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Framing Disease: Studies in Cultural History
"In some ways disease does not exist until we have agreed that it does, by perceiving, naming, and responding to it, " writes Charles E. Rosenberg in his introduction to this stimulating set of essays. Disease is both a biological event and a social phenomenon. Patient, doctor, family, and social institutions—including employers, government, and insurance companies—all find ways to frame the biological event in terms that make sense to them and serve their own ends. Many diseases discussed here—endstage renal disease, rheumatic fever, parasitic infectious diseases, coronary thrombosis—came to be defined, redefined, and renamed over the course of several centuries. As these essays show, the concept of disease has also been used to frame culturally resonant suicide, homosexuality, anorexia nervosa, chronic fatigue syndrome. Disease is also framed by public policy, as the cases of industrial disability and of forensic psychiatry demonstrate. Medical institutions, as managers of people with disease, come to have vested interests in diagnoses, as the histories of facilities to treat tuberculosis or epilepsy reveal. Ultimately, the existence and conquest of disease serves to frame a society's sense of its own "healthiness" and to give direction to social reforms. The contributors include Steven J. Peitzman, Peter C. English, John Farley, Christopher Lawrence, Michael MacDonald, Bert Hansen, Joan Jacobs Brumberg, Robert A. Aronowitz, Gerald Markowitz, David Rosner, Janet A. Tighe, Barbara Bates, Ellen Dwyer, John M. Eyler, and Elizabeth Fee. For any student of disease and society, this book is essential, compelling reading.
368 pages, Paperback
First published March 31, 1992
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January 23, 2024
“In some ways disease does not exist until we have agreed that it does, by perceiving, naming, and responding to it.”
Disease, and its configuration of social characteristics, trigger disease-specific responses, so that one, if there was any doubt, knows perfectly how to behave.
Once diagnosed as suffering from cancer, I became, as an individual, in part, that diagnosis. Yet, what does it mean to belong to a certain frame of disease, when to me, the frame was constantly moving. From the patient’s perspective, a diagnosis is never static. There is always the implication of a future, perhaps coming from a reflection of the past, that does not allow one to sit still in-front of a single frame.
A disease is a social actor that shares a stage with the community in which it was born, structured by a specific configuration of social interactions, a doctor here, and a family member there. Yet there are boundaries to a disease, shaped by its biological character, that put a limit on one’s social reach.
The medical classification of my misfortune does not merely serve to rationalise, but more so serves to legitimise the relationship between the medical and bureaucratic society in which I am being taken care of.
I find myself gaping at an insurmountable gap between what is, and what ought to be. The real and the ideal now seem further away than ever before.
Much remains to be done in the cultivation of the growing appreciation of the potential significance of feeling a little bit of pain.
One reason why there is no history of medicine from the patient perspective, I believe, is because the study of disease seems to be limited to an agenda for continued research. As opposed to serving as a repository for something rich, something more cultural and understandable from an emotional and artistic perspective, disease remains alien in the sense that, foremost, we do not want to be reminded of it, embrace it, or indeed sit next to it on the bus.
Is sickness defined by one’s behavior towards it? Sure, I have cancer, but I am not letting it get the better of me, hell, I barely feel it, frankly, stoned out of my mind, I barely notice it at all. I am not sick because I am not feeling it nor showing it. Of course, it is a killer from inside, but aren’t we all dying slowly yet surely? Degrees of pain sprinkled over a large terrain.
Of course, suicide in the Middle Ages was sheer murder in the name of the devil, and although for some today it is still a negative, a sign of weakness, a sign of not being a winner, for others it has increasingly become a cry for help in a world that doesn’t care to listen. As such, we owe the secularization of suicide to laymen, men of letters, as opposed to the pillars of the medical world. The medical interpretation of suicide was formed by philosophers who analysed the plagues of the mind, as opposed to the leadership of the medical profession, that still today largely do not really care to understand the patient.
