Guest Editorial:

Suffering, Science and Sabotage

J of Musculoskeletal Pain, Vol. 12(2) 2004, pp. 3-18

Muhammad B. Yunus, MD

Muhammad B. Yunus, MD, is Professor of Medicine, Section of
Rheumatology, University of Illinois College of Medicine at Peoria 
E-mail: yunus@uic.edu

Address correspondence to: M. B. Yunus, MD, UICOM-P, One Illini Drive, Peoria,
IL 61605.


ABSTRACT.
Objectives: The objective of this paper is to discuss suffering in general, the
criticism against fibromyalgia and other central sensitivity syndromes [CSS],
the deleterious effects of disease-illness dualism, a new unifying paradigm for
this duality, and then to suggest a remedial model for better patient care.

Methods: A review of the literature using Medline and other sources, and an
amalgamation of known knowledge with author's own ideas and inquiry.

Results: Bias against CSS are harbored by many physicians, thwarting the
progress for a better understanding and treatment of these syndromes. Most
physicians believe in disease-illness dichotomy and pay more attention to the
structural than the functional pathology, e.g., neurochemical endocrine [NCE]
abnormalities. Both types of pathology are likely based on biology. Even
psychosocial distress is mediated by neurochemistry. A model is suggested for
proper care where patients and physicians work together with a common satisfying
goal, each fulfilling their individual responsibilities.

Conclusion: Most physicians treat CSS with a negative attitude. The outdated
model of disease-illness dualism should be abandoned in favor of a fresh
approach to medical education that fosters compassionate care irrespective of
the disease label.


KEYWORDS. Suffering, disease-illness dualism, phenomenology, biology,
compassionate care


Medicine, the only profession that labors incessantly to destroy the reason for
its own existence.
-James Bryce

© 2004 by The Haworth Press, Inc. All rights reserved.