Yesterday, we discussed the importance of doctors loving their patients and today I want to turn our eye to the responsibility of the patient in the medical dyad, especially those patients that demand to label their illness — even if one does not exist — for their imagined sickness. It isn’t enough today to just be sick.


We want to always feel special — even in illness — and we achieve that end by demanding labels from the medical profession for what ails us.

There used to be a time when labels like “depressed” or “melancholia” or “feeling down” were cover enough in the world for the sick person to feel their illness was well-defined, manageable, and — most important — worthy of patience and pity from others.

That need to suck the healthy into the imagined illness is a prime conceit in the contempt of illness labeling. Illness labeling is pressed from patient to doctor and it is the doctor’s job to give the illness a name. Insurance companies also demand labels for their pre-existing check boxes, but what if a person isn’t sick with a known disease?

What if a person is suffering from what we used to call “hypochondria” — when someone who is unnaturally anxious about their health demands a label for satiety even though all tests for all known diseases are negative?

What then?

The patient demands a label, the doctor must provide a diagnosis supporting the label so the dyad may continue to thrive and keep the flow of money moving.

The answer to that medical conundrum today is: Fibromyalgia — and here’s the introductory paragraph from the Mayo Clinic describing its effects:

You hurt all over, and you frequently feel exhausted. Even after numerous tests, your doctor can’t seem to find anything specifically wrong with you. If this sounds familiar, you may have Fibromyalgia.

Fibromyalgia is the new hypochondria: A label created to medicate the uneasy masses.

Fibromyalgia provides convenient cover to the weak and encourages pity from the unfairly healthy and the medical community backs the “mistruth in invented labeling” because the process gives them a socket to plug in the fantastical sick in order to check a box on an insurance claim form for reimbursement.

I also believe the Epstein-Barr Virus label was invented for hypochondriacs who didn’t feel “ordinary herpes” was a meaningful enough disease label for them:

Epstein-Barr virus, frequently referred to as EBV, is a member of the herpesvirus family and one of the most common human viruses. The virus occurs worldwide, and most people become infected with EBV sometime during their lives. In the United States, as many as 95% of adults between 35 and 40 years of age have been infected.

Infants become susceptible to EBV as soon as maternal antibody protection (present at birth) disappears. Many children become infected with EBV, and these infections usually cause no symptoms or are indistinguishable from the other mild, brief illnesses of childhood.

The next time you meet someone and are told, with a gleeful voice and joyous expression, they have been “diagnosed” with Fibromyalgia or the Epstein-Barr Virus — smile, turn around, and run the other way because a Pity Party is about to start and you are the invited sucker selected for shoveling the sympathy.

40 Comments

  1. More reason why we should move toward nationwide “fluoxetination” of our water supplies to prevent these types of illnesses.
    From Atheath.com:

    Perhaps the most useful medications for fibromyalgia are several in the antidepressant class. Antidepressants elevate the levels of certain chemicals in the brain, including serotonin and norepinephrine (which was formerly called adrenaline). Low levels of these chemicals are associated not only with depression, but also with pain and fatigue.

    We’d probably help a lot of depressed people stop smoking as well.
    From annals.org:

    One population-based trial examined the effectiveness of the combination of fluoxetine and cognitive behavioral treatment (31). One and 3 months after the quit date, fluoxetine increased the likelihood of abstinence compared with placebo among smokers with minor depression (odds ratio, 1.39 [CI, 1.02 to 1.89]) but not among those with little or no depression; fluoxetine selectively benefited medication-adherent smokers with mild depression.

  2. Hi Chris!
    Is there anything wrong with feeling blue or a bit down? Isn’t it our job to cheer ourselves instead of relying on medication to do it for us?
    Like a baby that must learn to comfort itself to sleep in the absence of a parent, isn’t it, too, our job as adults to find our own joy without tossing a pill down our throat first?
    I realize there are people who need psychotropic drugs because they have wonderings about death and killings — they require medication to help them out of that darkness, but the explosion of children being “diagnosed” and labeled “ADD” and put on medication in order to cover and excuse bad parenting is yet another example of “it’s them not me” that too many people seek to confirm in invented illnesses and the application of misguided medical labels.

  3. Hi David,
    Sometimes I think we need to feel blue so that we can feel alive later.
    The medication is good if feeling blue develops into a chronic state that affects other areas of life. And, it does really help with smoking. Of course, some suggest that some smokers are self-medicating, so it would make sense.
    People are ADD people there are too many choices and time demands today. Kids have 5000 channels of entertainment competing with a relatively unentertaining math worksheet or English assignment. Adults are the same way. It’s hard to focus when there is always “something better or more exciting” singing its siren song.
    I have a feeling that many of the diseases we face come from our stressful existence. Americans needs to figure out ways of reducing stress so that we can lead a better quality of life.
    I’ve read that people in France eat more fat than we do, but have healthier hearts.
    Maybe their lifestyle keeps them healthy.
    Maybe we should all slow down and enjoy our journey through life, instead of rushing from here to there always worrying about things that aren’t really that important in the grand scheme of the universe.

