Making Sense of Illness: Science, Society and Disease / Edition 1

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Overview

In Making Sense of Illness Robert Aronowitz offers historical essays about how diseases change their meaning. Each of the diseases or etiologic hypotheses in this book has had a controversial and contested history: psychosomatic views of ulcerative colitis, twentieth century chronic fatigue syndromes, Lyme disease, angina pectoris, risk factors for coronary heart disease, and the type A hypothesis. At the core of these controversies are disagreements among investigators, clinicians, and patients over the best way to deal with what individuals bring to disease. By juxtaposing the history of the different diseases, Aronowitz shows how values and interests have determined research programs, public health activities, clinical decisions, and the patient's experience of illness.

The book contains no figures.

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Editorial Reviews

Christopher Crenner
This original and thought-provoking book charts the history of several new diseases that have emerged during the twentieth century. The author invites his readers to consider how modern medicine defines and gives meaning to disease. The author argues that the recognition of a new disease results from complex negotiations among physicians, scientists, and patients. People who are concerned about medical diagnoses, either because they make them, have them, or use them, will gain from this book. The author links six case studies of new diseases into a subtle and convincing analysis of the process of acknowledging and defining illness. He examines Lyme disease, chronic fatigue syndrome, psychosomatic ulcerative colitis, coronary heart disease, coronary risk factors, and type-A personality. The history of a contentious condition like chronic fatigue syndrome, or type-A personality, highlights the importance of successful negotiations among social groups in creating diseases. The author extends this insight to his analysis of other conditions, like coronary heart disease, that have developed a more durable, empirical grounding. There are limitations to the social analysis of disease concepts. Such an analysis may seem an embellishment to our understanding of a disease with accepted empirical grounding. Alternately, it may serve to undermine the legitimacy of a disease that lacks such grounding. The author does an unrivaled job of identifying and overcoming these limitations. His arguments work to wonderful effect in the case of Lyme disease. He shows that the boundary between Lyme disease and the contentious diagnosis of chronic Lyme disease is itself negotiated, and is contingentupon agreements among different groups about such things as the interpretation of empirical evidence. The author does not tackle directly the problem of reckoning with the stigmatized, subjective elements in all illness. He makes a bold attempt to diagram the implications of medicine's avoidance of subjectivity and idiosyncrasy in explaining disease. He successfully pursues a line of analysis suggested by several authors in Framing Disease: Studies in Cultural History (Rutgers Univ Pr 1992) edited by Charles Rosenberg and Janet Golden. Comparable historical analysis of changing disease categories appears in Allan Young, The Harmony of Illusions: Inventing Post-Traumatic Stress Disorder (Princeton Univ Pr 1996), and Mark Micale, Approaching Hysteria: Disease and Its Interpretations (Princeton Univ Pr 1995).
Doody's Review Service
Reviewer: Christopher Crenner, MD, PhD (University of Kansas Medical Center)
Description: This original and thought-provoking book charts the history of several new diseases that have emerged during the twentieth century. The author invites his readers to consider how modern medicine defines and gives meaning to disease.
Purpose: The author argues that the recognition of a new disease results from complex negotiations among physicians, scientists, and patients.
Audience: People who are concerned about medical diagnoses, either because they make them, have them, or use them, will gain from this book.
Features: The author links six case studies of new diseases into a subtle and convincing analysis of the process of acknowledging and defining illness. He examines Lyme disease, chronic fatigue syndrome, psychosomatic ulcerative colitis, coronary heart disease, coronary risk factors, and type-A personality. The history of a contentious condition like chronic fatigue syndrome, or type-A personality, highlights the importance of successful negotiations among social groups in creating diseases. The author extends this insight to his analysis of other conditions, like coronary heart disease, that have developed a more durable, empirical grounding. There are limitations to the social analysis of disease concepts. Such an analysis may seem an embellishment to our understanding of a disease with accepted empirical grounding. Alternately, it may serve to undermine the legitimacy of a disease that lacks such grounding. The author does an unrivaled job of identifying and overcoming these limitations. His arguments work to wonderful effect in the case of Lyme disease. He shows that the boundary between Lyme disease and the contentious diagnosis of chronic Lyme disease is itself negotiated, and is contingent upon agreements among different groups about such things as the interpretation of empirical evidence.
Assessment: The author does not tackle directly the problem of reckoning with the stigmatized, subjective elements in all illness. He makes a bold attempt to diagram the implications of medicine's avoidance of subjectivity and idiosyncrasy in explaining disease. He successfully pursues a line of analysis suggested by several authors in Framing Disease: Studies in Cultural History (Rutgers Univ Pr 1992) edited by Charles Rosenberg and Janet Golden. Comparable historical analysis of changing disease categories appears in Allan Young, The Harmony of Illusions: Inventing Post-Traumatic Stress Disorder (Princeton Univ Pr 1996), and Mark Micale, Approaching Hysteria: Disease and Its Interpretations (Princeton Univ Pr 1995).
From the Publisher
"Making Sense of Illness succeeds as both a medical monograph and a book for the lay reader because it speaks to such deep matters of health and health care delivery, and accomplishes its task in relatively jargon-free language. This is a book for the thinking reader." The Washington Post

