THREAD: I wrote a piece for @Open_Notebook offering advice to science journalists covering contested illnesses, coming out of 15 years of being both a journalist and a patient. Here are some highlights, plus links to some of the high-quality coverage. theopennotebook.com/2021/01/26/how… 1/
@Open_Notebook When I got #mecfs, I was shocked that science, medicine, and journalism on my illness were all… pretty bad. “I felt as though I had fallen through the looking glass and found that up and down and right and wrong and science and bullshit had scrambled into a nauseating mess.” 2/
@Open_Notebook With long Covid, “journalists will play a major role in determining whether these new chronically ill patients face the same ignorance and disregard experienced by patients with other contested illnesses.” 3/
@Open_Notebook “Good science journalists ordinarily aim to present the scientific consensus… But with contested illnesses, there is no scientific consensus on many or even most questions; that is the essence of their contested nature.” 4/
@Open_Notebook “It is easy to be fooled, though, because powerful scientists often express strong opinions that they present as representing a consensus when in fact, many other highly respected researchers disagree. Always remember that credentials aren’t the same as correctness.” 5/
@Open_Notebook “Regard patients as experts. They are the only people who can observe an illness from the inside, so they offer critical expertise.” 6/
@Open_Notebook “Too often, empathy is interpreted as a kind of condescending softheartedness. For example, journalists sometimes write, ‘I believe their suffering is real… even if it might be mostly in their heads.’ It’s no gift to merely say you don’t believe someone is out-and-out lying.” 7/
@Open_Notebook “Patients with contested illnesses are among the most vulnerable populations there are. They’ve lost power in so many ways.” There’s loss of health and (often) income and access to skilled healthcare, plus prejudice and an active denial of their most basic bodily experiences. 8/
@Open_Notebook “Avoid the temptation to use psychology as a magic wand to fill in gaps in scientific understanding of how poorly understood ailments work, and be watchful for sources who do so. Like any theory, psychological explanations of disease require evidence.” 9/
@Open_Notebook “Remember that you could become ill too, that individual virtue doesn’t suffice to fend off illness, and that every single one of us faces physical decline eventually.” This will help you avoid ableism, one key prejudice to watch for. 10/
@Open_Notebook Sexism too: “The mere fact that an illness affects women more frequently has been repeatedly used as evidence that the illness is psychological.” So we don’t dedicate research $$ to it—why bother? Then lack of scientific understanding reinforces the idea it’s psychological. 11/
@Open_Notebook “Avoiding bias and being empathetic aren’t just necessary for being a nice person—they’re essential for getting the story and the science right.” 12/
@Open_Notebook Watch for language traps. One example: Don’t abbreviate “chronic fatigue syndrome” as “chronic fatigue.” The former is an illness with symptoms far beyond fatigue, the latter is a symptom common to many, many illnesses. 13/
@Open_Notebook Editors: Hire writers w/ contested illnesses. Considering us biased “is a bit like considering Black reporters biased on stories on race. There’s no neutral position: We all have a race, and we all have bodies w/ varying capacities. Ignorance does not equate to lack of bias.” 14/
@Open_Notebook “Please, please, cover these illnesses, and invest the effort and care required to do so well. Patients and patients-to-be—and, hopefully, people who might have gotten sick but won’t because of the research that will protect them—need you.” 15/
@Open_Notebook Here are some pieces that have done an excellent job covering contested illnesses. Happily, I know of more than I feel like I should list! If you know of excellent pieces on contested illnesses I haven’t included here, please add them. 16/
1/ Paul Garner seems to be describing some form of brain retraining in claiming that positive thinking cured him of ME. He's extrapolating hugely from his own, n=1 case to make claims that are deeply harmful to the ME community and that are ungrounded in evidence.
2/ The tricky thing, though, is that there's something to brain retraining. Many ME patients have benefited from it. The problem isn't the idea that brain retraining can be a useful tool; the problem is extrapolating that brain retraining solves the entire problem of ME.
3/ Plus, of course, that he made other egregious, hurtful statements about ME patients.
This is a scary thing to talk about, because the issues here are subtle, and Twitter is not a good forum for nuanced conversations. Nevertheless, I think it's important to try.
There are lots of ME recovery stories, even though recovery is rare for ppl w/ ME for more than a few years. Often, people who recover are... really annoying. I've remitted 2x, and I've tried to talk about it v carefully. I'd like to suggest some guidelines for recovery stories.
1. What worked for you may not work for others. ME is hetergoeneous. Say that.
2. You may not understand correctly what worked for you. Sometimes ME remits spontaneously, especially at the beginning. Present the evidence for your conclusion, and acknowledge that you may be wrong
3. Every treatment has risks. Give your best assessment of what those risks are for the treatment you chose, even if you didn't experience them.
It's been 13 months since my craniocervical fusion surgery and 7 months since my tethered cord surgery. My diagnoses were craniocervical instability, tethered cord, ME/CFS, MCAS, POTS, and mold illness (which may or may be fully explained by MCAS). 1/n
Before my first surgery, I couldn't sleep inside a house b/c of mold illness/MCAS. I got paralyzed, unable to speak, and barely able to breathe, sometimes 8 or more times a day. This could result from tilting my head back, speaking too much, a loud sound, a tap on the head. 2/n
Traction (pulling my head away from my body) brought me back from these episodes. I couldn't ever be left alone. I wasn't bedbound, but I could do essentially nothing for myself. 3/n
One of the biggest challenges #mecfs has faced is that there isn't a tidy story to organize one's thoughts around. "Fatigue" has been offered up as the story, but it's a TERRIBLE one. Trivializing, false, and vague. 1/
Some percentage of long-haulers will end up meeting the criteria for #mecfs. The big advantage that they have is that they have a better story: they never recovered from a pandemic. 2/
Long-haulers likely do face some challenges that are unique to that virus. There is a lot of heterogeneity among #mecfs pts, so even just from that perspective , it should be expected that their experience won't be identical to any other #mecfs patient. 3/