Susceptibility for a disease is a consequence of the fall, and any ailment might be considered a punishment for sin, or a retribution or judgement either divine or natural. Indeed, he or she must have done something wrong, is a faint voice that lingers in the back of many heads.
Disease does not exist until we have agreed that it does. And so with a diagnosis, and the shake of a hand, one becomes a patient. This newly adopted position is then reaffirmed, by the kind yet sad smiles suddenly appearing, everywhere.
Disease, and its configuration of social characteristics, trigger disease-specific responses, so that one, if there was any doubt, knows perfectly how to behave.
Once diagnosed as suffering from cancer, I became, as an individual, in part, that diagnosis. Yet, what does it mean to belong to a certain frame of disease, when to me, the frame was constantly moving. From the patient’s perspective, a diagnosis is never static. There is always the implication of a future, perhaps coming from a reflection of the past, that does not allow one to sit still in-front of a single frame.
A disease is a social actor that shares a stage with the community in which it was born, structured by a specific configuration of social interactions, a doctor here, and a family member there. Yet there are boundaries to a disease, shaped by its biological character, that put a limit on one’s social reach.
The medical classification of my misfortune does not merely serve to rationalise, but more so serves to legitimise the relationship between the medical and bureaucratic society in which I am being taken care of.
I find myself gaping at an insurmountable gap between what is, and what ought to be. The real and the ideal now seem further away than ever before.
Much remains to be done in the cultivation of the growing appreciation of the potential significance of feeling a little bit of pain.
One reason why there is no history of medicine from the patient perspective, I believe, is because the study of disease seems to be limited to an agenda for continued research. As opposed to serving as a repository for something rich, something more cultural and understandable from an emotional and artistic perspective, disease remains alien in the sense that, foremost, we do not want to be reminded of it, embrace it, or indeed sit next to it on the bus.
Is sickness defined by one’s behavior towards it? Sure, I have cancer, but I am not letting it get the better of me, hell, I barely feel it, frankly, stoned out of my mind, I barely notice it at all. I am not sick because I am not feeling it nor showing it. Of course, it is a killer from inside, but aren’t we all dying slowly yet surely? Degrees of pain sprinkled over a large terrain.
Of course, suicide in the Middle Ages was sheer murder in the name of the devil, and although for some today it is still a negative, a sign of weakness, a sign of not being a winner, for others it has increasingly become a cry for help in a world that doesn’t care to listen. As such, we owe the secularization of suicide to laymen, men of letters, as opposed to the pillars of the medical world. The medical interpretation of suicide was formed by philosophers who analysed the plagues of the mind, as opposed to the leadership of the medical profession, that still today largely do not really care to understand the patient.
Susceptibility for a disease is a consequence of the fall, and any ailment might be considered a punishment for sin, or a retribution or judgement either divine or natural. Indeed, he or she must have done something wrong, is a faint voice that lingers in the back of many heads.
Disease does not exist until we have agreed that it does. And so with a diagnosis, and the shake of a hand, one becomes a patient. This newly adopted position is then reaffirmed, by the kind yet sad smiles suddenly appearing, everywhere.
February 22, 2012
Framing Disease is a constructivist account of disease and medicine: How diseases become real through the interactions of theories and practices, how various kinds of experts can speak to the relevance of a disease, and how disease acts as instrument of social and political power.
The papers in this collection range between 'decent' and 'excellent' (an accomplishment for an academic work of this kind, which usually includes a few real stinkers). A core work if you do any kind of history/sociology/anthropology of medicine, although 20 years after publishing, you probably already have an opinion on the usefulness of constructivist methods.
The papers in this collection range between 'decent' and 'excellent' (an accomplishment for an academic work of this kind, which usually includes a few real stinkers). A core work if you do any kind of history/sociology/anthropology of medicine, although 20 years after publishing, you probably already have an opinion on the usefulness of constructivist methods.
Displaying 1 - 2 of 2 reviews