Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick

by Maya Dusenbery

Previously, diseases were defined as collections of symptoms; “fever” or “pains” were disease categories in their own right. As historian of medicine Charles Rosenberg writes, “Recognizably modern notions of specific, mechanism-based ailments with characteristic clinical courses were a product of the nineteenth century.” This transformation led to an important change in the way medicine thought about symptoms. Before, doctors had no choice but to take patients at their word about what they were experiencing in their bodies; after all, without any tools to see within the body and without the foggiest notion, really, about what caused most diseases, they usually didn’t have anything else to go on. But as diseases came to be categorized based on the physiological disturbance at their root, symptoms were transformed into clues that could help the doctors uncover their source. The patients’ subjective reports of what they felt—pain, dizziness, nausea, et cetera—were becoming “complaints” that became symptoms of a disease only once the doctor—assisted by the ever-growing arsenal of laboratory tests and technologies he’d begun accumulating by the beginning of the twentieth century—found an objectively observable cause that explained them.