The Nature of Illness

See the short introduction to these essays and the rest of my sociomedical essays here. Especially the essay Being Sick Is Wrong continues with the same theme.

Hospital clothes are the perfect symbol for the loss of identity caused by illness. Even someone who has never been to a hospital, never had to don the bland, personality-erasing uniform, can surely grasp at least some of their significance. Even people who pay no particular attention to their clothes or appearance usually do not like the idea of wearing someone else's anonymous clothes.

Even if we have not chosen our own clothes, the ownership is important. In some countries school uniforms are in use and others may need to wear a particular uniform for work, though in the latter case the acceptance of such uniform comes from acceptance of the line of work. We may be willing to swap clothes with a friend, a family member or a roommate, or wear random stranger's second hand apparel - though many people shun even that - but it is different than letting someone else give us a collectively owned, less than flattering uniform without a choice on our part.

Even in the face of risk of death of severe disability or death the loss of appearance, the loss of identity, can seem a worse threat. When hearing of their cancer diagnosis, one of the first causes of panic for many is the thought about losing their hair.

The changes in appearance present a two-fold challenge. Things like complete hair loss signal illness, they signal death, disability and change. Yet other things do make one think of illness, but loss of control or flawed personality. Weight gain is likely one of the most common symptoms of illness and especially their treatments. Most common illness-related causes are hypothyroidism (which affects up to several per cent of the population and usually goes untreated) and psychiatric drugs, especially antipsychotic drugs.

Chronic illness isolates you from other people, but it also isolates you from yourself. When you become ill, you have to form a new identity for yourself, the identity of a sick person. If you have based your identity and self-worth on things you can do and things you achieve, there might be nothing left. You are left empty.

The loss of identity is particularly devastating for people who have been battling depression or low self esteem. They have spent a lot of effort trying to convince themselves that they are good, they are adequate. Then suddenly, they will have to face the fact that they are not adequate and that is no longer in your head. They cannot do what normal people do and no amount of therapy or coping mechanisms is going to fix that.

When you get sick, you will notice how helpful people are. You will also notice that most of them are utter waste of oxygen. Many people will say they are always there to help you. This is another mantra, it is one thing to say you will help than actually helping.

They will come and poke you with a stick to see if you are still alive. If they notice signs of you being alive, they will conclude that you were not that sick to begin with. They will suspiciously ask if you are still sick. And they will say they would have brought you chocolate, but they did not know if you can eat it, so instead you get a brand new self-help book printed in a font size so small that you would not be able to read it even if you were willing to wade through that crap.

Fatigue, vertigo and cognitive problems often do not appear outward. Pain is seen by many as just another discomfort. It is impossible to know what chronic pain is like unless you have experienced it. People like to offer their advice, even if they have no clue about the illness. People with depression get told to start thinking happy thoughts, those with acne are reminded that looks are not that important. They like to offer their own diagnoses based on latest fads and something their godmother's aunt spotted in Reader's Digest.

Chronic illness takes a massive toll on the society. The biggest burden may not even be the actual illness, but the contempt the sick person faces from his friends, family and doctors. The pressure to be a productive citizen with a career, family and material possessions is not helping any. They say that psychologically, the worst thing that can happen to a person is losing the control of your own life and own future.

A chronic illness can make you feel worthless and hopeless. And even worse, if you do feel happy, if you feel joyful, if you have energy to do nice things, chances are you will feel guilty for it. Because sick people - especially if those who are not working but are supported by the society or their families - are not supposed to enjoy their lives, they are supposed to suffer.

When you are sick, you have much fewer choices to make. You do not have to decide whether you will have a career or a family. You may not get either. You do not have to face the decision of choosing your holiday destination. But there are other decisions for you to face, like whether to lie on the sofa or on the bed. Either you focus on living or focus on getting better. And this decision is incredibly hard, as by choosing one of them you choose to give up on the other alternative.

When you are facing a serious illness, it slowly takes up your life and thoughts. They become full of pills, supplements, doctor visits, therapies and limitations. Everything you do or do not do will have to be reconsidered. Everything carries the connotation of being either good or bad for you. Even worse, some things have the status of unknown and you do not know if they will make you better or worse. Then there is that friend that says "Wow, I could never take so many pills or remember those arbitrary diet restrictions". And you are so thankful for that advice.