Health and Illness

Charlene had just turned 36 years of age and was in her second semester at university when
her world began to unravel. Charlene had always been a ‘happy-go-lucky’ person
and was incredibly optimistic about life; in fact this was one of the things
that attracted Ray, her husband, to her. Being an energetic and outgoing person
with many friends – she and Ray
enjoy a good social life. They both
smoke and drink in moderation. Smoking is the main way Charlene relaxes and
often jokingly claims she needs ‘at least one cigarette’ for breakfast, another
for lunch and a third for dinner to ‘chillax’. Alice is Charlene’s best friend and
they meet up frequently to chat and
indulge their passion ‘for all things chocolate’. They then spend their time
moaning about how they both need to lose weight. Charlene’s 12-year-old son
Andrew disapproves strongly of his mother’s smoking habit.

One
bitterly cold night in January, Charlene went to bed exhausted, Ray was working
a night shift. As she slowly drifted to
sleep, she mulled over the events of the past few days. So much had happened though
her feedback from
her previous semester’s coursework was rather disappointing, Andrew’s twelfth
birthday party had been brilliant fun and it was great to see him so happy but
it was overshadowed by news the next day that her sister Anne had been involved
in a car accident. Having eventually got
to sleep, she woke up with a start and was aware of a sharp pain on the right
side of her head. When she cleaned her teeth later, she noticed a reddish lump
towards the inside of her top lip that she was sure was not there before. She
assumed she had accidentally bitten her lip. The pain of the headache eased and
she went about her regular activities for the next couple of months unaware
that these symptoms would have far-reaching consequences.

Quite
suddenly her health began to deteriorate – she began to lose weight and felt
tired all the time although she had difficulty sleeping. While she was pleased to
lose weight, the
tiredness could not have come at a worse time. She needed lots of energy and
concentration to improve her grades on her Health and Social Policy
degree. The lump on her lip worsened but
she was reluctant to go to her General Practitioner (GP) Doctor O’Neil, and
reasoned that she was just run down as she was always on the go. She was anxious
that he would not be that
sympathetic about her tiredness and would refuse to give her sleeping tablets
which she felt would allow her body to recover. Also, she thought Dr. O’Neill
would only tell her off for smoking. Her friend Melanie recommended a new
relaxation technique to help her to sleep which she tried a few times but it
did not seem to help. Gradually her social life ground to a halt because of her
overwhelming tiredness and she became embarrassed as the disfiguring appearance
of her lip as the lump grew and appeared ulcerated. Ray noticed her lip was not
improving but
decided not to say anything as he knew she was under pressure. However, when it
was clear she was missing classes, he knew something was very wrong. When he
confronted her she told him how anxious and exhausted she was feeling he made
her promise to go the doctor.

Charlene
is of mixed English-Scottish parentage. Her paternal grandmother was Scottish
and a strict Roman Catholic. Charlene had been brought up in a liberal
household though she had been a regular churchgoer to till the age of 13yrs,
when she mostly abandoned her religious beliefs – though she prayed in crisis
situations. Increasingly as her symptoms got worse found herself thinking dark
thoughts and she was beginning to think she would never be her old self. As her
health worsened, see saw less of her
friends including Alice, who stopped making contact. At first she thought Alice
was jealous because she had lost weight while Alice’s weight continued to
increase, but she knew deep down she was not the fun and optimistic person she
had always been and so feared people did not want to be with her. She found
that hard to take. Ray was also on her case insisting she go to the doctor, she
was worried that Ray no longer fancied her wand was repulsed by her unsightly
lip. Eventually, Charlene saw Dr O’Neil who was sympathetic but told her that
she had to stop smoking immediately as he suspected the mouth ulcer may be more
sinister and would need to rule out cancer. He referred her immediately to the
local hospital. Charlene’s diagnosis was confirmed following a series of
diagnostic consultations and tests. She is scheduled to have surgery and
radiotherapy soon. She is also being investigated for any spread of the cancer
to her brain or lungs. The shock of this devastating news has shuttered
Charlene‘s world– and she cannot see a future – just endless pain and
intervention.

QUESTIONS:

1.How
true is the sociological assumption that the fear of enacted stigma is more
disruptive of the lives of the sick than the illness (Scambler, 2004:58) in the
light of the case study above?

2.With
reference to Scambler’s (2004:58) Hidden Distress Model, discuss the claim that
the pain endured by the sick comes more from the reactions of others than the
actual symptoms.

3.In line with
Charlene’s illness experience above, how do biomedical and sociological
conceptions of health and illness differ?
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