Wednesday, August 21, 2013

In the Kingdom of the Sick


In the Kingdom of the Sick: A Social History of Chronic Illness in America [Unabridged] [Audible Audio Edition]

Author: | Language: English | ISBN: B00I3PS53S | Format: PDF, EPUB

In the Kingdom of the Sick: A Social History of Chronic Illness in America
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Thirty years ago, Susan Sontag wrote, "Everyone who is born holds dual citizenship in the kingdom of the well and the kingdom of the sick¿Sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place."

Now more than 133 million Americans live with chronic illness, accounting for nearly three-quarters of all health care dollars, and untold pain and disability. There has been an alarming rise in illnesses that defy diagnosis through clinical tests or have no known cure. Millions of people, especially women, with illnesses such as irritable bowel syndrome, chronic pain, and chronic fatigue syndrome face skepticism from physicians and the public alike. And people with diseases as varied as cardiovascular disease, HIV, certain cancers, and type 2 diabetes have been accused of causing their preventable illnesses through their lifestyle choices. We must balance our faith in medical technology with awareness of the limits of science, and confront our throwback beliefs that people who are sick have weaker character than those who are well. Through research and patient narratives, health writer Laurie Edwards explores patient rights, the role of social media in medical advocacy, the origins of our attitudes about chronic illness, and much more. What The Noonday Demon did for people suffering from depression, In the Kingdom of the Sick does for those who are chronically ill.


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  • Audible Audio Edition
  • Listening Length: 8 hours and 52 minutes
  • Program Type: Audiobook
  • Version: Unabridged
  • Publisher: Audible Studios for Bloomsbury
  • Audible.com Release Date: January 28, 2014
  • Language: English
  • ASIN: B00I3PS53S
You have to take Kingdom of the Sick for what it is - a cry of frustration. If you're looking for answers, you won't find them. If you're looking for breakthroughs, you won't find them. If you're looking for reinforcement that you are not alone, there's tons of it.

Laurie Edwards is not a doctor or a scientist, so there should be no expectations along the lines of solutions. She does a fine job of chronicling the miasma of chronic disease through history. But she also misses the greater picture: 1) Chronic disease has been increasing exponentially since the 1950s in western society, and 2) Those with one chronic disease are extremely likely to develop others (co-morbidity). But the book is too heavily focused on the doctor/patient relationship to notice.

The frustration comes from doctors being unable and then unwilling to understand chronic disease, like Edwards'. She says they withhold information and minimize the symptoms. They get their patients to do the same, creating a downward spiral of miscommunication. Sooner or later they tell the patient it's all in her head - it's stress, anxiety, fear - instability in her brain, not her body. The result is the patient gets nowhere, but becomes self doubting - and stressed.

At the root of the problem is the medical framework itself. Doctors are rigorously trained to treat an organ. Everything they know is focused on tracking down the culprit organ and treating it. But what if there are multiple organs involved? What if a matrix of organs are the victims and not the problems? At that point, docs are at a loss. And that's precisely where chronic disease patients find themselves.
About 30 years ago, in her book "Illness as Metaphor," the noted writer Susan Sontag said: "Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick.... Sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place."

Author Laurie Edwards, who has been chronically ill most of her life, is intimately acquainted with being a citizen of "that other place." She uses Sontag's famous quote as a jumping off point for her new book, "In the Kingdom of the Sick: A social history of chronic illness in America."

Although the author's personal experiences (with celiac disease and a genetic lung disorder) are interwoven throughout, the book mostly takes a "big picture" look at how chronic illness is viewed in our society. More than 130 million Americans now live with such conditions as HIV, various cancers, diabetes, autoimmune disorders, chronic fatigue, asthma, and Lyme disease. Most of the healthcare dollars spent in the US go for the treatment of chronic illness. Yet many of the chronically ill are viewed with mistrust by doctors and the public at large. Either their largely invisible symptoms are disbelieved entirely (such as with CFS or Lyme) or they are blamed as being the cause of their own illness due to perceived lifestyle choices (HIV and type-2 diabetes).

"In the Kingdom of the Sick" examines the rise of the disability rights movement, AIDS activism, the women's health movement (with its emphasis on breast cancer awareness), gender bias in the treatment of pain, and patient activism in the digital age. The book reports on academic research as well as the stories of individual patients from across the spectrum of chronic illness.

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