The making and unmaking of Hashimoto’s thyroiditis: On the mismatch between illness and disease. Results from an Italian study

[helvella]

Probably doesn't say anything that has not already been said here numerous times. But it would be interesting to see the full paper.

The making and unmaking of Hashimoto’s thyroiditis: On the mismatch between illness and disease. Results from an Italian study

Mario Cardano, Eleonora Rossero

First Published October 29, 2021 Research Article

doi.org/10.1177/13634593211...

Abstract

The diagnostic process in contemporary medical practice is increasingly technical, specialised and relying on population-based ranges of biological normalcy. Disease is defined according to a hierarchy of evidence that privileges specialist knowledge and marginalises subjective experiences of illness. Medical and individual definitions of the situation can conflict in two ways: (i) a diagnosis is made in the absence of symptoms, (ii) individual suffering does not constitute ‘real’ disease if it is not validated by scientific evidence. This article investigates how the discrepancy between specialist and embodied knowledge is experienced and tentatively solved by patients’ self-narratives. Starting from the analysis of 22 in-depth interviews with people affected by autoimmune diseases, we focus on the subgroup affected by Hashimoto’s thyroiditis. Applying the most-different-systems design, we confront two flesh-and-blood ideal-types of illness narratives characterised by a mismatch between illness and disease. Their diagnostic trajectories are outlined and discussed as poles of a continuum of experiences resulting from different configurations of medical evidence of disease and subjective evidence of illness.

Keywords

autoimmune disease, diagnosis, Hashimoto’s thyroiditis, illness trajectory, self-narrative

Full paper behind paywall:

journals.sagepub.com/doi/pd...

[Hypopotamus]

Is this the mantra of every doctor in the world? - "individual suffering does not constitute ‘real’ disease if it is not validated by scientific evidence. "

[helvella Administrator in reply to Hypopotamus]

It certainly feels like that.

[elaine2447]

Thanks, just had a look but it seems they want £29 just for 24 hours viewing unless I have misread. A shame as it is the most up to date article.

[helvella Administrator in reply to elaine2447]

That is the problem we keep hitting.

The prices they post seem solely to prove the good value of institutional subscriptions to these rapacious publishers.

[humanbean]

I think the separation of illness and disease is a massive con job to reduce the number of things that doctors will treat or "believe in". It is just a way for medical systems to save money.

It also helps to expand the empires of psychiatrists and other mental health professionals. After all, if someone has a symptom that is subjective (based on current medical opinion and testing ability) then doctors won't treat you. They'll just prescribe anti-depressants and CBT.