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Anatomía de una enfermedad: O la voluntad de vivir

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Libro que narra la historia de una enfermedad particular. A partir de esta experiencia propia, el autor remite a unos cuantos principios generales de la llamada medicina integral. La base de toda curación está en saber cómo emplear las propias capacidades del paciente para superar el mal.

120 pages, Paperback

First published January 1, 1979

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About the author

Norman Cousins

137 books83 followers

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Displaying 1 - 30 of 191 reviews
Profile Image for Dr. Appu Sasidharan (Dasfill).
1,381 reviews3,654 followers
September 7, 2023
This is one of the first books that showed us the importance of humor in a patient's life. Cousins tells us how humor helps in healing the patients. The medical fraternity severely criticized this book regarding the authors, claims of how he was cured of a severe condition. Even though what he claims is a highly debatable topic, there is no doubt that laughter helps a lot in patient's lives.

"Time is the one thing that patients need most from their doctors--time to be heard, time to have things explained, time to reassured, time to be introduced by the doctor personally to specialists or other attendants whose very existence seems to reflect something new and threatening.



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Profile Image for Todd.
13 reviews3 followers
April 4, 2013
I was undergoing treatment for a life-threatening condition. One of the medical techs at the hospital loaned this book to me. I found the author's observations to be spot-on and had been espousing many of the same thoughts from my own experience.

This is a short read and one that puts the patient's role in his or her own healing in perspective. My doctors didn't let me take a passive role in my treatment and I'm so glad they didn't. Anatomy of an Illness was ahead of its time in that respect, but today, there's no excuse for someone to glibly hand their health over to anyone. Moreover, the role of attitude, pain, and outlook are so important.

Highly recommended!
Profile Image for Kali.
524 reviews38 followers
January 11, 2014
from kalireads.com:

Norman Cousins, a journalist and professor, believed in taking massive doses of Vitamin C and laughing to cure illness. Perhaps more important than either one of those specific treatments, he believed in the power of placebo and each person’s ability to heal their own illnesses. Cousins’ Anatomy of an Illness as Perceived by the Patient: Reflections on Healing and Regeneration was originally published in 1979 and is now considered an important classic of patient involvement in medical care. Cousins documents his own path to healing from his diagnosis of a serious form of arthritis called ankylosing spondylitis (doctors give him a chance of recovery of 1 in 500): he stops taking his prescribed medications, and he leaves the hospital, which he views as not conducive to his healing. He checks into a hotel, and watches funny movies, laughing bunches. After he laughs, he sleeps. He gets an IV of Vitamin C, a slow drip so his body can absorb the Vitamin C better than if he consumed it all at once. And then he gets better.

Obviously, there is much debate about Cousins healing himself this way. Many doctors speculate that he has experienced a placebo effect, or a perhaps (it is now speculated) a misdiagnosis. Rather than protest the placebo idea, Cousins embraced it. “Many medical scholars believed that the history of medicine is actually the history of the placebo effect,” he said. The history of medicine is full of toxic remedies, and we survived these things and even felt better once we took them as cures, perhaps because of placebo. “The placebo is the doctor who resides within,” Cousins said, claiming placebo as an amazing part of our own capacity to heal.

While some of the book is outdated, some of it comes across as an almost prescient warning of what will be lacking in medical care in the future. I have been reading Ben Goldacre‘s Bad Pharma as well. If Cousins’ book, written 30 years ago, was a warning shot fired into the air that something was wrong with the way we demand and receive medical care, then Goldacre’s book is the summation of that dysfunctional medical train rolling forwards at full speed.

