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What's wrong with the word "fatigue"?

By Mary Schweitzer, copyright 1997
In the English language "fatigue" means "tired." Drawing it out more, the connation is tired from working.

In the public mind, to say we have "fatigue" sounds like we're tired from working. Well, who isn't these days?

The "fatigue" that we have--I would identify almost seven varieties myself--is not like anything I ever experienced in my other life. But it is incredibly hard to explain that to people.

When you have "walking pneumonia," the principal symptom is extreme fatigue. I can recall my son having it and not even coughing. They don't call it "coughing fatigue syndrome." or "coughing fatigue disease."

Any serious disease is going to make you fatigued. But identifying our disease from the single symptom of fatigue translates into "tired for no good reason."

The reaction I get from people when I say I have Chronic Fatigue Syndrome (if they have not known anyone else with it--increasingly, I am finding people have known someone with it and do know it is serious)--runs the gamut from "I knew you were working too hard" (NOT! I was ALIVE!!!!!) to "Yeah, I've been tired lately too" to "Well, when you get a few weeks of rest you'll be fine again" to the absolute worst, at a cocktail party, "Oh, how au courante."

Compare that with the reaction I get when I say that I have CFS, but then qualify it by saying the name is stupid but it's actually a very serious neurological illness, resembling MS. Much different reaction.

I shouldn't have to say, "the name is stupid." But I do.

There is another, more insidious problem with the name.

The insurance companies intertangle these three phrases in their press releases and glossy brochures: "chronic fatigue," "chronic fatigue conditions," and "chronic fatigue syndrome." If you know how to read subtexts, this is a beaut. The subtext is--tired like the rest of us but always complaining about it. Goldbrick. Lazy.

Add fat and female and boy do you have an incendiary combination.

Add the subtext of racism and see how difficult it is can be for an African-American or Hispanic-American to get respect for this disease.

The implication from insurance companies is that we are cheats; the implication in the outside world is that we are lazy.

Finally, if you look at any pop chart for "how to diagnose depression," what are the top criteria? (1) Unexplained fatigue; (2) trouble sleeping; (3) unexplained aches and pains--and what is one of the principal recommendations to people suffering from mild clinical depression? Exercise. Well, that's the worst thing you can do if you have this disease, because unless you are very very careful, you switch into anaerobic metabolism quickly and can do real damage to your body. Many people with chronic fatigue syndrome cannot use a stationary bike for longer than 2 minutes without shifting into anaerobic metabolism -- and crashing into worse symptoms for up to nine days afterwards.

But GP's and HMO gatekeepers and friendly neighbors and family play pop psychiatrist all the time and say--Oh, you wouldn't feel so fatigued if you would just get out and get some exercise, dear.

So I hate that name. I hate the word "fatigue." For that matter, I hate the word chronic. It has the connotation "chronic complainer," right? "All the time." Whining. Whining about being tired. Can't suck it up, eh?

OR--yeah, well, you brought it on yourself, you overachieving yuppie. (Never mind the people who get this who are poor who are hardly "overachieving yuppies" but are working two jobs to support their families).

OR--oh, don't be so self-absorbed. Go get involved in something. Go take a good long walk.

Too easy for Bryant Gumbel and Jay Leno to crack jokes about people with chronic fatigue syndrome. Do they make jokes about people with multiple sclerosis? Well, it's funny as a rubber crutch, guys.

The name "chronic fatigue syndrome" makes me feel I have to scream to the outside world: "I am not a liar. I am not a cheat. I am not lazy." I loved my life. I was alive. This is not a vacation. I'm not "resting." It takes physical effort for me to do everything I continue to do. This is not easy, it is hard.

So, that's why a lot of us hate the word "fatigue."

--Mary Schweitzer

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