Abstract

What if the patients most health professionals actively seek to avoid, people with "medically unexplained" or functional symptoms, were those who hold the key to a more successful, more rewarding and more just system of medical practice for all? I think they do. They force us to answer the question, to paraphrase Wittgenstein: What is left over, if I subtract the fact that I have a disease, from the fact that I am ill? Within the answer to this question is the human, participatory aspect of illness, which, despite hundreds of mission statements to the contrary from healthcare organisations the world over, is not adequately addressed in our medical training, practice and principles. We can and should do better, and this is a proposal for how.