Have You Remembered to Take the Coumadin? Life Trajectories and Invisible Work in the Narratives of Coronary Heart Disease Patients

This paper presents some results of a sociological field research study done in a cardiology rehabilitation ward. We studied how patients with severe coronary heart disease interpreted the illness’s disruption of their life course. Using patient narrative interviews, we studied the “disease trajectory”, how patients redesign their lives and how they put together the “breaking pieces of their biography” through the invisible work that takes place day by day. Looking at chronic illness from a trajectory perspective, we are able to highlight the illness in terms of a set of actions combining patients’ efforts, their kin and the health staff. We investigated how patients with severe coronary heart disease explained their experience before, during and after diagnosis and treatment. How did they face the problem of living with chronic illness, including household routines, emotional burden and occupational sphere? How did they cope with the new situation, and what material and symbolic resources were mobilised to manage and shape the new trajectory? Our research tried to answer these questions in relation to the Biographical Body Conception (BBC) chain. We paid attention to three BBC dimensions: biographical time, body conceptions and conceptions of the self. The combination of these three elements is the core of the BBC chain that is disrupted by chronic disease. We also investigated gender differences between those facing chronic illness and redesigning their lifestyles. Do men and women put together the pieces of their biographical BBC chain in the same way? What practices may be highlighted through what Corbin and Strauss have called “biographical work”? Do men and women mobilise the same resources? Do they adopt the same strategies? Do they manifest differences by developing new conceptions of the self?