Epilepsy... and what next!
The epilepsies, as 'endemic' illness, require a combination of short- and longterm treatment, during the entire lifetime. People suffering from epilepsy form a collectivum with its own characteristics, which might make the group recognizable. Every human being functions within a number of systems of relations. It might well be possible that epilepsy determines those systems, as the case may be influences the functioning within those systems. With 'short term treatment' is meant 'the taking of medicine', by means of different experts, if so required. With 'long term treatment' is meant 'the taking of medicine' and social guidance during the entire lifetime. 'Short term treatment' typically takes place within the medical model. In that model the relation patient-doctor (the one who asks help versus the one who offers it) has to be the issue of the investigation. Therefore both the 'illness'- and the medical behaviour ought to be analysed. The structure of health care offers a possibility for integration into other systems especially into the social model. With it the patient has to play an active role. It appears from personal investigation that a satisfactory result is reached in the medical dimension by medical executives. As far as (the) man with epilepsy is concerned that does not appear to be the case in the social and occupational dimensions. In these dimensions a care-offering in a social model system has to be built up. With this system one prevents that with epilepsy on one side a) the behaviour of complaining is labelled as an illness and b) secondary 'illness gain' is obtained (which intensifies the passivity) in the medical model and that on the other hand the activity is stimulated in the social model by means of the 'coping response' (Mechanic). The social worker, the expert in the field of labour and/or the public health specialist is pre-eminently indicated as the executive within the scope of that social model. The extra-mural work of the Institute for epilepsy-control (nine out-patient departments and social advisory bodies) throws a bridge from the medical to the social model. The combination of an out-patients' department and a social advisory body offers a potentiality to review in a 'helicopter posture' the obstacles of epilepsy on the path of life in a much broader sense, for both the 'consumer' and the 'producer'.