Exposure to high-frequency sound waves over a prolonged period of time would explain the headaches, fatigue, dizziness, mental fog, hearing loss, and nausea. Plus this is technically an invisible energy force that is easy to place and employ.
Discernible medical injury was reported in this study: https://www.nytimes.com/2018/12/12/world/americas/cuba-embassy-attacks.html and in the paper cited by the NYT: https://onlinelibrary.wiley.com/doi/full/10.1002/lio2.231
So far no one has grappled with the findings in this report.
"If they moved to a different room, or walked outside, the noise stopped."
A Caribbean cricket INSIDE a room would explain the localization of the sounds.
Thanks to Saint999 (Albuquerque) for posting a link to a bioRxiv article about the call of a Caribbean cricket:
Recording of “sonic attacks” on U.S. diplomats in Cuba spectrally matches the echoing call of a Caribbean cricket
by Alexander L. Stubbs, Fernando Montealegre-Z
first posted online Jan. 4, 2019
I don't have the definitive answer from this article. If it were me having the symptoms, without a plausable scientific explanation, then I might want to explore the medical services provided in Louisville. One patient walked out after arriving there on wheels after only a week, and that says something, even if it is a solitary case.
Your article does an extreme disservice to those who have suffered brain trauma from any cause and those who have experienced prolonged post-concussion syndrome. You may be writing a book about functional disorders, but this article of conjecture and playing down people's symptoms because of an elusive source did not deserve publication in the NYT. Just because they don't have an obvious injury, like a severed limb that you can see with your big, dumb eyes, does not mean they're symptoms and disabilities are psychogenic.
1
'On the street where the first diplomats said they heard strange noises and became sick, I heard nothing but the odd bleating of a goat.'
The lede says that the patients heard the sound in their homes in a particular room, so that proves nothing.
Likewise, historical examples prove nothing -- the conditions are completely different.
Ric Tell: "If a guy is standing in front of a high-powered radio antenna ..."
Allan H. Frey: "The idea that someone could beam huge amounts of microwave energy at people and not have it be obvious defies credibility."
Those are too vague to be meaningful. The frequency and antenna-design need to specified precisely. In particular, dish antennas direct power in a specific direction. Satellite-television antennas operate on the same principle, although the power is flowing in instead of out.
'I asked Douglas Smith, ..., what kinds of devices might have injured the diplomats. While noting that he is not an expert on such devices, ...'
IOW, the Times's source doesn't know what he is talking about.
BTW, the Times should have interviewed an expert on epidemiology.
"If they moved to a different room, or walked outside, the noise stopped."
Which room? Was it the same room in all cases (e.g. the bedroom)? Did spouses or children report anything? How did animals react? Where were the homes located relative to each other?
An expert on epidemiology would have asked those sorts of questions, but the author doesn't quote any epidemiologists.
The author here, Dan Hurley, in "writing a book about the history of functional disorders" also comes from a slightly biased position as his preferred 'diagnosis' would most certainly help sales of his book,
When MTBE, a gasoline additive, was introduced in the 1990s in various U.S. cities, people in some (but not all) communities reported adverse reactions such as headache, nausea, and eye irritation when refueling their vehicles. Although many scientific studies and assessments were undertaken to investigate the factors contributing to these acute health complaints, one study (H.A. Anderson et al., Wisc. Dept. Health & Social Services, Milwaukee, 1995) might be particularly relevant to the topic of Hurley's article . The results of the Wisconsin study suggested that individuals who reported adverse effects related to MTBE-gasoline exposure were also more likely to have had recent illnesses such as colds AND were also more likely to be aware of the recent addition of MTBE to gasoline through local news reports. This in no way "explains away" the health complaints of either motorists or diplomats, but it does raise some interesting questions about the role of communication through social media and other channels as a possible factor contributing to multiple reports of symptoms in certain settings.
ProPublica has a much more thorough report on this matter, including the speculation that the symptoms are a caused by mass hysteria, but diplomats/CIA officers don't have hysteria. They have to find another term for it.
Considering that the CIA officers were the first people to be suddenly affected by this phenomena and they immediately reflexively started covering it up, making a deep dark secret out of it then one must consider that there is already a great deal of misinformation embedded in this story. The story teller here, the NYT reporter, has effectively suggested, by excluding certain facts, and suggesting others, that it's all just mass hysteria. Most of the commentators are already convinced of it.
Of note - Charcot's "hysteria" symptoms are now recognized as dystonia, w/ known biological processes, including genetic mutations....
Also..why is this not some sort of viral vestibular neuronitis?
Never trust a diagnosis of hysteria. It's usually if not always a ploy to blame the victim for a disorder that can't yet be explained. We've seen this again and again, sometimes with fatal consequences.
2
hypnosis is often successful in treating conversion disorders. Has it been tried? Success would lend credence to the theory, and a set of failures would be counter-evidence
1
The hysteria diagnosis is a clear sign of ignorance on the part of physicians. But even Charcot syndrome and functional disorder require a triggering event, and every example of them provided here was an individual case, not several people reporting the same or similar symptoms and experiences.
