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My Three Teachers
By Walter M. Robinson, MD
Copyright © 2002 W. M. Robinson
One of the most important lessons I learned during my medical training was to remember the difference between disease and illness. Disease is a process that occurs in an organ system; it's something that you could see under a microscope or on an X-ray. Doctors are experts in diseases. In contrast, illness is the experience of being sick. That experience can only be reported on by the patient, and so patients are the experts in illness. The patient's experience of being sick includes events which happen outside the exam room or the hospital; family relationships, the burden of taking medications, life at school and at work, all of these are part of illness, but they can be missed if all we think about is disease.
The difference between disease and illness is particularly clear when a cure is not possible for a medical condition. In my experience taking care of people with CF who are in the last stages of their lives, I have been privileged to receive teaching from many patients about the wide variety of ways that people with CF can cope with both disease and illness. In what follows, I would like to describe three of my teachers.
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