Patient 1 is a 44-year-old white, Protestant, married physician who is the father of three teenage children and suffers an occlusion of the anterior descending coronary artery. After three weeks in the hospital, he returns home on a regimen of aspirin, a low-cholesterol diet, and a systematic exercise program. When his cardiologist sees him for a follow-up visit after two months, the patient has returned to his medical practice and reports that he has lost 7 lbs. In addition, the patient describes the resumption of his sexual life, his usual parenting activities, and leisure time pursuits. While still somewhat anxious about his prognosis, he requires no psychiatric intervention or psychotropic medication.
Patient 2 is another 44-year-old white, Protestant, married physician who is the father of three and who suffers an occlusion identical to that of Patient 1. After three weeks in the hospital, he also returns home on a regimen of aspirin, a low-cholesterol diet, and a systematic exercise program. However, when his cardiologist sees him for a follow-up visit, after two months, Patient 2 and his wife report that he constantly feels tired, stays in bed, avoids exercise including sex, and has made sporadic visits to his office but has not seen patients. On interview, the patient reports being terrified of a fatal recurrence of the myocardial infarction. In addition, he is having difficulty sleeping, eats sporadically but not in accord with his diet, can't enjoy sex and other pleasurable activities, and feels that his active life is over and that he is "no longer a man." Although there is no difference between the cardiac status of Patients 1 and 2, four months later Patient 2 is still unable to return to work and his family life is colored by his inability to resume his functions as an effective father and husband.
that play significant roles in the occurrence of work disabilities. One such factor is the degree to which an individual has been socialized for work and thus the degree to which personal worth and success are defined in the context of one's occupation. Similarly, level of educational attainment is also related to the risk of work disability. Brodsky maintains that with increasing educational attainment comes a greater belief in the intrinsic rewards of work, a greater likelihood of extrinsic rewards derived from work, and a more intellectually rewarding content of work.
Some of the workers in the Brodsky study who developed disability perceived themselves prior to injury as physically, emotionally, or intellectually inadequate, a perception underlain by a variety of factors including those related to age, job-personality fit, and family relationships. For these individuals, disability is a more likely outcome than for those who do not feel inadequate on the job.
The nature of the work performed also influences the outcome of work-related injury: low pay, boring and repetitive work, and heavy physical