  4. People are ADD people there are too many choices and time demands today.

    I’m suffering from ADD today. 😉
    I should have written: “People are ADD today because there are so many choices and time demands today.”

  5. Chris —
    I agree life is fast and stressful — but hasn’t it always been that way for each generational churn?
    Those born in 1880 had a much slower and less stressful life than those born in 1920 but their lives were faster and more stressful than those born in 1840.
    I think we need to feel both the highs and the lows to finally enjoy the neutral center.
    As technology grows and our discontent and dystopia deepens, we need to find ways around the pill-as-a-solution for necessary melancholia as a mark of being alive — or else we’ll just medicate ourselves into zombies unable to feel pain and to be empathetic and understand decisions to go to war abroad and to starve children at home has repercussions beyond a solitary dark mine. That find of despair needs to be healed by action. A pill can’t cure that kind of depression.

  6. While I agree that the medical community is quick to label things and the insurance companies and drug companies are more than happy to oblige, I’m not going to immediately dismiss someone’s condition. I had a friend who was in a fibromyalgia-type condition (I don’t think he was ever specifically diagnosed with it) where he had extreme fatigue and sensitivity but nothing showed up on standard medical tests. He never had any history of being overly concerned with his health, but finally his body just wouldn’t let him do what he normally did – and this was a very fit, active man at the age of 34. Finally, a reluctant trip to a naturopathic physician presented him someone who was able to treat him. While there certainly is the medical trend to pathologize, the scientific community also has the tendency to ignore and dismiss what it does not understand. I believe it is important to keep that reality in mind.

  7. Hi Marc —
    What was the final medical diagnosis for your friend?
    Was he placed on standard medication or was a homeopathic solution used instead?
    I do not believe people do not believe they are sick — every hypochondriac truly believes there is something wrong with them — the test is, and must be, some kind of scientific proof. Even if a diagnosis is unable to be made there is, somewhere, an indication that something is wrong if something is truly wrong. The body does not lie.
    Have there been many medical community dismissals of verifiably ill patients? We need some kind of proof of the body to make an in situ diagnosis, don’t we?
    In the wake of a lack of any sort of evidence of illness one must continue to dig deeper instead of dismissing the person as a hypochondriac as routinely happened 20 years ago or, even worse, giving them a special label today like “Fibromyalgia” to make them feel better even though there is no proven medical treatment for that conditional diagnosis.

  8. Hi David,
    I think some of our national depression comes from the realization at a certain point that accumulating wealth isn’t going to bring happiness.
    People work harder and harder in the hopes of making more money — and many accomplish that goal — but realize that they aren’t any happier making $500,000 per year as they were making $50,000.
    But, when someone is “wired” in such a way that they might always feel down, getting good psychological care and medication is important. It’s too bad we often ignore mental health when it is as much a disease as any other and a great cause of many of the problems faced by society.

  9. I also think if we had a Democrat House or Senate — we would see much more protesting in the streets — if you own the message and the means of punishing those who dare to disagree you don’t get acquiescence of affirmation, you get a sullen silence. We’ve had that forced napping for the last six years.
    Wrenching just one arm away from the current power majority should help the moderates across all national strata to awaken — even if for a moment — to wonder where we are now and what happen to us and how the heck we’re going to get out of that over there to get on with our lives over here, right here.

  10. Aren’t the possible side-effects scarier than what the medication is supposed to cure? Have you seen the commercials for the drugs today? They have a long list of things that they might cause ie. migraines, nausea, dry-mouth, abdominal pain, loss of bladder control, dizziness, depression, etc… and in some rare cases death. I’ve heard some doctors say that that’s for legal purposes and they don’t necessarily cause all of those things but doesn’t it make you want to fake well rather than ill?

  11. You’re right there’s no money in happiness, Chris. Content comes from within and is generated by selfless deeds.
    My concern is when the body fails — the mind is blamed. Bones ache — but there’s no proof of disease — so we somehow turn around as a society and decide to medicate the brain instead to turn off the pain in the bones.
    It’s a vicious circle that can begin to wound the delicate chemistry of the brain instead of using the brain’s own unfettered magic to heal the body proper.

