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July 30, 2011           

me+ME: Excellent letter by professor Hooper to the BMJ

Professor Malcolm Hooper recently got another excellent letter published in the British Medical Journal (BMJ):


Re:History of prejudice

Malcolm Hooper, Emeritus Professor of Medicinal Chemistry
University of Sunderland

Re: Ending the stalemate over CFS/ME. Godlee 342:doi:10.1136/bmj.d3956

The editor of the BMJ refers to the "unproductive standoff" in relation to the long-running disagreement about the nature of ME between the evidence-based biomedical school dating back to at least 1956 (with the WHO classifying ME as a neurological disorder in 1969) versus the ideology of the "psychosocial" school, whose vested interests in maintaining their idiosyncratic categorisation of ME as a mental disorder are a matter of public record (1).

That standoff includes the psychosocial school directing in 1992 that in patients with ME, the first duty of the doctor is to avoid legitimisation of symptoms (2); in 1994 ME was described by them as merely "a belief"(3); in 1996 they recommended that no investigations should be performed to confirm the diagnosis (4); in 1997 they referred to ME as a "pseudo-disease diagnosis" (5), and in 1999 they said about ME patients: "Those who cannot be fitted into a scheme of objective bodily illness yet refuse to be placed into and accept the stigma of mental illness remain the undeserving sick of our society and our health service" (6).

In his letter to the BMJ (7) Peter White et al dismiss key symptomatology of ME including ataxia, palpitations with cardiac arrhythmias and loss of thermostatic stability as being of dubious validity, yet those symptoms are specifically required for a diagnosis of ME as stipulated by 26 international experts from 13 countries who between them have 400 years experience of diagnosing over 50,000 patients (.

These experts base their latest criteria on biomedical research and clinical experience of widespread inflammation and multisystemic neuropathology found in ME.

Although claiming to do so, Peter White et al do not study ME; they use their own Oxford criteria that select people with psychiatric disorders in which chronic fatigue is a feature (9) .

White says their own criteria are easier to use and insists that they do not exclude those with ME simply because he believes ME to be a mental disorder.

Furthermore, in his letter to the BMJ Peter White complains that the criteria which define people with classic ME are too burdensome for doctors to use.

When did the careful assessment of sick people stop being part of the practice of medicine, especially when the disorder in question is known to be a complex multi-system disorder?


1. http://erythos.com/gibsonenquiry/Doc...iry_Report.pdf

2. Medical Research Council Highlights of the CIBA Foundation Symposium on CFS, 12-14th May 1992, reference S 1528/1 (section entitled "The Treatment Process"), now held in the MRC secret files on ME at the National Archive, Kew, and closed not for the customary 30 years but for the unusually lengthy period of 73 years

3. "Microbes, Mental Illness, The Media and ME - The Construction of Disease". Simon Wessely; 9th Eliot Slater Memorial Lecture, Institute of Psychiatry, 12th May 1994 (transcript and Wessely's own working notes)

4. Chronic Fatigue Syndrome. Report of a Joint Working Group of the Royal Colleges of Physicians, Psychiatrists and General Practitioners; Royal Society of Medicine (CR54), October 1996

5. "Chronic Fatigue Syndrome and Occupational Health"; A Mountstephen & M Sharpe; Occupational Medicine 1997:47:4:217-227

6. "ME. What do we know - real physical illness or all in the mind?" Lecture given in October 1999 by Michael Sharpe, hosted by the University of Strathclyde (transcript)

7. BMJ 2011:343:d4589

8. Journal of Internal Medicine: Accepted Article: doi:10.1111/j.1365- 2796.2011.02428.x

9. JRSM 1991:84:118-121

Competing interests: I am a long term advocate for people with ME and have published and lectured extensively on their plight and the injustices they and their carers have suffered as a conseqence of the deeply flawed ideological views of some psychiatrists and the Government agencies that have persistently denied or ignored the massive volume of peer-reviewed, published biomedical evidence.

I intend myself to discuss Ms. Godlee and Mr. Hawkes, in a decidedly more satirical manner than professor Hooper - so they should look forward to this with joyful anticipation: not many are thus honoured by me! - but as usual professor Hooper seems to me to be both morally and intellectually quite right, and I also like his statement of his "Competing interests", and thank him deeply for his many excellent writings:

Without him, the position of patients with ME|CFS in the UK would have been quite a lot worse than it is - which is as much to professor Hooper's credit as it is, by parity, to the lack of credit of very many English professors of medicine, psychology and other subjects, who turned the other way, and served their own interests and careers, and let patients with ME|CFS and some other diseases, such as Gulf War Illness, suffer without help while being discriminated and slandered by English psychiatrists and clinical psychologists.

Indeed, I can only cogently explain this basic lack of humanity or intellectual competence by referring the readers to the historians who outlined the horrors of Stalin's Soviet Union or Mao's China (*), that also were based on the failings of many men, and of many intellectuals, to be rational and reasonable - with this excuse, quite unlike professor Hooper's academic contemporaries, that they lived in dictatorships, and speaking up was very dangerous to themselves and their families.

See also my

for while this is what ordinary men do not like to hear or read - the willing executioners for their leaders, nations, religions and parties all love to hear thay they are themselves the equivalents or better of the greatest and most courageous, and are quite willing of murdering or at least levelling or locking up the greatest and most courageous for the crimes of being better than most - it does explain rather a lot about the reasons why Machiavelli and Gibbon were right, speaking of the majority, to be sure:

"You do not know the unfathomable cowardice of humanity... servile in the face of force, pitiless in the face of weakness, implacable before blunders, indulgent before crimes... and patient to the point of martyrdom before all the violences of bold despotism."
   (Niccolò Machiavelli)

"History is little else but the register of the crimes, follies and misfortunes of mankind"

There is more to history than just ''crimes, follies and misfortunes", but it is not the work of ordinary men nor of ordinary leaders, both of which are and have been instrumental in bringing about the facts that justify Machiavelli's and Gibbon's sayings, through all of the last 25 centuries of human civilization, at least.

See also my

(*) Such as: Jung Chang, Robert Conquest, Simon Leys, Simon Sebag Montefiore, Anne Applebaum: See

P.S. Corrections, if any are necessary, have to be made later.

As to ME/CFS (that I prefer to call ME):

1.  Anthony Komaroff Ten discoveries about the biology of CFS (pdf)
3.  Hillary Johnson The Why
4.  Consensus of M.D.s Canadian Consensus Government Report on ME (pdf)
5.   Eleanor Stein Clinical Guidelines for Psychiatrists (pdf)
6.  William Clifford The Ethics of Belief
7.  Paul Lutus

Is Psychology a Science?

8.  Malcolm Hooper Magical Medicine (pdf)
 Maarten Maartensz
ME in Amsterdam - surviving in Amsterdam with ME (Dutch)
 Maarten Maartensz Myalgic Encephalomyelitis

Short descriptions of the above:                

1. Ten reasons why ME/CFS is a real disease by a professor of medicine of Harvard.
2. Long essay by a professor emeritus of medical chemistry about maltreatment of ME.
3. Explanation of what's happening around ME by an investigative journalist.
4. Report to Canadian Government on ME, by many medical experts.
5. Advice to psychiatrist by a psychiatrist who understands ME is an organic disease
6. English mathematical genius on one's responsibilities in the matter of one's beliefs:

7. A space- and computer-scientist takes a look at psychology.
8. Malcolm Hooper puts things together status 2010.
9. I tell my story of surviving (so far) in Amsterdam with ME.
10. The directory on my site about ME.

See also: ME -Documentation and ME - Resources
The last has many files, all on my site to keep them accessible.

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