Naming the Disease Creates the Patient
Christina Applegate does not have multiple sclerosis, though she spent years treating a disease she never had — and the treatment made her genuinely ill.
Most accounts end with vindication and relief. But Applegate's case exposes how neurology has systematized misdiagnosis without admitting it. MS requires no blood test, no biopsy, no imaging consensus — only a neurologist's interpretation of white matter lesions on an MRI combined with nonspecific symptoms that appear across dozens of neurological conditions.
Overdiagnosis happens at scale. Studies suggest MS is overdiagnosed in early stages at rates between fifteen and thirty percent depending on the population studied, with most patients never learning the truth. They remain on disease-modifying therapies carrying serious side effects. Immunosuppression, progressive multifocal leukoencephalopathy, opportunistic infection. For a disease that is not present.
The diagnostic framework itself creates MS patients out of ambiguity. Once the MRI is read as "consistent with MS" and the chart organizes around that center, other conditions recede from consideration. Lupus, vitamin deficiencies, autoimmune encephalitis. All replaced by the diagnosis. The disease becomes real through naming it, through treatment, through the infrastructure that accumulates around the name. Every symptom that follows gets reinterpreted as evidence of progression rather than something else entirely.
The moment a framework becomes standard, it begins producing the thing it was designed to find.
This logic appears everywhere diagnosis requires interpretation rather than detection. The radiologist reading mammograms, the psychiatrist distinguishing depression from grief, the teacher identifying learning disabilities from behavior. The moment a framework becomes standard, it begins producing the thing it was designed to find. Applegate had access and visibility to overturn hers, but most people simply inherit the story they were told.