In the chapter called “Pain Is Not the Ultimate Enemy,” Cousins speaks to one of the main themes of his book, the overprescription of unneeded drugs. We are overeducated on pills we can take, while being undereducated on usual causes of pain (like stress) and how to solve those problems ourselves. He says, “We know very little about pain and what we don’t know makes it hurt all the more. Indeed, no form of illiteracy in the United States is so widespread or costly as ignorance about pain–what it is, what causes it, how to deal with it without panic. Almost everyone can rattle off the names of at least a dozen drugs that can deaden pain from every conceivable cause–all the way from headaches to hemorrhoids.” Cousins suggests we could combat this lack of knowledge with education about pain in schools, and “If our broadcasting stations cannot provide equal time for responses to the pain-killing advertisements, they might at least set aside a few minutes each day for common sense remarks on the subject of pain.” I do wonder how Cousins would react if he saw the advertisements on television now, not only for over-the-counter pain medication but for prescription drugs tailored towards every ailment you can imagine, side effects crammed into a voice-over while people dance through a field on screen for the last ten seconds of the commercial, like some bizarre bad joke.

In the last chapter, “Three Thousand Doctors,” Cousins talks of the importance of touch in the doctor/patient relationship. I have talked about this with so many people, how doctors seem to just read charts and then prescribe medicines without doing much of a physical exam anymore, and how odd that is. A pain doctor recommended facet injections for lower back pain without feeling the area of my lower back that was in pain. Did the doctor know what he was doing? Probably. Am I confident in my doctor, knowing he will shoot a needle in my spine without taking the time to feel what is going on in my lower back? Certainly not. In this chapter Cousins also brings up what seems like a quaint idea to me, that in order to have trust with your physician, they need to be the one to meet you at the Emergency Room during a heart attack. Who has that sort of relationship with a doctor now?

And finally, Cousins encourages laughter. He encourages it for everyone, especially those with serious diseases, morose and in bed. At one point he explains the purpose of laughter to a depressed young woman with a progressive illness:

"What was significant about the laughter, I said, was not just the fact that it provides internal exercise for a person flat on his or her back — a form of jogging for the innards–but that it creates a mood in which the other positive emotions can be put to work, too. In short, it helps make it possible for good things to happen.
Carole wanted to know how she could find things worth laughing about. I said she would have to work at it, just as she would have to work at anything else worthwhile."


There is some debate about Cousins’ actual diagnosis. Thirty years later, it seems that Cousins may have been saving himself from bad medical advice and incorrect diagnoses for much of his life. He was misdiagnosed with tuberculosis when he was young. While in the sanitarium, he stuck with the kids who believed they were healthy until he was released; he was diagnosed with a heart problem and told to stay in bed, he refused (and later he was told that vigorous exercise probably kept him alive), and there are a lot of suggestions on the web that Cousins was suffering from reactive arthritis (from some sort of infection) rather than his more serious diagnosis of ankylosing spondylitis.
Profile Image for Bryan Kibbe.
93 reviews35 followers
February 10, 2009
Never doubt the power of the mind over the body, at least that is the pressing message of Norman Cousins' book, Anatomy of an Illness. Without succumbing to abstract speculation without any clear evidence, Cousins offers an inspiring narrative of how he overcame the medical odds when diagnosed with a debilitating disease. Important to his account is an emphasis on the use of vitamin C and comic television shows. Cousins' point is that whether it was regaining an intense will to live or some biochemical effect of the vitamin C, or perhaps both, there is more to medicine than just the empirical science. Whether it is a yet unexplored domain of science, or a domain of science that cannot be explored, there are tools and mechanisms within the human person that may seem mysterious, but which can enact effective change.
Profile Image for Cindy.
957 reviews33 followers
September 17, 2016
Anatomy of an Illness gives you a patient in the 1960s who was diagnosed with a life threatening illness. He didn't just accept the doctor's news, he decided he would try different concepts in helping to heal himself.

He was a big believer in Vitamin C which made a difference in his illness. Fortunately, his doctor went along in trying some of the various ways he was tested. Laughter was found to be a large part of helping pain level. They would test before and after watching a funny show and how it allowed him to get a pain free rest. As anyone who has spent time a hospital knows, sleep is hard to get when the nurses are waking you for vitals throughout the night.

This was an interesting book and definitely worth reading to see if laughter is the best medicine for you!