Most glaringly missing from this article's rundown of possible causes, however, is infrasound and low-frequency noise (ILFN), which does indeed damage the vestibular organs and is experienced as exactly the symptoms described: headaches, fatigue, dizziness, mental fog, hearing loss, nausea. And although infrasound is by definition inaudible, it is often "heard" as a high-pitched cricket-like sound, or tinnitus. Furthermore, long-term exposure damages body cells.
ILFN appears to be key to the ill effects of wind turbine proximity that some people suffer. And that is similarly dismissed as hysterical.
1
It's human nature to project onto others the same things we would do ourselves. A man who cheats on his wife is much more likely to suspect his wife of cheating than a man who does not. And so it's no surprise that US officials interpret these symptoms in terms of a malicious attack - that's the way US foreign policy has been done for decades now.
Does anyone remember the "yellow rain" incident in the early '80's? US officials were very quick to accuse the Russians of chemical warfare; what scientists found was that what actually occurred was an act of nature.
Some remain convinced, of course, that it really was a chemical attack by a hostile force, just as some will never be convinced that the diplomats in Cuba were not the victims of some sinister plot. Like the faithful wife who not only tolerates her husband's indiscretions but also his accusations, the rest of the world will unfortunately be forced to tolerate both America's aggressive meddling and it's frequent accusations of same against them.
Functional disorder - hogwash. It's great that 'functional disorder' specialists can help people bypass pre-existing issues. That doesn't mean there aren't gaps in knowledge/science/medicine regarding those issues.
I've gone through this personally, being told something was 'in my head'. It was a physical problem I located myself. I had it cut out. The many specialists wanted to diagnose me with depression, TMJ, etc, etc with 'pain management' at the ready. Imagine if I had listened to them.
Bacteria will produce cytotoxic compounds when stimulated, whether by simple nutrients or other stimuli - say energy fields (scientific research papers can be found online). Wifi, cellular, etc - oh and EMF from electrical wiring (as in your house or power lines) all emit measurable energy, all easily verified with an EMF meter. Studies with rats have shown metabolic disruption (read toxicity, imbalances, etc) when exposed to elevated EMF. You don't need to cook people to cause problems.
The Russians historically have recognised EMF dangers, being conservative on microwave oven use and the siting of power lines (look it up). It doesn't take a genius to see the ramifications. The Russians are repeatedly conducting fishing expeditions into the US grid system - guess why. A little frequency adjustment here, a little temporary surge there... EMF, wifi, cellular, etc.
And now they (or someone like them) are having a good laugh as the 'specialists' run around in circles spewing hogwash.
Crickets, that was the initial cause of this hyped diplomatic incident.
1
it is a security system .... personally knowing someone who would get violently ill when they walked into certain stores when we shot commercials for the stores after hours and they would have to have them turn off that particular part of the system if it was on.....
Forty years ago I was recruited by three government agencies. During the "counseling" period prior to the polygraph, it was obvious the agencies were looking for applicants easily controlled by peer group pressure, what we might today call herd animals. If they are recruiting people who have never colored outside the lines or questioned authority, they should expect more of this phenomena. However, I bet diplomats posted to great places like Paris don't have these issues.
Perhaps it is something like a body scanner. When I walk into certain stores, I feel something similar to dizziness and an unpleasant sensation in my ears. It usually happens at the entrance but doesn’t necessarily happen right at the entrance, but sometimes in a different location in the same store as though someone is pointing a scanner at me. It always stops in a few seconds, but if it were turned up and left on for a long time I could see how it would potentially be damaging.
It got through!
I have practical experience with something similar. I do believe either Russia or Trump are doing this. Both have an interest in sabotaging our relations with China, and Cuba, whom Obama bravely made peace with, and you know Trump is obsessed with Obama and Russia likely wants to rekindle their relationship with Cuba by dividing us.
My presumption is that the embassy is being impinged upon locally through the Earth or the sewers or the water supply by the use of sound frequency vibrations or waves that are tuned to the resonant frequency of the building as determined by it's dimensions related to the speed of sound through solids. When resonance occurs, maximum force occurs and would cause the kind of damage written of. An example you would know of is a singer breaking a wine glass with their voice occurring in air that can be a guide.
1
Lol, Great 4h grade physics. Comparing the mass of a wine glass to a biuildings mass was the give away. Almost thought you were serious Oh Master Witness.
You evidently never lived next to a nightclub. Low-frequency noise does indeed resonate through a building's walls.
"... that are tuned to the resonant frequency of the building ..."
You are on the right track by looking for known physical processes.
However, you might do better to think about resonant frequencies of the human head and its parts.
Also note that complex structures may have multiple resonant frequencies and unknown damping properties.
There is a TED Talk from 2004 that includes a cursory demonstration and explanation of something called hypersonic sound; basically, a uni-directional laser-like sound-beam technology.
That bit of gee-whiz technology was later utilized/weaponized into something called a Long Range Acoustical Device (LRAD). There are good videos of that bit of wonderfulness being used by cops against protesters in New York and Pittsburg.
Could not such a focused, targetable sound-beam be made to operate at non-audible frequencies (below 20Hz and/or above 20kHz)? And what, from a technical/feasibility perspective, would be the upper limit on the amplitude/"volume"/energy of such an inaudible beam?
And, as to the question posed by the title of this article, what kind of symptoms might be reported by people exposed to it?
Might it not be the case that the ultimate cutting-edge form of this technology is not sitting on a shelf at your local police station?
