A blog called Science-Based Medicine recently had a post on ghastly naturopaths chatting on Reddit about injecting people with hydrogen peroxide! Diluted yes, but still. It’s a poison. And no, injecting people with hydrogen peroxide has zero medical benefit. Ever.
But within this rather blandly stated exposé the writer, a surgeon, made a sneering throwaway comment about “chronic Lyme disease”. Now, Lyme disease is a real disease, no one disputes that. (What kind of world are we living in where that sentence needs to be said or even makes sense?) But a small group of Assholes Doctors (and I don’t mean proctologists) have convinced themselves, in defiance of rational thought, that some people who get Lyme disease after treatment still think that they have it when they don’t. Here’s the thing: the people who “think” they still have Lyme disease still have symptoms and are still positive for it on the Lyme disease test.
Seems the Asshole Doctors have decided the wimpy two weeks of antibiotics that are the standard treatment for Lyme (a duration some doctor pulled out of his ass when the disease was discovered 30 years ago) is for sure, enough, for everybody. Even though infection treatment doesn’t work like that. Drug treatment for TB is given until the TB is gone. Drug treatment for AIDS is given for life. The drugs we have are supposed to be used in a way that is effective not that conforms to some timetable in a book.
The people who, quite sensibly, believe they are still ill have positive Lyme tests. What do the Asshole Doctors say about that? ‘The test isn’t very good. It has all these problems… ‘ Now, for all I know these problems are real. Or made up. But the Asshole Doctors don’t dispute the test results when it’s finding new cases of Lyme. Only after the magic two weeks. Then it’s’oh the test is poor!’ So we know what kind of docs we are dealing with here. (Hint: Assholes.)
I think one (only one?) objection to the Lyme test was it can be positive if you have some other microbe. Fair enough. Cross-reaction. That’s a thing. But as is typical in Medical Bad Reasoning the Asshole Doctors don’t realize that went two things are possible: Lyme not cured yet or cross-reaction, that doesn’t mean you (Asshole Doctor) get to choose one. This isn’t shopping! It means either could be true and you need something else to tell you which. That’s logical reasoning 101. But then the MCAT (the med schools’ LSAT) is the only test of that sort, which include the GRE and engineering and management ones, that does not have a test of logical reasoning. And it shows.
If I was a doctor with a patient who after a wimpy two weeks antibiotics wasn’t all better I would be utterly unsurprised. If after three months they were still infected I’d wonder if their immune system was buggered in someway. But I certainly wouldn’t reach for the idiotic “all in your head” explanation. A non-medical, unscientific myth no better than astrology. With MDs like this who needs a naturopaths? (To have hideous superstitious weirdos providing “medical” care.)
Some patients are treated till cured, even when it takes years. And guess what? When the symptoms go, the lab tests are negative. This is completely straightforward. Get the disease, have the symptoms. Get test. Test positive. Given drugs. When they have worked, no symptoms, test negative. It doesn’t get any simpler.
The Asshole Doctors are in the grip of a nonrational myth. Patients “imagining” they are ill. The “imagining” is undefined and cannot be made to make sense. The uncomprehending zeal of the doctors who promote this myth makes them appear disturbed. This sort of superstitious nonsense is not something we can afford in medicine. And especially not in what wishes to be Science Based Medicine.