Hypochondriac Hermeneutics: Medicine and the Anxiety of Interpretation

This essay considers hypochondria not as a psychiatric diagnosis but as a hermeneutic position: a consequence of attending to the uncertainty of being an embodied human; an anxious skepticism; a resistance to reassurance based on an arguably too-close reading of body and self. Medicine commonly rejects such interpretation in order to reduce the potential proliferation of meaning to those signs it can interpret in diagnostically and therapeutically useful ways. I suggest that the literary model of close reading might helpfully illuminate interpretive anxiety as a problem facing both physician and patient, and I consider three ways that medicine might think about challenges to its hermeneutic security: pathologizing the uncertainty and "hating the hypochondriac" patient; attempting to override uncertainty with additional information; and, finally, imaginatively inhabiting the patient's anxiety and working within it, through the recognition that medicine itself is a hermeneutic and potentially hypochondriac enterprise.