Miriam Solomon

Medical language has implications for both public perception of and institutional responses to illness. A consensus panel of physicians, academics, advocates, and patients with diverse experiences and knowledge about migraine considered 3 questions: (1) What is migraine: an illness, disease, syndrome, condition, disorder, or susceptibility? (2) What ought we call someone with migraine? (3) What should we not call someone with migraine? Although consensus was not reached, theresponses were summarized and analyzed quantitatively and qualitatively. Panelists participated in writing and editing the paper. The panelists agreed that “migraine,” not “migraine headache,” was generally preferable, that migraine met the dictionary definition for each candidate moniker, terms with psychiatric valence should be avoided, and “sufferer” should be avoided except in very limited circumstances. Overall, while there was no consensus, “disease” was the preferred term in the most situations, and illness the least preferred. Panelists disagreed strongly whether one ought to use the term “migraineur” at all or if “person with migraine” was preferable. Panelists drew upon a variety of principles when considering language choices, including the extent to which candidate monikers could be defended using biomedical evidence, the cultural meaning of the proposed term, and the context within which the term would be used. Panelists strove to balance the need for terms to describe the best science on migraine, with the desire to choose language that would emphasize the credibility of migraine. The wide range of symptoms of migraine and its diverse effects may require considerable elasticity of language.

This article challenges the widespread view that there is both a science and an art of medicine. Through examination of recent work in medical humanities —Jodi Halpern’s From Detached Concern to Empathy (2001), Kathryn Montgomery’s How Doctors Think (2006), and Rita Charon’s Narrative Medicine (2006)—I argue that while a variety of epistemic techniques are important in medicine, it is not helpful to dichotomize them as “science” versus “art.” I assess the epistemic strengths and weaknesses of narrative medicine, a recent exemplar of humanistic medicine.

The Secret of Scent . Adventures in Perfume and the Science of Smell. By Luca Turin . Faber and Faber, London, 2006. 217 pp. £12.99. ISBN 0-571-21537-8. Forthcoming from Ecco, New York. ISBN 0-06-113383-3. A biophysicist and perfume critic describes his obsession with olfaction and his controversial theory that we smell primarily by detecting the vibrational frequency of molecules.

Defending Science -- Within Reason Between Scientism and Cynicism. by Susan Haack. Prometheus Books, Amherst, NY, 2003. 411 pp. $28. ISBN 1-59102-117-0. In an account written for both scientists and the public, the author explores issues of scientific evidence and method as well as the interdependence of science and society.