The Emperor’s New Clothes, Chronic Lyme Disease, and the Infectious Disease Society of America

Burton A Waisbren Sr. M.D. FACP
Founding Member and Fellow of the Infectious Disease Society of America

This essay will start with a definition of Chronic Lyme disease:  Chronic Lyme disease is a syndrome that results when individuals who have been inoculated with multiple microorganisms by infected ticks and who have not responded to an initial course of doxycycline develop extreme fatigue, intermittent fever, joint pain, muscle pain, brain fog, concentration difficulties, skin rashes, and in many instances symptoms of autoimmune disease to the extent that they impinge upon their quality of life. 

When one comes face to face with patients of this type in whom other diseases are ruled out, it is obvious that something serious is amiss.

It’s a conundrum why a group of respected physicians who are members of the Infectious Disease Society of America have not recognized this and have, instead, written a guideline that essentially denies that the syndrome exists.  This guideline has resulted in literally hundreds of patients unable to be treated for Chronic Lyme disease.

Conclusions regarding this conundrum may be: 
1) The physicians who wrote and signed the guidelines of the Infectious Disease Society of America may have seen what they expected to see in the manner of the populace described in the Hans Christian Anderson’s perceptive fairy tale, “The Emperor’s New Clothes.” 
2) Perhaps the authors of the guidelines had too much respect for authority and decided to sign the guidelines based on the opinion of some of the members of the society without having personal involvement in the treatment of the syndrome.
3) Perhaps they were unduly influenced by the expenses incurred in the many factors concerned in the empirical treatment of Chronic Lyme Disease.
4) Most probably they were influenced by controlled studies in the medical literature, which were based on Deductive conclusions rather than Inductive conclusions as described by Francis Bacon in 1622.  Have they forgotten the well accepted statistical dictum – absence of proof does not equal proof of absence.

Deductive conclusions in regard to Chronic Lyme disease are suspect because there is no way to prove that a person has Chronic Lyme disease.  Personal observations (inductive) are what has to be relied upon to conclude that an individual has Chronic Lyme disease.

In Hans Christian Anderson’s story, a little boy turns the tide by yelling out, “But the emperor has no clothes!”  At the present time we must await the time when many will yell out “These patients are sick!” 

This point will have to be proven by inductive observational studies of patients subjected to empirical treatment for chronic Lyme disease.   For these inductive studies to reach a level of scientific certainty great enough to indicate empirical multifactorial treatment of chronic Lyme disease, physicians will have to once again believe what their patients tell them.  To do this they will have to remove the “double blind” blinders put on their eyes by Claude Bernard in his monumental book of experimental medicine. 

The Internet will provide service in this regard if physicians who treat chronic Lyme disease will present to their colleagues and patients detailed case reports regarding this experience on the internet as well as in the medical literature.  Respected medical journals still reluctantly present case reports.  Unfortunately, when they do so they usually warn about anecdotal evidence.  In this respect isn’t it ironic that huge numbers of individuals strongly accept ideas based on anecdotes presented in religious tomes and serious literature.

Phillips, in a brilliant critique of the IDSA guidelines, has separated out numerous observational studies that suggest the occurrence of chronic Lyme disease as described in this essay.

For more:

~ by Rob on April 25, 2011.

One Response to “The Emperor’s New Clothes, Chronic Lyme Disease, and the Infectious Disease Society of America”

  1. Like this – thanks for sharing!

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