The Age of Diagnosis by Suzanne O'Sullivan

The Age of Diagnosis:

How Our Obsession with Medical Lables is Making Us Sicker

By Suzanne O’Sullivan

Thesis 2025

Another scientific contrarian returns from their stint in the hermitage! Readers have been trained to ignore many idiosyncratic thinkers who purport to thwack received wisdom in the jaw. Ever since Darwin published his pamphlet on the biological graduation of apes, authors of popular science have longed to leave the academy aghast and listeners ajitter. Thankfully, Suzanne O’Sullivan’s new book The Age of Diagnosis: Sickness, Health and Why Medicine Has Gone Too Far comes from the empathetic consideration of a clipboard-carrying neurology consultant, rather than the drivelled antagonism of a conspiratorial dingbat. It certainly upturns some stones, but is self-conscious enough to avoid the untutored, sweatily searching, pungently proud tactics of this genre’s dishonest grifters.

O’Sullivan is chiefly concerned with the hypermedicalisation of perceived well-being and the inadvertent damage dealt out to the legitimate sufferers when diagnostic brackets widen. When covering the recent sickly exorbitance in diagnoses, she writes “these statistics could indicate that ordinary life experiences, bodily imperfections, sadness and social anxiety are being subsumed into the category of medical disorder. In other words: we are not getting sicker - we are attributing more to sickness.”

When the subject of autism is broached, O’Sullivan shows few signs of abating with these flabbergasting indictments of lab coat follies. “As the borders of what it means to have autism have moved, the assessors making the diagnosis no longer need the mask to drop. A person may appear entirely socially capable and it is enough for them to describe a great deal of effort to maintain that front for the diagnosis to be made. The masking theory tells us to assume autism is there even if it can’t be seen.” So as the process’ rigidity is shaken, the diagnostic requirements are shaken in tandem.

Just when us namby-pambies thought all the white whales had been harpooned, O’Sullivan visits her most assertively corrosive reasoning on ADHD and the Crimean cavalry of other neurodivergent labels safely ensconced in the modern lexicon. “The frank truth of it is” she states “that despite decades of work, no biomedical research project has succeeded in finding any brain abnormality common to ADHD sufferers. There are no biomarkers that allow behaviours exhibited by people with ADHD to be distinguished from other disorders or even from normal human experience.” If, instead of writing this sentence in a lucidly damning book, O’Sullivan had said it in a university seminar, then she’d have been accused of numerously violating the Geneva Convention, and her pancreas would now be a chew toy for the seminar leader’s Alsatian.

Zillenials fail to recognise how self-evidently mind-altering are the technologies bleeping away in our pockets. If Euclid had been given short-form content and chirpy social media at age eight, he’d have spent no time founding the tenets of geometry and would instead have beguiled the small hours engrossed in the same burger-sizzling, gaff-compiling, pec-twitching nastiness which shortens our attention spans in an entirely natural and explicable way. To question the veracity of ADHD, and notions of immutable attention spans, is to place oneself on a moral par with Hermann Goering or Darth Vader. To hear O’Sullivan assert some uncomfortable truths with such unswayable probity is a fine alternative in this truth-twizzling era.

One emotion readers will not expect to be consulted throughout, but one called upon in nearly every chapter, is one of deep sadness. By citing interviews she has completed with those whose noses are pressed egregiously against the medical grindstone, O’Sullivan allows a novelistic catharsis to thaw any icy statistics and personalise hitherto nameless travails. Those with the greatest needs are having their care and attention jeopardised by a  new self-diagnosed influx. This broad-shouldered critic finds it difficult to read this sentence on autist Elijah’s incontestable viability and his beaming appreciation of life’s small pleasures, without tearing up. “When I met [Elijah] he was gripping four fluorescent-coloured, highly textured plastic caterpillars close to his chest. If Elijah is awake, he has two things in his hands - his caterpillars and his iPad. He also loves swimming, tennis and discos. He still likes bouncing, so has a trampoline. He enjoys going to Starbucks for a latte.”

Suzanne O’Sullivan is not Mary Wollstonecraft, so The Age of Diagnosis has stylistic blinds pots and missed polemical opportunities. We wish, for example, she’d fattened her book with another fifty pages on industry corruption and the madness of the DSM. With that said, the procedural way in which the book posits high-level malpractice and clinical errors marks her out as a courageous author. This is a crucible of forthright skepticism and the oddly moving work of someone deploring consensus who, for once, is not selling lizard blood or tickets to the earth’s core.

Joe Spivey is a book critic currently residing in Kingston upon Hull