Diagnosis

This chapter describes the phenomenon of metagnosis, defined here as a revelation of a long-standing undetected condition effecting a change in the terms of knowledge. In the medical sense, it can occur when a condition has remained undetected and/or when the diagnostic criteria have shifted, as with autism spectrum disorders. It also describes nonmedical revelations of knowledge bearing upon selfhood, such as unexpected genetic test results. The phenomenon’s relevance to individuals who experience it and to clinicians is discussed, as it offers a potentially new framing of identity and experience. In addition, its relevance to our understanding of medical knowledge as such is explored, for it alerts us to the presence of unknown unknowns and prompts us to reconcile this awareness with our conception of diagnosis and clinical authority. Finally, the plan for the book is outlined, its thesis and structure summarized.