I SEE that a senior consultant in the Northern Ireland medical service has said ME doesn't exist. "It's interesting," he says - he doesn't mean interesting, by the way, he means significant - "that a high percentage of patients happen to be middle class females...
"I know a sick patient when I see one, yet these people look quite healthy and can eat like a horse yet spend their day sitting around in a dressing gown. People believe they have the symptoms. They believe there is something wrong with them, but I believe there is no physical basis to it, and that they are imagining it..." he told The Irish Times last week.
Tears of rage sprang into my eyes when I read this. I pictured these words rising off the page in the still and despairing homes of the people I know who are trapped in those homes by the collection of symptoms popularly known as ME.
I know a woman who crawls to the window of her bedroom, some days, and throws down her keys, so her neighbour can come in to make her a cup of tea . . . Yes, it's true she is middle class. The word "middle class" when it is placed beside the word "woman" is shorthand for pampered, idle, over imaginative - as opposed, I presume, to peasants and factory workers and huntin' and shootin' types, who are sturdy and unimaginative; and don't go around annoying doctors.
The idle bit is exclusive to women, of course - no one ever suggests that middle class men have nothing better to do than sit around in their dressing gowns. Mind you, this woman though middle class was anything but idle. She had reared three children on the wages from her job, and she was too busy to get sick. But she got sick.
If the name for her sickness was Women Sitting Around In Their Dressing gowns disease, is there not an argument that doctors should do what they can to help her? Does anyone think that anyone in their right mind would want to live the way people who think they have ME have to live?
OFF COURSE, they are not in their right minds. "If they were told they had a psychological condition they would get better much faster . . ." the doctor is quoted as saying. ("You're crazy!" "Gee thanks, Doc! I'm feeling better already!") And they don't even know it.
These silly, silly women have been diagnosed as ill "by the patients themselves or non medical friends", says the doctor. Oh well. That explains it. What would people who haven't been to medical college know?
I'm acquainted with a most brilliant and good person whose whole life, including a wonderfully promising career, has been blasted by what is called, for convenience, ME. That's what must have happened! Her friend must have called around, and while they were sitting there stuffing themselves, and reading out tips from the health column in Woman's Own, they must have decided she had ME! If only they'd gone to a male consultant to be told she hadn't!
This doctor says one thing I might agree with. He says most of his medical colleagues agree that ME exists only in the mind, but are afraid to say so. I know a senior figure in medicine in the Republic who said to me I was trying to get help for a young, working class man, but let that pass - "It's all cod, Nuala. Most of the time they're just looking for notice".
There seems to be no furthest reach of denial a man like him, corrupted by the unquestioned exercise of authority, will not arrive at, when his expertise is questioned. Because that's what ME does, and that's why so many doctors are unsound on the subject. It represents the boundary at which even the cleverest doctor's knowledge runs out.
It reminds us that there is a lot doctors don't know. For a doctor to say that because he doesn't know what ME is, much less how to treat it, that it is therefore not a malaise of the body, is an indictment of doctoring. Doctoring should never be other than humble. The same profession that brought you thalidomide and hepatitis C and Mandrax, the safe sleeping pill, is iffy about ME. Tell me about it.
"I KNOW of one family who badgered their GP for a wheelchair for their daughter but she never used it," the North of Ireland doctor says. Well, while we're generalising from single examples, can I mention the Via Dolorosa of one sufferer?
This person, between 1987 and now, managed to raise the money to see consultants at St James's Hospital, Baggot Street Hospital, Beaumont Hospital, the Mater Hospital, the Blackrock Clinic, St Joseph's Hospital, Raheny, the Mater again, Blackrock again, a herbalist in Meath, a bio energy person in Lucan, a homeopath in Killaloe, and an HRT expert, and to consult numerous GPs including the one who at the moment is monitoring a low allergy elimination diet.
This person was so often told that the problem was "nerves" that it was a relief to be referred as an in patient to St Patrick's Psychiatric Hospital. Unfortunately or fortunately, depending on whether you agree with the North of Ireland doctor or not, the diagnosis was "no psychiatric illness evident". The sufferer was discharged with no medication and with no follow up treatment recommended.
You must conclude either that that person is as sane as anybody; or that mind doctors can't do any more for ME sufferers than body doctors can. (Though, how can poor humans bear the appalling spiritual and philosophical demands of malevolent illness, if there is no hope?)
I realise that doctors can say or do anything they like, more or less. In this jurisdiction, they have long gone their own way - witness the conflict between their representatives and the State in connection with the "right to die" case.
"Self regulating", in the case of the professions, is inclined to mean "we won't have mere earthlings telling us gods what to do". The North of Ireland doctor can say what he likes with no one to rebuke him, even though he has not only wounded ME sufferers deeply, but lessened the chances of their being taken seriously - as they so long to be taken by the medical profession as a whole.
His scepticism will lodge in other minds. It's easier to decide that the patient in front of you is "manipulative", to use his word, than to admit helplessness. But there is no Ombudsmedic to see that balance is preserved.
Perhaps the North of Ireland is going to be the last home of the patriarchal authoritative statement. It has died out everywhere else. There is very little that we know for sure. When we hear the note of absolute conclusiveness - "Outside the church there is no salvation," "Ulster will fight and Ulster will be right," "There is no such thing as Myalgic Encephalomyelitis" we can be nearly sure (there is no certainty) that a caste is overstating its authority as a ploy to hang on to unearned privileges. Better by far to bow the head in the presence of mysteries, and pray for enlightenment.