Shadow Syndromes

A fellow country doctor and blogger wrote a piece the other day about drug companies pushing medications for near-diseases like prediabetes and heartburn. I agreed with his sentiments and went on to think a lot about this.  There is a tendency among drug companies and even some doctors (perhaps looking for business?) to medicalize the human experience. We all have heartburn sometimes, but is it a disease or pre-disease, or did we simply eat too much of the wrong kind of food?

I have said before in these pages that Thomas Moore, the scholar and philosopher about matters of the soul, has said that book titles on your shelf can be inspiring even if you haven’t read the book.

A couple of years ago, at a Harvard psychiatry or psychopharmacology course, the booksellers in the lobby had a book that caught my imagination and has been an inspiration to me from that moment, even though I didn’t start to read it until today. It is by John Ratley, MD (co-author of “Driven to Distraction”) and Catherine Johnson, PhD (author of “When to Say Goodbye To Your Therapist”). The title says it all: “Shadow Syndromes” (The Mild Forms of Major Mental Disorders That Sabotage Us).

People with near-diseases can benefit from comparisons with the full-blown thing only if the analogy provides them with a deeper understanding of their situation and a course of action to change their trajectory away from the disease they are heading towards. This applies to labels in general. Labels are good if they help you understand what’s going on, and bad if they lock you into some sort of fixed category where you either don’t believe you can get out or, perhaps worse, start to feel comfortable and liberated from your own responsibility for your life and health. 

Somehow in the last generation of doctors, we seem to have lost our ability, or perhaps our perceived right, to give patients advice about their health; only if we diagnose them with a disease, or pre-disease, do we have something to tell them. We need to re-claim our position as health coaches, and fight for our right to tell people who are not yet diagnosable with an illness how to stay away from disease, instead of trying to make almost or completely healthy people carry a disease label, just so we can talk to them about how to stay out of trouble in the future.

5 Responses to “Shadow Syndromes”

  1. 1 rhondab1 August 11, 2008 at 2:33 am

    I think this is a great blog. I was sick for a long time, no labels.. I figured out that the doctors could not help me and started doing my own thing with alternative health. I have healed myself through alternative methods… and through no help of my doctor, who is an MD and Homeopath… everything I wanted to try, he discouraged…thank God I listened to my intuition and body… I will not take any of their medication as I know it is putting toxins in my body and that is part of what made me so sick… I am appalled that our government allows all this legal drug pushing to go on as well as surgeries… I really wonder about how they can allow such things when the industry does such a disservice to us as human beings…why is it that we respect the life of the unborn and aged and allow food companies to give us food that makes us sick… and drugs that only put band aids on the illness…

    Rhonda B

  2. 2 cathy August 12, 2008 at 6:07 am

    What a thought provoking post. You also hit on one of my main medical concerns. That being heartburn. I guess as patients we aren’t sure when something is a problem, so rather than be labeled, at times we keep symptoms to ourselves that would be much better out in the open, at least out in the open with our medical doctors. I had heartburn everyday for 30 years and thought it was normal, meaning I thought everyone else had heartburn every day.

    When I was finally diagnosed my esophagus was a mess. I had BE with
    HGD. Initially I had LGD but progressed to HGD. I underwent PDT but I still have problems with ulcers and strictures.

    If I had been honest and upfront years earlier, I would have given my Doc’s a chance to steer me away from what was in my future, but I didn’t even give them that chance.

    Great post!

  3. 3 acountrydoctorwrites August 12, 2008 at 5:05 pm

    I have Barret’s, and agree that checking whether what you have is within the “typical range” is a good idea.

  4. 4 elaine August 15, 2008 at 8:38 am

    That was a truly poignant post!

  1. 1 One size fits all? « The biopsy report Trackback on August 11, 2008 at 11:50 pm

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

Osler said “Listen to your patient, he is telling you the diagnosis”. Duvefelt says “Listen to your patient, he is telling you what kind of doctor he needs you to be”.



Error: Twitter did not respond. Please wait a few minutes and refresh this page.

Top 25 Doctor Blogs Award

Doctor Blogs

Enter your email address to subscribe to this blog and receive notifications of new posts by email.


contact @
Bookmark and Share
© A Country Doctor Writes, LLC 2008-2022 Unauthorized use and/or duplication of this material without express and written permission is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given.

%d bloggers like this: