Bleurgh. Done a transcript of the CFS section. It was painful, and typing it out made it clear how Wessely really avoids making much in the way of specific claims about anything. Jim doesn't seem to mind.
Earlier on he talks about how he and his colleagues at the Maudsley stick together and that reminded me of Robin Murray, editor of the journal that published the PACE recovery paper and has refused to publish letters pointing out inaccuracies, Psychological Medicine: "Then he started training in psychiatry at the Maudsley Hospital in London, and has remained there ever since apart from one year at the National Institute of Mental Health in the U"
https://en.wikipedia.org/wiki/Robin_Murray
Transcript:
15:26-
SW:...and that's where I got interested in Chronic Fatigue Syndrome, because these patients were being seen there, I have to be honest and say nobody really liked them…
JA: Tell me about some of these patients you saw at Queen’s Square?
SW: Well, there were people being referred, Queen’s Square is the home of neurology, and at that time it was felt that this might be a mysterious muscle disease, was the headline in one newspaper, and of course Queen Square exists on Earth to deal with mysterious muscle disease. They rapidly concluded that it wasn’t a muscle disease and then didn’t really want to have anything to do with the patients, to be honest with you. So they started, and this happens a lot when people don’t know what to do, they started asking psychiatrists to get involved, so I started to get involved, and I was the only one, and I just got more and more fascinated.
JA: Because this was the 1980s and Chronic Fatigue Syndrome, CFS, wasn’t a new condition, but at the time I remember it being misleadingly dubbed ‘yuppie flu’, and yet it was a real debilitating disease.
SW: Yes, it reappeared in, it had disappeared for many years, and then come back as illnesses do, under a different guise, in the, really in the early eighties, and it had only just started to hit the press, but at this time it was really seen as something quite mysterious.
JA: You’ve said that Chronic Fatigue Syndrome lives in an ambigous territory, somewhere between medicine and psychiatry. What was known, at the time when you started serious research into the condition?
SW: Well, really very little. It had not been an area where much of medicine, or academic medicine, feared to tread. I think that’s a reasonably fair comment. And certainly there’d been not systematic epidemiological studies, very little looking at what had been the mechanisms of chronic fatigue, and absolutely nothing on treatment, nothing at all. So the literature was really small, and some of it referred to completely different conditions.
JA: So how far have we come? What was it that you and your colleagues did manage to do?
SW: On the positive side, we showed, and I think further research has subsequently confirmed, that this is a central disorder not a peripheral disorder; we showed that it wasn’t linked to common viral infections but other colleagues showed that it was linked to things like EBV, Epstein-barr virus/glandular fever, which we confirmed; we showed that it had a different neuro-endochrine signature to depressive disorders, I originally thought it was a variation of depression but we changed our minds as the data changed and felt that actually that was important but not the same. We showed the social class gradient was, it wasn’t ‘yuppie flu’, and then we started to think about how can we improve treatments, which wasn’t difficult because there wasn’t any.
JA: So why was the research you were doing, Simon, so unpopular with the vociferous minority who really turned you in to a hate figure?
SW: Well, not just me, there’s a few of us that come under that heading, but I think that it’s to do with, for some people, the very existence of psychiatry was almost an affront to them, that the fact we unashamedly did what we did and that we were also showing that some of the treatments that we used, were not entirely biologically based, were helping, I think some people just couldn’t bear because they felt that it was denigrating them, that it was in some ways saying that they weren’t genuinely ill, and they felt that any association with psychiatry was close to intolerable, too painful, and they would rather if we simply weren’t there.
JA: And this reaction, this backlash, how bad did it get?
SW: Well, it’s difficult to talk about really because it’s been there for a long time, and it’s not just me by the way, it’s happened to lots of people in this area, but it’s a constant presence, you know, we talk to the same people that my friends who do animal work talk to and we get the same advice and information, and take some of the same precautions that they do, that’s…
JA: You’ve personally been threatened haven’t you?
SW: Yes I have, that’s not actually the biggest deal, it’s more the organised attempts at interfering with your science, your research, your career actually, and all sorts of pressure. It’s like being stalked I think. It very much feels like, very similar to that. But again, I have to say that the fact I’m here Jim suggests that it’s not been that effective, but it’s not been that pleasant either.
JA: And at its worst you decided, well, you tell me, what did you do?
SW: Well some years ago, coming back from a meeting in America with another colleague of mine, and both of us just took the decision, I think that it’s time to move on. I felt that I was not really in a good position to help take the subject forward and I just took a conscious decision it’s time to move on, and it was the right decision to take.
JA: You didn’t stop seeing patients?
SW: Oh no, patients I kept seeing all the time, it’s like A. J. Cronin’s Adventures In Two Worlds, there’s the world of the clinic, but there’s this other world of politics and internet and things like that which is pretty unpleasant at times.
JA: And looking back, you know, twenty-five years ago, do you think now or wish that you’d done anything differently?
SW: I think the youthful me probably could have handled it a bit more sensibly. I think that’s probably true, and I think that I certainly underestimated the depth of hostility that was out there, to psychiatry, and by the time I’d realised that some of the things had been said [?!]. But equally, I don’t think that it would have made much difference. There are some people out there who continue over the years to make things up and distort and tell lies about you and that would have happened anyway to be honest Jim, in this field, it happened to others as well.
JA: [Moves on to GWS]
[Minor additional bit 26:00:]
SW: And also, the other thing I like is when we do our research, you know Jim, we all know, you find something but it’s years before it makes any impact. I mentioned Chronic Fatigue Syndrome, it was years and years before we made any impact on policy. But [goes on to say military responds more quickly]