There is Something Wrong, But It's Not You
From my father’s surgical books to the era of self-diagnosis: finding the nuance between "I am broken" and "I am ill."
The Psyche
I was 6 years old when I assisted my father in suturing an open wound under my brother’s chin.
My father was a surgeon, my brother is a doctor and growing up amongst medical books nurtured a certain affinity towards medicine, medical terms and a drive towards understanding the human body and the way it functioned.
Pathology at the time was for me a way to offer clarity, to obtain a term which would explain what was wrong and offer the path towards treating it.
While initially it seemed very black and white, the more I delved into medical books and articles to sate my curiosity the more I understood that diagnostics were guidelines based on the information that was available at the time.
The more I accumulated experiences with doctors, the more I understood that the validity of a diagnosis was heavily based on the doctor’s professional experience and knowledge, but also on the doctor’s willingness to carefully listen to the patients without assumptions or judgement, to collaborate with other doctors and to stay curious and up to date with the emerging information.
While initially, I regarded a diagnosis as a win because FINALLY we had a name for what was wrong and thus the starting point of a path towards healing, in time I understood the more complex aspects and indirect consequences.
The System
There is a certain stigma that comes with certain diagnostics. While mental health diagnostics carry a stigma which points more strongly to it being one’s personal failure, plenty of diagnostics of the body seem to do the same thing. And this transforms an illness into one person’s sole responsibility and therefore one person’s sole failure.
Instead of treating an illness as the result of a complex combination of factors which interact and influence each other (personal genetics, current circumstances, lifestyle habits and history, closely tied to socio-economic and environmental factors) we’ve been treating it as one person’s insufficiency.
I have also noticed an even narrower approach in most doctors (fortunately, not all doctors), when approaching a consultation solely through their own speciality. Not only do they not correlate environmental factors to the person’s symptoms, but they do not seem to approach the body itself as a system, which tends to lead to misdiagnosis. A very common example of this is heartburn, an issue of the stomach, which can feel like a heart attack, despite the heart being perfectly fine. As a cardiologist, one should know the correlation between the two and not dismiss the symptom as imagined.
Another issue which leads to misdiagnosis, especially in the private sector, is the pressure of the time limit placed on doctors, to learn and filter through the (rarely available) history, consult, diagnose and offer treatment to a patient within 15-20 minutes, multiple times a day, all in the name of profit.
All these give rise to mistrust in the medical system and makes us turn to the most accessible tool we have: the internet.
While the information is more accessible, it can also be more easily skewed and the chance of misdiagnosis increases with the lack of systemic knowledge and understanding. The commodification of the technical language, the availability of bite-size content on professional knowledge, which also subversively encourages self-diagnosis, has led to the pathologization of ...well, everything.
While under-diagnosis is more prevalent in regards to our bodies as there is plenty of new research still emerging (e.g. endometriosis), over-diagnosis seems to be more prevalent in mental health, as we take to self-diagnosing based on social media posts, which skews our self-reporting in psychological testing.
The Self
We have ended up treating physical symptoms with whatever we can or ignoring them altogether, as we are dismissed by doctors, unconsciously feeding our belief that we can only rely on ourselves.
We have ended up pathologizing normal human behaviours, in an attempt to control our lives and our relationships, feeding the belief that there is something intrinsically wrong with us.
There is a delicate balance between the two conflicting beliefs that say “there is something wrong with me” and “I can only rely on myself” and both of them stem from unhealed wounds and both of them are not completely true and not completely untrue, depending on the situation.
I found that sometimes there can be something wrong with me and that does NOT mean there is something intrinsically wrong with me.
I found that at times I can truly only rely on myself and that does not mean I have nobody else to turn to for help.
I found that as much as we’d like things to be simple and easy to grasp, there is complexity and nuance to everything and very few things in this life are exhaustive. Even a diagnosis.
You know by now that my goal is for this to be a two-way street and as my articles seem to be longer and longer, I do want to hear from you. Tell me:
Have you ever received a diagnosis that felt like a relief, only to realise later that it came with a stigma you didn’t expect? How do you balance the ‘win’ of a label with the weight of it?
Thank you for exploring In the Dark with me! I look forward to reading your stories.