Biomedical Engineering Reference
In-Depth Information
sufferers from bleeding and rupturing aneurysms experience. The aneurysm,
as a condition, becomes loaded with values and emotions of fear and with an
imperative to act in favour of medical intervention.
Kavanagh and Broom's (1998) identifi cation of a third type of risk, in
addition to lifestyle risks and environmental risks, as something embodied in
the individual corresponds with the representation of an aneurysm. Studies
of patients being 'at risk' to develop some diseases report that risk has a
fundamentally different meaning for the patient as compared with the health
practitioners (Kavanagh and Broom 1998, Olin Lauritzen and Sachs 2001).
Health risks create a set of challenges for people who are diagnosed, such
as translating population characteristics into personal meaning, coping with
uncertainty, interpreting the possibility of illness in the non-appearance of
symptoms, and mobilizing supervision and risk reduction (Kavanagh and
Broom 1998; see also Chapter 6 in this volume). But when we calculate our
own health risks we have already taken on board the meaning of risk in our
social world, as Joffe (2003) points out.
People construct risks through lenses tinged with elements of group
attachment and of experiences of their in-groups and selves, in terms of
both the contemporary imagery that they are exposed to and from past
misfortunes. These elements do not distort a 'real risk'. Rather, they are the
'reality' in the minds of those who look upon the risks (Joffe 2003: 68). In
the case of a 'cold' aneurysm the patient has to calculate and balance two
risks, the risk of spontaneous rupture or bleeding and the risk of a rupture or
bleeding due to the preventive medical intervention. The symbolic power of
the representation works in a direction where every detected small balloon-
shaped discrepancy will be considered as disease and risk, as an embodied risk
that needs to be eliminated. The image of a ticking bomb submits no place
for biding one's time in passivity but promotes different kinds of actions to
defuse or eliminate the evil from its place. According to the 'cold aneurysm
narratives' the risk of intervention seems to be overshadowed by the risk of
rupture and of the unbearable situation of living a life in uncertainty. Surgery
seems to be the only way to reconstruct normality.
In search for information, English-speaking patients from all over the
world who have been informed that they have a 'cold' aneurysm may enter
the 'Brain Aneurysm Narrative-site', pick up ideas and then disseminate
elements of the social representation in other public spaces. However,
to understand to what extent such a representation really becomes an
element in the chain of actions that make up the medical decision process
in a concrete case of discovered 'cold' aneurysm, we need a more careful
examination of the neuromedical practice. Some tendencies observed in
different parts of the Western world support the ideas described here. First,
research has shown that aneurysm patients experience a decreased quality of
life after just having been informed that they have a 'cold' aneurysm, even
if they do not experience any symptoms. Second, patients who have been
informed about having a 'cold' aneurysm tend to let the risk of bleeding and
