Iatrogenic depression: the case of Frederic Chopin

Abstract

Psychological disorders caused by the doctor’s rash words are as common as the side effects of drug. Iatrogenic depression caused by ethical and psychological mistakes of doctors will never go away. Their frequency can be reduced only by improving the physicians’ skills in the fields of medical ethics and psychology. A clinical case analysis based on a famous person’s history of the disease is an effective pedagogical tool. The study aims to present the case of the famous Polish composer Frederic Chopin. The A comparative analysis of doctors’ objective actions and patients’ subjective evaluations of their actions were made based on a study of Chopin’s and Sand’s letters as well as the works of composer’s biographers. This approach provides a valuable opportunity to see doctors through the patient’s eyes. In the fall of 1838, during his rest in Majorca, the local doctors diagnosed pulmonary tuberculosis in Chopin. The Majorcan doctors made a serious ethical mistake. They ignored the patient’s anamnesis vitae indicating his phthisiophobia and informed Chopin about the diagnosis of pulmonary tuberculosis and a poor prognosis in a very cynical manner. Chopin wrote: ‘One (doctor) said I had died the second that I am dying, the 3rd that I shall die’. Chopin perceived the diagnosis of tuberculosis as a ‘death sentence’, as a result of which he developed iatrogenic depression. All previous and subsequent Chopin’s doctors used other tactics: they prescribed the correct treatment, but the diagnosis was not voiced. The analysis shows the effectiveness of this tactic: Chopin lived another 10 years after the Majorcan episode. Chopin’s case shows typical doctors’ ethical and psychological issues in informing the patient about the dangerous diagnosis and poor prognosis as well as tactics for building a good physician‑patient relationship.