Friday, May 20, 2011

Morgellons disease

Here's an interesting article in The Seattle Times:
They complain of mysterious, creepy symptoms: bugs — or some form of infestation — crawling beneath their skin, sometimes burrowing to the surface, leaving odd specks and colored filaments in their wake.

They have flocked to websites to share details of their malady, which they call Morgellons disease; they have charged the medical community with ignoring their plight and have strong-armed the government into studying it.

They go from doctor to doctor, carrying specimens in Ziploc bags and on glass slides, desperate to find a physical cause.

Now a Mayo Clinic study reviewing samples provided by 108 such patients, published Monday in the Archives of Dermatology, has concluded that the perceived infestation exists only in their minds.

Although one patient who consulted dermatologists for Morgellons was found to have pubic lice, microscopic examination showed that none of the remaining 107 patients — who were seen over a seven-year period ending in 2007 — had any evidence of infestation by bugs or parasites, despite their firm conviction that they did.

Instead, the authors concluded, the rashes, eruptions and skin ulcerations patients suffered were either mundane skin conditions that gave rise to delusions of infestation, or the result of sufferers scratching or picking at their skin to make it go away.

And the fibers and filaments so often described and offered as evidence of infestation were, upon microscopic examination, skin flakes, scabs, hair, lint, textile fiber and everyday debris.

I sympathize with these people. But this kind of thing seems to be more common than ever. People imagine something worrisome, so they start to dwell on it. That makes the symptoms worse. And with the internet these days, you can almost always find someone else with the same delusion, no matter what it might be.

Outside the political arena, we've seen it most prominently with believers in a vaccine-autism link. Autism is real, of course, and a link with vaccines wasn't necessarily a ridiculous idea. But it turned out to be based on fake research. It turned out to be completely bogus. Yet the true believers refuse to accept that, no matter what. They are so convinced they are right that nothing will change their minds.

The human mind is a complex thing. Incidents of mass hysteria have never been uncommon, but with the internet, these things don't even have to be localized geographically anymore. And some people are just naturally fantasy-prone. Some people are more gullible than others. Some are naturally more skeptical and some less.

If you've ever seen a stage hypnotist, you'll know that some people are better subjects than others. A stage hypnotist generally gathers a bunch of people from the audience, and then quickly identifies the best for his purposes. There's almost always someone who's very susceptible to suggestion. Well, that includes self-hypnosis, too.

And it's also the case that doctors often act like they don't really care. They're busy, and they can't spend much time with each patient. Frequently, they don't even seem willing to listen to a complaint. Or it seems to the patient that they leap to a diagnosis without even thinking about it. Going to a doctor can be a very frustrating experience.

Providers of alternative medicine, on the other hand, may not actually do anything useful but listen sympathetically. That placebo effect is quite powerful, though. Homeopathic preparations might be nothing but pure water, but if you think they're supposed to do something, you still might feel better.

And spinal manipulation might do nothing to fix your hangnail or cure your headaches, but a chiropractor is likely to listen to you and to act like he cares. And since pain is subjective, that might actually help, too. (I don't mean to imply that chiropractors don't do anything useful, but very few of them limit themselves to what they can usefully affect.)

But this is why the scientific method is so crucial in medicine. Double-blind testing is essential to determine what works and what just makes people think it's working. Sugar pills might actually "work," but it's just the placebo effect. Real medicine must be shown to work better than placebos.

And what do they call alternative medicine that actually works better than a placebo? Medicine.

Well, I just think this article is interesting, because it shows how powerful our minds are. It shows how we can even imagine maladies that don't exist. I'm certain that these people were suffering, but they weren't suffering from anything real. It was all in their minds.

It's also a cautionary tale. It shows the importance of maintaining a skeptical, scientific mindset. Just because you can find other people who believe the same things you do, that doesn't mean they're real. You can find almost anything on the internet these days. The trouble is determining what to believe.

It's very, very easy to believe what you want to believe. That's the case for all of us. Yes, it applies to skeptics as much as to anyone else. But skeptics understand that and try to compensate for it. Skeptics know that the scientific method was developed to help counter that natural inclination. They understand how it works and why, though it's far from perfect, it's the best way to determine the truth.

This won't keep you from ever being wrong. But it will help you be right more often. It will help keep your imagination from running away with you. An imagination is a great thing, but you have to keep it under control. Just because you can imagine something, that doesn't mean that it's real.

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