Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
  • About KevinMD | Kevin Pho, MD
  • Be heard on social media’s leading physician voice
  • Contact Kevin
  • Discounted enhanced author page
  • DMCA Policy
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • Group vs. individual disability insurance for doctors: pros and cons
  • KevinMD influencer opportunities
  • Opinion and commentary by KevinMD
  • Physician burnout speakers to keynote your conference
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Primary care physician in Nashua, NH | Doctor accepting new patients
  • Privacy Policy
  • Recommended services by KevinMD
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The biggest mistake doctors make when purchasing disability insurance
  • The doctor’s guide to disability insurance: short-term vs. long-term
  • The KevinMD ToolKit
  • Upgrade to the KevinMD enhanced author page
  • Why own-occupation disability insurance is a must for doctors

An apology to patients with chronic fatigue syndrome

Toni Bernhard, JD
Conditions
August 12, 2011
Share
Tweet
Share

I’ve been sick since 2001 when I failed to recover from what appeared to be an acute viral infection. It has left me mostly house-bound, often bed-bound. In effect, I’ve had the flu without the fever for almost ten years: the aches and pains, the dazed sick feeling, the low grade headache, the severe fatigue. It cost me my career as a law professor; it cost me the ability to be active in the lives of my children and grandchildren.

Because I meet the Centers for Disease Control (CDC) case definition, I’ve been given the diagnosis, Chronic Fatigue Syndrome (CFS). Although there have been some promising developments (a possible connection to a retrovirus; the presence of unique proteins in the spinal fluid of CFS patients), as of this writing, there’s no proven cause and no cure. This is not surprising, given that so little money is allocated for research into this debilitating illness. Why? One reason is the absurd name. As others have pointed out, calling it, “Chronic Fatigue Syndrome,” is like calling Emphysema, “Chronic Cough Syndrome,” or Alzheimer’s, “Chronic Forgetfulness Syndrome.”

On October 15, 2009, Dr. Nancy Klimas of University of Miami’s Miller School of Medicine spoke about the lack of research money to the New York Times:

My H.I.V. patients for the most part are hale and hearty thanks to three decades of intense and excellent research and billions of dollars invested. Many of my C.F.S. patients, on the other hand, are terribly ill and unable to work or participate in the care of their families. I split my clinical time between the two illnesses, and I can tell you, if I had to choose between the two illnesses in 2009, I would rather have H.I.V.

When doctors ask what’s wrong with me, I can give one of two answers, neither of which is satisfactory in the context of obtaining quality health care for myself and others with CFS. That leaves me in a no-win position in the doctor’s office.

Option #1: If I say, “I have Chronic Fatigue Syndrome,” I’m likely to be discredited as a witness to my own condition. I’ve had doctors tell me there’s no such thing as Chronic Fatigue Syndrome. One doctor said: “Just drink some coffee.”

Option #2: If I say, “I contracted a serious viral infection and never recovered,” it goes down better, but by saying this, I’m undermining the effort to bring legitimacy to the illness. Legitimacy means research money. By avoiding the phrase, Chronic Fatigue Syndrome, I’m also undervaluing the lifelong work of many doctors, including Nancy Klimas, Dr. Anthony Komaroff of Harvard Medical School, Dr. Charles Lapp of the Hunter-Hopkins Center, and Dr. José Montoya of Stanford University School of Medicine, all of whom have dedicated their careers to CFS research and patient care.

A few weeks ago, I had an appointment with a doctor regarding something unrelated to my illness. The New Patient Form asked, “Are you in good health?” I checked “no.” Next question: “If you checked ‘no,’ please explain.” How many times have I faced “please explain” on a medical form and had to choose between those two unsatisfactory options? I’ve lost count. I needed the best care I could get from this doctor so, playing it safe, I reluctantly took option #2 and wrote, “Contracted a serious viral infection in 2001 and never recovered.”

On the back side of the form was a list of symptoms with instructions to put a check in the box next to any that applied. Looking down the list, I reached: “Fatigue.” What’s a person with CFS supposed to do with that choice? Most of the people I know say they’re tired. But the fatigue of Chronic Fatigue Syndrome? The CFIDS Association of America calls it bone-crushing fatigue. I call it bone-crushing and sickly fatigue—that flu without the fever. Laura Hillenbrand, bestselling author of Seabiscuit and Unbroken, and a CFS sufferer herself, put it this way: “This illness is to fatigue what a nuclear bomb is to a match. It’s an absurd mischaracterization.”

Given no alternative but “Fatigue,” I checked the box and moved on.

In the exam room, the doctor looked at my form and asked: “What’s this viral infection you never recovered from?” Without using the phrase Chronic Fatigue Syndrome, I succinctly explained the different theories regarding the cause of my continued illness. He listened and then said: “What’s the diagnosis?” I was cornered. “Chronic Fatigue Syndrome,” I said. I watched him disengage from me. He swiveled on his stool, put his note pad down, turned back to me as if we’d just met and said: “What have you come to see me about today?”

On March 3rd, Dr. Montoya said in a talk at Stanford University that it was his dream that the medical community would someday produce a formal apology to patients for not believing them all these years when they said they were facing a real illness.

Millions of us share your dream, Dr. Montoya.

ADVERTISEMENT

Toni Bernhard was a law professor at the University of California—Davis. She is the author of How to Be Sick: A Buddhist-Inspired Guide for the Chronically Ill and their Caregivers. Her forthcoming book is titled How to Wake Up: A Buddhist-Inspired Guide to Navigating Joy and Sorrow. She can be found online at her self-titled site, Toni Bernhard.

