A Body Made of Glass

 A Body Made of Glass: A Cultural History of Hypochondria
by Caroline Crampton

As a physician, this book is of great import.  If you want to see my notes on the book, go to A Body Made of Glass and I can give you access.

From Harper Collins' website:

Part cultural history, part literary criticism, and part memoir, A Body Made of Glass is a definitive biography of hypochondria.

Caroline Crampton’s life was upended at the age of seventeen, when she was diagnosed with Hodgkin’s lymphoma, a relatively rare blood cancer. After years of invasive treatment, she was finally given the all clear. But being cured of the cancer didn’t mean she felt well. Instead, the fear lingered, and she found herself always on the alert, braced for signs that the illness had reemerged. 

Now, in A Body Made of Glass, Crampton has drawn from her own experiences with health anxiety to write a revelatory exploration of hypochondria—a condition that, though often suffered silently, is widespread and rising. She deftly weaves together history, memoir, and literary criticism to make sense of this invisible and underexplored sickness. From the earliest medical case of Hippocrates to the literary accounts of sufferers like Virginia Woolf and Marcel Proust to the modern perils of internet self-diagnosis, Crampton unspools this topic to reveal the far-reaching impact of health anxiety on our physical, mental, and emotional health.

At its heart, Crampton explains, hypochondria is a yearning for knowledge. It is a never-ending attempt to replace the edgeless terror of uncertainty with the comforting solidity of a definitive explanation. Through intimate personal stories and compelling cultural perspectives, A Body Made of Glass brings this uniquely ephemeral condition into much-needed focus for the first time.

Chronic Itch Is Miserable

Journalist Annie Lowrey suffers from primary biliary cholangitis (PBC), a degenerative liver disease in which the body mistakenly attacks cells lining the bile ducts. The result is a severe itch that doesn't respond to antihistamines or steroids.

 
This 45 minute November 12, 2024 NPR Fresh Air interview is a great introduction to the topic of Itch.

It is based on Ms. Lowrey's October 2024 The Atlantic Article, " Why People Itch, and How to Stop It."

What Does It Feel Like?

 by Sophie Kinsella

 BLOODY, BRILLIANT
            BRITISH!

This book is Ms. Kinsella's glioblastoma multiples (GBM) pathography told as a roman a clef.  It is a poowerfull story that is well-worth the time spent reading its 144 pages book or listening to the 2 hour audio version.  Kinsella's journey illustrates the classical illness trajectories* of GBM patients: physical, psychological, spiritual and social.

When she writes, "All my words disintegrated in my brain" one can appreciate that and feel for her.

Kinsella was diagnosed with GBM in December 2022.  A recent Instagram post from her contains this paragraph:

To everyone who is suffering from cancer in any form I send love and best wishes, as well as to those who support them. It can feel very lonely and scary to have a tough diagnosis, and the support and care of those around you means more than words can say.

All care providers, and some patients, will benefit from engaging with "What Does It Feel Like?"

* Scott A. Murray. Social, psychological and existential well-being in patients with glioma and their caregivers: a qualitative study,  CMAJ. 2012 Apr 17;184(7):E373–E382. PMC

Be Mine by Rishard Ford

from Good Reads: [with] "Be Mine" Richard Ford has crafted an ambitious, incisive, and singular view of American life as lived. Unconstrained, astute, provocative, often laugh-out-loud funny, Frank Bascombe is once more our guide to the great American midway.

Now in the twilight of life, a man who has occupied many colorful lives--sportswriter, father, husband, ex-husband, friend, real estate agent--Bascombe finds himself in the most sorrowing role of all: caregiver to his son, Paul, diagnosed with ALS. On a shared winter odyssey to Mount Rushmore, Frank, in typical Bascombe fashion, faces down the mortality that is assured each of us, and in doing so confronts what happiness might signify at the end of days.

In this memorable novel, Richard Ford puts on displays the prose, wit, and intelligence that make him one of our most acclaimed living writers. Be Mine is a profound, funny, poignant love letter to our beleaguered world."

  From a  medical point of view, this book is a picture of a family dealing with ALS.  Bascom finds himself as care giver to his son. Most of the book takes place at the Mayo Clinic and there are many memorable scenes in and around Rochester, MN..  Ford, I believe, was a patient there when he was being treated for prostate cancer.  I thoroughly enjoyed this book and learned a bit about care giving from it.

In My Time Of Dying

In My Time Of Dying: How I Cane Face-To-Face With The Idea Of An Afterlife

by Sebastian Junger (2024)

 

 This is the pathography of the author who had a near death experience (NDE) after the rupture of a pancreatic artery.  His medical problem was probably the result of a pancreaticoduodenal artery aneurysm (PDAA), which is often associated with celiac axis stenosis caused by median arcuate ligament syndrome (MALS).

 

Junger is a well-known writer, and the book is quite interesting. However, for me, The In-Between was more instructive about NDEs. Junger's book has many useful references and the Vlados book has none.

 

If you want to see my notes, I put them on GoogleDocs. Just email me and I'll send you a link. 

About This Blog

Pathographies are illness narratives and have become increasingly popular over the past few decades.  This blog contains references to illness narratives that I have found helpful.  The genre is interesting and important.   

There are three main types of pathography (and they may overlap):  Quest, Chaos and Restitution stories.  Pathographies are an essential adjunct to learning about the illness experience.

·      Quest: a person journeys through and faces suffering head on in the belief that something is to be gained from the illness experience.

·      Chaos: The rarest type and often the most important.  When people are overwhelmed by the intensity of their illness, to speak coherently becomes impossible. The underlying message is that life does not get better. All this provokes anxiety as the mask slips off to reveal human frailty and vulnerability. No Hollywood endings here.  

·      Restitution: In the West, we are mainly preoccupied with the restitution narrative, which goes: "Yesterday I was healthy, today I am sick but tomorrow I will be healthy again." There is a belief in restorable health.  Planet Hollywood rules.

Arthur Frank wrote a book about pathographies called "The Wounded Storyteller" (1995).  Notes on this can be found at Google-Docs. It's more than most people will want to read, but if you do, contact me if you need an invitation.

Illness Narrative Collections

Illness narratives, aka Pathographies, instruct health care professional about their patients’ experiences of being on the flip side of medical care: recipients, not providers.

Tamar Hudson, in a JAMA essay about her breast nodule opines, “On the other side of medicine, when the physician becomes the patient, the chasm between delivery and receipt of care becomes evident. Standards of care can stand in stark contrast to quality and even reality of care.” (1) Her experience led her to “redouble efforts not only to counsel more and listen more but to meet patients where they are. The vulnerability of placing one’s health in someone else’s hands requires a trust fall.”

There are three collections of doctors’ illness narratives that we know of:

1. Pinner M, Miller BF.  When Doctors are Patients. 1952

2.  Manedell H, Spiro H.  When Doctors Get Sick, 1987

3. Klitxzman R. When Doctors Become Patients, 2008

In my opinion, the most accessible is Mandel and Spiro’s “When Doctors Get Sick.”


Reference
1. Huson T. Being Patient. JAMA 2023;330(22):2163-2164