Dr Jeff Rediger,  Harvard Medical School (2020) Cured: The Remarkable Science and Stories of Spontaneous Healing and Recovery.

Printed on a postcard, My Wife and Mother-in-Law, and distributed as a novelty by an unknown French artist (1888). They are both in the picture; find them? (p254-5). An old woman with a hooked nose, and her chin tucked into her fur coat is in one picture. The elegant young woman in the other. Initially, I couldn’t see the old woman, just the young. I tried rotating it. Blocking out parts of the picture and concentrating on where her long chin was supposed to be, resting on the furs. Then I could see her. I could see both pictures. Switch-shifting attention from one to the other. Miracles are like that. Although Dr Jeff Rediger doesn’t call them that. He was looking at the outliers in conventional medicine. Things that weren’t reported in respected journals because there was no scientific way of explaining spontaneous healing and recovery. It was seen as akin to quackery, and more importantly trying to report it could destroy a research doctor’s career. That’s why underneath the author’s name, in smaller font, are the words: Harvard Medical School.

What Dr Jeff Rediger is saying is hey, I’m one of you, one of the establishment. But also signalling to us outside the establishment, hey, I’m also one of you. If covers of books could wink, that is what he was doing.  There is a checklist and a story attached that reads like a Greek saying: ‘Live each moment of your life as if it were your last’ (331).

So what’s the science and what’s the hoo-ha? I’m old enough to remember the cure for cancer was carrot juice and coffee enemas. And those that died were the unpure, the unbelievers that didn’t believe enough or purge enough. Only the virtuous survived.

Rediger begins with some self-help philosophy of Soren Kierkegaard: ‘There are two ways to be fooled. One is to believe what isn’t true. The other is to refuse to believe what is true.’

Bad guys and good guys. Everything’s connected. The head rules the heart. The heart rules the head. Our stomach rules the heart, rules the head. Rediger is a medical doctor, but he also trained as a theologian. He visits healing centres in rural Brazil because he hears of miraculous cures of killer diseases.

Bad guys. Inflexibility. Not being willing to change. Takes you on the same old path of least resistance that’s killing you.

Good guys. ‘I accept your diagnosis, but not your prognosis.’

Scepticism is a cousin of inflexibility. It’s part of the medical condition. Don’t prove me right, but try and prove me wrong. If nothing can be done, nothing will be done.

In Oprah speak, ‘When we know better, we do better.’ (p343).

But certain ways of thinking can be addictive. Thought patterns, habits, ways of behaving.

Bad guys, a dismissal of spiritualism.

Good guys, an active seeking of meaning in your life. A strong will to live. Embracing your new vision of a new life.

Case study, Opening the lines of communication: How to talk to your immune system.

26-year-old Daniel, embryonic cell cancer or the testicles. Prognosis, ‘Weeks’ to live.

Therapist asked him what he wanted to do before he died?

‘I want to get ordained and married.’

You know what happened next. Documented case of spontaneous remission. He embraced his new vision of life.

‘We know that the nervous system and the immune system are, in fact, intricately interwoven… Neuroreceptors were believed to be limited to the brain and nervous system until Candice Pert, often called ‘the mother of psychoimmunology,’ discovered the presence of neurotransmitters and neuropeptides in the walls of cells of both the immune system and the brain… they’re a way for the nervous system of communicating cell to cell… meaning whatever’s going on in your mind is being broadcast directly into your immune system… Our emotions talk to our immune system’ (p53).

‘Good’ bacteria. 100 trillion bacteria that live in your body, each with their own DNA.

80% of your immune system cells are in your gut.

Antibiotics wipe out ‘bad’ bacteria. Can impact your gut bacteria for up to a year. (pp55-56).

The secret to health, killing the germ? Destroy the microbe. From Silver Bullets to Superbugs.

Preparing the soil (yourself) for spontaneous healing.

Case Study, Clare Haster, pancreatic cancer, went home and began to prepare to die.

Changed her diet, gradually, from foods that left her fatigued, with Irritable Bowel Syndrome, to more plant-based foods.

Something shifts that allows the immune system to do its work.

‘Everything we put in our bodies affects our terrain.

The strength of your team of natural killer cells and other disease-fighting cells within your immune system are linked not only to what you eat, how you exercise, and other lifestyle choices but also how you manage stress, relationships, old traumas, what you believe, and how you see and understand yourself’ (p65). 

