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Oh heck, another thing for the notebook!

It is on message in a very comprehensive way. One side considers ME to be a mental disorder. This is exemplified by a leading proponent of the idea, consultant psychiatrist Professor Sir Simon Wessely; while delivering the 9th Eliot Slater Memorial Lecture in 1994, he argued that ME is...

By hinting that there might be evidence for a biological mechanism that might be treatable. That was enough of some to say 'well yes I suppose actually some of them really are very ill'. In contrast if I had started off by saying 'actually some of them really are very ill' my colleagues would...

Everything quoted seems to be twaddle. Back pain has a whole range of causes, which need to be identified and treated in an appropriate way. Broad brush propaganda on what is good or bad, like surgery or medicine or CBT is simple nonsense. Some people benefit from surgery. Many do not. There is...

Twaddle.

Dear @Gingergrrl, These are all very reasonable questions but they do have answers! The maths of correlations between tests and illnesses is quite subtle and complicated. As non-mathematical ordinary people we are actually quite good at picking out what signifies what. We can work out that if...

@Mfairma, I see what you are saying and agree in considerable part. But a story is only strong if it is perceived as strong by a listener. Who is the story intended to convince? As a doctor I guess I am the sort of person you might want to convince. I see the human cost as a strong line but I...

This is what researchers who are studying aspects of CFS/ME that activists don't want studied are up against. Has it not occurred to Sharpe that he might be talking to himself only? The study of these aspects has been very useful - it shows they are a blind alley.

Now you don't want to get me started on this. Firstly it is me that is always right, not either of these ladies. Always. Secondly, Descartes was right that mind rules matter. Mind is dynamic action (like, er, neuron membrane excitation to be modern) and matter is merely aggregates of fermions...

I very fair question @Gingergrrl, but here is my answer. Autoantibodies are only taken as likely to be important in an illness if they are the sort of antibodies that correlate with that particular illness. That statistical correlation is the way of having confidence that they are not just...

So that's why they like the BPS model?

T cell clonal expansion does not mean T cell auto reactivity. In Lyme the T cells will be anti-Lyme. In MS I think the T cell expansion is in the brain. That is a quite different matter because once T cells get to a tissue they will expand clones either in response to antigen or innate signals...

I am comforted to think that actually we all agree much more than it seemed. It is so easy to misread what people are saying and equally easy not to get a message completely clear. I very much agree that now is the time for advocacy to change into a higher gear. It is still worth...

I really love the end bit: I do feel that being one of the few people in the world who can really understand imposes a certain burden and definite isolation. (I often feel that, yes.) ... quite frankly if it is a choice between carrying the burden of RCP politics and ending up like my old...

Try rebooting it? I got nothing audible the first two times and then it worked.

The problem with looking at T cell 'auto reactivity' is that you have to look at cell responses to peptides in a dish. And all T cells in a dish respond a bit to anything so you have to decide how much response you consider positive. If there are 1000 brain proteins then there might be 100,000...

Maybe you meant it but there could be NO autoimmune subgroup. Autoantibodies are commonplace in normal healthy people. Autoimmunity as an aspect of disease implies more than that and at present we do not have strong evidence for autoimmunity as such in ME.

Some interesting comments, @Pibee. I tend to agree. It is doubtful whether T cell autoimmunity actually exists, except in the rare genetic AIRE syndrome where there is a defect in thymic selection. A lot of immunologists assume that T cell autoimmunity underlies B cell autoimmunity but in fact...

I think things have changed a lot in the last few months. MEGA per se is off the menu. When something gets back on the menu I think it is much more likely to involved the LSHTM Biobank now.

Touché @Sasha