What Is a Chronic Illness?

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Many experiencing persistent physical symptoms are told by their doctors that there is no medical explanation.

The problem may be more to do with mainstream medicine's limited assumptions around what causes symptoms.

Medicine reduces symptoms to structural damage, delegitimizing symptoms that aren't explained by lab tests.

Mind-body dualism leaves little room for patients to do more than passively cope with "incurable" symptoms.

Most of my patients first come to see me in states of extreme confusion, frustration, and exasperation. They have commonly already seen a number of different doctors—generalists and specialists alike—in search of a coherent explanation for their symptoms, only to be routinely told that all tests have come back normal, and that no medical explanation for their suffering can be found.

Sometimes these patients are told that there’s nothing wrong with them. Sometimes, their doctors suggest that they may be suffering from an underlying disease that has not yet been uncovered by medical science. And sometimes, their doctor tells them that the problem is somehow all in their head.

At best, sufferers are offered diagnoses that turn out to offer a mere description of their symptoms, rather than an explanation or a pathway to treatment: think chronic pain syndrome, post-COVID-19 syndrome, chronic fatigue syndrome, and irritable bowel syndrome.

Research suggests that around a quarter of general practice patients experience significant persistent physical symptoms, and that roughly 10 percent have a history of multiple, distressing chronic symptoms.

Fortunately, a growing body of research from neuroscience and psychoneuroimmunology is offering scientifically robust explanations for why some people develop persistent physical symptoms, even in the apparent absence of an underlying disease.

What remains highly problematic is that most health professionals are not aware of this new science, nor of the emerging treatments that can help people to recover.

As a result, besides a possible referral to a counselor or psychologist to help the person learn to cope with their apparently inexplicable and incurable symptoms, many clinicians have come to believe that their job is complete once disease has been excluded as an explanation for their patients’ suffering.

This isn’t to vilify doctors who haven’t been trained in the latest science, but rather to draw attention to the sluggish failure of mainstream medicine to expand and update its core assumptions around health and illness.

So, what are these increasingly outdated assumptions that prevent medicine from being able to explain and treat persistent symptoms?

Unhelpful assumption 1: Analyzing biological phenomena at a microscopic level is the only way to understand and cure illness

Medicine is reductionistic.........

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