Hippocrates (Do No Harm) but also ‘All disease begins in the gut’ (p75).

Eat to Heal (chapter 3)

The person who takes medicine most recover twice. Once from the disease and once from the medicine William Oder, M.D.

‘Every day we are bombarded with conflicting messages about what we should eat’ (p75).

Michael Pollan, In Defence of Food (2008): ‘Eat food, not too much. Mostly plants’(p76).

He meant the kind of food your grandmother would have recognised. That rots. Not processed foods that looks and tastes the same a decade later. No sugar. Very little salt.

What we eat is deeply ingrained. Like any other of our addictions.

Anti-cancer diet takes out processed and salty foods. Gravitates towards whole-foods.

Case study. Tom: ‘I ate more Burgher King than anybody alive’ (p81).

Type-2 diabetes. Insulin, saved millions of lives, but causes weight gain, which worsens insulin resistance. Spiral continues  (p82).

Dr Joel Fuhromon, The End of Diabetes.    Eat highly nutritional food, loaded with vitamins, minerals and phytochemicals, but low in calories.

Notice how Tom uses the language of addiction, ‘I don’t feel the need…The cravings were gone’ (p87)  Burger King was gone.

‘Detox from years of accumulated toxins’ (p87).

‘Claire has made it a rule not to share the specific menu she followed after her diagnosis. Obviously, what worked for me didn’t work for [everybody]

I believe each of us responds to and needs different things…I don’t believe there is any silver bullet out there for everyone. We need to find out what works for us individually’ (p90).

‘A study with mice at Georgia State University established a disturbing correlation between emulsifiers and cancer. Emulsifiers are ubiquitously present in everything from mayonnaise to ice cream…added to extend shelf life and ‘improve the mouthfeed’ [taste]

FDA limits how much of an emulsifier can go in a product, but companies dodge this by using different kinds of emulsifiers.

The Georgia study suggests disrupted the microbiome and triggering chronic inflammation, emulsifiers may contribute to weight gain, inflammatory illnesses, autoimmune disorder and even cancer’ (p91).

T. Colin Campbell, The China Study (2005) link between diet and disease. Western diet, rich in meat and dairy, disease-creating diet (p94).

‘Individual nutrients matter less than the overall diet. Occasionally eating a bit of dairy didn’t seem to increase disease risk in the Chinese population, but they truly did eat only a very small amount. Mere ounces of pork to flavour soup…’(p95).

Case study, Pablo, Stage IV tumour, glioblastoma. Ketogenic diet. Most people find the keto diet difficult to adhere to because it’s extremely specific and limiting.

‘He started with a few days of fasting, a quick way to achieve ketosis—a metabolic state where the body deprived of glucose (which cancer cells feed on) begins to break down its own fats. Once he achieved ketosis, he switched to the standard ketogenic diet. He maintained ketosis for the next three years’ (p101).

Chapter 4, Shut down the disease superhighway.

Hippocrates: Before you heal someone, ask if he’s willing to give up those things that make him sick (p111).

‘In the short-term, there’s nothing wrong with treating symptoms.’

‘The so-called lifestyle illnesses—cancer, heart disease, stroke, lung disease and diabetes—are the top causes of death and disability in the United States, and they account for 75 percent of all health-care spending’ (p116).

Death due to dementia more than doubled from 2000 to 2015. And there’s depression, announced by the World Health Organization (WHO) in 2017 as the leading cause of ill health and disability worldwide. More than 300 million people worldwide are living with depression, according to WHO estimates, and that represents an increase of more than 18 percent between 2005 and 2015. People who are depressed have less robust immune systems and are vulnerable to more illness in general and poorer recoveries (p116).

Chronic inflammation comes from how we think, how we feel, how we live (p217).

Case study: Juniper Stein, ‘a picture of health’ (pp117-

Her back started bothering her.

Incurable, autoimmune disease.  Over a 100 autoimmune disorders. Characterised as ‘inflammatory disorders’ (p125).

When your immune system is your own worst enemy. (p124).

Link between chronic stress and inflammation. Study found alter genes of immune system, which help determine a cell’s function. (p126).

1) Get rid of processed foods and sugar which fuel the inflammatory response.

2) Look at personal stress triggers.

3) Larger life overhaul.

‘I accepted the diagnosis,’ she say, ‘but not the prognosis’ (p130).  

