My friends Rachel Maines and Garrel Pottinger (both historians) have enlisted me in their campaign to add a much-needed new word to the English lexicon: "Iatromoric," or doctor-baffling. Garrel and Rachel were moved to coin the term when he was diagnosed with “idiopathic” – meaning self-caused – seizures, which struck Garrel as patient-blaming. Hence, the need for a more descriptive term. "Iatromoric" derives from the Greek roots for doctor (iatros) and fooled (moros, the opposite of sophos). Thus, an iatromoric diseases is one that fools, confounds, or baffles the doctors. It corresponds etymologically to the well-known category of iatrogenic illnesses, which are caused by hospitalization.
This all struck home for me. Although it hasn’t happened to me, virtually every other ME/CFS patient has at some time been referred to a psychiatrist after a battery of tests failed to identify a known disease. In the most benign version, the doctor says something like, “There is nothing wrong with you that I can find. Would you like to see a psychiatrist?” In the more patronizing version, the doctor says, “You are experiencing ‘false illness beliefs.’ You need to see someone for psychotherapy.” The latter is still the standard response in the U.K., although we are seeing it less and less in the U.S.
ME/CFS patients would be much better off if their physicians would simply admit that they do not know the cause of their symptoms. If the tests are all negative and the patient is obviously sick, the word “iatromoric” would provide a much needed term for a physician’s current inability to provide a diagnosis.
The rush to declare ME/CFS a psycho-social or psychogenic illness – rather than admit bafflement – has caused incalculable harm to patients, including the decades-long delay of serious biomedical research. It is admittedly hard for doctors to say “I don’t know,” and it is understandable that they would search for a psychological diagnosis as a fall-back. In the mid-twentieth century, asthma, rheumatoid arthritis, ulcerative colitis were all included in the “holy seven” of psychosomatic diseases, although they are now recognized as biomedical. As should be obvious, not all unexplained symptoms are psychological (nor are they caused by “ill-humors” or “unbalanced bile,” as physicians thought in the eighteenth and nineteenth centuries).
Fortunately, leading institutions in the American medical establishment -- including the Institute of Medicine and the National Institute of Health -- have been shaking off the regrettable influence of British psychiatry, and have now recognized ME/CFS as a biomedical disease. Progress on identifying biomarkers has been made at Stanford, Columbia, and other medical centers.
Still, there is much that is unknown, and “iatromoric” provides a good way to describe it.
UPDATE: In an email, a psychotherapist friend of mine added that "doctors need the legitimacy of a category like iatromoric to have a way to not just respond to but to think about the existence of medical conditions that aren’t yet known or understood. [Most] doctors are trying to be helpful and have no construct to guide them. This new word is helpful not just to patients but to doctors as well."