"This book will stimulate responses from both the ontologic and holistic camps...It should be especially appreciated by the new breed of academics incessantly involved in designing and redesigning the medical school curriculum." The New England Journal of Medicine

"The author of this very sensible book is no ideologue; he makes us think hard about interactions among social and biological determinants of disease meaning....Making Sense of Illness succeeds as both a medical monograph and a book for the lay reader because it speaks to such deep matters of health and health care delivery, and accomplishes its task in relatively jargon-free language. This is a book for the thinking reader." Harold J. Morowitz, The Washington Post

"Robert A. Aronowitz has written a challenging and most interesting short book perhaps best characterized as medical historicosociologic in scope...I hope that Making Sense of Illness will be widely read and discussed within our profession." Joseph S. Alpert, MD, JAMA

"...a doctor's effort to do justice...bringing us to our (clinical senses) so that we can appreciate the limits as well as the extent of our new knowledge." Robert Coles, The Lancet

"The great virtue of this book is the author's esential even handedness. He is an astute clinician...alert to the way new knowledge can becloud as well as inform..." Robert Coloe, The Lancet

"The author wants us to examine closely the way our thinking about diseases in the abstract effects our relationship with our patients...those broader social and cultural matters as they bear down on the daily encounters that take place in medical offices across the world, and especially among the priveledged, health-conscious bourgeoisie of the western world." Robert Coloe, The Lancet

"...in this century, we have acquired an astonishing body of knowledge about the mechanisms of various diseases, and this book in no way underestimates or undervalues that knowledge." Robert Coles, The Lancet

"...an insightful book focused on 20th-century medical developments and based on his own clinical experiences with chronic disease. ...should be read by everybody who cares for the future of medicine." Inquirer

"His argmumentation is lucid, temperate, and scholarly. His intention is to open his readers' eyes to the historical contingencies and unexamined assumptions that underpin medical knowledge. His case studies wil be substantively interesting to psychiatric audiences, but it would be a mistake to ignore the book's larger imlications for psychiatry. Aronowitz's splendid book points us in this direction." Allan Young, Ph.D., The Journal of Nervous and Mental Disease


3 Stars from Doody
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Product Details

  • ISBN-13: 9780521558259
  • Publisher: Cambridge University Press
  • Publication date: 5/28/2011
  • Series: Cambridge Studies in the History of Medicine Series
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 284
  • Sales rank: 1,333,628
  • Product dimensions: 5.98 (w) x 8.98 (h) x 0.63 (d)

Table of Contents

Preface
Introduction 1
1 From Myalgic Encephalitis to Yuppie Flu: A History of Chronic Fatigue Syndromes 19
2 The Rise and Fall of the Psychosomatic Hypothesis in Ulcerative Colitis 39
3 Lyme Disease: The Social Construction of a New Disease and Its Social Consequences 57
4 From the Patient's Angina Pectoris to the Cardiologist's Coronary Heart Disease 84
5 The Social Construction of Coronary Heart Disease Risk Factors 111
6 The Rise and Fall of the Type A Hypothesis 145
Conclusion 166
Notes 191
Index 249
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