Fatigue is a concept we all know but is inconsistent and difficult to define. Its meaning is often vague and difficult to operationalize [4]. After over 100 years of inquiry, its definition remains elusive, and some have suggested the term be abandoned (e.g., Muscio [20], Hubbard [
27]). Years ago, Muscio [
27] concluded that “it is obviously absurd to set about finding a test of an undefined entity”.
The hell are they talking about here? It's plenty well-defined, enough to be useful, the problem is that it can't be measured and everything in health care breaks down when faced with the subjective experience of illness, which is a far larger and fundamental problem. At its core the problem is that medicine doesn't trust patient input and is infinitely willing to distort it with bias, but it's all they have, so they locked themselves in a bind, entirely on purpose.
There are dozens of definitions of fatigue, which themselves illustrate the problem
Not dozens, several, but not dozens. However there are dozens of BS psychosomatic concepts, and somehow that multiplicity is not a problem here. Funny how that works.
If we don’t know what fatigue is, and we are not sure we are able to measure it, how can we treat it?
The standard biopsychosocial approach has been to simply make stuff up and pretend that bad evidence that doesn't support traditional conclusions somehow does. Predictably it hasn't worked, but an entire parasitic industry has been created pretending otherwise, and that has locked everything in a permanent state of failure. This plays a huge role in the total lack of progress on medicine's approach to symptoms that don't directly relate to a simple biological measurement, which is most of them. Delusional garbage like this has infected the whole profession:
A recent review of 10 RCT’s found that mindfulness-based interventions were moderately effective for improving fatigue [34], and confirmed in a more recent review [29].
The idea that dispassionate scientists are able to understand subjective experience completely removed from theirs was always flawed. But nothing has blocked progress here more than psychosomatic ideology and its various bizarre beliefs and myths, which are heavily reflected here yet again. The profession seems incapable of finding the motivation to move away from a failed model, would rather fanatically keep on trying it while pretending that the fake results they get have any value.
The simple truth is that medicine hasn't just made zero progress at understanding illness without a simple direct relationship to an isolated disease process, it has effectively regressed at it, after decades of miserable failure. The problem isn't just with us, it's just that with us, there is nothing else, so everything is worse off for it.
