What other cultural changes are we likely to see?

One we're already seeing is a change in men's thinking and behavior. For so long we've had this macho male image about everything that's harmful or illegal.

If I smoke and it's bad for me, I must really enjoy it. It's a sort of bad-boy mentality. To have fun, you've got to be destructive—driving too fast, abusing your body or those of people around you.

That tough-guy mentality is softening. As I go into groups of my peers—men in their late forties or early fifties—I find I seldom hear the sort of thing which was the rule not very many years ago. You know, " Boy, did we have a good time last night. I bet old Fred and I drank a fifth of booze . . ." and so on. That kind of bragging.

Now I'll more likely hear a guy say, "You know, I'm so proud of myself. I finally quit smoking after twenty-two years." And everyone is very interested in how he did it. They're talking about jogging and cutting down on their drinking.

I had some unpleasant experiences—before going to medical school—when I tried to find certain health information in a medical library. It would have been much easier to look for comparable information in just about any other field—engineering, physics, biology. But technical medical information—for someone who is not a medical professional—is almost impossible to come by.

I recently called the National Arthritis Foundation to ask how our readers could order copies of a book they put out. It covers arthritic diseases in depth, it's comprehensive, and it's cheap—one of the best available sources of information on arthritis. I was told that it wasn't available to laypeople, ''because they might misunderstand it. " A medical librarian at Yale told me that she had been taught to discourage laypeople who came into the medical library in search of information, "because it was probably somebody looking for evidence for a malpractice suit. " Why is medical information kept so secret?

Until recently, the medical mystique was much like the religious mystique in the days of Martin Luther and the Protestant Reformation—the language of the laity was one world and the language of the clergy was another. They didn't even say their prayers in the same language. It was a priesthood. There were things that the layperson wasn't supposed to know about.

I think that what we're seeing now, with the demystification of medical language, is comparable to the change Luther made in bringing Christianity into the language of the people.

That's the most important thing that happens in these self-care classes. First, you let people know that it's okay for them to step into this formerly forbidden area, and second, you guide them in their first steps. So the main thing is not the class itself, but the fact that it can get people started. It's a perceptual door opener.

It should be the goal of every health professional to transfer useful and accurate tools, skills, and knowledge to his or her clients. To hide these "professional secrets" and keep them for one's own aggrandizement is a malfunction of one's professional role.

One last question, Keith. Would you look into your crystal ball and share your thoughts about the kinds of changes we're going to see in the next ten years as a result of the growing enthusiasm for self-care?

When I first moved to Minnesota last year, I picked up a paper and saw that a man was considering running for governor on a health-promotion platform. I think we're going to see mayors and governors and other political leaders picking this up—and probably in your state of California, too. I think self-care will be one of the big political issues of the next decade—in the way that education and agricultural reform and honesty in government have been hot political issues.