Untimely diagnosis: examining the experience of a diagnosis seen as dissonant with chronological age

Following Bury’s (1982) exploration of chronic illness as biographical disruption, it has been argued that it may instead be accepted as biographically anticipated ‘normal illness’, (Williams 2000), especially at particular life stages. Sanders, Donovan and Dieppe (2002) found that older people saw the pain and impaired mobility of osteoarthritis as a normal part of ageing, consistent with their expected biography rather than disruptive of it (even if at the same time it disrupted practical daily living). Pound et al (1998) encourage us to pay attention to ‘the straightforward possibility…..that chronic illness may be anticipated and experienced by some older people as normal’.
However, much of the literature has focused on examples where illness is congruent with age-related expectations, rather than situations where it is seen as dissonant with chronological age. Some conditions are typically associated with particular life phases. This may include ‘childhood’ infections such as chickenpox or measles; type 1 diabetes as a condition of childhood or adolescence contrasted with type 2 as a disease of late middle age; or dementia as a condition of old age. In all these cases, however, the condition may be diagnosed at a different, unexpected time of life. In this paper we use secondary analysis to explore two conditions where diagnosis seems to conflict with age-related expectations (adult onset asthma and juvenile arthritis); how this affects people’s experiences; and the meanings they and others attach to it. We propose ‘untimely diagnosis’ as a contribution the sociology of diagnosis.