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Article Summary Robert F. Murphy’s article en d “Signs and Symptoms” (1987) describes the universal human experience of ageing, and the need that everyone has to come to terms with the finite nature of human life, and the limitations of the physical body. As an anthropologist the author has much to say about the social and psychological construction of illness, and the way that most people in the earlier phases of life take for granted their good health, and their ability to plan whatever they choose in family and career, and follow up these plans over a long space of time.

The author describes his own gradual discovery of life-threatening illness, and the implications of this for him on a personal level, and he sets this within the wider context of the human condition generally. The first major insight that the author reports is that he becomes obsessed, in a rather unpleasant way, with his own body and that it is not so much the physical symptoms of disease that affect him, as the psychological ones “its most profound effect was upon my consciousness, my self-awareness, the way I apprehended and constructed the world and my position in it” (p. 13). Murphy comments on the tendency of clinicians to diagnose psycho-somatic illness when they cannot identify any clear physical cause for the symptoms reported.

There is an amusing account of a visit to a psychiatrist, whom the author dismisses with an academic remark about the proposed treatments, and an honest admission of the author’s limited understanding of the field of neurology. Throughout the article the author highlights the euphemistic use of language as a way of trying to reassure people in the face of unwelcome developments, for example “the unforgivable neologism restructuring” (p. 10) which really means financial cuts, and medical terms like “obstruction” (p. 17) which really means a tumor.

This illustrates one of his main themes, which is the way that sub-groups in society using slanted definitions to pull unwary outsiders into their own mini-world in which power structures privilege the insiders. This insight relates to the theories of Talcott Parsons relating to the so called “sick role” and Goffman relating to front and back stage behavior, which explain how illness takes over the whole of a person’s life, robbing him or her of freedom and prescribing new rules and a new objective, namely to get well again.

The institution imposes a new identity on the patient, and he has to adjust to its expectations. The article ends with some reflections on the idea of the Disembodied Self, and the decision to life one day at a time, which are common mechanisms that people use to cope with serious physical illness. The author situates his own coping strategies with his family background which had significant hardship and an expectation of stoic endurance in the face of loss. He compares this with other views of illness, such as the Mundurucu shamanic beliefs which he had studied in the 1950s (p. 29) and modern science-fiction narratives about alien invasion (p. 31). The final insight of the article is that the author conceives of his descent into the sick role as a “journey into entropy”, giving a scientific explanation for the disintegration of his former life.

Overall, the personal narrative brings alive many of the main twentieth century theories on embodied human existence with memorable and concrete examples.ReferencesMurphy, R.F. (1987) Signs and Symptoms. In: The Body Silent. New York: Henry Holt and Co., pp. 9-34.