Biopsychosocial Approaches In Primary Care

ST MEDICINE IN A CHANGING UNIVERSE AT THE THRESHOLD OF THE 21 CENTURY Hoyle Leigh, M. D. I Professor ofPsychiatry San Francisco, University ofCalifornia, and Fresno VAMedical Center INTRODUCTION During my lifetime, the universe has changed beyond recognition. The universe into 111 which I was born, in the first halfofthe 20 century, was still infinite, permanent, orderly, and tranquil --- a universe that worked like a masterfully constructed clock. Matter and energy followed Newton''s lawsofconservation. Shortly after my birth, Hiroshima proved, with a big bang, that matter was no longer permanent, everything was relative. Einstein had also shown thateverything that happened was local, that is, there was an event horizon beyond which no information could reach as nothing can travel faster than light. When I was growing up, the moon was for lovers, and going there was an impossible dream. Cosmologically, the Big Bang theory that postulates that the universe was born out ofan explosion s