1. With the current use of DSM-IV, "we have lost the patient and his or her story" (p. 159). In all of medicine, there is, and always has been, the danger that the patient as a unique individual will get lost as the clinician focuses on the patient’s symptoms and disorder. We recall how—in pre-DSM-III times—the symptoms and personal experiences of psychiatric patients were lost in other ways—e.g., in unfounded speculation about the mother’s etiologic role in schizophrenia and the presumed causative role of early childhood experiences in all serious psychopathology. As evidence of DSM complicity, Dr. Tucker cites a teaching case (at his own institution?) in which the resident apparently was unaware of a critical psychosocial stressor that immediately preceded his patient’s extreme weight loss. Should this oversight be blamed on DSM? It would not have happened with one of our residents or any resident who has been taught the importance of obtaining information to evaluate axis IV (psychosocial and environmental problems) as part of a comprehensive psychiatric assessment.