Editor’s Column

Chronic—The Book

by Edward C. Leonard, Jr., MD, DLFAPA

The third author, Kristin Loberg, uses her professional writer skills to weave the ideas of Stephen Phillips and Dana Parish into an engrossing story. Phillips, a physician, finds that many multisymptom patients have long-lasting infections. Parish is his former patient and a Lyme Disease activist. Loberg has edited many best-selling books and it looks like Chronic: The Hidden Cause

of the Autoimmune Pandemic and How to Get Healthy

Again will be another. It is well worth a psychiatrist’s attention. The reader will learn about many vector-transmitted diseases--how to test for them and what may help. Phillips and Parish criticize physicians who rush to use autoimmune treatments without looking for possible causative infections. They suggest that long-lasting medical, neurologic, and psychiatric disorders may be caused by chronic infections. This book can be divided into three parts, but the boundaries are faint. Careful reports of research, painful memories of illness, and enthusiastic treatment testimonials interact to show the role of infection. The primary authors suffered greatly during standard treatment for their initially ignored Lyme Disease. They ultimately improved with prolonged use of rationally selected antibiotics given in pulses and not continuously. They describe many therapies that helped maintain them while the disease raged, probably causing PTSD. Somatic Experiencing and EMDR are praised. The section on COVID-19 continues Chronic’s discussion of the inadequacies of many physicians by detailing the challenges facing adoption of repurposed generic medicines. Physicians are seen as herding together to avoid examining new research findings. Economic realities also may be involved. The companies developing off-patent medicines have no multi-million-dollar budgets to buy advertisements in medical journals, and reprints of the favorable articles their editors accept. Generic manufacturers cannot afford large public-relations staff to foster positive media stories. They have few staff devoted to flattering interactions with regulatory agencies’ officials and have no positions open for former government employees. Perhaps crucial to lack of respect for repurposed medicines is that generic companies make few political contributions. Is it possible that some pharmaceutical businesses encourage attacks on inexpensive repurposed medicines to protect potential profits from their newly patented drugs? The book generally provides pertinent facts without undue repetition. However, I find it ludicrous that Phillips always admonishes the reader to check with doctors before starting any treatments, although he constantly quotes patients as finding their doctors are ignorant. His advice may be needed to document that there is no doctor-patient relationship on which to base a lawsuit against the authors, but it becomes a distracting drone. Chronic ends with a comparison to Ignaz Semmelweis who discovered 150 years ago that there were fewer patient deaths when obstetricians, after doing autopsies, washed their hands and instruments and rinsed with a chlorine solution. His peers mocked his ideas, and he died with his research unaccepted. Does Dr. Phillips imply a similar sad fate for his book’s teachings? Probably not, for he ends with a militant plea: “We need to wash our hands clean of the dirty politics of medicine and forge ahead with resolve to end the scourge of chronic and autoimmune diseases with science.” I wish each of the quoted testimonials came with a research grant because too much remains too little studied.