This episode revolves around three young adults coping with diabetes, coming to terms with their diagnosis and limitations, navigating the social realm with their disability, and facing difficulty in adopting the disciplined lifestyle required. The characters include Kristyn, a woman in her mid-twenties with $12,000 in debt working eighty hours a week to pay off medical expenses, who is forced to resume living with her parents. Next, Jen is a nineteen year old struggling to modify her eating habits and facing pregnancy complications due to diabetes. Matthew is a twenty year old student who does not want his condition to interfere with his college partying experience.
The illness narrative of the characters resembles the Chaos motif, since diabetes is a chronic affliction posing degenerative and life-threatening consequences with failure to administer insulin and stabilize glucose. Helplessness and a sense of spiraling out of control are prominent themes in this episode. For instance, after working multiple shifts, Kristyn breaks down crying and confides in her friend about feelings of social isolation. Along the same lines, after her newborn is put in the neonatal intensive care unit, Jen cries to her husband that “It’s not fair…I feel like this is all my fault, and there’s nothing I can do about it,” illustrating her sense of desperation and guilt. These examples also highlight other features of the Chaos Narrative, including hopelessness surrounding potential for a normal life, being overwhelmed by the intensity of the illness, and intimate relationships being the witnesses to the patient’s testimony.
The narrative is used by characters in order to explain decisions or justify health-compromising behavior to self, family, friend networks, and health care personnel, to mobilize sympathy and emotional support, to legitimize their sick role, or to involve others in their treatment selection or therapeutic course. For example, Kristyn uses narrative in talking to her mother in order to rationalize her decision to go to the bar despite being sleep deprived, while Matthew prepares roommates for what they should do in a diabetic emergency.
Adoption of the sick role and revealing of their illness narrative is stigmatizing for the characters, as their condition precludes them from engaging in culturally-prescribed behavior for individuals of their age group. For example, Kristyn is socially alienated since her medical bills have forced her to forgo independent residency and work two full-time jobs. Jen has difficulty being estranged from our culture of fast-food consumerism, and feels excluded when she cannot indulge in sugary foods at the buffet like her mother. Matthew feels pressured by friends at his birthday party when he cannot conform to social norms for imbibing alcohol.
This episode also portrays how the experience with medical professionals represents a transactional exchange between patient and practitioner, where they negotiate modification in treatment employed and articulate the extent of ‘the sick role’ of the patient. This underscores the superior position in the social hierarchy occupied by the doctor, who is the gatekeeper to treatment modalities and has power to impose diagnostic labels and exert control over patient behavior. For instance, Jen’s doctor had her switch from oral medication to injections despite her objections, and her physician changed her diagnosis from Type II to the more restrictive, irreversible Type I. In addition, Matthew felt as though he had to convince his doctor that he could manage his condition and consume alcohol, and resisted the sick role the biomedical community had assigned, not wanting to compromise his partying. Moreover, the characters forgo certain rights in assuming the sick role, such as Jen’s right to deliver the baby when and how she wanted, and Matthew’s right to drink without inhibitions (instead, he has to take glucose readings at parties and carry Mountain Dew in case of hypoglycemia). Sick role responsibilities portrayed include managing the financial burden of illness in Kristyn’s case, and complying with a dietician’s orders in Jen’s case.
The illness narrative is useful to patients in documenting their illness journey, deriving meaning from illness, and re-capturing a sense of agency. Importantly, the narrative can be a tool of catharsis and introspection, enabling the patient to self-reflect on their decisions and reactions and to find self-actualization through the transformative aspects of illness. In particular, the lecture underscored how the Restitution Narrative provides hope for cure by emphasizing the impermanent nature of illness, the Chaos Narrative provides acceptance and resignation, and the Quest Narrative provides self-empowerment and enlightens an individual about a positive metamorphosis in identity that can occur as a result of illness. On the other hand, the illness narrative is useful to family because it offers a coherent scheme of events for the purpose of clarity and provides insight into the experiential facets of illness, such as the patient’s battery of emotions. For health care providers, the illness narrative can communicate subjective feelings of pain and distress and showcases a logical timeline of symptom expression and remedies pursued, which may illuminate etiology or better avenues for treatment.
As lecture stated, benefits for listeners with similar conditions include finding a sense of community and advice for recovering autonomy and living an enriching life with the illness. For example, Craig Mullins found solidarity with other men who had paternal postpartum depression, raised awareness about the disease, and identified afflicted men by releasing his illness narrative. Moreover, he was able to find redeeming aspects of confessing his illness experience, as demonstrated with: “Recognizing that what you’re experiencing is real and then seeking help…demonstrates strength and courage” (Stone, 2012). Likewise, on his YouTube video, Jeremy divulges that he posted his YouTube video illness narrative “in an effort to connect with other people out there who understand” (Jeremy, 2011). Hence, his illness narrative serves to initiate friendships with others with bipolar disorder, to share coping strategies, and to create a social identity through their shared suffering.
Jeremy. (January 30, 2011). My Story [Video File]. Retrieved from http://www.youtube.com/watch?v=dHS0rvizbJo&feature=related
Stone, K. (April 24, 2012). Depression in Men: A Dad’s Story of Male Postpartum Depression. Postpartum Progress: Together, Stronger. Retrieved from http://postpartumprogress.com/depression-in-men-a-dads-story-of-male-postpartum-depression