Unwell: What Makes a Disease a Disease?

by Mike McRae

In a world where illness seems to be everywhere, where does failing biology stop and personal responsibility begin?

Nostalgia used to be a killer nervous condition. Emotional women were once treated with a good orgasm, left-handed folk were beaten to be turned ‘right’, and rotten teeth pulled to cure the mentally unwell. Just who made these diseases ‘diseases’ anyway? And what makes us think we understand any better today?

Unwell is a fascinating and insightful exploration of the ever-changing nature of illness. Using humour, historical anecdotes, scientific research and personal stories, McRae illuminates the power of disease and medical diagnoses to define who we are and how we live.

In a time when extreme violence is blamed on poor mental health, when people suffer for want of health insurance, and research dollars depend on sharp marketing campaigns, understanding the social and cultural nature of disease is vital for our wellbeing – and the wellbeing of our community.

Genres: Nonfiction, Medical, Health, Medicine, Science

300 pages, Paperback

First published September 3, 2018

Reviews

[Justine Tringham · Rating 5 out of 5]

Interesting discussion on whether disease is defined by physiological or moral factors. Pleased to know that my wandering uterus is in fact the cause of all my problems.

[Mason Brooks · Rating 5 out of 5]

Picked this up thanks to a book club suggestion, and I’m so glad I did. Unwell is a clever, unsettling, and brilliantly written exploration of how illness is often more about culture than biology. McRae challenges the reader to question long-held beliefs about health, from outdated diagnoses like "hysteria" and "nostalgia," to today’s debates on mental health, medical bias, and the commodification of disease.

What makes this book stand out is its blend of humor, research, and real-world examples, it's informative without ever feeling heavy. McRae’s writing is sharp, accessible, and at times startling in how clearly it shows the absurdity of some historical (and current) medical thinking.

It’s one of those books that leaves you seeing the world, and the healthcare system, a little differently. An absolute must-read for anyone curious about the hidden forces behind how we define and treat illness.

[Eleanor Brooks · Rating 5 out of 5]

I discovered Unwell through a book club, and it quickly became one of the most thought-provoking reads I’ve encountered this year. McRae offers a fascinating deep dive into the cultural, historical, and psychological dimensions of illness, challenging the boundaries between biology and personal responsibility. With wit, empathy, and rigorous research, the book traces how society has defined, and often misdefined, disease over time, from hysteria and left-handedness to today’s debates around mental health and healthcare access. It’s a compelling, timely reminder that our understanding of illness is never static, and that the stories we tell about health shape not only individual lives but entire communities. Unwell is both enlightening and essential reading for anyone interested in the intersection of medicine, culture, and identity.

[Steph · Rating 4 out of 5]

This was a book I enjoyed more as it went along (reading a couple of chapters, leaving it buried on my bedside table for a year, then finishing it quickly), I think because at first I was expecting more in the way of a consistent sociological argument. However, once I understood and settled into the pattern of historical exploration, personal anecdotes and current examples, it was an entertaining and enlightening read.

McRea is a pathology-lab-tech-turned-science-educator and does a good job of presenting hard science in an accessible way and tackling some thorny ethical issues with both empathy and objectivity.

[Crystal Croteau · Rating 4 out of 5]

This book came up in my book club, and I’m so glad it did. Unwell completely reframes the way we think about illness and health. McRae doesn’t just explore the science, he dives into the social, historical, and cultural forces that have shaped our understanding of disease. From outdated cures and bizarre diagnoses to modern-day assumptions around mental health and personal responsibility, this book is packed with sharp insights. It’s thought-provoking, often funny, and leaves you questioning what we call “normal.” A must-read if you're interested in medicine, psychology, or just understanding the human condition more deeply.

[Anna Ahveninen · Rating 5 out of 5]

A brilliant tapestry of most every way a human body or psyche can be considered to differ from the norm, and what that has meant in the past, means now and could mean in the future.

Also a very personal journey given my current struggles with chronic illness, the lack of a conclusive diagnosis (and so, treatment and prognosis) and the tumultuous feelings that surround that whole mess. Is it normal to cry at a nonfiction book or does that fit under one of those ephemeral definitions of disease?

[George · Rating 4 out of 5]

A great read that examine the many influences on what we call a disease in modern society. It is also a great romp through many topics within science that can be thought of as socially determined, but also how well we do (and don't) balance factors such as agency, self-determinism, as well as baggage we keep with us such as racism, sexism and elitism.

A great read.

[Jo · Rating 5 out of 5]

Fascinating book and brilliantly researched, it delves into what we consider a disease and how this has changed throughout history and will continue to evolve. Loved the personal anecdotes and stories and the way the author blends science and philosophy. The chapter on circumcision is the most detailed and well researched one I've read. Highly recommended.

[Isabel · Rating 2 out of 5]

Only got through about a quarter of it. Disjointed anecdotes with only a semblance of a unifying message tying everything together.