The Silent Revolution: When Illness Becomes a Lifelong Companion

The landscape of our health has undergone a profound and discreet transformation in recent decades. Forget the image of illness as a passing crisis, an acute episode that one overcomes to return to a "normal life." Today, a reality forcefully imposes itself: the chronicity of disease.

In the 1950s, a wave of medical progress, improved hygiene, and prevention campaigns bestowed an invaluable gift upon humanity: a significantly extended life expectancy. But this advancement brought to light a phenomenon that had long remained in the shadows: the rise of chronic and degenerative diseases.

For a long time, illness was synonymous with intense suffering, a temporary state from which one hoped to recover thanks to the expert intervention of a doctor. The schema was simple: symptoms, diagnosis, treatment, and, ideally, recovery. A binary model where one moved from the state of being sick to that of being well, summarized by Baszinger (1986) in the sequence: symptoms-diagnosis-treatment-cure or death.

But the arrival of vaccines, eradicating scourges like tetanus, diphtheria, and polio (which still severely affect some regions of the world), and the discovery of antibiotics have considerably reduced the impact of acute illnesses. Ironically, this success has shone a spotlight on another reality: that of diseases that settle in for the long haul, sometimes for an entire lifetime.

Imagine: instead of an expected recovery, you learn to live with an illness on a daily basis. This is the immense challenge faced by millions of people living with chronic conditions. Their daily lives are disrupted, their social connections strained, their professional lives sometimes compromised. It's a double shock: the illness itself and the profound disruptions it engenders.

The great philosopher Georges Canguilhem (1904-1995) understood this well. He defined the doctor's activity in two registers: "to fight against the disease and to care for the sick person." Faced with chronicity, purely medical objectivity is no longer sufficient. To truly care for their patient on a human level, the doctor must "reduce the part of their medical objectivity in favor of their subjectivity by responding to potential affects and anxieties." Listening to anxieties and taking into account the patient's subjectivity become essential.

The traditional model of the "good patient" who passively follows prescriptions while awaiting recovery collapses, as Herzlich and Pierret (1991) point out. The therapeutic relationship evolves: the hope of a cure fades in favor of a collaboration focused on managing the disease, on learning to live with it.

The chronicity of disease is not a fatality, but a reality that invites us to rethink our approach to health. It underscores the importance of a holistic support system that doesn't just treat symptoms but considers the person in their entirety. It's a challenge for healthcare systems, for healthcare professionals, but also for society as a whole: how to offer a dignified quality of life to those whose illness has become a lifelong companion?

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What are your experiences or thoughts on the chronicity of disease? Share your testimonies in the comments!