Caught Between a Diagnosis and a Prognosis

Language shapes the way we humans interact with the world. Of the roughly 7,000 languages on earth, somewhere between 50-90% are heading towards extinction by the end of this century*.These are words that have been formed by multigenerational communion with a particular space on this planet. This loss matters. Languages contain stories and beliefs that can never be fully appreciated or understood outside the context of that particular culture. This point is exemplified in Daniel Everett’s book Don’t Sleep, There Are Snakes, an account of an English-speaking anthropologist living with the small Amazonian Piraha tribe**. He originally came to them as a missionary, with the goal of translating the Bible into their language. But as he lived with them and learned their dialect, he found that to be an impossible task. He writes, “My difficulty in successfully translating the Bible owed largely to the fact that Piraha society and language are interconnected in ways that make even the understanding of grammar, a subcomponent of language, impossible without studying the language and culture simultaneously. And I believe this is true for all languages and societies. Language is the product of synergism between values of a society, communication theory, biology, physiology, physics, and human thought.” When I read about place-based languages and the contextual gifts they bear (like the Inuit language containing dozens of words for snow and ice), I am left feeling like my mother-tongue is quite dull. As someone who speaks the conquering language of English, I am motivated to examine how we might consciously influence the evolution of our communication, or at least be aware of how our language is influencing our conversations and our thoughts. There are innumerable aspects to this quandary; specifically here, I will be riffing on the language of diagnoses. Within a language lies the foundation for how the culture views health and illness.

I have long thought about the effects of receiving a diagnosis of a chronic condition within the world of western medicine, or biomedicine. A diagnosis is the identification of the nature of an illness by examination of signs & symptoms. Sometimes a diagnosis refers to the root of the problem, or sometimes it is just a word to describe that particular presentation of symptoms. On the one hand, it can be enlightening and relieving to know what the “problem” is. The possibilities become narrowed and, therefore, the approach is targeted. On the other hand, this narrowing view of the “problem” often feels concrete and long-term. Some common diagnoses in biomedicine are: ulcerative colitis, heart disease, herniated disc, attention deficit & hyperactivity disorder, anxiety neurosis. When I hear these words, they sound like labels: definite, immovable, heavy, the end of the story. Receiving these labels can seem like health is in the past, and this illness is the new normal. I can think of a few reasons for this. One reason is that many allopathic treatments are symptom suppressors, but do not reach the root cause; thus, the conclusion is that the disease can be managed, but not cured. Another reason is that a diagnosis always comes with a prognosis; an expectation of how the disease will play out (which is usually void of any lifestyle considerations). These predictions have a powerful effect on our psyche, and can limit what the path to balance might look like. In some cases, these predictions are full-on death sentences. Too often biomedical diagnoses and prognoses give us a sense of feeling trapped in our body, victims of the inescapable. 

For a handful of years, I have been flirting with Chinese medicine diagnostics. If you see an acupuncturist, your condition might be described as yin deficiency, qi stagnation, liver yang rising, or damp heat in the lower burner; translations from an older language and culture. These phrases dictate an imbalance; a state that is fluid and able to be influenced. To me, this wording feels empowering, like the beginning of balance. As a western herbalist who is probably too dependent on my biomedical training, the autonomy that comes with an elementally-influenced diagnostic system inspires hope for flexibility and affirmative change within oneself.

When dealing with biomedical specialists whose speech may be saturated with disempowering diagnostic language, I think most folks could benefit from a hefty dose of both body awareness and ravenous research. I’ve rarely heard of good treatment results from solely depending on a doctor for a “cure”. They have allopathic tools that can be utilized; but when it comes to diet and lifestyle (critical factors in any sort of recovery), I’d be more interested in what my neighbor’s cat has to say! In our culture, doctors are seen as THE expert, the final say, and I personally think this is harmful. I find it extremely worthwhile to seek out other peoples’ experiences, alternative advice, read patiently, and think critically. At the very least, become familiar with the side effects of any medications you might take. If someone is trying to sell you something, then take their advice with a big grain of salt. Depending too much on one “expert”, whether that be a doctor, a naturopath, or anyone else, can strip you of your own intuitive powers. And this is precisely where I think about the importance of body awareness. To me, body awareness is an intimate acknowledging that the body knows what it needs, if we take the time to cultivate our listening skills. This decreases dependence on experts and shifts power to the individual living within that body. This awareness notes the experience of dis-ease, but is not dominated by the disease; an approach that takes time to (1.) unlearn cultural conditioning that lies in the very way we speak, and (2.) discover an intuitive, “deep-knowing” way of moving through the many seasons of life. Body awareness recognizes that our entire existence is psychosomatic; that is, our mind and body are one entity. Our emotional state is always influencing our physical experience, and vice versa. I don’t mean to make this sound easy, or a “cure-all”. It’s not. It is hard to go against the flow of receiving our assurance from someone with letters behind their name. And some conditions are chronic no matter how hard you wish it away. But that is all the more reason to invest in cultivating body awareness; not just for the individual, but to collectively shift our disempowered state. It is always worth compassionately asking the self, “What do you need? What would make life more wonderful?” Aimless time alone, along with deep breathing, is a good place to start when you’re caught between a diagnosis and a prognosis.

To increase body awareness, I have been finding it helpful to work through Full Catastrophe Living, by Jon Kabat Zinn; a guide to mindfulness meditation specific for coping with pain and illness.

I’ve also recently come across The Fourfold Path to Healing, by Thomas Cowan, and find it to be a very holistic reference for health and dis-ease. A worthwhile addition to your resource books.


**Don’t Sleep, There Are Snakes, by Daniel Everett. 2008. (A fascinating read!)

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Content: Creative Commons 2020 Annie SewDev