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[Help, I can work again. Analysis of the rehabilitation process into work life of a chronically ill patient after survival of myocardial infarct].

The prime objective of the pension insurances' rehabilitation measures is to successfully reintegrate clients into their working environment. The high number of early retired clients indicates that Germany's health system cannot reach this objective satisfactorily. Empirical studies as to the various causes and factors leading to illness and--as a consequence--to early retirement provided only a few results. The client's personal and psycho-social situation in particular, as well as her/his biographical data and the available scope of action are hardly ever considered appropriately. With this in mind, we set out to reconstruct the rehabilitation process from a client's view using the method of structural hermeneutics. Against the background of biographical development, we describe the origin of illness, rehabilitation results and the opinion of social medicine experts preceding reintegration. The hermeneutic analysis shows that--in spite of the intentions of the persons concerned--an unconscious agreement arises between the client and the therapeutic system manifesting itself in the application of rehabilitation measures reproducing premorbid behaviour. On the basis of the reconstructed client-related situation a critical aspect of the general structure of Germany's health system becomes apparent: the fragmentation of the client into responsibilities of experts giving the opinion and those responsible for treatment.