Team Science

 

Recently Dr. Dennis Mangan, retired NIH chair of the ME/CFS Research Working Group, penned a problematic piece with the convoluted title “Writing an NIH grant application—Team science: Playing in the same sandbox.”

Mangan delivered the news that ME deserves research. The anticipated “but” arrived in no time with the word “regrettably” as in “Regrettably, Congress is now talking about a decreased budget for non-defense related ‘discretionary’ expenses… such as NIH-supported medical research. The success rate for applications is likely to decrease. Opportunities for additional research on ME/CFS will be lost.”

Pass the potatoes. I should add that I once worked for a boss who couldn’t give me a raise but had a wastebasket worth $14,000.

Mangan went on to discuss how researchers working on a team science project should “know their collaborators,” get input in the early planning stages, decide who should be a “team leader,” and get “everyone fully committed to the project.” Who the hell is this piece for?  Children? You know, when my niece was about 5 years old, she saw a photo of the Backstreet Boys on the cover of my Entertainment Weekly. Pointing to their white T-shirts, she said shrewdly:  “Those boys are on the same team.”  

With what passes for wit in the government, Mangan drove home his point by including a lame T-shirt in his piece:

In a follow-up letter came Mangan's inevitable catch-22:  Until we have a "breakthrough" about ME, the government won't throw any meaningful money at it.

In my view, the only redeeming things about the Mangan missive were the brilliant, piercing letters by ME patient Matthew Lazell-Fairman and CFIDS Association board member Jennifer Spotila. In particular, Lazell-Fairman discussed the concept of “will”—or the lack of it, when it comes to the government’s longtime lip service to ME. 

In her letter, the CFIDS Association’s Kim McCleary hurled a bunch of statistics, always guaranteed to bore readers to death. I have no recollection of any of it, as I had to hold my head to keep it from exploding. Please stop doing this, Kim. See the forest through the trees.

A man I used to sleep next to had the bizarro habit of squirming uncontrollably before falling asleep, making it impossible for me to fall asleep. So we devised a code word for keeping still: “tomato.” And he’d remain blessedly still until I slipped into unconsciousness. I have no idea how we arrived at “tomato,” except that we both loved Jersey tomatoes (with coarse sea salt), so it conjured pleasant thoughts.

Maybe ME patients need a code word for “cut the crap,” when it comes to government mumbo jumbo. What should it be?

The Blood Became Sick

A disease discovered about eight years ago is spreading in Asia and parts of the United States. Its victims, most of whom are Asian, are HIV-negative. Their immune systems are paralyzed due to the body churning out autoantibodies that inhibit gamma interferon, which fights infections. For more:  click here.

The Secret Files

Slogging through the sealed U.K. ME files that have finally been released isn't exactly like combing through Girl with the Dragon Tattoo material. But a few of the many entries--most of which concern disability eligibility--may prove illuminating, despite the fact that the patronizing author of what may be the most problematic entry is unknown: The beginning of the letter and signature are missing. The mystery writer intones, "It is important to avoid anything that suggests that disability is permanent, progressive or unchanging. Benefits can often make patients worse." 

Next, psychiatrist Simon Wessely penned an enlightening letter, writing to the Department of Social Security on June 10 of 1993 that ME is a psychiatric disease but that its "powerful lobby group" has earned ME a coveted slip in the neurological harbor.  Explains Wessely:

"I  regret to say that it seems to me that in order to be fair to the ME Association you have now gone to the other extreme. I am disturbed that this disorder should be listed as a neurological disease. I enclosed an editorial that I had written last year for a neurological journal reviewing the evidence on this subject, and concluding that there was little to point to a neurological origin of symptoms. Since then more research has been published in the leading neurological journals, and nothing has happened to alter those conclusion [sic].

"Instead I feel this decision represents the triumph of an effective lobby over scientific evidence. If CFS/ME is to be listed as a neurological disorder, I for one will begin to campaign via the mental health charities for schizophrenia and manic depression to be also listed under the same heading. Indeed, there is far more evidence suggesting that these disorders have a neurological origin than does CFS/ME.

"I also feel that this decision, if it has been made, reflects an undesirable stigmatisation of psychiatric disorders. The main difference between CFS and the major psychiatric disorders is neither aetiological, nor symptomatic, but the existence of a powerful lobby group that dislikes any association with psychiatry." 

PLAY IT AGAIN, AND AGAIN AND AGAIN

  A New ME Outbreak?

A group of mostly female students aged 12 to 19 in San Antonio, Texas, have come down with a constellation of symptoms physicians are terming unusual. Those symptoms include chronic fatigue, headaches, nausea, vertigo, stomach problems and seizure-like activity. In a recent news segment by San Antonio reporter Sarah Lucero, a mother of one of the girls said that one doctor accused her daughter of faking it—because the symptoms are so uncommon—and urged psychiatric care.

In the segment, other diseases that afflict teenagers are mentioned, including “chronic fatigue syndrome, postural tachycardia syndrome or POTS.”

When will doctors get it that POTS often goes hand-in-hand with chronic fatigue syndrome and that these Texas students probably have CFS?  Perhaps when the name CFS is changed to Myalgic Encephalomyelitis (ME) or something else that explains how serious this disease really is.

One bright light: The San Antonio illness is being termed “neuroimmune syndrome.”

Has CDC gone to San Antonio to investigate?  My bet is no.

Sadly, the mother of the teenage girl in the piece is taking her daughter to the Mayo Clinic for help. Perhaps more than any other hospital in the United States, the Mayo Clinic is known for its dismissal and psychologizing of ME.  The most egregious example that I know of:  Back in the 1980s, Nancy Kaiser, who suffered from a severe case of ME—before she had a name for it—traveled to more than 200 physicians for help until she found ME-literate physician Daniel Peterson. One of her stops along the way was Mayo.

During the visit, Nancy had a seizure—she had multiple seizures every day before going on the experimental drug Ampligen—and fell off her chair. The Mayo physician kicked her and told her that she was faking it.  Nancy, of course, had no memory of the event, but her husband, Jim, who accompanied her, certainly did.  Nancy died of ME in 2008.

To view the San Antonio news segment, click here.

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My thanks to Zac for emailing the clip about the San Antonio students.