NEARLY all practicing surgeons would agree in principle that a total-care approach to the management of patients undergoing surgery should include careful psychological preparation. But such preparation for emotional and social problems resulting from hospitalization, surgery, convalescence, and rehabilitation is not always regarded as essential to comprehensive medicine, even though the literature attests to its importance. Kaufman (1) writing of the patient's need for emotional support, states: patient must be emotionally prepared to accept necessary surgery without undue and fear. Everything must be directed toward reducing the psychological stress and trauma of anesthesia and surgery to a minimum. The patient must receive the emotional support he needs and deserves during the immediate postoperative periods. . . . A properly utilized half hour or hour of psychological preparation may give the patient sufficient emotional security to obviate preventable psychosomatic complications. Furthermore, it seems to me that such briefing reduces the patient's anxieties and fears to such an extent that he takes the anesthesia better and has less postoperative pain and discomfort. . . . And he seems to make speedier recovery from the effects of surgery than the patient who is emotionally unprepared. This is equally true for emotionally normal patients as it is for neurotic patients. Dyk and Sutherland (2) also stress the surgical patient's need for emotional guidance and rapport with his surgeon. In their study of colostomy patients they found that anxiety and fear of injury, in some cases mounting to confusion, panic, or despair, were reported by all as reactions to impending surgery. In another report, concerned with depressive reactions of patients to cancer surgery, Sutherland and Orbach (3), after speaking of anxieties about the nature of the disease, the impending surgery, possible death, or postsurgical social isolation and inacceptability, commented: These reactions are particularly prone to occur when the patient is unable to relate to medical personnel. . . . Mistrust is reinforced by the impersonality of clinic and ward procedures and the 'faceless surgeons.' To one depressed patient, surgery represented being cut up by a group of strangers. Elsewhere, Sutherland (4) wrote: Apparently prophylaxis is the best treatment. A warm relationship between the patient and the physician is essential. This relationship should permit the doctor to be seen as protective rather than threatening; it should permit easy comDr. Brant is assistant professor of anthropology and sociology, Portland State College, Portland, Oreg., and was formerly research associate in surgery at the Albert Einstein College of Medicine. Dr. Volk is assistant professor of surgery, and Dr. Kutner is assistant professor of preventive and environmental medicine at the Albert Einstein College. Their research was supported by the Russell Sage Foundation and by a grant from the National Institutes of Health, Public Health Service.