a tiny non-fiction miscellany

[kaberett]

Last year I read Spirals in Time (Helen Scales), and the main thing that stuck with me (apart from the section on byssus cloth, which turned out to be relevant to Hands of the Emperor...) was the concept of morphospaces (see Raup 1962, Raup and Michelson 1965). The book introduces this fantastic imaginary museum filled with glass shells hanging on strings, the shapes varying systematically in space according to Raup's parameters -- and I am most put out that this doesn't actually seem to be something that exists digitally (the closest I've found is Leggio et al. 2019). (Related: an R implementation for plotting your ammonoid data).

It turns out that people have (inevitably) gone "... I think you'll find it's a bit more complicated than that", but I love the idea. At least a bunch of Raup's art is available for perusal...

Meanwhile, I have spent the past few days dipping in and out of Gavin Francis' Recovery, which consists of a series of short essays. One of the later ones includes the almost-afterthought line

Suzanne O'Sullivan is a neurologist in London specialising in what are now called 'functional illnesses' and used to be called 'psychosomatic' illnesses.

This is referenced to one of her books -- which I've now got on hold with the library -- and I am fascinated to read more about this, because I'd been increasingly aware of "functional illnesses" but had totally failed to register that this was terminology that was displacing "psychosomatic". For me the Big Thing is the way this suggests a shift from the default assumption that such illnesses are Something The Patient Is (in some sense) Doing to, instead, the idea that just because you can't find it via dissection -- just because the disorder arises not from physical structures but from the ways in which they work -- doesn't mean there isn't a (transient, short-lived) physical basis. And then there's the shift in focus from etiology to management of functional impairment, which I am also fascinated by.

recessional managed to dig up for me [an NHS resource that corroborates this shift in usage]:

Functional Neurological Disorders (FND's) is the name given for symptoms in the body which appear to be caused by problems in the nervous system but which are not caused by a physical neurological disease or disorder. Health professionals sometimes call these disorders ‘medically unexplained’, psychosomatic or somatisation. We prefer the term ‘functional’ which just means that the body is not functioning quite as it should.

This is also tying in to some things Migraine (Katherine Foxhall) has me musing on, about the lines we draw between comorbidities (illnesses that occur together at a rate greater than can be plausibly explained by chance) versus syndromes (clusters of signs and symptoms, some subset of which is sufficient for a diagnosis to be given). The extent to which headache has been considered an essential feature of migraine -- or nausea, or aura, and so on -- has shifted over time; I don't have any conclusions about what constitutes a meaningful diagnostic unit (or atom, I suppose), but I'm definitely interested in looking for more writing on the topic.

Comments

[watersword]

I am v. interested in hearing your thoughts on these matters as they develop.

[angelofthenorth]

Thank you. As someone prone to somatisation/ functional disorders knowing that they've now shifted terminology is really useful to know.

[ludy]

I thought the term Functional was being used for “we don’t know why it’s happening even though we can see that it is happening” type issues as well as somatisation? But maybe that’s me not getting the nuance of medic explanations?

I don’t know how much overlap there might be but Caroline Crampton (of the Shedunnit podcast) has a book coming out this spring about the history of hypercondria/health anxiety I love her writing and think it’s probably going to be fascinating but as someone with some now-diagnosed physical conditions (including endometriosis and PCOS) that were originally dismissed by not-bothering-to-investigate-fully medics as psychosomatic (because I was young and am female and do have other mental health stuff going on) I find the whole subject quite ouchy to engage with.

[rugessnome]

interesting to hear about the byssus cloth! Confusingly there's a yarn I've long known of made partly with the product Seacell (a lyocell-seaweed blend apparently) that also goes by Sea Silk...

(other parts also interesting; I do not know much about the stuff for morphospaces, and I don't really have comment at this point on functional illnesses other than to echo that it ...may be a more useful and/or sympathetic paradigm. I know someone who has such a condition but I am not privy to much about how it impacts them, and they were subsequently diagnosed with other conditions that I think have a more prominent effect presently.)

[lunabee34]

Reading and taking notes.