TY - JOUR T1 - Shame, stigma and medicine JF - Medical Humanities JO - J Med Humanit SP - 208 LP - 210 DO - 10.1136/medhum-2017-011392 VL - 43 IS - 4 AU - Barry Lyons AU - Luna Dolezal Y1 - 2017/12/01 UR - http://mh.bmj.com/content/43/4/208.abstract N2 - “As a young physician in the mid-80s, caring for people who had contracted HIV, I lost two of my patients to suicide at a time when the virus was doing very little harm to them. I have always thought of them as having been killed by a metaphor, by the burden of secrecy and shame associated with the disease”.         Abraham Verghese1 When, in the late 1980s, the psychiatrist Donald Nathanson organised a symposium on the nature of shame, it turned out to be the first such event to deal with the subject in the history of psychiatry or psychoanalysis on either side of the Atlantic. It seems strange that such a ubiquitous emotion had excited so little academic interest to that point, but as Nathanson points out—shame makes us so uncomfortable that we will go to great lengths to avoid it.2 Yet, despite our efforts to ignore it, shame remains universal—there can be few of us who have not been seared by shame at some stage of our life. In fact, some philosophers argue that shame is inescapable in human experience, a fundamental part of child development that textures personal, social and political aspects of adolescent and adult life.3 4 As Tanner states (when responding to an accusation of impudence) in Shaw’s Man and Superman:“Yet even I cannot wholly conquer shame. We live in an atmosphere of shame. We are ashamed of everything that is real about us; ashamed of ourselves, of our relatives, of our incomes, of our accents, of our opinions, of our experience, just as we are ashamed of our naked skins”.5 The prevalence of shame in the medical clinic was identified by the physician Aaron Lazare around the same time as Nathanson’s symposium. Lazare proposed that patients were at a … ER -