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CHAPTER 10 A Second Opinion The Unmaking of a "Fibromyalgic" On November 6 S. traveled to New York City to obtain a second opinion on her case. This chapter tells the story of that visit and its life-restoring effects on the hapless patient. Dr. K., the reader will recall, had been S.'s rheumatologist for five years before she moved to California. Dr. K. provided a radically new perspective on S.'s treatment. Without criticizing D., Dr. K. said that, in her opinion, the diagnosis of fibromyalgia made no sense, the prognosis was overdrawn, and some of D.'s practices were unorthodox and risky ifnot outright dangerous to the patient. And Dr. K. identified the source of the headaches and fogginess as Indocin, the antiinflammatory to which Dr. D. had insisted on tolerizing his patient. Dr. D. had presented his story as the only true story of S.'s ills. But Dr. K. told another story that made more sense. This chapter relates how the visit with K. turned S.'s life around. At last rid of the diagnosis that had caused her such psychic and physical torment, she left the office on a cloud of ecstasy,jettisoning her "fibromyalgic " identity on her way out the door. The next day she went off the offending drug, and the neurological symptoms vanished into thin air. And she realized for the very first time that her faith in her ultrascientific doctor had been badly misplaced. Jolted out of her lifelong belief in the mystique of medicine, she saw that her doctor's science of the body was anything but infallible,disinterested, and invariably beneficial for its objects. Dr. D. was neither hero nor medical miracle worker. He was but a technician of the body who had rhetorically exaggerated his abilities and made serious mistakes at her expense. D.'s medicine had lost its luster. Dr. K. also outlined a new theory of the female-body-in-pain that transformed S.'s understandings of her physical problems. K.'s account employed a new, postbiomedical discourse on the body that recognized the contributions of gender, the emotions, and larger societal forces in the development of bodily ills. Dr. K. posited a syndrome of symptomization of psychosocial stress and traced its roots to women's childhood socialization into pleasantness. Becauseit pointed to the larger social roots 245 chapter 10 246 / Rebellion and Self-Renewal of the syndrome, the theory provided a way out of the trap of self-blame in which S. had been caught for so long. Although Dr. K. herself relied exclusively on drug therapies, her theory of the roots of women's pain suggested new strategies for pain alleviation that centered on addressing the underlyingpsychosocial sources of symptoms rather than simply suppressing them with strong drugs. If D.'s story had shortcomings, so too did Dr. K.'s. It may have overstated the role of childhood socialization in adult behavior. It failed to specify the mechanism connecting personality and symptom. Its psychological therapies might have been incapable of eliminating symptoms rooted in such deeply embedded structures of the personality. The theory might have applied only to certain ethnic or class categories of women. Yet at the time S. did not see these possible weaknesses of K.'s theory. In her neediness, sheclutched onto the gender story like she might grab onto a lifeboat in a raging flood. The gender story was attractive in part because it fit S.'s life and intellectual predispositions like a glove. It also gave her fresh hope at a time when she desperately needed it. If she seems to heroize K. and demonize D., it is for these personal, intellectual, and emotional reasons. Dr. K. gave S. what she needed at the time: new understandings of her symptoms and new hopes for a future without them. Another Story of the Suffering Body S. had spent a long time preparing what she would tell Dr. K. in the November 6 appointment. Her planned presentation, sketched out in detailed notes, is highly revealing of her mind-set at the time. Dr. D. had represented his story of S.'s ills—the multiple diagnosis, the dismal prognosis , the drug-intensivetreatment—as the only credible story that could be told. S. had taken it as the final truth of her body. Believing her doctor to be a scientific genius and a medical miracle worker who could do no wrong, she had come to believe deep in her heart that she...


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