* I received an ARC from the publisher and NetGalley in exchange for an honest review.
Profile Image for Charlotte.
174 reviews6 followers
February 20, 2013
A mind over matter account of illness. Great one to be reading at this time of year when everyone around me is dropping like flies, slayed by this or that lurghy. With the vitamin C and positive thinking endorsed by Cousins, I feel like I have the best defence.

Both fascinating and empowering, this book is one I would really recommend. Cousins highlights the medicinal power of psychological cheer, noting the physiological and chemical effects that laughing and contentment can have. HIs reasoning was that if negative emotions can cause illness, why shouldn't positive emotions help to combat it. The only issue I had with this argument is that by believing in the power of the patient to deal with illness through psychological positivity, we put a lot of pressure on them to recover. Already, when someone is ill there are often feelings of resentment, disgust or blame towards them. Sometimes, surely, one is just ill, through no fault of their own and regardless of how vulnerable one allows themself to feel. An interesting little issue or tension that I hope to figure out in the next few weeks.
Profile Image for Pete.
447 reviews42 followers
March 19, 2015
Anatomy of an Illness as Percieved by the Patient is a great book by Norman Cousins that I frequently suggest to patients and families of patients who have significant illnesses and have lost hope.

I volunteer visit assisted living facilities with one purpose in mind. Laughter!!! Cousins’ book suggests vitamin C and various methods to distract the infirm individual from dwindling away.

Laughter can make tons of difference. I have a 3 star rating system of 1= smile, 2=chuckle, and 3=robust laughing. My goal is many 3s as possible. This works even during childbirth to reduce discomfort and supplement faster births.

Cousins suggests patients watch funny TV, even cartoons that generate laughter.

Robust laughing releases endorphins which have restorative and regeneration powers as well as reducing pain, and vulnerability as well as improving outlook no matter how old you are.

I recommend this book often.
Profile Image for  Cookie M..
1,439 reviews161 followers
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September 26, 2021
I am neither finishing nor rating this. I should have read it when it was written over 40 years ago, but I missed my chance.
It was groundbreaking, but now it is dated and outmoded. Our understanding of the role we play in our own healthcare as patients has advanced since Cousins' time.
Unfortunately, government's understanding has not.
This is no longer the book I need to read.
If you are starting from zero, it may be for you.
Profile Image for Daniel Taylor.
Author 4 books95 followers
July 8, 2015
On May 1, 2015, I will have prevented mania or depression from sending me to hospital for 14 years. Even though I only finished reading this book today, many of its ideas and principles have been key to me staying well. Patients need to participate with their physicians in their treatment. Brilliant work!
Profile Image for Mary Karpel-Jergic.
410 reviews30 followers
May 10, 2017
In this book Norman Cousins makes some interesting observations about dealing with illness and the often difficult relationships between medical practice and the individuals that it purports to help. However, overall it is a self-help book which rallies the patient to take responsibility for their part in their healing. Whilst not for one moment suggesting that this is not a good idea, I got the sense that it was getting very close to the tyranny of positive thinking. Whilst positive thinking can help some individuals to play the hand that life has dealt them (John Milton famously said that the mind is its own place, and in itself can make a heaven of a hell, and a hell of a heaven), I don't believe that positive thinking can cure a terminal illness. There just is not enough evidence for either positive thinking or vitamin C. It is more like faith.

As for watching funny films instead of taking pain relief - well, if it works for you - great!

Dealing with illness is a huge challenge and Cousins articulates a number of these challenges but his proposed solutions which all hinge on the power of the mind over the body are to me much like praying to a god of some kind. No doubt, this works for some but unfortunately I fear that many positive thinkers have been floored by illness as much as the non-positive thinkers.


Profile Image for Sofi.
2 reviews10 followers
June 10, 2014
Anatomía de una enfermedad es un libro alucinante. No solo habla acerca de la enfermedad en si, sino que también de la risa, el humor, la vida y hasta la capacidad mental y corporal de la persona para buscar componerse de un mal.

