Here's my transcript, though it's from the unofficial video so times might be a bit off compared to the official YouTube version:
Slide: Book cover of "We Landed by Moonlight" by Hugh Verity (0-35 seconds)
My grandfather was a war hero, and he flew planes that crossed into France, and on secret air missions to pick up spies and resistance fighters. Because they were secret he needed to land his plane by moonlight, sometimes lit by torches in fields in the middle of nowhere.
He gave up a scholarship to Oxford, and what would have presumably been a glittering career to do this. And when I was a child I'd ask him "Why?", and he would say "Because it's the right thing to do." Because he wanted to protect his children, his grandchildren, you and me. And whilst I understood it was right, I thought it must have been a difficult decision for him.
When I was a child, I didn't want to be brave like him. And even though my childhood was loving and mostly happy, I was often forced to do very terrifying things, or face rejection by my father. For example, he took us swimming in a typhoon when I was 11, and I was swept out to sea. And I remember very clearly being on the bottom of the sea floor and looking up what felt like miles to the sky, wondering if I would survive, and wondering what my life would be like.
Slide: Girl in bed (1:30-2:40)
And as a grownup I've had to reconcile that and I've had to forgive, and I think it's probably a good thing that I don't scare easily. But if I could, I would take away those experiences of my childhood because I really believe that children shouldn't be forced to be brave. This is Sarah, she's 14. She loves school, she loves hockey, she loves her friends, she loves all that life can give her. But she hasn't been able to go to school for several years. She hasn't played sport for years either. She hardly sees her friends. Her concentration and memory is so poor that she can hardly read. She's in almost constant pain. She has almost daily headaches, sore throats, muscle aches, and pains. She has fatigue but fatigue is a word that doesn't describe her experience. Her fatigue is pervasive, it makes her feel like she can't move her limbs. Sometimes it's so bad she can't get out of bed.
She has chronic fatigue syndrome or ME, and illness that is completely devestating to children and their families. Parents usually have to give up or reduce work. It has a big impact on society. Children can't go to school, they can't get their education, they can't socialize normally. But we know very little about it. It affects 1 in a hundred children, and we really desperately need more research to understand the biology and treatment. We're making progress. 10 years ago people said to me that it doesn't exist in primary school children. We now know that it does, and we know much more about the symptoms that they had. And that's really important because that means that they can now get a diagnosis and get treatment.
We know some about it. We know for example that (kind of ticks and jumps?) genetically heritable, that means it runs in families. And interestingly it's much more heritable in children, children seem to be more genetically vulnerable. Which explains why they get their first, second, or third infection, compared to adults. And we know that infection is a terribly important trigger, and what's important about infection is not the particular bug that's important, what's important is the severity of the infection, how much of a hit do you actually get.
Slide: ME/CFS worldwide funding compared to other neurological disorders (3:50-4:50)
We're beginning to understand much more about how the brain works, so the concentration and memory problems, we can do imaging scans in children, and we can understand more about how they actually think and function and why they have this thing called brain fog. We understand more about the (?) changes. But the truth is that we really, really have so much more that we need to understand, and so much more that we need to explore. And one of the really big problems of chronic fatigue syndrome is the lack of research funding. You can see here on the left-hand side, how little research funding researchers into chronic fatigue syndrome get. And when you compare it to ataxia telangiectasia which is the column just next to it, chronic fatigue syndrome is 200 times more common, but receives half the funding. It's just not good enough, for this important disabling condition.
One of the problems with research in this area is that it's very complicated. So whilst all patients have this thing caused post-exertional malaise, which means that symptoms of pain and fatigue get worse after exertion, there are different groups of patients that have different clusters of symptoms. And these clusters of symptoms probably represent different underlying biological pathways. And that's very important for two reasons. First of all it helps us understand why some patients respond to treatment and other patients don't. And secondly it means that research needs to use really large sample sizes of patients, where we understand and measure a lot of their symptoms. And it needs researchers working together with expertise in different biological pathways and different experimental techniques. And that's absolutely the right thing to do, and we are making progress in both the UK and the USA.
But the problem is that that's going to take time. Research takes time. Research is iterative, it builds on each other and we're a long way off from developing completely new treatments for this condition. And the children that come to my clinic, they want treatment, and they want treatment now. They can't wait 10 or 15 years for a new medicine. Treatment for children with chronic fatigue syndrome is much more effective than for adults. We don't have a tablet, so we use natural methods. We change ... support children changing their sleep. If you change your sleep, you change the internal body clock, and that changes the way that your body produces hormones (?).
We also help children to change their physical activity or exercise, and contrary to what you might read, the really important and tricky thing is to reduce exercise (?) particularly for the start, and then help them (do more?) ever day until they can get back to doing the things that they want to do. And if we do that, we can increase the child's chances of recovery from less than 10% to more than 60% at 6 months. A 6 fold increase, much better than adults. This is good news for some children, but I don't think it's good enough. I don't think that it's good enough that 40% of teenagers are still unwell after 6 months. And we need better treatments. We need treatments that work, we need treatments that work for all children. We need children that work for children at home so they don't have to travel when they're really sick.
