Opinion 'Long covid' and how medical information is causing illness: A philosophical issue affecting public health, 2023, Garner, Vogt

[NelliePledge]

He should try taking a look at the wolf in sheep’s clothing psychosomatic philosophy of medicine.

 

[rvallee]

Seeing arguments like this being just as common as they were a century ago makes me think of the Sophons in the 3 body problem. In the books or TV series, it's this imaginary technology that allows a technologically superior civilization to effectively end our ability to progress scientifically, by making scientific experiments unusable. This way they can be sure that we remain technologically inferior when they arrive to conquer us.

Psychosomatic ideology is really acting exactly this way on medicine, but it wasn't created by technologically superior aliens, it was invented by our ancestors, and its origins date back millennia. It's like a cap on medical science, it makes even thinking or discussing it about it rationally impossible. Fortunately the rest of science and technology will make all of this be overcome by events, but the regression of medical science is truly one of the oddest anomalies in the modern world.

 

[Hutan]

I really don't know where these people get those bizarre ideas about medicine providing people with meaning. It's such a bizarre bunch of nonsense that flies in the face of literally all human behavior about illness and the place of medicine in society or its history.

He should try taking a look at the wolf in sheep’s clothing psychosomatic philosophy of medicine.

Just to push back on the idea that medicine doesn't provide meaning, I think, depending on how you define 'meaning', medicine can provide it, and it can be a good thing. A person with MS who has been searching for a diagnosis for years and who is finally diagnosed does feel grateful to have an explanation for their symptoms, a diagnosis that opens the door to helpful treatment, and all sorts of support, including feeling part of a community going through the same experience.

We've had it suggested that one of the benefits of a diagnosis of FND is that it provides a reason for the symptoms and helps to create a community of people who can provide mutual support. It is odd that Richard Smith didn't include FND in that list of diagnoses that have been rapidly becoming more common, because the diagnostic pattern from one clinic that we have seen suggests that FND is actually one of the biggest winners out of the post-Covid conditions lottery. And odd that he doesn't seem to understand the substantial increase in SSRI use flows, as rvallee says, from

the damn biopsychosocial ideology that the author obviously sees as the solution to itself.

The third driver are patients themselves, sharing stories, often through social media, of symptoms and fears. Nature has recently reported on a group of patient who frustrated by what they see as an inadequate response from health systems have started their own research programme. https://www.nature.com/articles/d41...ail&utm_term=0_b27a691814-cedc5d5936-51976720 The Patient-Led Research Collaborative has identified over 200 symptoms linked with long Covid. Another patient researcher has identified more than 150 medications and supplements that people have tried for treating myalgic encephalomyelitis (or chronic fatigue syndrome), a condition with strong advocates that, as Vogt and Garner observe, has merged with long Covid. The advocates state that the conditions are “a ‘biomedical disease’, nothing “psychological” is causing it, activity is dangerous, many will never recover. These groups crack down on any mention of a biopsychosocial approach, portraying this narrative as ‘gaslighting’ patients.”

As I read about a conditions with over 200 symptoms and possibly 150 treatments, I think of the writings of the neurologist Suzanne O’Sullivan’s, who specialises in treating what medicine currently labels as “functional disorders.” Acutely aware of the limitations of her medical craft, O’Sullivan describes how these patients undergo many tests and pick up diagnoses. They may become permanent patients and find themselves in battles with the medical establishment, the very people who have provided a way to give meaning to their problems.

I can’t conclude much with confidence from all this, but I think that I can conclude that responding to the increasing numbers of people with long-term sickness, long Covid, attention deficit and hyperactivity disorder, and other conditions with more diagnostic labels, tests, and treatments is unlikely to be the best response.

One of the things that Richard Smith fails to have noticed is that informed patient advocates are actually calling for less treatment of post-Covid ME/CFS rather than more. We don't want singing classes with the Welsh National Opera, or whoever it was getting on the bandwagon, or classes on how to breathe, or education on sleep hygiene. We don't want GET, or CBT to fix false illness beliefs, we don't think formal counselling and anti-depressants should be a first and blanket response. We don't want the RNZCGP promoting the Lightning Process as a treatment. Some of us don't even think that a network of specialist clinics providing help for Long Covid is a top priority. Because, until there are some medical breakthroughs, there are no significant treatments to offer, and the existence of clinics just provides an invitation to the clinicians to make something up.

We want people treated with empathy and without false certainty. We want research.

It's utterly preposterous to suggest that Suzanne O'Sullivan and others like her 'who specialise in treating what medicine currently labels as "functional disorders"' are 'acutely aware of the limitations of [their] medical craft' and that they are not providing a way to give meaning to the problems of their patients. To the contrary, in slapping functional disorder diagnoses on people with Long Covid, they are providing unevidenced meaning that will cause the person harm in their subsequent encounters with medical professionals.

 

[Hutan]

A counter view to the idea that the media is creating Long Covid

Hidden disability: The quiet struggle with Long Covid in Kenya
https://thesicktimes.org/2024/04/09/hidden-disability-the-quiet-struggle-with-long-covid-in-kenya/

Researchers at Aga Khan Hospital in Nairobi are working to address these challenges through ongoing research aimed at understanding Long Covid specifically within Kenya. “By focusing our research efforts on Long Covid within Kenya, we aim to generate crucial insights that not only benefit our local communities but also contribute to the broader understanding of this complex health condition across Africa,” said Lucy Bobo, a researcher at the hospital.

“Limited media coverage exacerbates the issue,” Wanjiku said, the insurance agent in Kiambu who has had Long Covid since 2021. “If the media had more coverage on Long Covid, particularly in Africa, a lot of patients would understand their symptoms and better manage them.”

 

[rvallee]

Just to push back on the idea that medicine doesn't provide meaning, I think, depending on how you define 'meaning', medicine can provide it, and it can be a good thing. A person with MS who has been searching for a diagnosis for years and who is finally diagnosed does feel grateful to have an explanation for their symptoms, a diagnosis that opens the door to helpful treatment, and all sorts of support, including feeling part of a community going through the same experience.

Those are real explanations leading to useful, practical outcomes. The general fluffy meaning of providing meaning like the one in that blog is always based around cultural tropes and other weird biopsychosocial nonsense derived from old narratives about how our lives are empty and devoid of meaning and that we find meaning in explanations for our psychological ills of being losers who can't cope with normal life, or whatever. Just completely, completely different things.

Because otherwise restaurants provide meaning to hungry people and hair stylists provide meaning to people with long hair and so on. But really, it's just people doing their job and not trying to create a deeper meaning out of it. It's just this weird continuation of old paternalistic "doctor knows best" mythology that places them as if having answers to deep philosophical questions they obviously don't have, but find appealing for themselves since they do, and this sure is fact, save a lot of people from certain death.