Su protagonista y autor, Norman Cousins, fue, a los cincuenta años de edad, diagnosticado con espondolitis anquilosante. Una enfermedad sumamente dolorosa que lo aisló completamente hasta entrar en una depresión. A medida que la enfermedad lo consumía, los médicos no lograban detectar como curar esa enfermedad, por lo que, como recurso para mantenerlo alerta, el médico de cabecera le recetó ver películas cómicas.

Personalmente leí esta historia porque su nombre surgió entre algo que estaba leyendo y me llamó la atención. Es un libro, totalmente recomendable como una lectura rápida e interesante.
Profile Image for Amy.
Author 2 books160 followers
February 3, 2009
Celebrating the truth that laughter is the best medicine. This is a book that when I originally read (when it came out) I thought was wonderful.

When I became ill, I still thought it wonderful. Now that I am somewhat more in a stable health state, which a chronic illness, I still say laughter heals. Laugh often and laugh freely, alone or with loved ones. It makes life sweeter.
Profile Image for Cheri.
32 reviews1 follower
October 19, 2009
My Mother gave me this book early this past year. I had forgotten about it and saw it on my bookshelf. I would have given this book 5 stars but Chapter 5 bothered me a great deal. I couldn't disagree with the author more on his comments regarding doctors and holistic medicine. Perhaps his experience has been a positive one but my personal experience and that of my family's, doctors were outright hostile about even discussing holistic medicine. Regardless of how much holistic medicine has helped certain individuals, many doctors scream quakery. Doctors that I have met dismiss nutrition. This sort of attitude came from a team of doctors at 1 of the top hospitals in Boston. So perhaps the author was fortunate enough to encounter good doctors, who do in fact care about their patients, this however was not our experience.
I do agree with the author about the will to live and the need for laughter. The human body has an amazing power to heal itself and this book is inspirational in these terms.
Profile Image for Elizabeth Brush.
189 reviews
May 20, 2019
fun story about this book: I was doing shelf maintenance at the library when I stumbled upon it. it was a cute little book, and then when I saw it was about patients' perspectives on illness, I knew I had to check it out. then, when I did check it out, it turned out it was a missing book and I had found it (even though it was shelved exactly where it was supposed to be...not sure what that means...)

if you couldn't tell by my excessive updating and quoting, I adore this book. it blows my mind that something written in 1979 that has very important things to say about nutritition, the role of mental health in physical health, and many other things is so on point--while we're still struggling with these things today. it captures so many of the thoughts and feelings I felt while dealing with my own illness, and it only added to the desire of pursuing clinical health psychology as a career.
Profile Image for s_evan.
317 reviews58 followers
August 16, 2010
This books is something I've been looking for in my search of 'healthcare for humans' slant on the topic. The author attitude with which he faced illness is inspirational, for he challenged his doctors and encourages others to do the same. I like also how he has researched the power of the placebo, among other issues, to get me thinking about certain elements of western medicine. A quick read and I would say a definitive must read for any doctor or patient (esp of a severe diagnosis) to understand the importance of the patient's autonomy and will in facing illness.
Profile Image for Sherrie.
324 reviews9 followers
June 27, 2014
I imagine this book read as fresher when it was first published, but I can't imagine that it didn't sound as pompous then as it does now. OK, OK, you know what all of us poor slobs trusting in our physicians' best advice really need better than they or we do. Got it. A colleague recommended this as a source of inspiration for battling my own illness. I appreciate the supportive thought, but I'll have to keep looking.
Profile Image for Cory.
97 reviews11 followers
October 31, 2011
Only 1 chapter was on his illness; the rest was about the system in general. Wanted more personal stories!
Profile Image for Deb.
1,573 reviews21 followers
April 1, 2019
At first I didn't realize this book was published in the 70s. I hadn't before read anything about Cousins's experience, but his name was familiar. Our minds are powerful. What we think about matters and definitely has an effect on our bodies. I believe in the placebo effect. It was interesting reading about it in this book.

I like what he says about pain. I do take pain relief too quickly without getting rid of the stress and other sources first. It's too easy to run to a doctor than to let our bodies have time to heal. Sometimes strange things happen that quickly come and go on their own. The older and more experienced I get the less worried I am about physical ailments. I pay attention to trends and ask myself, "Is it getting better? Or worse?" If it's not healing on its own it makes sense to seek medical treatment and help. Hopefully I'll recognize if something needs immediate help.

