Ralph,
Kudos! I read the whole essay start to finish, and have to say: that tick messed with the wrong person when it bit you. I hope you will keep writing and will keep after those in the medical world who refuse to see reason.
Your comments about the geographic spread of Lyme are spot on and are the best takedown I have seen of the 'we don't have Lyme here' position. My motto has long been that "ticks don't read maps." I suspect the origin of the we-don't-have-Lyme-here is the scientific method of isolating and comparing two items, controlling for variables by excluding them. This gives a clean comparison of A to B, but doesn't account for A1, A2, B1, and B2 (never mind factors C, D, and E), especially over time. The scientific method thus becomes a bunker in which to hide from inconvenient facts.
Clinging to an assumption of status quo as the natural state of the universe introduces all sorts of errors, and your comments on biodiversity and the effect of large populations of small rodents explains elegantly the effects of deforestation as woods and forests were cleared for farm land over the last few centuries, now followed (as Weintraub describes in her book) by the suburbanization of the farmland -- thus providing cover for the tick-bearing rodents but not for the natural predators of those rodents.
A chunk of my family is from the piney woods of the deep South, and I have grown to suspect that those who may seem to outsiders as lazy and stupid (though springing from an otherwise reasonably intelligent and industrious gene pool) are perhaps simply ill ... from some unidentified infection. I also think about the sudden 'epidemic' of Alzheimer's. Hmmm.
I have read little about transmission of Lyme in utero, but know that it happens. That's another cause mainstream medicine seems to overlook.
I appreciate your comments about dogs and their status as both harbinger and vector of disease. You note that dogs spend a lot more time outside than their humans ... and the compounding factor of that is that humans are exposed more often and for longer periods of time to those same vectors due to the special status and living arrangements of humans and dogs. That is: the squirrel in the park across the street may have Lyme, but the squirrel doesn't sleep at the foot of my bed or curl up on the carpet in my house. A one-two punch.
I see our biggest adversary to be the IDSA: unless and until Wormser and Steere and their acolytes are deposed or retired and replaced by clear-thinking true scientists, we will continue to suffer as individuals and as a society.
I hope you will update us on your writings and your 'adventures' with Lyme. We need more like you, and if you write that well when you are ill, I definitely look forward to your further commentaries. The holistic view of an anthropologist is sorely needed in these matters.
Best to you --
Sorry, my cutting and pasted submitted prematurely....
This is a fantastic article! I am sorry that you are sick, but I do love it when smart people have the same disease as me. :)
I think you do a fantastic job proving your thesis that the geographical perception of where lyme disease exists is an unnecessary hinderance to a diagnosis.
I was asked by every doctor I saw...."Have you been to Long Point?."...(the only place where Lyme exists in my province)...when I said no, they said then I can't have Lyme disease. It is totally ridiculous and it is one of the reasons (on top of poor testing and the need to see a bullseye) that it took so long to get diagnosed.
I love the way your paper moves between an academic paper and a personal essay and back to an academic paper. It gives credit to you as a patient and you as a researcher.
"Lyme disease is a controversial issue.” I disagree. Lymedisease is neither an issue nor a controversy, it is a physical ailment – it justhappens to be surrounded by issues and controversies. "
...I love this statement. It sums it up so nicely.I wish it was just a controversy. People question me all the time when I can't get treatment in Canada...they are suggesting that it is me who is crazy because I think I know more than Canadian doctors... The disease is what it is...it doesn't care who treats me.
a young PA - is this a professor's assistant?
There is always a gap between scientific research and public information,and rightly so. If every hypothesis-in-working was instantly disseminated to thepublic before being submitted to adequate testing and scrutiny, then our everyday knowledge about the world would be even more convoluted and self-contradictory than it already is....
This is great....Lyme (not the disease itself :))does feel like it is full of contradictions because IDSA isn't evolving, it has forced the hand of ILADS to put it's info out there that appears contradictory.
Anyways, awesome! You have done such a great job of laying out the controversy in a way that is easy to understand. By addressing the geography head-on like that...you show how something so futile and ridiculous is causing so many people to get more sick then they need to be.
“Lyme disease is a controversial issue.” I disagree. Lymedisease is neither an issue nor a controversy, it is a physical ailment – it justhappens to be surrounded by issues and controversies.
over half a year
a young PA
The most commonly cited vector for transmission is the deer tick, althoughthe list of potential vectors is increasing – of which, more later.