Prev

There is no such thing as a complete physical examination

August 12, 2011 Kevin 1
…
Next

6 reasons why doctors won't call patients back

August 12, 2011 Kevin 8
…

Tagged as: Patients

< Previous Post
There is no such thing as a complete physical examination
Next Post >
6 reasons why doctors won't call patients back

ADVERTISEMENT

More by Toni Bernhard, JD

  • 4 things the chronically ill wish others understood

    Toni Bernhard, JD
  • 5 hidden consequences of chronic pain

    Toni Bernhard, JD
  • 10 challenges faced by those with chronic pain and illness

    Toni Bernhard, JD

More in Conditions

  • The “ethical canary”: How moral injury signals systemic failure

    Courtney Markham-Abedi, MD
  • Trauma reactivation: Why news headlines trigger past abuse

    Barbara Sparacino, MD
  • The healing power of physician presence in modern medicine

    Farid Sabet-Sharghi, MD
  • ATTR-CM screening: the missing link in heart failure diagnosis

    Radhesh K. Gupta
  • When the doctor becomes the patient: a breast cancer journey

    Amy E. Sanders, MD
  • Menstrual health in medicine: Addressing the gender gap in care

    Cynthia Kumaran
  • Most Popular

  • Past Week

    • Missed diagnosis visceral leishmaniasis: a tragedy of note bloat

      Arthur Lazarus, MD, MBA | Conditions
    • Sabbaticals provide a critical lifeline for sustainable medical careers [PODCAST]

      The Podcast by KevinMD | Podcast
    • Menstrual health in medicine: Addressing the gender gap in care

      Cynthia Kumaran | Conditions
    • Antimicrobial resistance causes: Why social factors matter more than drugs

      Maureen Oluwaseun Adeboye | Conditions
    • Executive order on homelessness: Why forced treatment fails

      Gary McMurtrie | Policy
    • Single-payer health care vs. market-based solutions: an economic reality check

      Allan Dobzyniak, MD | Policy
  • Past 6 Months

    • Missed diagnosis visceral leishmaniasis: a tragedy of note bloat

      Arthur Lazarus, MD, MBA | Conditions
    • Alex Pretti: a physician’s open letter defending his legacy

      Mousson Berrouet, DO | Physician
    • Health care as a human right vs. commodity: Resolving the paradox

      Timothy Lesaca, MD | Physician
    • The American Board of Internal Medicine maintenance of certification lawsuit: What physicians need to know

      Brian Hudes, MD | Physician
    • Why voicemail in outpatient care is failing patients and staff

      Dan Ouellet | Tech
    • AI-enabled clinical data abstraction: a nurse’s perspective

      Pamela Ashenfelter, RN | Tech
  • Recent Posts

    • Single-payer health care vs. market-based solutions: an economic reality check

      Allan Dobzyniak, MD | Policy
    • Learning from patients: How a physician gained strength and resilience

      Samantha Fernandes, MD | Physician
    • Early screening saves limbs from silent vascular disease [PODCAST]

      The Podcast by KevinMD | Podcast
    • The “ethical canary”: How moral injury signals systemic failure

      Courtney Markham-Abedi, MD | Conditions
    • Beyond Flexner: Why we must rethink medical training reform

      Ravi Agarwala, MD | Education
    • Rural emergency medicine in New Mexico: a physician’s firsthand account

      Sarah Bridge, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 16 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Missed diagnosis visceral leishmaniasis: a tragedy of note bloat

      Arthur Lazarus, MD, MBA | Conditions
    • Sabbaticals provide a critical lifeline for sustainable medical careers [PODCAST]

      The Podcast by KevinMD | Podcast
    • Menstrual health in medicine: Addressing the gender gap in care

      Cynthia Kumaran | Conditions
    • Antimicrobial resistance causes: Why social factors matter more than drugs

      Maureen Oluwaseun Adeboye | Conditions
    • Executive order on homelessness: Why forced treatment fails

      Gary McMurtrie | Policy
    • Single-payer health care vs. market-based solutions: an economic reality check

      Allan Dobzyniak, MD | Policy
  • Past 6 Months

    • Missed diagnosis visceral leishmaniasis: a tragedy of note bloat

      Arthur Lazarus, MD, MBA | Conditions
    • Alex Pretti: a physician’s open letter defending his legacy

      Mousson Berrouet, DO | Physician
    • Health care as a human right vs. commodity: Resolving the paradox

      Timothy Lesaca, MD | Physician
    • The American Board of Internal Medicine maintenance of certification lawsuit: What physicians need to know

      Brian Hudes, MD | Physician
    • Why voicemail in outpatient care is failing patients and staff

      Dan Ouellet | Tech
    • AI-enabled clinical data abstraction: a nurse’s perspective

      Pamela Ashenfelter, RN | Tech
  • Recent Posts

    • Single-payer health care vs. market-based solutions: an economic reality check

      Allan Dobzyniak, MD | Policy
    • Learning from patients: How a physician gained strength and resilience

      Samantha Fernandes, MD | Physician
    • Early screening saves limbs from silent vascular disease [PODCAST]

      The Podcast by KevinMD | Podcast
    • The “ethical canary”: How moral injury signals systemic failure

      Courtney Markham-Abedi, MD | Conditions
    • Beyond Flexner: Why we must rethink medical training reform

      Ravi Agarwala, MD | Education
    • Rural emergency medicine in New Mexico: a physician’s firsthand account

      Sarah Bridge, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

An apology to patients with chronic fatigue syndrome
16 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...