Paper short abstract:

This paper explores how patients and clinicians relate to uncertainty in the context of medically unexplained symptoms. Approaching uncertainty as a flickering, ephemeral polyphony, I argue that it can interrupt constricting regimes of thought in the clinic and generate possibilities for healing.

Paper long abstract:

Medical knowledge tends to be associated with certainty and solidity, however, medicine is foundationally uncertain; both suffering and recovery are slippery and often cannot be explained biomedically. ‘Medically unexplained symptoms’ refers to the phenomenon in which someone is seriously ill – e.g. seizures, complex pain, paralysis – but no pathophysiological cause can be found. Whether these cases are explained psychosomatically or neurologically, profound uncertainties in care and illness experience remain. While research has historically focused on the therapeutic benefits of certainty, this paper argues that uncertainty is not a cipher for ignorance, but rather a flicker, a simultaneous, if precarious and ephemeral, polyphony.

Based on ethnographic fieldwork with clinicians and patients with medically unexplained symptoms in a Canadian neuropsychiatric hospital, this paper argues that not only is uncertainty a fundamental aspect of medicine, its flickering, spectral nature also offers generative therapeutic possibilities. Exploring how patients and clinicians relate to this flickering in the clinic, I approach medical uncertainty not as the absence of knowledge, but as a slippery maybe – multiple possibilities (in terms of etiology, treatment, meaning) entwining and entangling, moving into sight and then out of view. Thinking with Despret, Didi-Hubermann, Stewart, and Benjamin, I consider how the flicker of uncertainty rejects the drive towards objectivity and control in the clinic and acts as a dialectic of healing in itself. Part ethnographic and part theoretical, this paper explores both the force of ephemeral, flickering things in suffering and recovery and how to write ethnographically about those flickers.