Diagnosis Case

It was September of 2011 and the beginning of Katia Elisman's sophomore year of high school when she awoke one morning with a very sore throat. Like any normal teenager propelled into a world of homework and friends, Katia went on with her daily routine, putting her throat pains aside. After a week elapsed, her soar throat became difficult to ignore. Katia had difficulty swallowing and many times the pain was so severe that she was reduced to tears. This pain not only affected her speech but her ability to consume food, clearly this problem would not resolve itself.

A week after Katia had first discovered this pain, she decided to visit the school nurse for a quick check-up. Katia suggested to the nurse that there was a possibility that she had tonsillitis, but the nurse assured her that this was not the case. The nurse believed it was bronchitis, and suggested Katia visit a doctor.

After a thorough check-up by her physician, Katia's doctor diagnosed her with bronchitis. The young girl was prescribed antibiotics and sent on her way. Katia continued taking her antibiotics diligently, and by the time she had finished her prescription the pain in her throat subsided. A week later, and to Katia's chagrin, the sharp pain in her throat had reappeared. "The pain was so bad I remember nights of constant agony, waking up in tears," Katia told me.

Katia and her concerned parents returned to the doctor, where they received an even stronger dose of antibiotics for what the doctors believed they were treating, (i.e. bronchitis). Katia's visit to the doctor did not end there. The Elisman household returned two more times where they continued to receive stronger doses of the same antibiotic. It is at this point that we might wonder why the doctors elected not to test for a different disease. American sociologist Talcott Parsons introduced an idea called the "sick role" in 1951. This role was granted any sick person an exemption from their normal social roles as well as not making them responsible for their condition (www.sociologyblog-parsons.blogspot.com). Katia now assumed the sick role during this time due to her constant high fevers and throat pains, exempting her from school, sports, and social gatherings.

Taking a closer look at the sick role, there are both positive and negative affects to assuming this role. For cancer patients, you can imagine that they would take advantage of the sick role as it grants them many social advantages. A counter example would be a patient with AIDS who do not necessarily want to obtain the sick role, as their disease is considered socially unacceptable. In Katia's case, she felt unappreciative and did not want to assume the sick role as it prevented her from doing many of the things she enjoys in life.

Diagnosis is central to medicine. It is the basis for social order, explains illness, and provides a light out of the dark tunnel that is the disease (Jutel 2011). Volleyball season had just begun, one of the best members on the team, Katia was eager to get going despite her recent illness. To her disappointment, Katia's parents would not let her play due to her respiratory issues and constant high fever. Once again, Katia was one of the rare examples of someone who occupied the sick role, but did not necessarily want to do so. As her illness progressed, Katia became increasingly unable to undertake activities in her daily routine. As winter break neared, her condition had not improved, and exams were quickly approaching. Having missed so much school already, Katia was not equipped to take these tests, yet she continued to study while at home with a fever. The week of exams arrived, and Katia's fever reached an all-time high (104 degrees) and she was rushed