Fatigue-Related Cognitive-Behavioral Factors in Survivors of Childhood Cancer, 2020, Knoop et al

Full title: Fatigue-Related Cognitive-Behavioral Factors in Survivors of Childhood Cancer: Comparison with Chronic Fatigue Syndrome and Survivors of Adult-Onset Cancer

Paywall, https://www.liebertpub.com/doi/10.1089/jayao.2020.0094
Sci hub, https://sci-hub.tw/10.1089/jayao.2020.0094

 

From the Introduction (my emphasis) :

I have recently wondered how often using the word "subjective" to describe anything in medicine is ever accurate.

If I break my leg and the injury shows up on x-ray then the pain I get from the injury would be considered by doctors to be "objective" and therefore "real".

If I had had cancer treatment - chemotherapy - then I have, in effect, been deliberately poisoned, just enough to (hopefully) kill cancer cells while people cross their fingers and hope the healthy cells I have stay alive. I think it might be common afterwards for testing not to show how well my body repairs or replaces those damaged, previously healthy cells - and if it (my body) does replace unhealthy cells they might not be the same as they would have been before chemo if the chemo had induced DNA damage. If enough healthy cells have been damaged and my body's repair systems can't actually repair them or replace them accurately then I might feel unwell for the rest of my life. But if those cells can't be found or tested for then doctors will tell me I'm absolutely fine and dandy and I'm well again and any feelings of being unwell are subjective.

I'm not dismissing the idea of something being subjective entirely. For example, someone with flu may shiver with cold when their body temperature is actually high with a fever. I would describe feeling cold in that situation as a subjective feeling (it's not "real"). But I do believe that the word "subjective" to describe anything in medicine is vastly over-used and it is often just a sleight of hand trick to hide what doctors don't actually understand or don't know.

 

Not a thing.

Clowns. These people are sewer-dwelling clowns.

 

In the 80s/90s there were a few children with ME after cancer treatments. Their mothers were at particular risk of being accused of munchhausen's by proxy as it was claimed they missed the attention they got as parents of sick children.