Condition of Doubt

The "hypochondriac" is a complicated figure, often treated with scorn and derision, resented for making excessive demands on attention and health care resources. Lacking credibility but needing to be taken seriously, the hypochondriac is most doctors' least favorite patient. Yet people who suffer from hypochondria endure the anxiety of suspecting they are seriously ill, or are about to be, and having their suspicions and their suffering dismissed as baseless. A Condition of Doubt seeks to change the way we think about hypochondria, and to use hypochondria to sharpen our thinking about health care. It claims that contemporary hypochondria should be understood less as mental illness in particular patients than as a rational if maladaptive condition emerging from gaps between doctors' and patients' expectations of contemporary Western medicine. Medicine relies on objective evidence to verify the absence or presence of disease. The hypochondriac struggles to accept reassurance that no disease can be found. Examining the tension between these two positions reveals insights into clinical reasoning and practice, into patients' (not just hypochondriacs') clinical experiences, and into our medicalizing culture's troubled understandings of health, illness, risk, and uncertainty. The book's four parts examine hypochondria as a condition of biology; of medicine; of culture; and of narrative. Using a wealth of texts from the medical literature, published illness narratives, psychiatric diagnostics, online discussions, and popular culture, A Condition of Doubt is both an example of, and a case for, the place of serious humanities scholarship in understanding medicine and in understanding how medicine thinks about itself and trains its practitioners. This book argues that over the last half-century, patients have become postmodern but medicine has not, and claims that hypochondria-as a shared cultural condition-can be addressed by rethinking both patients' expectations of medical omniscience and physicians' need to meet such expectations. This means reconceptualizing hypochondria and, more broadly, reconceptualizing medicine's orientation toward the unknown