‘But there were a lot of wrong turns,’ (p135).

‘An anti-inflammatory lifestyle is ultimately based on changing your relationship with your body’ (p136).

Chapter 5, Activate Healing Mode.

‘We can either change the complexities of life—and unlikely event, for they are likely to increase—or to develop ways which enable us to cope more effectively.’ Herbert Benson, (p139).

  Fight or flight?

Benson suggested stress the invisible killer in heart disease (in all disease?)

Case study, Jan Shaw (p143-

The woman in the photograph was overweight and obviously ill.

Sick as a teenager…aged 25 ruptured a disc in her back.  Aged 28, diagnosed with dry nerve root.

Jaw implant…that didn’t work.

Misdiagnosed for decades. Nothing worked. Lupus progressed to her brain. Renal failure. Multiple organ failure.

‘Spiritual healing?’ A centre in Brazil.

‘I poo-pooed it,’ she says ‘It sounded crazy.’ (p147).

Within ten days she was off the drugs she’d been taking for decades (p149).

Mediation and relaxation breaking the fight/flight response

‘We now know that mediation can literally change the shape of the brain’ (p151).

The stress conundrum, can’t live with it, can’t live without it.

Autonomy and how you perceive stress. More autonomy of job/life/ relationships the less flooding of body with stress hormones, less inflammation and wear and tear, less heart disease.

Jan Shaw: ‘I’m a different person now.’ (p171).

Chapter 6, The Healing Heart.

‘The body is the instrument of the mind…the mind is the instrument of the heart’ Hazrat Inyat Khan (p173).

‘You can teach yourself how to shift into parasympathetic mode by managing stress, eliminating stress, or changing your lens on stress’ (p174).

Case study: Matt. Glioblastoma multiform, the most aggressive form of brain cancer.

‘Matt first turned to diet as Pablo Kelly had. He read Beating Cancer with Nutrition and learned that one in five cancer patients don’t actually die from cancer—they die from malnutrition.’ (p177).  

‘It was love that healed me,’ he says with conviction. ‘To me that’s what God is, that’s what life is. That’s what getting better is, it’s love.’ (p182.).

‘Our narrow concept of love could be making us sick. In her book on the topic, Fredrickson makes the bold claim that our fixation on the ideas of love as something that can only be shared in long-term, intimate romantic relationships shows “a worldwide collapse of imagination”.’  (p186).

Survival of the fittest or the kindest? (p189).

Social connection, a more evolved strategy than fight or flight. (p193).

Heartbreak?

Something we talk about metaphorically; we don’t actually believe our heart can break like a dropped vase.

Case study: Joanie Simpson (p197).

Heart attack. Doctors expected to find blocked arteries that they would have to prop open with a stent, but they were crystal clear.

An intense flood of stress hormones, stun the heart. (p197).

(p.199) we know the vagus nerve is activated by compassion for others, compassion for the self…love.

Chapter 7. Faith Healing and Heating Faith.

‘It is better to believe than to disbelieve; in so doing you bring everything to the realm of possibility.’ Albert Einstein. (p205).

Case Study: Dr Nemeh (faith healer).

‘Dr Nemeh has detractors, people who believe he is a false prophet, peddling a fantasy. But when you witness the sheer number that flock to be treated by him and listen to their stories of hope and recovery…There’s a down-to-earth practicality about him that, as a doctor myself I find refreshing; though he believes fervently in the power of prayer, he also advises those to come to him to continue seeking mainstream medical treatment.’ (p207).

‘Gallup polls, nine in ten Americans say they engage in prayer, and three out of four pray daily.’ (p208.)

Leanard DeBenedictus whose bones were literally dissolving after working for decades with toxic chemicals. Many of his co-workers had died.

“God wants you healed.”’  (p209-210).

(p214)’ Dr Nemeh’s patients believed their healing came from God and that Dr Nemeh was their conduit.’

‘Faith the assurance of things hoped for, the evidence of things not seen’ (p219).

Chapter 8. The Power of Placebo.

‘In the theory of relativity there is no unique absolute time, but instead each individual has own personal measure of time that depends on where he is and how he is moving.’  Stephen Hawkins. (p228).

Placebo>L> ‘I shall please’.

Case study. During World War II, Doctor Henry Beecher.

