A New Social Understanding of Illness and Health

One of the immediate consequences of the increasing prevalence of chronic disease is its profound impact on the patient's social life. Historically, infectious diseases typically presented patients with two outcomes: recovery or death. When a patient contracted an infectious disease, they often withdrew temporarily from their social circle, confining themselves primarily to their family. This was largely due to the risk of contagion. Conditions like tuberculosis serve as a prime example of social exclusion as a preventive measure.

However, the rise of chronic diseases has led to a more enduring restructuring of the patient's social environment (Adam & Herzlich, 2014). While patients may retain their place in society, they must navigate the complex interplay between their work, marital relationships, social connections, and their experience of living with a chronic, yet often stabilized, condition. This "socializing" of chronic illness involves a constant oscillation between anxiety and hope. The ongoing confrontation with their condition prompts patients to grapple with existential questions: "Why me?", "Will this be fatal?". While patients with acute illnesses might have pondered similar questions, this was often for a much shorter period and with a more transient sense of introspection. Individuals with chronic conditions face these existential inquiries persistently, along with moral judgments about their state of being, and the implications of increased life expectancy. Paradoxically, they encounter a secularized society that may be less equipped to provide moral or philosophical answers.

In this context, patients may turn to their physicians as confidants, sharing their experiences of suffering and witnessing the deaths of others with the same illness. If the patient perceives the physician's response as inadequate, they may seek support from other professionals, such as psychologists or relaxation therapists, or explore alternative medicine practices, including homeopathy, traditional Chinese medicine, and other "holistic" approaches. These alternative practices often appeal to patients because they prioritize the individual's perspective: their personal interpretations, specific expectations, and values. In essence, they reconnect with a holistic approach to care that conventional medicine has, to some extent, moved away from in favor of a more scientific focus (Pierron, 2007).

A disconnect can emerge between patients seeking comprehensive care and a medical system that increasingly specializes. Faced with the complexity of chronic diseases affecting the entire organism, the medical profession may tend to treat individual organs in isolation, leading to a fragmentation of the patient, who is dispersed among specialists who often lack coordination.

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Footnotes:

1. Adam, P., & Herzlich, C. (2014). Sociologie de la maladie et de la médecine. Armand Colin.
2. Pierron, J. P. (2007). Santé et société: éléments de sociologie appliquée à l'univers de la santé. Dunod.