UNDER THE MEDICAL GAZE: Facts and Fictions of Chronic Pain

Greenhalgh, associate professor of anthropology at the University of California, Irvine, has written an autoethnography (autobiography analyzed through a cultural lens) of the eight months she spent as a patient ("patient S.," as she refers to herself) of "Dr. D.," a highly recommended rheumatologist, who diagnosed her chronic joint pain and sleeplessness as fibromyalgia, a relatively new and still not completely understood medical disorder, which, the author writes, claims more women than men as its victims. Based on the detailed diaries S. kept during her treatment under Dr. D., Greenhalgh describes how his regimen first relieved S.'s anxiety and then drove her into a severe depression. He prescribed an aggressive management plan with drugs that caused serious side effects, including fogginess, headaches and vision loss, and encouraged her to give up swimming, an exercise she greatly enjoyed. The author speculates at length about the role her female identity played in her willingness to accept the forceful and ultimately wrong advice of a male physician who was committed to the veracity of medical science. After a flirtation with alternative treatments, S. sought a second opinion from her original New York rheumatologist ("Dr. K."), a woman, who convinced her that she did not have fibromyalgia and recommended that she stop taking the previously prescribed medication. Afflicted with what was finally diagnosed as an arthritic condition, she is no longer heavily medicated or depressed. As a more straightforward medical memoir, this might have reached the wider audience of patients whom the author wants to reach. In its present form as a scholarly work of anthropology, though it raises provocative and controversial issues, it will mostly attract the attention of physicians and social scientists. Illus. (May)