A field surgeon he ran out of morphine. He didn’t want to tell men in excruciating pain that he couldn’t help them. In a remote battlefield surgery tent, he rigged up an IV of saline solution, hooked it up for his suffering patients and told them it was morphine.’ (p230).

‘40 percent of the men reported a ‘significant’ decrease in pain.

Today, going into any kind of research study on the efficacy of a drug, the expectation is that a full 35 percent of participants will experience a strong placebo response. (p230).

And it’s important to remember that 35 is the average. The range is actually between 10 and 90 percent depending on the specific illness and the particular medical treatment being tested.’ (p230).

Case study. Knee arthroscopy in the United States makes up $4 billion of health-care spending.

But when researchers ran studies to compare the outcomes between an arthroscopy and a faux arthroscopy (in which the surgeon makes an incision during ‘surgery’ but repairs nothing so the patient only believes he’s had surgery) it was revealed that there was no difference between the actual surgery and the sham surgery [to reduce pain and increase the client’s range of knee movements] (p230-231).

Case study. Mr Wright (1957) The Wonder Drug that Wasn’t. (p237).

Cancer patient, end stage. He struggled to breathe.  He’d read about a new miracle drug and begged his doctor to try it.

As soon as his hospital received a shipment he got a first injection.

Three days later, his doctor returned to work on Monday morning to find him out of bed, breathing easily, walking around the ward, joking with the nurses.

A written report noted his tumours had ‘melted like snowballs on a hot stove.’ (p232).

He was sent home.

A couple of months later, some stories hit the news about Krebiozen not being an anticancer miracle drug…but a fake quack remedy.

When Wright read this he suffered an immediate relapse.

His doctor told him on his deathbed, the report was false and he’d received a new, retooled, ‘double-strength’ version of the serum.

After one injection the tumour melted away again. But this time, Wright’s doctor hadn’t even injected him with actual medication…it was water.

Mr Wright enjoyed two months of robust good health. He went back to his life. And then he read another report in the news. Krebiozen was debunked, definitely, as a cancer treatment.

He relapsed immediately. He died within days.’ (pp292-293).

Beyond Placebo (p237).

Case study: Stephen Dunne (2011)  multiple melanoma, multiple remission. (pp237-240).

The Quantum Physics of the Body. (p241).

Quantum physics is essentially the study of the building blocks of matter. (p242).

Some reserachers are asking if MRI technology can do more than imaging?

[eg]

A placebo-controlled study found that people who were exposed to particular MRI experience marked improvements in mood (p243).

Dr Michael Rosen using MRI as a treatment for depression.

{but} more questions than answers. (p244).

The Observer Effect.

Richard Feynman’s observation. ‘If you think you understand quantum physics, then you don’t understand it.’ (p248).

Case study: the double-split experiment. (pp245-247).

Picture a tennis court. Enclosed with fences. Two open doorways equally apart.

You start throwing tennis balls at the wall in the middle, with the doorways in it. Some of them are going to miss the doors and bounce off the walls (or miss the walls and bounce off the doors).

Others will go through and hit the fence.

The double-slit experiment did the same thing, but with an electronic beam gun. It fired (single) electrons at a wall with two slits in it.

But the particles didn’t bounce off the wall like tennis balls at predictable angles (as the laws of physics and motion would suggest).

Instead, they took on properties of a wave between the slats. (no beginning, no middle, no bounce).

Physicists placed a ‘camera’ to film this response.

Particles stopped their wave-like behaviour and ‘bounced’ again and hit the fence in predictable ways.

‘It was like they knew they were being watched.’

‘The observer effect suggests, perhaps, that we are each the observer for our ongoing experiment… create the reality we see and touch’. (p247). 

When Belief Runs Deep. (p250).

A placebo works even when you don’t believe it will.

Paul Tilich: ‘Everyone has an ‘ultimate concern’ around which we organise our entire lives.’ (p251).

When we receive a pill that we know is a placebo and therefore chemically powerless to therefore help us—we nevertheless feel better when we take it. Why? Because we feel cared for…It might be everything from the doctor in the white coat dispensing the pill to the sensory experience of the being in the doctor’s office (p251).

Michael Polayni, the chemist turned philosopher called this ‘tacit knowledge’, very distinct from explicit or conscious knowledge. (p251).

When it comes to belief and its role in healing, the most important question may be: What do we believe about ourselves?   (p253)

[who are we? What are we?]

