The journalist Caroline Crampton often wishes that she could see her own insides. She is as desperate for knowledge of the darkest corners of her anatomy as she is terrified of her fragility. “I am a hypochondriac,” she writes in her new book, “A Body Made of Glass: A Cultural History of Hypochondria.” “Or, at least, I worry that I am, which really amounts to the same thing.” She has suffered from this secondary malady since she was diagnosed with the primary malady of Hodgkin’s lymphoma as a teenager. After months of treatment, her doctors assured her that she was in remission — but a year later, the disease returned. Crampton beat it again, but her anxiety lingers to this day. Is her apprehension irrational?
“A Body Made of Glass” proposes that it is and it isn’t. On the one hand, Crampton often experiences symptoms that she later recognizes to be psychosomatic; on the other, her hyper-vigilance after her supposedly successful first cancer treatment enabled her to spot a suspicious lump the second time. “My fears about health are persistent and at times intrusive,” she concedes, “but they are not necessarily unwarranted.” She concludes that “diagnosable illness and hypochondria can coexist.” Although “we tend to think of hypochondria as shorthand for an illness that’s all in your head,” the people most worried about their health are very often the people who have the most reason to be.
Unfortunately, many of us have cause to brood on the indignities of embodiment. Crampton writes that “a serious illness is much easier to cope with if it can be slotted into a familiar structure with a beginning, middle, and end,” but she knows that the comforts of recovery and resolution are denied to the ever-increasing number of patients with chronic or autoimmune conditions. Like those conditions, hypochondria is “a plotless story.”
“Without a firm diagnosis for my unreliable symptoms, I am stuck in the first scene of the drama, endlessly looping around the same few lines of dialogue,” Crampton writes. “The compulsion to narrativize this experience is always there, but always thwarted.” There is no satisfying ending, no definitive interpretation of a vague pain or a mysterious twinge.
Indeed, there is no absolute agreement about what qualifies as diagnosis and what qualifies as delusion. In a society riddled with biases, credibility is not apportioned equally, and marginalized populations are often dismissed as hysterical. A host of studies have demonstrated that doctors are less likely to listen to women and non-White people, and Crampton knows that she is “taken more seriously in medical examinations” because she is White and upper middle class. The prejudice cuts both ways: Patients, too, rely on “irrelevant details like confidence, carriage, and body language” to determine whether a physician is trustworthy.
And of course, sickness itself — and therefore hypochondria — is a culturally specific construct that is always subject to revision. The catalogue of medically reputable diseases expands and contracts as research advances and outdated theories are debunked. “It is now possible to test for conditions that were previously undetectable,” Crampton writes. The novelist Marcel Proust was regarded by his contemporaries (and even his father) as deranged because he took such strenuous precautions to avoid fits of coughing, but contemporary medicine might have vindicated his concerns. One century’s hypochondriac is another’s confirmed patient.
In 1733, the physician George Cheyne described hypochondria as a “disease of civilization.” According to Crampton, he meant that it was “a consequence of the excesses of an imperial and consumerist society that had abandoned the simplicity of earlier human existence in favor of an indulgent diet and inactive lifestyle,” but hypochondria is also a disease of civilization because it increases as our knowledge does. The more we understand about the myriad ways our bodies can fail, the more we have to fear.
Because the boundaries delineating hypochondria from verifiable sickness are not fixed, it is difficult to pin down either notion with precision. Crampton acknowledges that her topic of choice “resists definition, like oil sliding over the surface of water.” She is right that hypochondria is a shifting target, but her refusal to venture even a provisional characterization can make for frustrating reading.
“A Body Made of Glass” is a product of impressively thorough research, but it is sometimes circuitous and digressive to the point of frenzy. It blends memoir and literary criticism with micro-histories of subjects of varying relevance, among them the emergence of quack medicine and the medieval theory of the humors.
“Hypochondria” is an old word but a relatively new concept, and it is not always clear whether Crampton’s book traces the history of the phenomenon or the history of the term. Sometimes, her concern is etymological: She informs us that the word first appeared in the Hippocratic Corpus, a collection of medical tracts produced and disseminated in ancient Greece, where it referred to “the place where hard ribs give way to soft abdomen.” Elsewhere, however, Crampton discusses not language but terror in the face of mortality. Her wide-ranging reflections touch on such eminences as John Donne, Molière and Charles Darwin, all of whom had both palpable ailments and debilitating anxiety about their palpable ailments. (It’s difficult to have the former without the latter, it turns out.)
Still, “A Body Made of Glass” is full of fascinating forays. If it is hard to read for its claims or conclusions, it can still be read for its many sobering observations about sickness — a misfortune that will eventually befall even the heartiest among us. After all, as Crampton darkly notes, “hypochondria is merely the human condition with the comforting fictions stripped away. Whether we choose to think about it all the time or not, we are all just one freak accident away from the end.”
Becca Rothfeld is the nonfiction book critic for The Washington Post and the author of “All Things Are Too Small: Essays in Praise of Excess.”
A Cultural History of Hypochondria