  12. Hi A S —
    Those lists of drug side-effects are discovered in the clinical trials and they are required by law to be mentioned. The symptoms are not made up. They are observed, logged and dealt with in the trials.
    Lots of internal stomach ailments can be healed with a change in diet instead of merely masking the problem with a medication.
    Modern day medication is used to veil the mind — to turn off pain centers — to acquiesce responsibility of the body from the person to the pill.

  13. I strongly disagree with your original article. You did clear it up some later by saying doctors should dig deeper to find the real cause of illness instead of attaching a convenient label to symptoms. I do not however think the patient is to blame. A neurologist told me I had the disease and you are exactly right they could not find an exact cause. I think probably stress on the body doing certain activities during ones life play a part in the symptoms leading up to the tag they put on it. It does not diminish the pain however. I am sick from something. I felt better when the doctor at least put some tag on it that people recognize. Like you, he obviously had more education than I and so I took his word for it. For all I know it could be a bone, muscle, ligament or tendon disease with a yet unknown name that keeps from from walking after sitting for an hour or keeps me from relaxing while others can rest or waking up exhausted while others stretch and go for a run. I was in the Marines for eight years, worked freight docks and lifted weights. I could still run three miles when I was past forty then something happened, I don’t know what, my strength just left me. I must say that I strongly believe it is a physical problem and not a mental problem, although it does have negative effects on my thought process or enthusiasm for life and excitment over the next mountain to climb. Maybe it is a combination of pollution, poor water, depleted food and the world going down the tube. Maybe some people are just blessed with stronger bodies than others. As for the thinking that anyone enjoys having to have their wife steady them while going for a walk, it is not always the case. I think ‘flower’ is an accurate word to cover a wide variety of blooming plants although rose would be more specific when talking about a rose should one know that it is a rose. If they don’t, flower gets them in the ball park.

  14. This so reminds me of an ex friend of mine. She was a total hypochondriac! From telling us that she was dyslexic … to telling us the doctor told her she’d get Cancer if she QUIT smoking … this girl had it all and was one of the healthiest people I knew.
    Just to make sure we knew she wasn’t lying … she’d make a point of telling us it was “In her doctors notes.” She fell out with me when I laughed at her saying she’d get Cancer if she quit smoking.
    If she’s going to get Cancer, she’s going to get it regardless of whether she quits smoking or not. I don’t know where she is today, or what she’s doing – and honestly, I’m not sure I’m bothered. Just so long as I don’t run into her again.
    Oh and David, I love you! I did as you suggested with the Cat adoption center and called them. They do Boarding for Cats that can’t go home right away, and so now we’re trying to arrange for the adoption and boarding of little Tara. If you hadn’t made the suggestion, I might never have called them.
    Thanks. 🙂

  15. Remember the warnings that used to be put on products that contained Olestra?
    Writes the Southwest Texas State U. Daily University Star:

    One writer shared her experiences with the product in a story that originally appeared in Salon.

    I jumped on the Olean train with glee, snapping up bags and bags of WOW Doritos. All was well. It was a veritable summer of love. Pretty much every day after work, as I watched the evening news, I camped out on the couch with my (newly) guilt-free treat.
    One day, after work and post-Doritos, I went for a run. I was living in Boston at the time, so I took to the banks of the Charles River. As I trotted along, I started to feel some cramping in my abdomen. Figuring it would go away, I kept jogging. But with every step, a new wave of pain welled in my belly. It got progressively worse and worse, even as I slowed to a mere crawl. I barely made it to a bathroom in time. I’d never felt such urgency or such sharp discomfort. WOW, indeed.
    I was pretty positive it was the Doritos. I sheepishly told friends and family about my river runs. First, they laughed. Then, they were disgusted. Their chiding persuaded me to lay off the WOWs.
    And I did.
    But nine or 10 months later, just when the memory of the pain withered away, I started buying WOWs again.

    Ouch … :O
    You can read more about Liz Krieger’s love-hate relationship with her chips here.
    Reading a warning about those types of nightmare scenarios before eating your barbeque potato chips could ruin someones appetite!
    Of course, there’s no warning now because there’s no problem. 🙂

    FDA concluded that the label statement was no longer warranted because:
    “Real-life” consumption studies of products containing olestra showed olestra caused only infrequent, mild gastrointestinal (GI) effects.
    In fact, a 6-week study with more than 3,000 people showed that the group consuming olestra-containing chips experienced only a minor increase in bowel movement frequency compared to those people who consumed only full-fat chips.
    * Post-market studies showed consumers are aware of olestra and its potential GI effects. …

    Source: FDA.
    There could be worse side effects — people sometimes die as a result. But, these “GI effects” have to be right up there for being bad.
    I’m thinking a diet change is in order.
    Can someone pass some spinach salad over here. 😉