I have reviewed the majority of the medical literature published on this topic through a few months ago in order to write a lecture. The diplomat's symptoms and (abnormal) test findings as reported are completely consistent with microwave injury, a phenomenon which may be accidental (close and prolonged exposure to a microwave source, such wearing Bluetooth headphones all night long while streaming youtube videos from your phone under your pillow) or intentional (microwave weapon or surveillance device, as experienced by American diplomats in Moscow during the cold war). People with functional illness do not have abnormal brain imaging studies. People with functional illness do not transmit symptoms to pets in the home (as happened with Catherine Werner's dogs).
What is really mysterious here is why so many articulate people believe that something that they cannot see, feel, hear, or smell, cannot possibly hurt them or anyone else, and probably doesn't even exist. There are a great many examples to prove them wrong: radon gas, carbon monoxide, microbes before the advent of microscopes, gamma rays, x-rays, microwaves, to name a few.
Perhaps the author should the patient's doctor's have done: believe them.
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Hi, this is Dan, the author of the article. So people should diagnose their own illnesses, and scientists should stay out of it? In fact I spoke to four diplomats and none of them claim to know what happened, although all of them do think it was something physical, some kind of attack.
So your claims that people get sick from wearing bluetooth headphones and other forms of radiation are not consistent with scientific consensus. But of course, as with vaccines, there are plenty of people who don't believe the "experts," and that is their right. But when the State Department is claiming that public servants have been harmed by an "attack," that is a claim that must be examined.
You mentioned the "microwave weapon or surveillance device, as experienced by American diplomats in Moscow during the cold war." Did you know that the Johns Hopkins doctors brought in by the State Department to review what happened at the US embassy in Moscow back in the 1970s found...nothing? Check it out: https://www.washingtonpost.com/archive/politics/1978/11/21/moscow-microwaves-no-harm-seen/7a4b045f-e2ff-401e-a1f5-34e748d4cf13/?utm_term=.5617ea7be08a
And here is a medical journal article that re-examined those conclusions: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3509929/
I
The article fails to discuss: Disability Insurance Companies. Most private insurance disability polices contain a two year limit on the payment of benefits caused by mental illness. For disabilities caused by physical illnesses benefits are typically paid until the term of the policy. Therefore insurance companies have a big interest in having the symptoms causing an individual's disability to be caused by mental illness and not physical diseases. And insurance companies spend a lot of money promoting the existence of, and large numbers of these "conversion" disorders.
This fact should have been presented in commentary. The failure to do so makes me wonder of the bias and true agenda of the author.
The "sonic weapon" was identified in a bioRxiv article by detailed comparison of "The sound linked to these attacks... recorded by U.S. personnel in Cuba and released by the Associated Press (AP)" to multiple recordings of Caribbean Crickets.
"As shown here, the calling song of the Indies short-tailed cricket (Anurogryllus celerinictus) matches, in nuanced detail, the AP recording in duration, pulse repetition rate, power spectrum, pulse rate stability, and oscillations per pulse. The AP recording also exhibits frequency decay in individual pulses, a distinct acoustic signature of cricket sound production. While the temporal pulse structure in the recording is unlike any natural insect source, when the cricket call is played on a loudspeaker and recorded indoors, the interaction of reflected sound pulses yields a sound virtually indistinguishable from the AP sample. This provides strong evidence that an echoing cricket call, rather than a sonic attack or other technological device, is responsible for the sound in the released recording."
As a biologist I loved this: "Although the causes of the health problems reported by embassy personnel are beyond the scope of this paper, our findings highlight the need for more rigorous research into the source of these ailments, including the potential psychogenic effects, as well as possible physiological explanations unrelated to sonic attacks."
https://www.biorxiv.org/content/biorxiv/early/2019/01/04/510834.full.pdf
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The AP "recording" was actually a simulation of the sensation of tinnitus, not an actual recording of anything, let alone a specific species of cricket.
1
"... a bioRxiv article [about the call of a Caribbean cricket] ..."
Thanks for posting that link. A cricket INSIDE a bedroom would explain the localization of the sounds reported in the article.
Even if one is open to accept that it might be a psychogenic disease, there area many questions that the specialist who consider it such have left unanswered. The first one is why specifically State Dept. officers? Why mostly in Cuba? Why not in other parts of the world or in the State Dept buildings in DC? What is the supposed stress that is triggering it? Why have they not offered treatment to these people to see if they can be cured, as it happened with Jason Lindsley, when referred to Dr. LaFaver? To dismiss the injuries these people have sustained as being "functional" without also proving it is equally nonsensical as those who say they cannot have been produced by an outside source.
1
I am very hesitant to ever interpret physical symptoms that patients report as psychogenic. All of the people affected had very different psychological and physical profiles. Given that variability, it seems highly unlikely that they would all report such similar experiences and consequences. This feels like blaming the victim to me.
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Hi SHJ, this is Dan Hurley, the author of the article. First you say that you don't think it's functional because they have different profiles, then you say it's unlikely that they would report such similar experiences and consequences. You conclude by saying that a diagnosis of functional disorder is "blaming the victim." I'm not really following you. How is saying that they are suffering from functional neurologic disorder "blaming" them? Nobody is suggesting that they woke up one morning and decided, "Today I will make myself sick and miserable!" Saying that someone has depression is not blaming them either.
