"There is much we don't understand about how the body works"

In today’s paper we read the distressing story of Katie and her very real symptoms for which she struggles to get support (page 24). Her condition- Functional Neurological Disorder -falls into a group of conditions that cause terrible dilemmas for doctors and patients.

Thursday, 6th May 2021, 12:00 am
Katie McIver lives with FND, a condition that causes her to be extremely weak and tired. Picture Scott Merrylees

There is much we don’t understand about how the body works. We find it easiest to comprehend when there are structural problems in the body, things we can see. When a joint is swollen we understand there is a problem. With scans we can look inside the body, but we still search for structural changes we can see. What we struggle much more with is appreciating problems with how the body works, or how it functions.

When trying to explain functional conditions people often draw parallels with computers and compare ‘hardware’ and ‘software’. The hardware is the screen or wires. We understand when the screen is cracked that things are wrong. However very often the problem with computers is how the programs work – the software. How often do we see our video call freeze, but it is much harder to understand why?

The body is similar, a structural problem is like a hardware problem, a broken bone like a cracked screen. In contrast a functional problem is like our body’s software ‘crashing’. Sometimes we will see chemical evidence of the body not working properly, things we can pick up on tests. However often not. ‘Nerve software’ is often some of the most complex in the body, but when it ‘crashes’ there is often nothing to see.

Nerve software. Getty Images.

It can become an issue of belief. For patients: ‘Do people believe what I am reporting, even though there is nothing to see?’ For doctors there is the worry patients will believe there is such a thing as functional conditions. It is very complicated explaining how people can have very real symptoms because ‘software is not working’.

Of course, what we all worry about is what to do. Most often there are no easy cures, and our recognition of these conditions is new. It is often about learning to adapt. No wonder we all often feel out of our depth. There is much to learn for everyone.