ABSTRACT
Diagnosis is the key point of a medical encounter where some sort of sense, and an explanation of causation, is made of bodily signs and of disabling and painful conditions. Definitive diagnosis allows clinicians to map out various actions to mitigate current symptoms and delay the progression of disease and associated debility, despite some variability in even the most common health conditions (Lutfey and McKinlay 2009). Yet for some conditions, diagnosis provides neither certainty in explaining the person’s embodied (and affective) experiences nor guidance in planning for treatment, remediation, and future health management. Although uncertainty has been explored within the context of mental and developmental illness (see Potter and Myers, this volume), less attention has been paid to the vagary of diagnosis for other conditions. The reason for this, as we suggest, is that physical health problems typically present in terms of their materiality-i.e., they are on, in, and of the body-whereas mental and developmental illness diagnoses rely more on self-reports from the individual or from others around them. But uncertainty characterizes conditions where the etiology remains unknown or is not fully explicated, and for conditions where there are no obvious biomarkers. Typically, the conditions that fall into this category are contested, seen as “psychosomatic” in origin: chronic pelvic and severe menstrual pain, repetitive strain injury and back pain, myalgic encephalomyelitis, and fibromyalgia are examples here (Frazier 2002; Manderson et al. 2008; Pinder 1990). Other conditions are accepted as “real” despite diagnostic uncertainty: Parkinson’s disease (PD) is one of these.