Regardless of whether or not it's actually curative, I feel better when I think more positively and when I'm surrounded by laughter. After reading this book, I want to take better ownership of my health. I want to laugh more. Vitamin C supplements aside, this book just makes sense to me.

I had an experience when anxiety about a measurable physical ailment made the physical problem worse. Once I understood what was causing the physical problem, my mind calmed down and my brain was able to compensate for my worst symptoms. At first I thought the doctor was telling me my problem was "all in my head" and that really bothered me, but the more I thought about it I realized how my mind was definitely worsening actual physical problems.
Profile Image for Matthew Liberio.
67 reviews2 followers
July 8, 2023
3.5 stars. The thing I liked most about this book is how Cousins used humility in testimony to express how he took ownership of his own illness. Rather than defer to common practice and standard procedures, he considered what he believed he needed. I appreciate his take on naturalpathic medicine and especially his emphasis on the role of the human spirit (laughter, joy, purpose).

This book has some examples that are increasingly irrelevant. Most of his citings are circa 1965 many some still hold water. He seemed to circle back a lot to his particular treatment plan which may or may not have actually been the solution (vitamin C based treatments).

I believe this book was a good challenge for me, and it helped me strive for greater personal ownership of how I handle my own wellness.
Profile Image for Cynthia.
311 reviews11 followers
August 31, 2022
This little book has achieved 'classic' status based largely on the radical steps the author, Norman Cousins, had taken previously to let the world know about his success in overcoming a painful, life-threatening disease that plagued him and that 'doctors' at that time (1960s) gave no hope for overcoming.

This book is an analysis of how the ill perceive their illness and the prognosis for overcoming it with/ without medical interventions and the opinions of medical experts. It looks at studies that show that placebos are often almost as effective as some of the "medications" being studied before being brought onto the market. There is a pretty clear case made for the benefits of optimism, having a clear understanding how the body and the mind work together to achieve wellness (or conversely, give into sickness), and how important it is to be persistent and creative in seeking alternative ways of healing for oneself when one runs into negativity, neglect and promotion of interests other than caring for a patient's welfare in the medical "system".

Even though much of the book's content has been shared since the book was published in 1979, there were still interesting and inspiring findings to read and to marvel at. My husband and I read this little book aloud and discussed each chapter. He was also reading "Laughter Yoga" at the same time (see my review HERE) and we both have been paying a lot of attention to laughing (or voluntary/ fake laughing) as well. The two books work well to reinforce similar principles of healing through positivity.
233 reviews1 follower
December 22, 2022
I found this book very interesting. I didn't agree with everything, but thought there was much food for thought. My biggest problem is finding a doctor like his, who is willing to explore other means of treatment, rather than just prescribing a medication. It was fascinating that the two biggest things to help Norman Cousins, were laughter/humor and ascorbic acid. (The Bible does say that "a merry heart doeth good, like medicine.")
Profile Image for Eryn.
207 reviews1 follower
January 11, 2018
Pretty interesting read, especially given that it was written in the 70s. In some ways we've come a long way since then. In others, we have a long way to go.
7 reviews
April 28, 2019
Recommended for every human being. Medical classic
Profile Image for Marco.
437 reviews69 followers
October 4, 2022
An engaging and balanced book on how the human body works regarding the placebo effect and some other reflections on the medical profession in general.

