First Reading Response

It is important to differentiate between sickness, illness, and disease as they all carry very different connotations about the suffering, environment, and person. According to Kleinman, illness refers to the personal experience of suffering, the disease is what the doctor is trained to see as the problem, while sickness is how to understand a disorder from the individual case in relation to social factors. This is important because disease and illness are more focused on the individual, while sickness accounts for how the suffering exists in a social and environmental context. This also will carry significance for the healing methods. When the physician attempts to heal the disease, they are disregarding the relationships and context of the problem and effects. The example that Kleinman gives is of tuberculosis. While the disease is tuberculosis as named by the physician, and the illness is the physical and mental suffering that goes along with tuberculosis, the sickness refers to the larger range of what is affected. It accounts for the relationship of tuberculosis to low-income houses and malnutrition, where some demographics are more likely to be at risk for the disorder. This is significant when thinking about healing- it is not about fixing the biology of the illness, but looking at the scope of where problems arise and how to heal social burdens and relations. When a physician attempts to heal a disease biologically, they are concerned only with fixing the disease. This puts too much emphasis on the symptoms of the individual, and not enough on the meanings of the individual’s illness experience. By “materialistic pursuit” the physician is looking only for biomedical and medical ways of healing disease, not examining the wider scope of potential conflict or difficulty.

Kleinman, Arthur. The Illness Narratives: Suffering, Healing, and the Human Condition, Chapter 1. New York: Basic Books, 1988.