Chapter 9, Healing Your Identity.

‘Guilt results from unused life, from the unlived in us.’ Ernest Becker (p254).

Case study, Mirae, Too Busy to Be Sick. (p259)

Looking back, always sick, never healthy. Chronic Lyme disease from a tick bite.

Metastatic melanoma.  

(p264) primary site, where the mutation starts, somewhere cutaneous on the skin. You might notice an unusual skin lesion or mole.

‘the cancer that kills you be millimetres,’ (p265).

Before her diagnosis time had seemed infinite—like an ocean. You could scoop up a bucketful and there was always more (p268).

‘What hit me hardest,’ Mirae says, ‘was that I was out of time to rewrite things.’ (p268).

The Importance of Your Story.

The black box of spontaneous healing.

The black box I’m talking about isn’t just a metaphor. It’s real.

A more scientific name is your default mode network (DMN).

‘The DMN is basically a collection of loosely connected regions of the brain, both older structures deep in the brain and newer ones in the cerebral cortex, which are activated, or light up, when you engage in certain categories of thinking.. (p269-270

The DMN is more active when you’re not focussing on elements of the outside world but instead are turning on a more introspective mode. It yearns for narrative, helping us compose our story of who we are by linking the past with the present and what we consider possible or likely for the future.’

The idea of the DMN is relatively new in neuroscience.

Any definition should include the prefrontal cortex (locus of planning, decision-making and behaviour regulation.

The cingulate cortex (part of the limbic system, tasked with emotion and memory function).

Inferior parietal lobe  ( in charge of interpreting those formed emotions and processing language and sensory information).

Your person>reality< personality?

The me network.

It’s who you are (p270). 

How much did you weigh when you were sexually active? [Freudian slip of the tongue]

Professor Vincent Felitti, Preventative Medicine [what’s in your black box?] (p271…]

People were dropping out of the weight-loss clinic not because they were losing weight, but because of it.

‘Overweight is overlooked and that’s the way I want to be.’ (p272)

Felitti and Richard Anda, a leading epidemiologist, identified ten types of childhood stress.

Adverse childhood experiences (ACE). > disrupted neurodevelopment> Disease causing behaviour (correlation does not equal causation).

Strong links between childhood traumas and present-day illnesses existed across multiple types of experiences and multiple categories of disease (p272).

Best treatment, early intervention (p275).

Getting Out of Your Default Network. (p277).

Healing is less about what happens on the outside. (p280).

Some people use meditation or yoga to get out of their default network [some people get pissed]

Chapter 10. You are Not Your Illness.

‘Everyone is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid.’  Albert Einstein.

The power of perception.

cf. McGurg effect. What you taste and hear. (p282).

Taking off the mask of illness. (p304)

A central paradox of the whole situation is you can’t force a ground shift to occur.

We can’t force these flashes of insight. (any more than we can force ourselves to see the hag or elegant young women in the same postcard).

Chapter 11 Healing death. (p309).

‘Physician heal thyself.’ Luke 4: 23.

Why was I still alive?

Facing death can be a pivotal moment in life. (p312).

The denial of death is programmed into us at every level.

Refusing to die on schedule.

Case study, Lula Wang’s grandmother, feisty matriarch. (p316

Three months, maybe less to live.

The family refused to tell her. Stage IV lung cancer.

The family expected her to decline quickly and pass away. But she just…didn’t.

A year after her ‘expiration date’. She refused to go for her medical. Another year, and when she went to the doctor the diagnosis was the same, three months to live. (p317). 

The years went by and nothing changed. Her body, it seemed, hadn’t got the message she was supposed to get sicker, so she didn’t.

There’s no real consensus that emerges from research on withholding diagnoses (blissful ignorance or defence of ignorance). (p318).

(p321) How running for death runs us down.

It might not come as a shock to find that hospice care can extend life.

The earlier you enter the hospice the more it can extend your life. (p323).

Every story has an ending. Spontaneous remission doesn’t mean cured forever. (p324).

Chapter 12. Burn Your Boat.

‘I had the feeling there would be no harm, no shame, no judgement if I wanted to be done. But also that if I wanted to, if I chose life, it would be hard work.’ Mirae Bunnell metastatic melanoma. (p332).

Cunnigham’s (2002) study. Those that survived longer.

