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Excerpt: The Quest for Mercy
SSR: Editing
Chapter One
Understanding Illness, Disease, and Suffering
We spend much of our lives trying to avoid, ignore, or minimize suffering—but sooner or later it finds all of us. Suffering is part of the human condition. Caregivers, especially doctors and nurses, have a dramatically larger experience with suffering than others because they minister to those suffering people we call patients, a word that connotes suffering or endurance. In fact, I believe that you are not a patient if you are not suffering, and you cannot be an effective caregiver if you do not know a great deal about suffering and its alleviation.
The Connection and the Distinction
How do disease and illness connect to the concept of suffering? Simply put, disease plus suffering equals illness! There is a rich distinction between the two terms, disease and illness. A disease can be labeled (for example, diabetes, multiple sclerosis, tuberculosis, or breast cancer). The label typically refers to an identifiable pathologic state with a known or unknown cause, a pattern of symptomatic involvement and diagnostic laboratory tests, a describable clinical course, and a range of known courses that has been established by following the lives of previous patients. In each case, the hope is that a physiologically or molecularly precise, effective, and safe treatment will be discovered and made widely available.
Beyond Physical Pain
Illness, on the other hand, describes how that disease affects a particular patient because of that patient's life experiences, including the patient's ethnicity, age, sex, family, and sociocultural situation. The person's underlying emotional state and emotional response to the disease have a great influence on the illness. Understanding an individual's illness is essential to estimating the degree of suffering the patient is experiencing and, in turn, to establishing a method for helping the sufferer deal with the illness. . . .
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