Very good.
Profile Image for Elizabeth.
30 reviews3 followers
October 25, 2007
This book examines the patient experience as the author found it in the 1960s and into the 1970s. Cousins emphasizes the importance of the patient taking responsibility for his own recovery, especially in the sense that the patient must have the will to live. Cousins uses his own experience with a collagen deficiency that the doctors told him was incurable to illustrate how the human body has a stronger capacity to heal itself than perhaps the medical community recognizes. He discusses the need for the body to return to homeostasis, which he achieved by going off most of his medication. He promotes laughter as a treatment because positive emotions lead to favorable effects on other bodily processes, just as stress can wreak havoc on the body. Cousins also advocates proper nutrition as a means to achieve homeostasis. He comes out generally in favor of the holistic approach to health care. He believes in the power of the placebo because he thinks, with research to back his point, that the mind has some control over bodily function. He points out that there are cases where serious medical intervention is necessary, but he wishes that more doctors would be open to new ideas in nutritional and homeostatic approaches as well.
Because of my most recent surgeries and radiation, I very much related to this book. I have been on so much medication in addition to the actual addition that at times I felt as though I was being poisoned. It got to the point where I preferred the pain to the drugs because there were so many side effects. Cousins thinks we have become too afraid of pain and that we miss cues from our bodies by shutting off pain signals. This lack of attention can prolong our problems because we never fix the root cause. I found this circumstance to be true. I had every kind of pain killer, muscle relaxant, Botox injections, but it was not until they found that I had inflammation from radiation that they were able to actually help me relieve my pain. This book was the first place I found support for not wanting to take more pills. I imagine my body as craving this homeostasis, the ability to function on its own. Unlike many of the patients in Cousins’ examples, I had no difficulty in talking with my doctors about different options, and they never dismissed my opinions, but it still took months to find a solution.
Cousins points out that his homeostatic approach does not work well in hospitals. It made me think how antithetical to healing and comfort the hospital really is. It becomes a question of treating the disease or treating the patient. For example, does every patient need to be woken up to have their temperature taken when they can only get a few hours of sleep? Of course, some do need to be monitored that closely, but not all. I have often heard that patients recover much faster when they can return home, and that has been true in my situation. Cousins theories of being able to sleep and eat well at home more than in the hospital make a lot of sense. But I believe it is a failing of our system that we have not addressed some of these issues in the hospital setting.
I found one passage from the book that described the experience of chronic illness very well. It might be helpful in trying to explain the patient experience to others.

There was a subconscious fear of never being able to function normally again—and it produced a wall of separation between us and the world of open movement, open sounds, open expectations.
There was a reluctance to be thought a complainer.
There was a desire not to add to the already great burden of apprehension felt by one’s family; this added to the isolation.
There was the conflict between the terror of loneliness and the desire to be left alone.
There was the lack of self-esteem, the subconscious feeling perhaps that our illness was a manifestation of our inadequacy. 153


Profile Image for Melinda.
827 reviews52 followers
June 24, 2017
I didn't know what to expect with this book, but was astonishingly surprised to find a jewel.

What does healthy aging look like? What does recovery from disease and illness look like? Norman Cousins was diagnosed with a life threatening illness. He was blessed with a cooperative physician who was also a personal friend, and he rejected the traditional diagnosis and treatment for his illness. He instead replaced the hospital with a stay in a hotel where he had massive IV doses of Vitamin C and watched comedy after comedy to allow "laughter" to be the best medicine.

Cousins thus began a book where he examines illness, disease, aging, and death..... all from the perspective of the patient. I found out about this book when I was reading "The Grace In Dying", and it referenced a powerful description of how medical technology and medical help appears to someone who is ill, old, or in need of a healing human touch.

The two sections that were most amazing to me involved the author's visit with Pablo Casals when he was in his 90's, and also Albert Schweitzer, also in his 90's. Cousins witnessed Casals being led into the room by his wife, bent over and shuffling from arthritis and age. When he sat at the piano and began to play his daily dose of Bach, his hands unstiffened, his back straightened, and his hands became supple and active. As the author says, "Creativity for Pablo Casals was the source of his own cortisone." Creativity heals! Schweitzer also believed firmly in the healing power of music and also of the role of humor in healing. He made a special effort each day to bring laughter into the routine of the patients, nurses and doctors at the hospital.

pg 96 "At any rate, long before my own serious illness, I became convinced that creativity, the will to live, hope, faith, and love have biochemical significance and contribute strongly to healing and to well being. The positive emotions are life-giving experiences."