1) willingness to radically change habits, routines and

2) even the larger scaffolding of their lives (p338).

‘get up and go’ might be related to survival or remission.

Conditions associated with poor survival outcomes.

1) Inflexibility associated with low self-esteem or fixed world view.

2) Scepticism about self-help techniques, or a limited ability to apply them.

3) Other activities seemed more immediately appealing.  

4) Meaning was habitually sought outside the individual from some external source.

5) Strong, contrary views about the validity of spiritual ideas.

Conditions associated with longer survival:

1) Strong will to live.

2) Actual changes in habit of thought and activity.

3) Relaxation practices, meditation, mental imaging, cognitive monitoring.

4) Becoming involved for a search for meaning in one’s life. (pp340-341).

They fill the hole in the soul

You can too be Cured. The Remarkable Science.

The mad, the bad and the sad. Your number’s up.

Suzanne O’Sullivan (2015) It’s All in Your Head. True Stories of Imaginary Illness.

ghost maps.jpg

I like stories of imaginary illnesses. Dr Faraday in Sarah Waters The Little Stranger errs on the side of caution and attributes a collective form of psychosomatic illness to the aristocratic Ayre’s family staying at rundown Hundreds Hall, and the subconscious as place and time combine, the equivalent of old cartographers whom declared this be the end of the world, here be ghosts. The coroner at Caroline’s death was quite happy to accept that she died while her mind was unbalanced. I thought it was her body that toppled over the balcony, but there you go, it was her mind. The two are inextricably linked.

Wilkie Collins in The Woman in White has private asylums, doppelgangers and rich hypochondriac uncles that can’t bear loud noise, or indeed most everyday noise, as key parts of his plot.

Suzanne O’Sullivan touches on The Devils of Louden and it’s clear that she doesn’t think there was anything devilish about them. O’Sullivan calls for a compassionate response to those suffering from illness, whether mental or physical, because one impinges on the other. Fling in Abigail Williams from The Crucible. It takes more than one to cry witch, to be heard and collective responsibility must be taken seriously. One of my favourite stories wasn’t directly about the sad, the mad or the bad, but the gullibility of the rich for new fads.

I’m biased in that way. Those that could afford a nurse and private asylum in Collins’s time would be treated far better than those in Bethlem Royal Hospital that coined the term Bedlam.  Just before the start of the First World War a young Winston Churchill was calling for the creation of purpose-built asylums where feeble-minded men and women could be segregated from the general population. Sterilisation of women would be compulsory to ensure they did not reproduce. These measures were introduced in some American states. Eugenics is a rallying call against the poor. I like to listen to rallying calls against the rich. If you want to look at how the poor were treated during the First World War for shell shock Pat Barker’s Regeneration novels shows the dichotomy of how anthropologist, ethnologist, neurologist and psychiatrist W.H.R. Rivers treated officers of the ruling class at Lockhart hospital, most notably Siegfried Sassoon and Robert Graves, and how Rivers’s counterparts tortured working-class soldiers until they were reported fit for duty. Post-traumatic-stress disorder treated with electric shocks to make the blind see and the lame walk is nothing new. If you’ve got an imaginary friend you better get on the blower to him quick style.

Julian Barnes short story ‘Harmony’ tells the story of a young musical prodigy Maria, born 15th May 175-. The child’s health was normal, until she woke up blind at the age of three and half. It was held to be the perfect case of amaurosis, there was no fault detectable in the organs of the eyes, but she was blind. Her condition was attributed to some fright the she received during the night. Her musical education continued and the blind infant prodigy was much sought after in royal courts throughout Europe. M—sought to cure her with magnetism, with some success, but Maria’s parents were not blind to society’s measuring rod and blind prodigy was a mere prodigy without her condition.