  16. I messed up my post — the credit to the Southwest Texas newspaper should have gone in the middle of the post.
    Maybe it’s a sign of some sort of malady. 😉

  18. Hi Dawn!
    I know your friend thinks she is very sick and in many ways convincing herself she is sick is making her sick! It’s a sad thing to deal with when you live in the real world where test results count and labels matter.
    Their pain is perceived as real and dangerous and no one will listen to them and they get weaker and sicker by the day. It’s unfortunate that medical science and insurance companies require proof of illness through tests and examination in order to treat an illness – and so that’s why we have these invented diagnoses that allow leeway for these sorts of interesting cases.
    I’m so glad you are working hard for your new cat! I hope you visit her every day and tell her how much you love her and miss her! I MISS HER! I can’t wait to see photos of her on your blog. Let’s hold thumbs you get out of that current housing situation as soon as you can to add some furry cat ears to your family!

  19. Chris!
    I loved Dorito WOWs! Never gave me a problem. I read all the warnings. The point was portion control. If you ate too many in one sitting your digestive system couldn’t handle all that oil at once. They were more a nibble-and-put-away snack than an all-you-can-eat comfort food like regular Doritos.
    😀
    WOWs were great if you were dieting and craved a Dorito or two — I wouldn’t use them as a straight replacement for the originals.

  20. Hi David,
    I find that most GI problems can be prevented by eating veggies and making sure to get some “good bacteria” in the system by eating some yogurt every so often.
    Of course, cutting back to only a couple BK Quadruple Stackers a day can also solve some of those problems as well. 🙂

  21. Hi Chris!
    Right on! Veggies are nature’s magic. The raw-er, the better!
    :grin”
    A Burger King Quadruple Stacker? Yikes! Have you tried one yet?

  22. Hi David,
    I haven’t tried one of those creations yet.
    When I get a burger, I always try to get something that won’t spill all over me if I’m eating in the car.
    I do have a bunch of steaks in the deep freezer. I could stack four of those up and make a quadruple steak dinner. 🙂
    Doesn’t the Bible warn against slamming down too much meat?
    See Numbers 11:33 (NLT)

    But while they were gorging themselves on the meat—while it was still in their mouths—the anger of the LORD blazed against the people, and he struck them with a severe plague.

    After last week’s God discussion, I couldn’t help bringing out another Bible verse. 😉

  24. Hi Chris —
    I think you should try one of those burgers sometime — but eat it slowly and cut it up so as not to anger anyone who might seek to punish you!
    😀

  25. Chris —
    I turned off Gravatars because that system was overloaded:
    http://www.gravatar.com/blog/
    That server was so unresponsive loading Gravatars — that never loaded – it all slowed things down here something awful because the pages would never fully load. It was real messy.
    So, I disabled the plugin and everything became really fast here again.
    We’ll see what the 2.0 version brings. It’s always a test between serving local images and remote images and you can’t complain about the Gravatars because they are served for free — but you also don’t have to use them if the system is unable to cope with demand in an invisible way that doesn’t bog down your blog!
    I wish I had a way I could use Avatars here on my server — install the whole thing here locally — let everyone upload their Avatars here as they wished…

  26. Hey Chris,
    I’m sure you were speaking jestfully –
    but the reason the people were being punished there wasn’t for slamming down meat – it was because they had the manna coming to them every day which could simulate any taste or texture they wanted in their minds and yet they complained that they wanted meat. They complained that all they had to look forward to was the manna.
    It was the complaining that got punished. Be happy for what you have is the lesson, I guess.

  28. Hi Gordon,
    You are correct!
    The people in the desert on their way to the Promised Land were always complaining, even though they had been freed from bondage and were having all of their needs met.
    Here’s some nutritional information about the Quad Stacker:

    BK Stackers Quad is 4 beef patties, 4 slices of American cheese, 8 strips of bacon, and BK Stacker Sauce (featuring high fructose corn syrup!) all on a sesame seed bun. It weighs 311 grams and has 1000 calories, 620 calories from fat, 68 grams of fat, 30 grams of saturated fat, 2 grams of the dreaded trans fat, 240 mg of cholesterol, 1800 mg of sodium, 34 grams of carbs, 1 gram of fiber, 6 grams of sugars and 62 grams of protein.

