Bibliophile | Unwell: What Makes a Disease a Disease

Unwell: What Makes a Disease a Disease
by Mike McRae
University of Queensland Press

Medical scientist Mike McRae admits to being ‘a little broken’. In fact, he considers that all his family and all his friends are in some way ‘broken’. If they had lived at different moments in history, they would have had different labels, including mad and evil, and treatments could have included beatings, incarceration, exile or death.

Some conditions of the past are no longer classified as illnesses such as left-handedness, hysteria and nostalgia (treated by the male doctor providing the female patient with an orgasm). McRae outlines how diseases, disorders and disabilities have been treated differently depending on how society saw fit at certain times. When HIV became an epidemic in the 1980s, the ‘gay plague’ raised little concern until people started contracting it from blood transfusions.

McRae’s research into the history of how diseases have been defined and the medical interventions used is intriguing. His chapter on circumcision shows how our beliefs are shaped by different voices, each with differing “agendas, priorities and definitions of what constitutes clean, good and normal”. He devotes a whole chapter to illnesses that strike women being diagnosed over the ages by “people who don’t own female genitalia”.

McRae makes his informed observations very personal. “Like many, I’ve suffered chronic levels of depression throughout my life … I have best friends whose gender identity or sexuality has been pathologised, and I see my own son, diagnosed with autism, growing into an amazingly gifted young man.”

The book is full of little gems, such as when John Harvey Kellogg developed a bland form of nourishment that he hoped would reduce arousal – to promote “sexual abstinence for a healthy lifestyle”. That didn’t go as planned but many people still munch on toasted corn flakes with no impunity to their sexual arousal! He also tells of how a botched circumcision led to the need to rethink expectations and values surrounding gender.

McRae challenges us to consider whether addictions are diseases and reflect on how much control we have over what is broken. He encourages debate issues surrounding mental illness, suicide, abortion, euthanasia and assisting people to breed. Our definition of disease dictates who to treat as broken. “It is a statement of what defines ‘normal’ and therefore ‘valuable’ and Mike McRae advocates that we need to get beyond that to alleviate all hurt and suffering in his highly informative and very readable popular science book.

Unwell is written for all those who have grappled with questions of health, of identity, and shows how history has dealt with these questions, and how ultimately science does march on in a positive direction. But only if the voices of those affected are heard”, says McRae.

Lezly Herbert

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