She has not seen a physician since she was given a terminal diagnosis 6 months ago at another institution. She is nutritionally depleted and has an apparent gastrointestinal obstruction causing significant bloating and discomfort. While you are admitting her, she informs you that she is curing herself by drinking fresh fruit and vegetable juices. One strategy is to strive to understand both Mary s disease and her illness. Disease refers to a biological, pathophysiological process.
Illness refers to the patient s experience.
You can assess a patient s illness experience by asking about four dimensions Feelings, Ideas, Function and Expectations. The acronym FIFE can be a helpful reminder. I imagine you have had many different feelings as you have coped with this illness. Sometimes people have fears that they keep to themselves and don t tell their doctor. Understanding the patient s illness experience complements, but does not replace, understanding the disease.