So how do we do research on treatments? Well there's two ways I think that you can do it. The first way (?) to other illness, and say well in that illness this particular treatment worked on similar symptoms, so we can try that for chronic fatigue syndrome. Or you can listen to what children and their parents tell you. When children and parents tell you that something has worked and (?), I think what you must do tests, trials to see if that treatment works. Because if it does work, we need to tell other children about it. And if it doesn't work, (?) it's not gonna work. So either way, if people are trying stuff, we must test it. And I think that we can do that.
Slide: girl in bed (8:25-9:05)
I feel really optomistic. My vision is that in a few years time, "Oh, where's Sarah?" In a few years time I'll be able to say to Sarah, when she comes to clinic, "I know what you have, but I also know how to get it better. Actually I have to tell you the truth, this isn't Sarah, and it's not even a picture of a patient. I couldn't put a picture of a patient up today because I was really worried about them being attacked, like I am attacked.
Slide: threat letter mockup "You evil bastards... we're going to cut your balls off. Stay out of this... time is running out for you all. Pray to god for forgiveness." (9:05-9:40)
It is the nature of doing research in chronic fatigue syndrome. It is the research environment. Medical students are told not to go into this area. Researchers are told not to do research. Researchers who do research, leave. This is an email that I got a few years ago. It was used on the front cover of the Sunday Times, to discuss the research environment for chronic fatigue syndrome. I still laugh at the idea that someone was going to cut my balls off. (laughter from audience). Does make you wonder.
But most of it isn't very funny. The things I particularly hate, actually the thing I hate the most for me, is the cyberstalking. I hate being stalked. I also hate the defamation. But the thing I really hate, is the impact this has on the children that see me, the children that come to my clinic. Children suffer because clinicians don't have the research evidence to know what to do in this condition. They suffer because there's so few people working in the area, and they have to travel a long way. They suffer because researchers like me spend so much time dealing with investigations and threats that we can't do the research that we need to do. They suffer because there's so much false news out there, false information, it's hard to know what the truth is. But they suffer in particular because researchers won't do treatment trials in this condition.
I did a trial a few years ago, in fact I do trials still, I did a trial, I finished a trial a few years ago. I did a trial a few years ago because children and parents came to me and told me about an intervention, a treatment that they thought was helpful. And other children and parents came to me and they said "Does this treatment work?" and I didn't know what the answer was. So we did the right thing, we did a trial to be a fair test, trials to be fair tests of treatments. And the children and parents, all the time we were doing it, were desperate to know the results, and wanted to help us with this trial. But a few people tried to stop us. A few people and a few organizations tried very hard to stop the trial. They reported me to every institution, they campaigned against the trial. We finished the trial, and interestingly, well maybe I'm surprised (?), the children who had come to me, they were right. This treatment helped some people, not everybody, but it helped some children. Children got better faster with it. We were published a few weeks ago. This is good news. It's not the end of the story, we need to do more research, but it's good news for children that have something else that might be helpful. But not good news. Not good news for those who try to stop us.
I talked to a professor last year actually, in America. He made a vaccine that saved hundreds of thousands of babies lives. Really amazing. Imagine doing something like that, fantastic. And he then started realizing that people were telling vulnerable mothers not to have this vaccine and they were saying things about the vaccine that weren't true. And he spoke out against it, and he said what the truth was, and he spoke out agains what they were doing. And he received personalized specific death threats against him and against his own children. And I said to him, I said, "You could do anything, why do you stay in this area?" He's really smart. And he said "I stay in this area because it's the right thing to do." He said, "I walk down the corridor and every time I see a needless death, I have to do something about it, you can't have anymore needless deaths. It's the right thing to do."
Slide: Photo of girl in bed: (13:20-14:20)
When I was a child, I didn't have a choice about what happened to me. Children with chronic fatigue syndrome or ME, they don't have a choice either. But now I'm a grownup, I do have a choice, and I choose to do the right thing. I choose to stay doing research despite what happens to me. I dot the research because children deserve, with chronic fatigue syndrome, deserve better. The children that come to see me in clinic deserve better treatments. The children that don't get a diagnosis deserve help. And it's not okay for children to suffer for two years before they know what's going on with them, that's not okay. You all have a choice, all this, all of you who know someone with chronic fatigue syndrome or ME. You have a choice about whether you love and support them. You also have a choice about whether we stand together and argue for more research in this important area.
We need to disrupt views of this illness. We do need to cast away the prejudices, the prejudices about what people think this illness is, because the truth is we know so little about it. We need to say "Enough is enough." We are going to support those doing research. And we're going to say to those who try and stop us, "We want research into treatment and into biology." And to say to the funders, "More research into this important condition." And we need to do that because those with chronic fatigue syndrome, particularly children with chronic fatigue syndrome, don't have a voice. They're too ill, so we need to be their voice.
Slide: Photo of girl in bed with referral info to Bath "Chronic Fatigue (ME)" service for children (15:35-end)
It's not going to be easy, changing what happens to people with chronic fatigue syndrome. Important things never are. But I believe, like my grandfather, we should do what is right, not what is easy. Thank you. (Applause)