Guilt, Pain, and Success

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Abstract
A case is presented in which is considered the role of pain in making success possible in a guilt-ridden man. A glomus tumor of the toe and a peptic ulcer both acted as sources of severe pain for more than 25 years, during which the sufferer achieved great success in the business world. The diagnosis and successful surgical cure of both lesions, with complete and permanent relief of pain, marked the beginning of a progressive decline in his health and his fortunes. Each "successful" medical intervention was followed by a worsening of his general condition. But a final catastrophe, with consequences inaccessible to any further medical help, ended his success in the business world, but inaugurated a prolonged period of peace and tranquility for both patient and family. The case is presented as a contribution to the understanding of disease and to raise questions as to the goals of medical and surgical treatment.

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