About the Book
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
Table of Contents:
Introduction: A Dubious Condition
PART I: A BIOLOGICAL CONDITION
Chapter 1: That Within: Biologies of Hypochondria
Chapter 2: Medicine's Ghost: The Unnatural History of an Unreliable Idea
Chapter 3: Swimming in the Dark: The Hypochondriac in the Body
PART II. A MEDICAL CONDITION
Chapter 4: Contested Authority: An Expert Patient Lectures the Physicians
Chapter 5: Hating Hypochondriacs: Stigma and Stereotype
Chapter 6: Dangerous Fearlessness: The Formation of Physicians
Part III. A CULTURAL CONDITION
Chapter 7: Be Informed: Medical Knowledge
Chapter 8. Be Responsible: Cautionary Tales
Chapter 9. Be Afraid: Horror Stories
PART FOUR: A NARRATIVE CONDITION
Chapter 10: How Can I Tell? Professing Hypochondria
Chapter 11: The Story that Won't Begin: Hypochondria's Narrative Structure
Chapter 12: Unreliable Historians: Hypochondria's Narrators
Conclusion
Bibliography
About the Author :
Catherine Belling is on the faculty of the Program in Medical Humanities and Bioethics at Northwestern University's Feinberg School of Medicine in Chicago. She came to the United States from South Africa on a Fulbright grant to complete her PhD in English, on representations of anatomy and physiology in Renaissance drama, at Stony Brook University, New York, where, on graduating, she took up a position in the medical school before moving to Chicago in 2007.
Review :
2013 Society for Literature, Science, and the Arts (SLSA) Michelle Kendrick Memorial Book Prize
"Hypochondria, one of the oldest medical quandaries, is seen freshly in this illuminating study. Exploring hypochondria as a biological, medical, cultural and narrative phenomenon, Catherine Belling reveals a hermeneutic uncertainty at the core of contemporary medicine, as the physician's expert authority collides with the visceral knowledge of the patient. Tracing the narrative strategies of a rich trove of hypochondria chronicles, she demonstrates how
hypochondria can serve as a source of insight for the clinician-reader, making physicians more skillful interpreters of the signs and symptoms patients bring to the medical encounter." -- Susan M. Squier,
Penn State University, author of Liminal Lives: Imagining the Human at the Frontiers of Biomedicine
"This book offers a profound and incontrovertible critique of contemporary medicine and, along the way, provides equipment for the examined life. Belling writes a book about doubt, about uncertainty, about the human craving, always unfulfilled, for certainty, problems general all over medicine and general all over life. She recognizes the hypochondriac as hero, brave enough to live in the glare of our shared and devastating mortal predicament. By this book,
Belling enters the ranks of the most authoritative literary scholars who can pierce through the obfuscations of contemporary medical and bioscientific practice to behold- and then display for us-the
necessary sight on our human situation, exposed in its frailty and its hope." -- Rita Charon, Professor of Clinical Medicine, Executive Director, Program in Narrative Medicine, Columbia University
"...hers is the first book in hypochondria I have finished-- and I have started many." -- Alexander Nazaryan, The New Yorker
"Hypochondria will never be the same. Catherine Belling shows how this ancient stereotype emerges in the contemporary world as medicine's 'ghost self': inherently ironic, slippery, and paradoxical, a condition in which medical expertise cannot erase equally expert personal knowledge of our own bodies, with its fears of lurking disease. Hypochondria, Belling writes, is 'the shape of doubt.' Doubt is the signature of the multiple accounts she describes as 'the
story of no disease told by a narrator who has no credibility.' This is the terrain of Kafka and of internet avatars where certainty vanishes as anxiety deepens. Our medicalized culture tells us to
scan our bodies regularly for risk factors and warning signs-but do we then brush inescapably close to the condition of the anxious hypochondriac? Brush close to the figure who just may appear, in Belling's brilliant retelling, as a representative figure of our time." -- David B. Morris, author of The Culture of Pain