O’Sullivan notes that whilst psychosomatic disorders may be thought of an illness of perception, there’s no escaping the damning statistic that seventy percent of such disorders are suffered by women. She draws not just on local knowledge but a wide body of research. A 2011 German study, for example, showed that twenty-two percent of those attending the equivalent of our GPs had a somatising disorder. Somatising disorder means that although the illness the patient comes to get treated for is real enough for the patient those treating the patient can find no organic reason why he or she is presenting those symptoms. The World Health Organisation 1997 estimated that twenty percent of those attending their doctor had at least six ‘medically unexplained symptoms’.  More recent pilot studies in London confirms the WHO’s findings. They are the imaginary friend in the room with doctor and patient. Hollywood is good at this kind of thing. Think The Three Faces of Eve, but the patient has only brought two faces into the consulting room and is presenting with a bit of a cough. Some of the cases presented by O’Sullivan are highly symbolic and could be said to be straight forward. The woman that goes blind and is unable to keep her eyes open after her husband is taken to jail for abusing a neighbour’s child. Women that take pseudoseizures (or dissociative seizures) at work. The language is useful and how the patient describes their seizure has been modelled and analyses to differentiate between psuedoseizures and epileptic seizures. One behavioural, the other which can be accurately measured by EEG. With no increased electrical activity in the brain O’Sullivan asks and answers the question are they real? Yes and No.

O’Sullivan widens the scope to those outside her practice whom she has come into direct contact with. The estimated 250 000 reported cases classified as Myalgic Encephalomylitis (ME) and/or Chronic Fatigue Syndrome (CFS). Two million CFS cases are documented in The United States.  The disease or syndrome is real enough for those suffering from it. Each new case is looking for a cure, another test, another diagnosis.

The neurologist Weir Mitchell rest cure was a response to Charcot’s definition of hysteria in women extreme fatigue, but geared towards rich men in Philadelphia. The crème de la crème who were thinking too much and suffering from neurasthenia. Patients were force fed fatty foods to build them up. Discouraged from standing. A bedpan was brought to them for their toilet needs. They could not read. Have conversations, or have any type of stimulation. Although this sounds much like my local pub, they were charged extraordinary amounts of money for their cure. If the cure didn’t work, apply more cure.

Our government’s response is  predictable, a wooly response, to place wellbeing at the centre of their strategy; delay of the publication of critical report,  A Five Year Forward View for Mental Health; promises of more money for NHS Mental Health services, a mooted figure of £1 billion to ‘plug gaps in service’; whilst as Daniel Boffey notes ‘incentivising’ the 250 000 with recognised psychiatric conditions to find work by cutting currently classified as disabled from £102.15 per week to 72.40 per week. Using the government’s template those with ME or CFS could be ‘incentivised’ to be cured by cutting disability payments to a more manageable figure of £0.00.

As O’Sullivan notes most ME/CFS sufferers have good reason to be defensive. Whether in or out of employment, they are regarded as the shirkers of the medical system, using up valuable resources that could be used better elsewhere. The government diagnosis of a personal defect poor people suffer from that can be instantly cured by them finding a job and the cynicism of medical staff that grow weary of test after test finding no organic reason for illness and an increasing readiness to find the failing in the patient is a potent mix. O’Sullivan calls for ‘an open mind’ but that door is already closed.

‘Neurasthenia, hysteria, melancholia, depression, chronic fatigue syndrome, chronic fatigue immune dysfunction syndrome, myalgic encephalomyelitis, yuppie flu, dissociative seizures, psychogenic non-epileptic seizures.’

Hippocrates 200 AD suggested hysteria was too much or too little of something: black bile, yellow bile, blood or phlegm. If any of the four humours were in conjunction the trouble may be the master organ of the wandering womb and the sympathetic responses travelling in spirit form induced in the patient. I quite liked the nineteen-century idea of such conditions being down to engorgement of the nasal membrane, but then again I do have a big nose.

‘So now I’m a psycho, am I?’ asks more than one of O’Sullivan’s patients.

‘This is boring now, I think you should get better,’ Jo Marchant’s father says to his daughter in an extract of her memoir Cure.

As O’Sullivan notes, ‘In the twenty-first century psychosomatic illness is a socially unacceptable disorder’. The media plays its part in carrying the symptoms that are spread throughout the general population. But on the bright side we no longer burn people as witches.  Of course the condition, syndrome, illness or whatever label you want it put on it is a matter of perception and the votes are in. Any right-thinking type would know who can be cured will be cured, the others are psychos. In the same way the First World War the Krauts or Bosche needed more cold steel right up them to be pushed back patients with ME/CFS are a small minority of shirkers that need to find work is finding increasing traction. She is a voice of reason, but she is drowned out by those with louder voices, big sticks and the ability to push their agenda through. When we are told it is not a question of money, we can be sure it is.  O’Sullivan tells us ‘laughter can be therapeutic’. Ha. Ha. That sounds like a cheap option, but more tests will be needed.