In speaking to many, many doctors about functional disorders, I found that docs who don't specialize in this area have all sorts of misconceptions, and that includes Doug Smith at the University of Pennsylvania who wrote the paper in JAMA insisting that the diplomats had brain damage. For instance, Smith et al stated in the paper there was no evidence of faking or malingering among the diplomats, that means they didn't have a functional disorder. That's entirely wrong, as functional disorders have nothing to do with faking. (Although it's true that sometimes people trying to get out of work do fake an illness.... but that's not what was going on here.)
All I can tell you is that a lot of very serious docs who have devoted their careers to studying these difficult disorders have concluded that a functional disorder is probably what's going on with these folks.
Very long article and you failed to mention the crickets!
https://www.nytimes.com/2019/01/04/science/sonic-attack-cuba-crickets.html
2
I wonder if this is similar or related to CRPS - Chronic Regional Pain Syndrome where someone who has an injury has chronic pain afterwards for year or permanently even though there is no longer a physical cause. For example, my wife had a serious fall and severely damaged her arm. after the broken arm was fully healed, she continued to have episodes of pain at the slightest touch many months later. - the skin on that arm would turn darker and it was noticeably different from her other arm. CRPS patients are known be unable to put their hand into an open paper bag or drawer, etc even with no contact whatsoever. They may even use the use of a limb even though there is no physical reason for this. It's sometimes referred to as the suicide disease since CRPS patients are at high risk of suicide due to the pain and frustraion it causes. It is rarely diagnosed and we only discovered it when one of several orthopedic surgeons looked at the skin texture and asked if we'd ever been told that she might have CRPS.
"Qui bono?" Who benefits? Only those who want a continued confrontational stance between the US and Cuba. Only those who want to erase an Obama era accomplishment. Only those who want to keep the Cuban resort market out of the reach of Americans. So, Kim Jun Un? Ayatollah Khamenei? Nicolás Maduro?
Or persons with a visceral hatred towards the ruling regime in Cuba?
Some mention should have been made in this article of the crickets. The preprint of the work, mentioned in some comments and which was reported exensively on-line in early 2019, can be found here: https://www.biorxiv.org/content/10.1101/510834v1
Note this work is on a preprint server, and, to my knowledge, has not yet appeared as a peer-reviewed scientific article. So in that sense, it's "not quite cricket"...! :-)
1
It sounds like Fox in this article and Comments section. Oh @David here just threw the one plausible idea put forth. I've seen more people in this Comment section try to walk over everyone else trying to show how intelligent (or creative they are). This has been interesting watching unfold. We truly are in a Post-Truth age and it's not just the Right with the uneducated; educated people have no yardstick as to Truth anymore. This Internet thing has really messed with our collective heads. To me it shows that no one ever learned how to critically think and that social status is the soma of this generation!
The alleged recording of crickets obtained by the AP is in fact a simulation of tinnitus easily found online. You can see the page of samples in their video.
1
Still a mystery, then?
No mention of the possibility discussed in your January article:
The Sounds That Haunted U.S. Diplomats in Cuba?
Lovelorn Crickets, Scientists Say
https://www.nytimes.com/2019/01/04/science/sonic-attack-cuba-crickets.html
1
You want have a conspiracy theory, but that pesky physics keeps intruding.
Rats!
3
It was rats! You found it.
I see from other sources that "research studies conducted since the war have consistently indicated that psychiatric illness ... do[es] not explain Gulf War veterans illnesses in the large majority of ill veterans."
1
Once you eliminate the impossible, whatever remains, no matter how improbable, must be the truth.
S. Holmes
Many commenters here are dismissing the idea that there is such a thing as conversion disorder or psychogenic disorders. They are wrong and/or uninformed on these issues. I work with patients who have PNES, or Psychogenic Non-Epileptic Seizures, formerly known as pseudoseizures. This does not mean that their events are faked or not 'real', and this disorder ruins people's lives. Working with these patients during their EEGs, I plant suggestions before hand and am able to get the patients to have an event while on video and EEG. Most of them have events beginning with some of my suggestions. They are not doing it on purpose and are not aware that they are doing it. The EEG and EKG show perfectly normal brainwaves and heart rates throughout the event. This is proof, in most cases, that there is no underlying physical cause. Usually, in PNES, we find that there has been some serious trauma in their past; many were victims of sexual assault or abuse. When they are under stress, they are apt to have an event. It is as if their minds, not their brains, are telling them to get away from the stress by having an event. This is a very difficult disorder to treat and unfortunately many of these patients fall between the cracks of psychiatry and neurology. I was pleased to read that some physicians are addressing this problem and hope that more clinics like these open. These patients need treatment and respect in order to recover.
So a writer who is focusing his personal career efforts on writing a book on "functional disorders" collects information about a situation of very unique and limited scope with unknown etiology and makes a case for a diagnosis of "functional disorder". Really? If this was the cause then why do we not see this more often in other work place situations where people are under stress? Or in other embassies as a widespread phenomena?
This reminds me of the old story about the man who is walking the streets one night and comes across a man searching the ground for something beneath a street light. The man asks " What are you doing?" to which the second man replies " I lost may keys." The first man then asks "You lost them here." To which the second man replies " No, but the light is much better here".
