“The” Covid

I have observed a unique phenomenon in that patients will mention certain diseases or diagnoses prefaced by “the.”  Such as gout:  it’s never, “I had gout” it’s “I had the gout.” Or, when a husband and wife are together in the room and he’s complaining of foot pain, she will say, “He has the gout, you know.” I’ve been practicing general internal medicine, if you count residency, for over 20 years now–and it’s been fairly consistent across age groups and across different health care systems.

Also, this is true for certain infections but not others:  “the clap” is a term we have all heard for gonorrhea, but nobody ever says, “the HIV.”  Patients will say, “I was sick with the flu” but instead say “I came down with a cold.” Fast forward to 2020.  Recently, almost every patient I see in the office refers to covid as THE covid.  “I had the covid back in October.”  “I have a cough, but I’m pretty sure it’s not the covid.”  “She was tested for the covid but it was negative.” “We didn’t travel for Thanksgiving due to the covid.”

I started to wonder why this is.  Talking it over the other day with a physician colleague, we came to the conclusion that prefacing a disease with “THE” seems to take on a specific naming or a labeling effect.  Because interestingly enough, the opposite is true for other diseases:  I generally always hear cancer or heart disease referred to as “mine.”  As in: “I had back pain the other day and I immediately thought, my cancer’s back.” Or: “After my heart attack, I started to follow the mediterranean diet.”   It seems that certain disease states are of a more personal nature, or the patient feels some sort of ownership of them, hence, the term “mine.”

Another angle; perhaps calling it THE covid somehow, in our patient’s minds, keeps it separate, apart, distinctively “out there” and at arm’s length, rather than an integral part of our being.  Or, it implies that it is a self limited, defined illness, instead of being a permanent part of our health story and health care decision making going forward, as would be the case for cancer or heart disease.  Sadly I wish that were true for all survivors of covid; it appears that some may be affected by residual symptoms for even months after.  Truly, there is much to learn about this disease.

After observing this phenomenon for some time, I actually started referring to it more and more as THE covid as well.  During the fall allergy season, I ran out of my nasal allergy spray, and with my pandemic coping mechanism being mainly outdoor exercise, I began to wake up every morning with a stuffy nose.  I mentioned this to my friend while on a bike ride and I said, “I really need to get more Nasonex.  I don’t want to confuse this with the covid.” 

So apparently we will add covid-19 and coronavirus to the list of diagnoses commonly preceded by “the.” Those of you who are writers, historians, or language experts, we can ponder together why this might be the case. There is much in the medical literature about the therapeutic effect of naming: when a patient has symptoms they can’t explain in their own mind, attaching a label to it, simply giving it a name has its own way of reducing symptoms and easing anxiety.  Similarly, perhaps giving it THE name has additional mental health benefits beyond simply establishing a correct diagnosis.  At this point, I say if that’s the case, I’m all for it.  Because a pandemic has been stressful enough, even for those who have yet to contract the covid.

There I go again…