Wittgenstein's opening to Philosophical Investigations points to a fundamental crisis in scientific and medical research: When is there enough explanation of a phenomenon to consider it settled and definable? If a cluster of symptoms – say dizziness, itching, extreme fatigue and weakness – afflicts a group of persons working together, what kind of explanation is good enough? Is finding a food they all ate, or common exposure to a rare gas, or a common brain pattern enough to say, “Okay, that is it”? Or is locating a certain gene they all share, or a drug that relieves some of the symptoms enough? What if only four out of five share the characteristic? Or yet again, do we need the entire pathophysiology of each symptom?

The fact that different people answer these questions differently points to the social location of these questions. The very meaning of “definable illness” and especially the entailments of that definition – whether a person with symptoms receives help or blame or dismissal – depend upon who is doing the assessing, where they are doing it from, and within what regime of social good and compassion they are operating. We may not like the implication that a person is sick in one place but not in another, but socially this may be a fact.

In this paper I begin an ethnographic characterization of what is shared across a set of contested fields I call the new socio-medical disorders.