Recommended highly.
8 reviews
October 27, 2017
This is an excellent read for people of all backgrounds. It never delves too deeply into the science, but it has just enough to satisfy individuals with basic background in healthcare.

As someone who is pursuing a career in healthcare and educated heavily in the basic sciences, I must admit that I came into this with a rather closed mind; I only picked up the book because another writer and physician who I highly admire and respect wrote of Norman Cousins in a very positive manner. I was pleasantly surprised at how easy of a read this was, and how skillfully Norman Cousins leads me to an understanding of what he was trying to accomplish in writing this book. He never makes any grandiose claims, always erring on the side of caution, and yet provides all with hope through his own experience.

I have highlighted specific sections that I will re-read at a later date. I feel that these will be one of those books that I will carry with me for a long time to come, so as to remember the important lessons within it as I practice in case I lose them over the years.

In short, I recommend this book for everyone! It brings the average individual a little closer to getting to know his or her own body and its health a little better. It also is quite interesting of a read for medical students and physicians alike, as sometimes we may fall into some of the traps that Norman Cousins outlines in his book and forget that patients are supposed to be partners in their healthcare, and not only our 'clients'.
Profile Image for Raffaello Palandri.
Author 11 books13 followers
February 22, 2025
Book of the Day – Anatomy of an Illness

Today’s Book of the Day is Anatomy of an Illness, written by Norman Cousins in 1979 and published by Norton & Company.

Norman Cousins (1915–1990) was an esteemed journalist, professor, and advocate for world peace, best known for his editorial work at Saturday Review, where he served as editor-in-chief for over 30 years. Cousins was also a prominent figure in nuclear disarmament efforts and international diplomacy.

I chose this book because I remember reading it during my first extended hospital stay for life-threatening allergies, when I was ten years old. My doctor, who was treating me, suggested it might aid my recovery. That was exactly 45 years ago today.

Anatomy of an Illness is not merely a memoir of survival but a paradigm-shifting exploration of the complex interplay between psychology, physiology, and medicine.

In this deeply personal yet scientifically rigorous account, Cousins documents his unexpected recovery from a severe and life-threatening connective tissue disease, later believed to be ankylosing spondylitis, an inflammatory condition affecting the spine and other joints. Faced with a grim prognosis and conventional medicine’s limited ability to intervene, he embarked on a radical, self-directed healing process that challenged the prevailing dogmas of medical science.

At its core, this book is a life-changing call to redefine the role of the patient—not as a passive recipient of medical interventions but as an active agent in the healing process.

Cousins‘ meticulous documentation of his methods, which included high doses of vitamin C, a carefully controlled environment, and—most famously—the therapeutic use of laughter through Marx Brothers films, demonstrated an early, anecdotal form of what is now recognized as psychoneuroimmunology.

His assertion that emotions such as joy, hope, and optimism could positively influence biochemistry prefigured contemporary understandings of the mind-body connection.

Before Anatomy of an Illness, Western medicine primarily focused on the mechanistic treatment of disease, viewing the body as an assemblage of systems to be corrected through pharmaceuticals and surgery. While effective in acute care, this reductionist model largely neglected health’s psychological and emotional dimensions.

Cousins’ experience served as an impetus for the emerging field of integrative medicine, which now acknowledges that emotional states, stress levels, and mental attitudes play a crucial role in recovery.

His story challenged two fundamental assumptions of medical orthodoxy:

The physician is the primary healer – Cousins posited that patients have significant control over their healing processes, arguing that medicine should empower rather than merely prescribe. His approach foreshadowed the rise of patient-centred care, which now encourages active participation in treatment decisions.
The mind and body are separate entities – Decades before psychoneuroimmunology gained mainstream recognition, Cousins provided compelling evidence that psychological states could induce biochemical changes, influencing immune response, inflammation, and pain perception.
This book laid the solid foundation for scientific inquiry into the physiological effects of positive emotions, ultimately influencing the development of disciplines such as stress reduction therapy, laughter therapy, and mindfulness-based interventions.

Cousins’ work, though initially met with scepticism, has since been validated by numerous studies confirming the bidirectional relationship between emotional states and immune function.

