I think giving these kinds of alternatives is awfully important, particularly because through them people can learn to get the same kinds of things they might now be getting from alcohol and various other chemicals. And those are not ways I like to see people relieve their stress.

How long did the Course for Activated Patients go on?

We ran two classes a year for almost three years. Then, in February of 1973, Howard Eisenberg did a story on the class for Parade magazine, and I got over two thousand letters as a result. That made me realize that what we were up to might be something with a much wider appeal than I'd thought.

About that time I began getting inquiries from the federal Department of Health, Education and Welfare, from a number of foundations, and from several of the faculty and deans who were interested in doing something more in the way of self-care at Georgetown University.

Several publishers started wining and dining me and convinced me that there was a need for a book on what we were doing. So I took a six-month sabbatical and collaborated with Howard Eisenberg on How to Be Your Own Doctor (Sometimes). Shortly after that, the Center for Continuing Health Education was formed at Georgetown, and I became its director.

So you were there until 1977?

Yes. Then our grant ran out, and the functions of the Center were divided between the Health Activated Person Program at the Georgetown School of Nursing, where they're continuing to give an ongoing self-care course for the Washington community, and the Health Activation Network (see page 268), who put out a newsletter, "The Health Activation News," to train self-care teachers and help people establish new courses.

You know, Keith, I have a feeling that if it had been some other doctor teaching that class, it might have ended up as just a lot of boring lectures. Have you had special training in communication, or are you just good at it?

Well, as you know, one of my daughters, Cindy, is deaf, and that's made me very aware of the importance of getting and giving feedback. It got me very interested in good communications, and when I was talking to a patient I would always give and ask for feedback to be sure we were understanding each other.

And then the other thing was how much I loved doing it. I discovered that I liked being a facilitator better than being an authority. There was a feeling of real partnership. It was wonderful to relax out of my professional role and, if somebody asked me a question, to say, "1 don't know. How do you suppose we'd go about finding out?"

It was a very rare thing in my medical education to hear a doctor say, "I don't know."

Incredibly rare. We were taught we were supposed to know all the answers.

How have health professionals reacted to self-care classes?

I like to say, scratch a doctor and you'll find a teacher underneath. Most doctors have been too busy with day-to-day practice to develop as teachers, but once they do it, they find that it's fun.

I've brought a lot of health professionals into selfcare classes, and while at times I've had to more or less drag them kicking and screaming into the pit, once they take off the white coat, loosen the tie, and get their shoes off, they find they're having a fine time. It's a real relief to be able to show your human side, and the people in the classes are always so appreciative.

There's a real sense of working together for a common goal. Most of us went into medicine for pretty altruistic reasons. We're not all dollar-sign guys. And when you start relating to people as active partners instead of passive pawns, they really appreciate it, and they let the doctor know.