BMJ: Chronic fatigue syndrome and Long Covid, moving beyond the controversy, 2021, Newman

Possibly also connected to her father's experience: https://www.bmj.com/content/373/bmj.n1575

 

Apologies if this link has already been posted:

https://twitter.com/user/status/1409807621763305475

 

My response to Godlee's editorial, focusing on pacing, has been published, https://www.bmj.com/content/373/bmj.n1610/rr-1

 

Well done, Andy - excellent letter.

 

Oh, FFS.

And of course like the vast majority of complaints it was dismissed, so that's basically textbook excessive worry over an unlikely event that carries little if any real consequences, because like everything it's all projection.

I have no idea what is the purpose of this... uh... biographical tidbit? What purpose is there to write it? Or to publish it in a medical journal? There is nothing of substance here.

 

I note it was commissioned, too:

"Provenance and peer review: Commissioned; not externally peer reviewed."

 

Basing from the tone of discussion of not just Gerada but others, the objective seems to be that patient complaints are awful and unnecessary and basically need to stop happening entirely.

There's something weird about many comments saying the GMC does not support physician during complaints when they actually only protect physicians, not patients. Like every professional medical association it is their primary purpose. It's like having 99% of the power imbalance and whining about the remaining 1%. Actually strike that it's not like it it literally is.
https://twitter.com/user/status/1409064224836440066


Imagine demanding no accountability when there already isn't any. Completely disconnected from reality.

 

The trouble with Gerrada's article is that the fact that a complaint was made against her father is not very good evidence of professional misconduct. The fact that he was cleared by the GMC is not very good evidence of innocence.

So that seems to be the normally accepted standard of proof for the journal.

 

Charles Shepherd's Rapid Response has now been published as a Letter to the Editor,

"Charities, patients, and researchers are working together to find the cause and effective treatments for ME/CFS

As a charity that funds biomedical research into myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), we are not aware of any researchers who hold negative views about the patient community.1 Patients, charities, and researchers are all working together on research initiatives such as Decode ME (https://www.decodeme.org.uk), the ME Biobank (https://cureme.lshtm.ac.uk/the-uk-mecfs-biobank), and cardiorespiratory exercise testing.2"

https://www.bmj.com/content/374/bmj.n1854.full

 

Another Rapid Response has been published as a letter to the Editor,

Chronic fatigue syndrome and long covid: individualisation, not compartmentalisation

"Newman’s investigation of chronic fatigue syndrome and long covid supports the development of specialised multidisciplinary support for patients with long covid.1 But compartmentalisation of a problem like chronic fatigue syndrome can sometimes miss the point."

https://www.bmj.com/content/374/bmj.n1863

 

Long covid: reshaping conversations about medically unexplained symptoms

"Newman’s article, a linked patient commentary, and the tranche of rapid responses show how “long covid” has reignited debate about the causes and management of chronic fatigue syndrome.1 Rather than moving beyond the controversy, most of the ensuing arguments have fallen back into familiar grooves deepened by confirmation bias and dualistic thinking.123 On a more positive note, the intense media attention on and public interest in long covid present a golden opportunity to reshape and extend discussions about medically unexplained symptoms."

https://www.bmj.com/content/374/bmj.n1859

 

I read the whole letter, but actually all you need to do is read to the phrase "dualistic thinking" and you can guess the rest. It never ceases to amaze me that people who believe in "real disease" on the one hand and "psychological problems masquerading as medical symptoms" on the other hand - can actually accuse other people of being dualistic.

A couple of NZ psychiatrists, from Waikato. Obviously hoping to increase their slice of the MUS pie. Kiwis, beware...

 

Statements like this consistently and deliberately miss the point. There is no psychological stigma or dualistic debate. If PWME stigmatise or debate anything, it's Sir Simon and his ilk's empire-building horseshit. That's all. We have no problem with psychology and no interest in a "dualistic debate", we are just objecting to a fictional narrative being foisted upon us. Stop pretending this is more of an intellectual argument than it is, or that it has something to do with psychology or dualism. PWME, just like everybody else, don't like bullshit, especially when it's foisted upon them to their detriment. It's no more complicated than that, for all the posturing and deflection of the BPS crowd. They have invaded the field of psychology and polluted it, it's just their corrupt version of psychology where evidence and data count for nothing in their ideological quest that we "stigmatise".

 

https://uk.linkedin.com/in/russell-malcolm-647a841a

I found the language in his letter pretty interesting.

 

Yes, it is intriguing @Esther12.

I have been having a discussion on HealthWatch (where a lot of people have worked to dislodge homeopathy from the NHS). Just this morning it came to me that the comment (source confidential but maybe now found in any BACME type mag), that it didn't really matter if PACE showed nothing because therapists now do everything on an individualised basis, was straight out of the homeopathy playbook. For years they have said randomised trials are no good because treatment has to be individualised (an invalid objection of course). I also commented to someone that having not so long ago given a seminar to the RLHIM (that was RLHomeopathicH) unit for fatigue that one might be tempted to quote from Animal Farm - it's back to two legs good now. Or maybe all singing all dancing multidisciplinary legs good.

This is precious: In the absence of objective data, the use of advanced and holistic history taking can explore the factors that perpetuate the clinical state.


I am slightly wondering if the people at the Royal London Hospital for Integrated Medicine may not thank Russell Malcolm for letting the cat out of the bag.

 

And the bit before that quote talking about how clinicians individualise cases with a high degree of detail... but what exactly does that mean? Is there any good evidence it benefits patients to have these specialised teams do this?

"Specialised teams, such as the fatigue clinic at the Royal London Hospital for Integrated Medicine, routinely individualise chronic fatigue syndrome cases to a high level of detail. In the absence of objective data, the use of advanced and holistic history taking can explore the factors that perpetuate the clinical state."