The Loss After a Diagnosis

Brandon Robbins
20 hours ago
3 min read

The Medical Naming of Death

(Including Disability, Disease, and Damage)

Within the Ds of Death framework, Diagnosis is not information. It is a declaration of loss.

Diagnosis marks the moment when medicine names an ending—of bodily continuity, assumed futures, identity, and agency—while the person remains alive. It is the point at which ambiguity collapses and consequence becomes unavoidable.

Disability, disease, and damage are not separate deaths within this framework. They are expressions of a single diagnostic death, differentiated only by speed, visibility, and duration.

Diagnosis as Threshold, Not Stage

Diagnosis functions as a threshold event, not a linear phase.

Before diagnosis:

Loss may already be occurring
Function may already be compromised
Grief may already be present but unvalidated

After diagnosis:

The loss is named
The future is restructured
Identity is medically reassigned
Life becomes conditional on systems and prognosis

Diagnosis converts lived experience into official reality. It is the moment loss becomes sanctioned.

Disability Under Diagnosis

The Death of the Assumed Body and Future

When disability is named through diagnosis, the death is not the body itself—it is the assumption of bodily reliability and continuity.

This diagnostic death includes:

Loss of predictability
Loss of autonomy
Loss of unexamined futures
Loss of the “default” self

Disability introduces a living death—one that does not resolve, does not conclude, and does not permit closure. Instead, the person must live alongside repeated confirmations that what was assumed will not return.

Grief here is recurrent and often socially denied.

Disease Under Diagnosis

Prolonged and Anticipatory Death

Disease introduces temporal instability into diagnosis.

Rather than marking a single loss, diagnosis initiates:

Anticipatory grief
Cycles of hope and collapse
Recurrent mourning at each progression

Each flare, decline, or complication becomes a secondary diagnostic event, reaffirming the original death.

This mirrors prolonged dying:

The person remains alive
Loss accumulates
Support erodes
Grief becomes invisible

Clinically, this grief is often misinterpreted as depression or resistance. Within this framework, it is understood as ongoing bereavement without an endpoint.

Damage Under Diagnosis

Sudden Diagnostic Death

Damage—through accident or injury—produces the most recognizable diagnostic death.

Here, diagnosis follows trauma and confirms a rupture:

A clear “before” and “after”
Sudden identity dislocation
Trauma fused with grief

The diagnosis confirms what the body already knows:the former self is gone.

This death is often publicly acknowledged in the immediate aftermath, then quickly abandoned once survival is secured. The individual is expected to transition from mourning to gratitude without ritual, containment, or time.

Diagnosis as Identity Reassignment

Diagnosis does not only describe a condition—it reassigns identity.

The diagnosed person becomes:

A patient
A case
A prognosis
A risk profile
A compliance subject

This produces secondary deaths:

Death of self-definition
Death of narrative authority
Death of privacy
Death of agency

Life becomes organized around appointments, assessments, eligibility, and adherence rather than desire or direction.

Diagnostic Language as Death Mechanism

Medical language carries finality:

Chronic
Degenerative
Progressive
Incurable
Permanent

These terms function as death notices, often delivered without ceremony, containment, or grief support. The person is left to mourn privately while continuing to perform survival and compliance.

Diagnosis delivers death without a funeral.

The Myth of Recovery Within Diagnosis

Diagnosis often introduces a false promise:that recovery means return.

When recovery is framed as restoration:

Grief is interpreted as failure
Limits are internalized as shame
The person becomes responsible for what cannot be undone

Within the Ds of Death framework, recovery is not resurrection. It is reconstruction after death.

Diagnostic Aftershocks Across the Ds

Once diagnosis occurs, it activates multiple secondary Ds:

Duty — life governed by care systems and compliance
Dismissal — loss of employment, role, credibility
Desertion — relational withdrawal and abandonment
Divorce — separation from the body and former identity
Disappearance — loss of normalcy and social belonging
Drugs — secondary responses to unacknowledged grief and pain

Diagnosis is therefore not an entry point alone; it is a structural reordering of life around loss.