Torrey: UCLA Professor’s Socio-Historic Account of Fatigue Touches on WC Themes| Employees Compensation Information

By David B. Torrey

Tuesday, July 13, 2021 | 0

University of California, Los Angeles, Public Health Professor Emily Abel has written a brief but far-reaching social history of the phenomenon of fatigue.

David B. Torrey

Abel, herself a breast cancer survivor who suffered years of fatigue after chemotherapy, combines her sober historical analysis with aspects of her memoir in “Sick and Tired: An Intimate History of Fatigue” (University of North Carolina Press. 196 p. 2021). This approach makes for a compelling read.

And the book, which covers an example of “controversial illness,” will be of interest to members of the workers’ compensation community.

Fatigue itself does not reflect a single injury or illness (as she says, “there are no diagnostic codes for fatigue”), but is often brought forward by patients (including injured workers) who describe the consequences of their injury and treatment. The example most frequently encountered by this author is the simple one: the worker taking medication (or overdosing) for pain and unable to return to work due to the dangers of drowsy driving.

Abel briefly mentions this situation, but the fatigue she focuses on is the state of extreme lethargy following an injury or medical treatment that prevents the individual from doing some or all of the normal activities of daily living. The leading disease currently recognized is chronic fatigue syndrome (CFS) and of particular interest to Abel is the feeling of illness that can often arise after cancer treatment.

Abel shows that for decades complaints about fatigue have been viewed with suspicion by a society that has long viewed “productivity” [as] the only measure of human worth. ”She compares this phenomenon to the intolerance of both the medical profession and society towards patients suffering from chronic long-term pain and other“ controversial diseases ”such as chronic Lyme disease that imply long-term disability.

Abel identifies and criticizes three issues she discovered in the socio-historical record of treating fatigue. All of this particularly affects how lawyers and judges feel about disability.

She initially focuses on what she calls modern medicine and society’s rejection of subjective exhaustion reports from sufferers (she calls this “embodied knowledge”). Most doctors and systems (like disability systems) require that objective signs of pathology must be evident before a condition can be legitimized. This consideration is of course also taken up by the well-known independent medical examiner that objective signs of injury must be recognizable before pain symptoms can be taken into account.

Second – and throughout the book – the devaluation of society as unproductive and thus burdensome for those who are unable to work due to chronic illnesses. This societal view, which the author denounces, is ubiquitous in our field, where the worker who refuses to return to a changed service is often seen as a burden on the employer, the insurance company and the community at large.

In her third and most compelling discussion, Abel analyzes the “triumphant recovery narrative” so popular in both medicine and the disability insurance community. A reliable readiness for workers’ accident seminars is in fact the speaker who contrasts the disappointing long-term injured worker with the much more severely injured worker who has recovered, has shown “resilience” and has distinguished himself.

Injured workers are encouraged by such speakers to follow the example of Christopher Reeve, whose quadriplegia did not prevent him from continuing a full and productive life.

Of course, the answer to this rhetoric typically offered by motivational speakers is that heroism is not or should not be the standard. Reflecting on this very point, the author says, “Physical imperfection is a condition of human life and not a cause for shame … Disability arises from social arrangements and cultural attitudes as well as from physical impairment. [and] … everyone cannot be expected to overcome all adversities. ”

She is right: we all admire the strong-willed, the true courageous and the resilient. But then again, not everyone is Superman.

The author’s historical review of how fatigue has been diagnosed by doctors and viewed by society over the past 150 years will educate and educate the disability expert. The book continues to deliver on its promise of intimacy. In this regard, Abel vividly recounts not only her battle with breast cancer, but also her childhood and how the then current scourge of polio affected her and how she thought about how to respond to illnesses, surgical interventions and, ultimately, their exhausting consequences should.

David B. Torrey is an Associate Professor of Law at the University of Pittsburgh School of Law and a Labor Compensation Judge for the Pennsylvania Department of Labor & Industry. This entry was posted with permission from the Workers’ Compensation Law Professors blog.