In his book Language, Thought, and Reality, Benjamin Whorf describes us as cutting up nature, organizing it into concepts, and ascribing significances as we do, largely because we are parties to an agreement to organize it in a certain way. It is staggering to think that the pattern of living each of us embraces grows out of approximately the 100 million nerve impulses pouring into our nervous system every second of the day. In all probability, the hypochondriac organizes aspects of nature, especially as it applies to the self, in a slightly different manner. As we listen to our patients on a daily basis, patterns of communicative expression begin to emerge.
Patients think and talk about their bodies differently.
They tend to disown the offending part and repossess it when it is well. How people perceive or misperceive themselves is a reality with which the physician must come to terms. We, as doctors, can neither confirm nor deny subjective symptoms. Unlike body temperature or blood pressure, they cannot be measured with a thermometer or sphygmomanometer. We are obliged to accept what we are told on faith.