29.50, Baltimore, Urban & Schwar-zenberg, 1986

This book portrays a detailed overview of hospice care. Contributions from 10 authors, representing a variety of health-care professionals, cover multi-ple hospice-related topics including the following: the history of hospice care, the relief of common physical symptoms among dying patients, psy-chosocial issues concerning terminally ill patients and their health-care providers, bereavement care, hospice care administration, general fea-tures of inpatient and outpatient hospice care, the spiritual dimensions and public perceptions of hospice practice, bioethical considerations regard-ing hospice care, and the future of hospice care. Using experience obtained from years of work in one of America's first modern-day hospice pro-grams, the authors make this a comprehensive book.

The book contents range from appropriate theo-retical concepts of death, dying, and bereavement to very practical and concrete considerations re-garding the management of physical symptoms