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Suffering, hope and diagnosis: on the negotiation of chronic fatigue syndrome

Lars-Christer HydÈn

Stockholm University, Sweden

Lisbeth Sachs

Karolinska Institute, Sweden

The medical interview has a central place in the transformation of suffering into disease. The focus in this article is on patients with suspected chronic fatigue syndrome (CFS). Central to the diagnosis of CFS is the absence of a clear medical pathology causing symptoms. To patients it is of central importance to present themselves in the medical interview in a way that makes a diagnosis of CFS possible, which provides both hope for a cure and a social legitimization of their suffering. To doctors it is important that they maintain their position as a medical authority and gatekeeper. This means that in a medical examination the doctor and the patient together must explore the patient's suffering to define symptoms enabling a diagnosis of CFS. The central issue in this article is how doctors and patients in medical interviews negotiate symptoms and diagnostic criteria in search of a legitimate diagnosis and illness, and how this constitutes the central concern in the patient's and doctor's collaborative diagnosis work in the medical encounter.

Key Words: chronic fatigue syndrome • chronic illness • doctor–patient interaction

Health:, Vol. 2, No. 2, 175-193 (1998)
DOI: 10.1177/136345939800200204


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