The article had a lead-in meant to make you think that they had actually found the cause of this event and then leads you down an interminable path with only well reasoned conjecture as the outcome. We might as well pick up a copy of National Enquirer. NYT, you can do better.
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I disagree that the writer is “mak(ing) a case for” anything. He presented the facts and opinions that he gathered. It’s up to you to come to your own conclusions. That’s called reporting.
1
Hi, this is Dan Hurley, the author who wrote the article. Um, you kind of have it backwards. I knew little to nothing about functional disorders until after I wrote this article. Only upon learning how widespread these disorders are, how misunderstood, how prejudiced people are against them, and how much suffering they cause, did I think, gee, maybe I should write more about it. I previously wrote a book about the diabetes epidemic. I developed type 1 diabetes back in 1975, during my first semester of college.(That was fun.) I suppose you might claim that I developed diabetes in order to write a book about it? Or maybe you think war reporters are glad to have wars so they can earn their living reporting on them? And maybe Woodward and Bernstein actually broke into the Democratic national headquarters in the Watergate building just so they could write about it? Come on, reporters routinely write books about interesting stories they learned about in the course of their reporting.
1
Never mind that all we (the global scientific and engineering communities) know about about the phenomenor rejected the idea, the media accepted it as real. Then Right-Wing USA fanatics used it a club to smash relations with Cuba. Fake science, over and over again, used as propaganda.
One characteristic of hysterical disorders not mentioned here (but in historical context holds up very well) is the presence of a respected minority of medical providers who support the medical model of the illness. There are always a group of physician “believers” who tie their professional reputation to these syndromes - and in the process add another brick to the load of illness. If it’s hard for these people to walk it back in the face of contrary evidence - imagine how hard it is for the patient.
This article doesn't mention that those affected were all CIA officers acting under diplomatic cover.
1
The means is a mystery to you but the motive is more important. The Russians have much to gain from destroying the peace between Cuba and America that Obama made. So does Trump.
I am a Doctor and a Physicist, and I have been to Cuba and know the environs of our Embassy and the area where many American staffers lived before this "issue". In fact,
The Embassy is too far away from any source of which we are aware that could cause auditory problems; the houses not so much. I seriously doubt that a "sonic weapon" is an issue here. MANY people experience dizziness and hearing loss for a variety of issues - "Build it and they will come" is a much more probable cause as is proposed.
I have had patients who exhibited cold symptoms which resulted in weeks in bed because they could not stand up due to disorientation. Lab tests were negative as were vestibular findings. Recovery was almost universal but in varying time periods. Older people have a greater percentage of hearing loss than children - each exposure to a very loud noise is cumulative.
Pompeo is the last person to declare anything medical. He believes, and encourages, the Rapture. Enough said. Perhaps Penn should conduct a very large cohort study on chronological hearing loss and coordinate that with psychogenic factors. I think the problem lies there. We are all, after all, electrobiochemical mechanisms.
1
I have no idea what really happened to those diplomats in Cuba and won’t speculate. I would like to know whether precise sound readings were collected in and around their homes and offices (not just what the reporter could or could not hear).
What I do know is that persistent, low-decibel sound can be harmful to mind and body. For several years many in my community complained about a low, thrumming sound that was most noticeable at night. I was one who heard it, my husband did not. The sound kept me from sleeping, and my mind could not let go of it once I heard it. My physical health was affected. Did this sound exist only in the minds of a cluster of people with matching functional disorders? No. The sound was traced to an industrial operation some miles away. The issue was fixed. When the sound was gone, sleep returned.
The following is an observation, not judgement or armchair diagnosis. The symptoms of the outlier in China sound exactly like those of a woman I know. She is in her 30s and has suffered auto-immune-like symptoms ever since she went through a bad divorce about a decade ago. Clumps of hair falling out, skin and joint problems, a reactive gut that keeps her from eating: all of these issues have been diagnosed and treated separately. She was also diagnosed as bipolar. But I wonder, after reading this, whether Dr. Stone, or others who hold to the functional disorder theory, would put all of these pathologies together and come up with another diagnosis.
2
As a retired Foreign Service Officer who almost went to Havana, a longtime ago. I hope some of the injured, notwithstanding their honest belief they were attacked, would agree to be treated for functional disorder.
There are two imperatives here: 1) Effectively treating the victims and 2) finding the cause. Both would be served. I hope the State Department's leadership would agree, rather than insist that the official story cannot be subject examination.
Who knows what treatment they are getting, since it’s all hush-hush. But I would draw your attention again to the last paragraph in the article:
“If people have a functional disorder, it’s obviously very damaging to tell them they have a brain injury,” Stone said. “Telling someone they have a traumatic brain injury is not going to help them if they actually have a functional disorder. And it can stop them from getting therapy that might help them.”
I think the opposite is true, too. To tell a patient, affirmatively, that he or she has a functional disorder, and that they must be treated accordingly, might stop them from getting the treatment and therapy they need for a traumatic brain injury.
2
...not doubting the reality of functional disorders, of course. I believe that people do hold emotional pain and trauma that can manifest years later as physical illness. However, this phenomenon — which used be be called hysteria — has been, and still is, disproportionately ascribed to women. Women are too often not believed by their doctors or other caregivers. Their words are filtered through a screen of preconceived notions. It’s even worse when a woman hits middle age, and beyond. Take an older woman’s word on the subject. Been there.
