Thirty years ago when a patient presented to a hospital clinic with unexplained fatigue, any medical school physician would have told the students to search for an occult malignancy, cardiac or other organ disease, or chronic infection. The concept that there is an entity called chronic fatigue syndrome has totally altered that essential medical guideline.
-- Byron Hyde, MD 2003
Dr. Hyde's comments reflect the experience of many patients: CFS is a convenient label to avoid having to figure out what's really wrong with the patient. As a support group leader, I see too many patients who've received the CFS label but have no idea what we're talking about when we start discussing the common neurologic symptoms of CFS; obviously, they've been misdiagnosed. (See Jodi's article, posted yesterday, containing numerous other possible diagnoses that might explain the symptoms.)
Dr. Bell noted in his book that calling a fatigued patient "depressed" satisfied the need to put a diagnosis in the records and obviated the necessity of doing research to find out the true cause of their symptoms. It didn't help the patient, but it got the doctor off the hook.
As Dr. Bell calls it, Game Show Medicine, as if the point were to be the first person to buzz in with a diagnosis, any diagnosis, instead of getting it right. Part of that is the fault of HMOs allowing only 7 minutes for a doctor appointment; part of it is that a lot of doctors were always the brightest kid in their class and it's in their nature to be the first to answer a question.
Dr. Elizabeth Dowsett observes "[ME/CFS researchers] should first be directed to papers published before 1988, the time at which all specialised experience about poliomyelitis and associated infections seem to have vanished mysteriously!" Coincidentally (or maybe not) it was in 1988 when CDC caused ME to vanish and replaced it with the notion of CFS. It wasn't politic to have another disabling viral epidemic so close on the heels of AIDS, so ME (and its apparent viral connections to polio) simply disappeared, and silly little CFS took its place, along with false assertions that there was no virus, no contagion, it spread via mass hysteria (which doesn't explain how people who'd never heard of the Incline Village epidemic were describing exactly the same symptoms).
As my fellow activist Steve frequently points out, because no one has been working on a vaccine, the CFS virus could attack anyone, anywhere. YOU could be next.
In fact, it's my experience that karma has a warped sense of humor; the thing I always hated most was being stuck in bed, and of all the disabilities that I could've gotten (e.g., blindness, deafness, losing a hand), the one I wound up with was the one I couldn't just take in stride, I had to take to my bed for weeks on end because I was too weak to stand. Since karma does have such a warped sense of humor, I wouldn't be surprised if some of the loudest CFS detractors and verbal abusers eventually wind up with the disease they made fun of. (It should be noted that the 1934 Los Angeles epidemic, the 1955 Royal Free Hospital epidemic, and the 1974 Mercy San Juan Hospital epidemic all affected numerous doctors and nurses; a surefire way to convince the medical community that the disease is real is to let them see their respected colleagues succumb to it.)
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