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Prof Brian Hughes: Psychogenic ME/CFS: Turning the Nostalgia Up to Eleven


Senior Member
Prof Hughes writes brilliantly on the increasingly desperate Three Desperadoes

Psychogenic ME/CFS: Turning the Nostalgia Up to Eleven

Written by Brian Hughes on November 24, 2021


Some examples of comedy are jarringly impactful precisely because they feel so authentic. A personal favourite of mine is the 1984 movie This is Spinal Tap, the legendary mockumentary depicting a fictional English rock band attempting to rescue their dwindling reputations by organising one last big-splash concert tour. It is a classic-form hagiography about pride coming before a fall. And therein lies the humour. Who hasn’t laughed at exactly this type of thing time and time again in the real world?

The band Spinal Tap comprises a perfect trio of comical characters: a combative but error-prone braggart, a passive-aggressive enabler, and an innocent underling whose occasional philosophical interjections are as hilarious as they are surreal. Despite some obvious past successes, the band members display a frighteningly poor capacity for common sense. In one famous scene, band leader Nigel shows off a specially modified amp: an extra number has been added to the volume knobs, allowing them to be turned “up to eleven.” He suggests that this superficial adjustment is sufficient to make the band’s music actually louder. Nigel believes he can determine what reality is, simply by attaching his own labels to it.

For one concert, Nigel orders the set designers to construct a Stonehenge-style megalith as a stage prop. Unfortunately, however, his innumeracy lets him down. He inaccurately represents the required dimensions and when the resulting prop is unveiled, it is a mere 18 inches tall instead of the intended 18 feet. Undeterred, Nigel and the band just keep playing their music in the hope that the audience will somehow ignore their error. The audience, however, are not so easily fooled. They immediately burst into laughter.

Much of the humour in This is Spinal Tap stems from how the band’s tendency for self-aggrandisement is juxtaposed against their obvious shortcomings. They see themselves as hit makers, but others just see them as has-beens. As spectators, we derive joy from this delusion.

As much as they try to overcome their limitations by turning the volume up to eleven, at the end of the day we all see through their façade. This is a group of people who are just not that good with numbers, logic, empirical reality, or dignity. Their piety makes them farcical, and this makes us laugh.

But anyway, I digress!

* * *

So where were we? Well, apropos of absolutely nothing, last week saw the formal publication of that new paper purporting to summarise research on “evidence-based care” for ME/CFS. As you might recall, its authors seem to be oblivious to the findings of the recent NICE review of this very same topic. (These authors’ academic paper runs to three pages; the corresponding review by NICE required a 400-page document to explain.)