1
I cannot fault the reporting and writing here. The piece is clear, straightforward and fascinating, without the unnecessary flourishes that so often creep into Times Magazine articles. However, I take issue with this statement by neurologist Jon Stone:
“They’re like depression or migraine. They happen in that gray area where the mind and the brain intersect.”
Huh? No, Dr. Stone. Half of that is just plain wrong.
Although it is true that depression straddles the psychological and the physical, Stone is outrageously incorrect about migraine. I have lost vast stretches of my life to intense, prolonged bouts of so-called complicated migraine. It is a one-hundred-percent-physical ailment. The best neurologist I ever had the joy to know was a kind man who also suffered from migraine. He understood that it was a real, hellish, excruciating, life altering, physical ailment. Not a function of the the mind, but of the body. A physical process. It was a relief to be validated.
Until I was in my late 30s I was disbelieved and dismissed by multiple doctors when I mentioned my migraine attacks. Even when I described visual charges and intend nausea that caused violent vomiting, they would say it was stress and my menstruated cycle, and all I need to do was calm down. So when I read that misinformation from Jon Stone, I gasped. I hope he is not treating any migraine sufferers.
2
I have a book that describes how to build various ultrasonic "weapons", for research purposes only, with commonly available electronic components, that produce the the very same symptoms claimed by the the affected individuals reported in the article. They are more powerful variations of those ultrasonic gadgets used to chase off small animals. One plan has the warning: "caution must be used as exposure to most people causes pain, headache,nausea and extreme irritability. Do not under any circumstances point the unit at a person's ears or head at close range or severe discomfort and possible ear damage may result."
This isn't the result of some ultra secret military research program. It's a consumer book published by McGraw-Hill. There are several variations using different components and power levels that create highly directional ultrasonic fields of differing frequencies and intensity. I've read elsewhere plans how to make a directional microwave "weapon" with parts from a microwave oven. These incidents don't have to be the acts of state sponsored government agencies. They could be inventive private citizens who believe the anti-Trump rhetoric they read in the American press.
This is a description of the same affliction that causes the majority of back problems in the US. According to the ground breaking work of Dr. John Sarno, author of many books on the subject, most back problems and many other physical problems are psychogenic just like the problems described in this article. I recommend you read Sarno's work. Many people, including me, have been cured of these problems just by reading one of Sarno's books. I bet the afflicted State Dept people could be cured by studying Sarno.
It's curious that an article on this topic would not have talked a bit about Dr. John Sarno's life-long discoveries in the field of "psychogenic" ailments. He cured tens of thousands of people from debilitating back pain, each in a matters of hours. Readers interested in this should read Dr. Sarno's books.
The trouble with guru-like doctors like Sarno is that their theories become a sort of Great Truth. And there is no Great Truth when it comes to medical care. Even if a particular patient’s pain is triggered by emotional pain, trauma or stress at work, the muscle spasm is still a physical ailment and it can be treated by traditional methods (lidocaine injections and physical therapy, for example) And it can, indeed, be a sign of other physical, organic problems that should be addressed (and might not be, if the doctor and patient decide that it’s an emotional problem).
Many years go I had muscle spasms in my lower back, and the weakness of my core muscles was pinpointed as the cause. After I completed the prescribed physical therapy program, the spasms disappeared. Later, I suffered through years of muscle spasms in my neck, and was repeatedly told that it was due to stress and emotional baggage. But when I had a cyst at the base of my neck removed, the near-constant neck spasms and chronic pain disappeared, and never returned. The cyst had been pressing on a nerve! So I am skeptical when anyone says that pain is 100 percent emotional or mind-based.
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The trouble I have with so-called "functional" or "psychogenic" disorders is that over the decades, so darn many of them turn out to result from cell damage or loss once we learn more about the body. Something seemingly "suggestible" may well one day turn out to be caused by some form of cell damage or loss in the basal ganglia in the brain, either acquired or genetic. Sure, it's possible that some things are purely psychogenic, but my money is on specific cellular or biochemical deficits for the vast majority of such cases. We should not fall into the false trap of thinking that if we can't find an "organic" cause today, that one doesn't exist.
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Hi there, this is Dan Hurley, author of the article. You make an excellent point. Ulcers, for instance, were once thought to be due to stress and such, until some researchers (who ended up winning the Nobel Prize) discovered that it was due to H Pylori gut bacteria. And back in the day, of course, people with things like epilepsy were thought to be possessed by demons.
Having been a science reporter for over 25 years, I was struck by the care and integrity of the doctors who now specialize in functional disorders. They mainly focus on people with bizarre movement disorders who look like they have something like Parkinson's or epilepsy or the like, but who turn out not to have the physical changes in the brain, and to have odd little variations in their symptoms that a trained neurologist can see is not Parkinson's or other known neurological disorders. In those cases, it's really beyond dispute that the people don't have any detectable, purely physical neurological problem, and that they clearly have a functional thing going on. It's particularly clear because these docs know how to treat these disorders, as I described in the case of Mark Lindsley.
