PACE Gets It Wrong on Chronic Fatigue Syndrome

I applaud the NY Times for running a timely Op-Ed on the PACE trial that wrongly concluded that CFS patients should be treated with psychotherapy.

The problem is not that these critically ill people are being offered counseling and conditioning exercises. These can be helpful for many with severe illnesses, such as crippling cancer, multiple sclerosis, heart failure, and any severe medical condition. That is, when the persons themselves feel they need it.

The crime is that some are using this research to imply that CFS & fibromyalgia are psychological and not physical disorders, and using it to deny crippled people (75% women) the option to get the healthcare they need, and even the disability insurance benefits they deserve and paid for. All the while ignoring countless studies showing these to be very real and devastating physical conditions.

Can you imagine if this had been done to people bedridden with multiple sclerosis, who are also predominantly women? If a doctor suggested to a woman's family that their wife or mother was simply being hysterical, and that they should not support "her delusion"? That insurers were given the excuse to deny her disability benefits because her illness wasn't real?

In fact, this used to be the case. MS used to be called "hysterical paralysis." Other conditions such as lupus and even rheumatoid arthritis went through this same process. What do they have in common? These are autoimmune conditions that predominantly affect women (as do most autoimmune illnesses). It's no surprise that the medical term "hysteria" comes from the Latin for "hystero," which means uterus. A dark stain on medicine's history, going on for over a century.

It's time that medicine moves out of the dark ages and into the 21st century. To stop abusing crippled women who are too ill to defend themselves just because it saves insurers' money and allows lazy doctors to not stay current on the research. Instead of doling out Prozac after a six-minute office visit, physicians need to spend the time needed to treat these complex illnesses.

In a generation, people will look back in shock at how doctor's and medicine could be so blind and abusive.

With a million people suffering from CFS and 3-6 million in the US with fibromyalgia, do we really have to wait another generation to escape the Dark Ages? As a physician — and someone who had been crippled with fibromyalgia until I recovered with proper medical treatments myself — I say that it's time to change this NOW!