    In the interest of full disclosure, I’d probably enjoy something like this once or twice, but I know it’s horrible for me. (And, I’d probably make my doctor even madder by eating this than I did by skipping my appointment).
    We’re like that in many ways — Americans have everything they need — including Quadruple Stackers — but often complain that the microwave is too slow, there’s nothing to watch on the 5000 available entertainment channels, or that they don’t have enough money when people in other parts of the world scrape by and would be happy to have just one of the patties on that huge burger for their daily meal.
    I probably should have used these passages against being greedy and being gluttonous:
    Proverbs 23:4-5 (NLT)

    Don’t wear yourself out trying to get rich.
    Be wise enough to know when to quit.
    In the blink of an eye wealth disappears,
    for it will sprout wings
    and fly away like an eagle.

    Proverbs 23:20-21 (NIV)

    Do not join those who drink too much wine
    or gorge themselves on meat,
    for drunkards and gluttons become poor,
    and drowsiness clothes them in rags.

  30. fruey —
    Yes, Gravatars 2.0 look interesting, but I’m curious if that plugin allows you to force hosting 100% of the Gravatars locally or if calls are still made to Gravatars.com?
    If even one Gravatar is called from Gravatar.com your blog becomes bethroed to the speed of Gravatars.com for page loads instead of the speed of your local server.

  32. David,
    It looks like you can have the calls to Gravatar made in a “batch” (say overnight) and then have a local cache. That way, you should never be calling Gravatar’s servers directly.
    Again, I haven’t actually installed it…
    -Fruey

  33. Sounds good, freuy! I think Gravatars2 will be natively supported in K2 when it is finally — if ever! — released.
    😀
    I will look forward to trying it out then!

  34. This is very interesting! I think at the same time people need and want to have a name attached to why they feel the way they do. I had a friend who was admittedly a hypochondriac who needed and wanted a reason for whatever was making her feel sick. But at the same time she not surprisingly had a “I know more than the doctors do” attitude that hampered her overall health care. Part of it is due to her needing to be on top of her health care and researching all of her symptoms…but, at the same time it opens her up to doctors who are dismissive of her because she is always presenting them with possible reasons why she feels the way that she does. I doubt she will ever find a label that suits her.

  35. Hi sally!
    Thanks for the great comment. I agree labels are created to give context to experience.
    My concern is that “Fibromyalgia” as a label solves nothing and does no healing. There is not standard treatment for that label in the medical community. That label is used as a pacifier and not a means to a cure or the start to a therapeutic regimen.
    If any doctor dared to label me, or someone I loved, with “Fibromyalgia” — I would quickly find a new doctor because that doctor chose a label to get off the hook and to shut down further investigation to make me go away and be quiet.

  36. Maybe there are some real people like Milton with a real disease with no symptoms found for it so far. And most fibromyalgia sufferers are like a relative of mine who was a hypochondriac just waiting for a great name for all her fake pains.
    However, I’m just turning 54 and for the last three months I’m aching all over, exhausted, and no swollen or hot spots to explain any of it.
    My diagnosis? I’ve got FatAssMyalgia. Yep, my body is exhausted and aching all over from dragging all this excess weight around every where I go. My bad.
    Oh and as for the lack of war protests…. Bill Maher explained that one…. bring back the draft. And you’ll see the streets FILLED with war protesters again. No one is protesting because it’s not OUR war. For most of us, we don’t suffer it, we don’t sacrifice for it, we just watch the little dribbles and drabs of it they spoon feed us on tv.
    The trouble with the show “24” is that it’s the real story without the ticking clock. We’re over there torturing people, most of them innocent. And we’re over there being tortured too. If we could just watch that show and imagine the truth of the torture happening to our kids…. why hells bells, even without the draft – betcha our war protests would be a lot bigger.
    Maybe we should just have daily tours through our V.A. Hospitals. All American’s need are bigger doses of the truth.

  38. As far as “Fibromyalgia” being the new “Hypochondria”, the current medical evidence shows that there are genometric indicators that validate these illnesses as real. These illnesses are heriditary and the prevelance is 8 times greater if you have a relative with this condition.
    The evidence is there in black and white for anyone to see. Please refer to Dr. Daniel J. Clauw, Professor of Rheumatology at the University of Michigan Medical School for confirmation.
    Years ago a lack of knowledge in this area lead many to label these illnesses as “hypochondria” because we simply didn’t have the understanding we have today. As time goe’s on we learn more because our diagnostics reveal more.
    Keeping current with the latest technology avoids the misconceptions of the past.
    “Fibromyalgia” is a very real illness that can be confirmed using modern Genometrics to locate these illnesses. More information can be found here:
    http://www.med.umich.edu/intmed/rheumatology/

  39. Fibromyalgia isn’t even a name for a disorder, all they did was give a name to the symptoms…fibro=fibrous tissue, myo=muscle, algia= pain…fibrous tissue and muscle pain…am I right?

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