Research in areas such as neuroplasticity, placebo effects, and the impact of chronic stress on disease progression has corroborated many of his insights. In particular, his emphasis on laughter as a therapeutic tool anticipated findings in neuroscience that demonstrate how humour triggers endorphin release, reduces cortisol levels, and enhances immune responses.

Today, many hospitals incorporate art therapy, meditation, and laughter therapy into patient care plans, reflecting a more holistic understanding of healing. The growing popularity of integrative medicine, which merges conventional and complementary therapies, owes much to the groundwork laid by Cousins. His book also contributed to shifting attitudes toward chronic illness management, particularly in conditions such as cancer, autoimmune diseases, and chronic pain syndromes, where patient engagement and mental resilience are now recognized as critical components of treatment.

Beyond its medical implications, Anatomy of an Illness offers a profound philosophical reflection on suffering, resilience, and the nature of human health. The author’s unwavering belief in the power of personal agency—the idea that even in the face of debilitating illness, one can choose optimism and take decisive steps toward healing—has implications far beyond the medical world.

His perspective aligns with both ancient wisdom traditions and contemporary ethical debates about healthcare. His advocacy for treating patients as whole beings rather than as collections of symptoms echoes the principles of Buddhist and Stoic philosophy, where the mind’s disposition plays a crucial role in determining suffering.

Moreover, his insistence on self-directed healing challenges the ethical responsibilities of the medical establishment, pushing for a model where doctors serve as guides rather than sole authorities.

Anatomy of an Illness is a positive manifesto for a more humane, scientifically nuanced, and patient-empowered approach to healthcare. It helped catalyze a shift in medical consciousness, paving the way for holistic and integrative medicine, and demonstrating that human resilience is as much a biological phenomenon as it is a psychological one.

For those dealing with chronic illness, it remains an invaluable source of hope and guidance. For healthcare practitioners, it is a clear reminder of the profound impact of patient autonomy and the need for a more comprehensive understanding of healing. And, for society at large, it is a holistic call to recognize that health is not merely the absence of disease but the harmonious integration of body, mind, and spirit.

Cousins’ work endures as a testament to the radical idea that laughter, love, and the will to live are not just abstract virtues but tangible forces in the fight against illness.
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1,635 reviews96 followers
September 3, 2008
I read Cousins' first edition of Anatomy of an Illness way back when...it was terrific then, and hasn't lost any of its relevance today. It essentially energized an entire movement around mind/body health, and cracked open the possibility in many previously closed minds that there might be more important inputs into human health than drugs and surgery. Indeed, as I recall, Cousins became the first non-MD member of the faculty at a prominent medical school, based on his experiences and writing.

The hope he gave (and that his books continue to give) to many who are facing serious illness and diminishment of quality of life is extraordinary. Attention to nutrition, spiritual and emotional health, and personal involvment in medical decisions are all still powerfully motivating forces in improving the health of people around the world. Simply recognizing the impact of maintaining a humorous perspective is an astonishingly powerful insight, let alone Cousin's numerous other contributions. His own recovery from a (thought to be) fatal illness, and his later recovery from a heart attack, add vitality to his thoughts on health.

Highly recommended.
154 reviews8 followers
May 1, 2009
Cousins is a hell of a good writer. I guess he was a long-time editor of the Saturday Review. He engages you by taking complex medical issues and humanizing them. I think the autobiographical component is the best part of the book.
It is amazing how sick he was and how completely he recovered. I also agree that the patient needs to be very involved in his/her healing, of course, much has changed in medicine since Anatomy was published. Perhaps this is a result of his writing,especially regarding the patient-doctor relationship.
One thing that needs to be noted is that Cousins has the advantage of wealth and has access to the finest doctors in the U.S. and the world. He doesn't really acknowledge this. Nor does he consider how his education factored into his approach to healing.
Yes, patients can get access to information, but would your average patient be able to interpret the information as well as Cousins does?
I would recommend this book for anyone battling a major illness and for anyone in the health care field.
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