Lyme Disease

And Frank Zappa.

The Baltimore Sun’s report about Johns Hopkins researchers’ plans to study chronic Lyme disease indicates that yet another disease that many doctors don’t believe in is passing into the realm of respectability.

Lyme disease is an infection caused by a spirochete, a type of bacteria that is usually corkscrew shaped.

Polly Murray, a housewife in Lyme, Conn., was the first person to be diagnosed with Lyme. Before she was diagnosed, many of her doctors considered her a flake, and she was even admitted to a psychiatric unit because of the inexplicable constellation of symptoms she presented and her persistent demands that someone figure out what was wrong.

Lyme disease is well recognized today, if difficult to diagnose. It is established that it is transmitted by a tick bite and pretty treatable with antibiotics.

But the medical profession continues to blow off some patients as being crazy, or hypochondriacal, because there’s no explanation for what is wrong with them.

There are many seriously frustrated patients with things no one can diagnose. And such patients often get labeled as “difficult.”

This blinkered vision for illnesses we don’t understand applies to a lot of pathologies, or possible pathologies, conditions people swear they’re suffering from, but which not a few doctors “don’t believe in,” or think are mainly a manifestation of the patient’s craziness.

You might think medicine is a science and an illness either exists or it doesn’t and that doctors “believing” in something is more appropriate to fairies or ghosts. But you would be naïve.

Gluten intolerance, vitamin D deficiency, chronic fatigue syndrome, female sexual dysfunction and “low T” (testosterone) in men are all in the “might or might not” exist camp.

We had a doctor in the group I was with (he didn’t stay for very long) who refused to see patients with fibromyalgia because he didn’t believe in it. And a lot of people consider irritable bowel syndrome to be a bit “iffy.”

But chronic Lyme disease, not to be confused with Lyme disease itself, is probably at the top of the list.

A lot of patients who don’t get better with standard antibiotic treatment and a subset of so-called “Lyme-literate” doctors, believe the disease can turn chronic. Opponents claim this is all nonsense, and that supposed “chronic Lyme” patients are just flakes.

The battle between the two factions has been acrimonious.

Skepticism about the existence of certain conditions is fired by the fact that drug companies will, if they have a product to sell, if not contrive an illness, at least grossly overplay its importance.

Osteoporosis and depression have been heavily promoted by the manufacturers of antidepressants and the osteoporosis-treating bisphosphonates. And you can bet you’ll get to hear a lot more about female sexual dysfunction, or Hypoactive Sexual Desire Disorder, when and if the fibanserin, the “female Viagra” to be marketed as Addyi, finally gets approval by the FDA.

So it’s interesting, and heartening, that Johns Hopkins is setting up a center to study chronic Lyme disease and look into the idea that it may not be a persistence of the spirochete causing the problem. (Note that Lyme-literate doctors have been prescribing massive doses of antibiotics taken, at great expense, over months or years which insurance companies have been refusing to cover).

The new theory is that the acute infection sets up some kind of autoimmune condition that causes the joint pains, fatigue, heart and nerve problems.

The history of medicine is replete with examples of the medical establishment pooh–poohing new ideas, not infrequently to our detriment.

To paraphrase the quote attributed to Frank Zappa, among others, “A mind is like a parachute. It works much better when it’s open.”


Dr. Patrick Neustatter, a longtime family practitioner, is the medical director of the Lloyd F. Moss Free Clinic.


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