Suzanne O’Sullivan’s new book ‘The Age of Diagnosis’ and her curious characterisation of Long Covid as a psychosomatic condition

The article mostly consists of good points. There are a few inaccuracies, especially with regards to PEM and pacing.

The terminology is a bit confused here.

This section makes it seem like pacing is a treatment.

 

Snippets from some of the comments:

Dr Selina Shaw:

Dr Sheri Winder:

 

It's a behavioral adjustment approach, so it's a fine characterization. The rest of the list aren't really treatments either, they're more generic support with the intent of supporting behavioral adjustments, little of which can fix specific problems.

And it's still a fact that pacing is the most effective thing to do, the fact that medical science is still unable to determine it either way is more of an indictment of how poor their methods and instruments are, than a judgment on what pacing is or does. It should not be considered a treatment, but medicine doesn't really seem to have the language or skills to integrate it with a more accurate meaning. It can't be called an intervention either, because that involves an external actor, and the whole point is precisely that no one can direct it with useful knowledge.

Yikes. Shows how distorted the training in medicine is. How can anyone be so ignorant that psychosomatic ideology has never been more influential and used than today? It's baffling. They are completely unaware of the big picture, which makes the entire premise of this ideology being 'holistic' so completely ridiculous.

Good comment from Winder on the problems with language, and how they so poorly convey what's going on. Not a surprise, that aside from fatigue, which medicine doesn't understand either, brain fog and PEM are colloquial terms that we have to use because the medical profession is negligent, and hasn't come up with ones they can use and understand. Not our fault, though, just like Long Covid the idea was that professionals would take it from there.

 

There’s this later on in the paragraph. So I still believe that pacing is portrayed as an attempted cure in this instance.

I think it’s mostly understandable. GPs primarily work alone and rarely get opportunities to interact with peers outside of their office. Although they should probably have been able to catch on by reading the news.

 

That's really it, though. Basic and updated training is inadequate for them to know some very basic things. It depends entirely on rare circumstances. It's like looking at official professional resources for ME/CFS or Long Covid, and how utterly inadequate they are, how a physician who relies only on those official sources is basically no better informed than a random person who has read a few magazine articles.

In itself this isn't unusual, training to become a programmer requires significant personal time practicing and reading about things outside of curriculum, forever. Hell, many programs don't even feature basic things like version control, people are expected to learn on the job.

But with the medical profession it becomes massively problematic because most physicians don't do that, they work too much, and in circumstances like dealing with ME/CFS, they accept the unreasoning that if it's not covered by basic or ongoing training, and especially if it's very popular, then it doesn't exist, and their knowledge remains static.

It's really all the damage done by psychosomatic ideology. It's doing exactly the role that the Catholic church did in opposite Galileo. Even what appears to be the recent weird trend about the "power of explanation" is exactly the same as the old "you have a divine explanation of God's work in the beauty of nature, why would you seek a lesser explanation when there is one that involves a perfect creator?". It's not similar, it's exactly the same: beliefs are overruling the entire purpose of science, of trying to know better.