Here's the thing about a possible ceullar, communicable or neurotoxic cause: *only* diplomats or their family members have gotten sick. Not one of the many Cubans who work with them. Not a single tourist. None of the Cuban neighbors. How does that happen? What is the toxin, virus or bacteria that will infect only diplomats?
"They heard the noises in their homes, in the city’s leafy western suburbs. If they moved to a different room, or walked outside, the noise stopped." Crickets? That would be my guess. Even the smallest can make a hellish racket and in concert they're scary.
It sounds like some not-insignificant fraction of all people are susceptible to psychological suggestions of ailments. In Cuba an outlandish suggestion explaining maybe only a single person's reactions to the intermittent sounds went viral among US diplomatic personnel ad an international incident was the result.
Thank goodness we have a stable leader at the helm …….
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"Hysteria", or "functional disorder" or whatever you want to call it is a convenient explanation for what happened to these diplomats. In essence, it's blaming the sufferers for their suffering. Leave it to the state department to come up with that one.
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can hypnosis be used to verify symptoms?
The hypothesis that some unknown energy source had beamed something harmful toward the victims makes perfect sense. So what if it's not "proved".
So it seems a bit ridiculous to go seeking a psychosomatic explanation.
My functional disorder isn't easy to explain/it has to do with body, nerves, and palpitating brain/When I wake up to go to work my body slumps instead/and I cannot remove myself from inside my soft bed/I struggle to get up and shave, to eat a piece of toast/and then when I go out the door I sweat like prime pot roast/When I reach the office my poor head begins to pound/and I get the feeling I have gotten myself drowned/The miracle occurs at 5 p.m. right on the dot/I walk out of the office and I do a turkey trot/Maybe I should find a job involving much less stress/But nobody will pay as good as that ol' IRS!
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The US considers itself (rightly so, I think) the most technologically advanced nation on the planet, yet it wishes us to believe that little Cuba has developed, in secret, such a pernicious weapon? One that cannot be duplicated by experts in the US?
I think this is a "herd mentality" syndrome. Diplomats are not infallible! They too are people and face life pressures just like everyone else. Also let's be honest, the State Departments isn't the best place in the world to be employed right now. Many senior members quit after Trump's election and their duties [extra work] piled on to the people who stayed. If there was a "super weapon" floating around somewhere, believe me we'd know about it!
Has anyone in the press - anyone at all - ever thought to investigate the possibility that the source of this medical problem is located somewhere inside the US Embassy in Cuba?
As in: one of the three-letter agencies of the USA has installed some whiz-bang spy device in the bowels of the Embassy and whatever that thing is doing and whatever that thing is radiating, that is the thing that is making the Embassy staff sick?
Think about it: No other western embassy in Cuba is reporting these problems, which would surely be the case if it was the Cubans who were in possession of some super-secret ray gun.
Think about it: if the CIA or the NSA has a super-secret ray gun in the basement of the Embassy then the Ambassador himself may not cleared to be briefed about it.
Think about it: if the NSA or the CIA had a super-secret ray gun that was delivering super-secrets about the Cubans then they may just decide that the value of the intel they are collecting actually outweighs the damage to the health of the Embassy staff.
"... the possibility that the source of this medical problem is located somewhere inside the US Embassy in Cuba?"
The patients were AT HOME when the symptoms occurred.
Counter-surveillance technology could have been covertly installed by the US in the residences of some embassy employees, although that seems unlikely because employees should be fully trained in security measures if they are to avoid mistakes.
Anyway, something like what you suggest was described in an earlier Times article:
"Some of those affected reported hearing odd sounds in particular rooms of their homes, leading some experts to speculate that some kind of sonic weapon or faulty surveillance device may have been at fault."
The Sounds That Haunted U.S. Diplomats in Cuba? Lovelorn Crickets, Scientists Say
By Carl Zimmer
Jan. 4, 2019
New York Times
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The Canadian Embassy in Havana reported the same problems with various of its diplomats, but not as many as the US ones.
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Did any of these diplomats have a vaccine prior to the onset of these symptoms?
Sounds like a possible poisoning or vaccine injury.
To say this is psychosomatic is absurd.
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Another case of, "science is wrong". But that is not surprising. And for those critical of expert neurologists, psychiatrists, ENTs the people who are suffering will continue to do so relentlessly. These experts are not denying the suffering but it is functional or psychogenic for which there is treatment. That is the real tragedy - refusing the right treatment and unnecessary suffering!
I hope these diplomats do not become pawns of the State Department ready to blame a country where our embassy was just opened, a country which has been a thorn in our sides over many Presidents' lifetimes. Cubans are smart but not that smart like ET. Especially when the only noise is produced by a goat!
Listen, scientists have already determined that crickets were to blame not some conspiracy-inducing idea.
Plenty of anecdotes about individuals with functional disorders, but not a single one involving a large group of people developing a limited group of symptoms (and yes, unlike the article implies, all of the victims had similar issues, varying only in severity).
Just because we haven't found the weapon that caused it doesn't mean it wasn't caused by a weapon.
