Treatment and life goals among veterans with Gulf War illness 2023 Sullivan et al

Abstract

Medically unexplained syndromes (MUS), also termed persistent physical symptoms, are both prevalent and disabling. Yet treatments for MUS are marked by high rates of patient dissatisfaction, as well as disagreement between patients and providers on the management of persistent physical symptoms. A better understanding of patient-generated goals could increase collaborative goal setting and promote person-centered care, a critical component of MUS treatment; yet research in this area is lacking.

This paper aimed to develop a typology of treatment and life goals among Gulf War veterans with a medically unexplained syndrome (Gulf War Illness). We examined participants’ responses to open-ended questions about treatment and life goals using Braun and Clarke’s thematic analysis methodology. Results showed that treatment goals could be categorized into four overarching themes: 1) Get better/healthier, 2) Improve quality of life, 3) Improve or seek additional treatment, and 4) Don’t know/Don’t have any. Life goals were categorized into six overarching themes: 1) Live a fulfilling life, 2) Live a happy life, 3) Live a healthy life, 4) Be productive/financially successful, 5) Manage GWI, and 6) Don’t know/Don’t have any. Treatment goals were largely focused on getting better/healthier (e.g., improving symptoms), whereas life goals focused on living a fulfilling life. Implications for the treatment of Gulf War Illness and patient-provider communication are discussed.

Open access, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0295168

 

So the discordance is over the nature and treatment of the illness, which is the fault of medical providers. This is really simple: the patients want their health back, the providers don't know how, so the patients are dissatisfied. This is not rocket science. It's actually probably the simplest thing they'll ever face in their whole career. It's as simple as hungry person wants food, a child can easily understand this, would give their own food to that person as a reflex even before they learn to talk.

But their conclusion, as is tradition, is that although the treatment and life goals of the patients are the same as their own, because the providers disagree over the nature and treatment of the illness, they should address... the treatment and life goals. They simply cannot accept the reality that not understanding the nature of the illness, not being able to alleviate the illness, is the problem.

They can even write the words, and simply fail to understand them:

And their solution is... more psychosomatic BS. This is basically meta-homeopathy, where instead of diluting a solution, they dilute the problem and feed it back to the patient. Some kind of diluted insanity, as it basically consists of doing the same thing that has failed before and expecting different results.

And still there is this overarching belief about "MUS" that the patients don't want to get better / aren't trying. It doesn't even matter what their own evidence shows, they can't accept the facts, which is something they project onto the patients simply because they can.

This is not a technical problem, this is basic human failure of understanding and accepting reality:

None of this is complicated. And yet they still conclude that they need to push the same failed psychosomatic ideology that failed the patients for decades, since at one point they'll all be dead and the whole thing will stop having concluded, yet again, just how powerful the mind is at causing illness, or whatever. Failure feeding itself for generations.

 

What is there to understand? Patients want to get better. Is that difficult to understand?