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Hi JB, this is Dan Hurley, author of the article. There are countless studies of cases of mass psychogenic illness in the medical literature. I didn't go into it because of length considerations for my already-long article. These outbreaks are totally fascinating. Check out the following:
https://www.nytimes.com/1999/06/16/.../in-a-crisis-coke-tries-to-be-reassuring.html
https://www.ncbi.nlm.nih.gov/pubmed/26553502
https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/604915
https://archive.nytimes.com/www.nytimes.com/library/national/science/health/011800hth-doctors.html
https://pdfs.semanticscholar.org/bf3c/3d183534c03286b87a162f642a68a8bc2890.pdf
Is there any possibility that there exist energies that we are not yet able to measure? If there were such energies, there might be some people who are very sensitive to them and others who are not. And if they were energies that had some relationship to the deep inner nature of the earth, there might be places where they were more perceptible than other places. And if there were people who were hypersensitive to these hypothetical energies, getting a blast of them could unbalance their physiology in ways that would carry forward into the future even after they left the geographical area where they encountered the phenomenon.
If we're all going to theorise about this subject we might as well open it up to new thoughts about it.
"If there were such energies, there might be some people who are very sensitive to them and others who are not."
Nature wouldn't discriminate between employees of certain western embassies and everyone else.
Further, "such energies" would need to be measurable with scientific instruments before they could be studied in biological systems.
See the scientific history of "rays" for examples: x-rays, cathode rays, cosmic rays, etc.
And see the biology of animals that can sense KNOWN physical phenomena that cannot be sensed by humans: bats and ultrasound, bees and ultraviolet light.
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Very true that something has to be measurable before it can be studied directly in biological systems. Nevertheless, if you have a mystery, it wouldn't hurt to get information from a broader range of sources than to try only to study it on the basis of what works, when what works isn't working. It wouldn't hurt to step back and see what is in common with all these events, not just what has already been noticed and studied. Who besides the US employees in Cuba, where in the world, any similarity in the sociological background, anything unusual in the geology of the regions where it occurred? Etc. Etc. I'm not saying I know something and sneakily trying to say it in code. I'm just saying that the biosphere is more mysterious than our present measurable view of it is, and if we want to know more, we need to look in unaccustomed ways and places.
This is a fascinating and very important article.
Personally, I have thought a functional disorder to be the most likely explanation. I used the term “mass hysteria,” but this phrase has a stigma, and perhaps should be avoided.
Determining whether this is a functional disorder, or the deliberate use of a mysterious weapon by Cuba, Russia, or whomever is of tremendous consequence. Believing this to have been malevolent use of an unknown weapon, the US came close to breaking diplomatic relations with Cuba. The US embassy was reduced to a skeleton staff, and many services were substantially curtailed. Thousands of people were inconvenienced, or worse.
More importantly, the diplomatic mission was undermined. Whatever one thinks about Cuba and its government, and its sponsor Russia, diplomacy is almost always a far better alternative than military action. Effective diplomacy requires that we have feet on the ground in Cuba. This is especially true given the deplorable situation in Venezuela, in which Cuba likely plays a role. Unless we wish to conduct a military invasion, our best course of action is likely diplomacy, in both Caracas and Havana.
Since the famous U Penn article in JAMA is open to question, there must be full and complete disclosure of all available medical data and scientific opinion, both from Penn and the NIH. The data can be anonymized to protect privacy, but it must be made public, without politically motivated redactions, so the world’s experts can judge.
In the spring of 1990, I lived in a wonderful guest house on a heavily forested hilltop near Fayetteville, Arkansas that was lightless at night. The silence was deafening--broken only be a strange, repetitive, mechanical sound that occurred again and again without relief from dusk until dawn. Trump was not yet in office (Reagan was!), but recently I had seen for the first time the then 12-year-old film "Close Encounters of the Third Kind." I knew something was up. Conspiracy theories were concocted. The next morning I broached the topic with a local colleague. "Oh, those be whippoorwills you been hearin'," he said, adding, "They keep at it, dont' they?" And then, with a twinkle in his eye, he said, "They're part of the territory. Glad they found you." At last, an article that explains the presence of the inexplicable in a truly impressive manner. A Pulitzer for Dan Hurley.
If you can't see it, it doesn't exist. This seems to be the outlook of the scientific/medical community. The power of the mind over the physical body is anathema to most humans. I suffered from debilitating back pain for 9 months. I saw multiple medical doctors. Nothing helped. Then a coworker handed me a book written by Dr. John E. Sarno. I accepted his explanation that the source of my physical pain was the result of emotional stress. Four days later, my back pain was gone. From my own experience, I know how resistant people are to the idea that the mind can seemingly arbitrarily alter our physical well-being. But it can and it does. The modern world in which we live is extremely stressful. Dr. Sarno focused on back pain, but virtually any part of the body can serve as an outlet to the day-to-day stressors in our lives. But until we stop attaching negative connotations to the realm of our emotions, we will continue to deny ourselves access to our overall health and well-being and instead remain forever flummoxed by the cause of so many of our "inexplicable" physical maladies.
Growing up, I had to learn that I am at times susceptible to false sensations, and have learned over the years to quickly investigate and then ignore them if there's nothing physical going on. For me, it took the form of auditory hallucinations (I would hear the doorbell ringing when there was no doorbell ringing) and vestibular disorders (I would feel that my auto had a flat tire, to the point of pulling off the road and looking for it). It's weird and disorienting and distressing until you figure out it's false information, something that happens and you have to deal with it.
I don't know what happened to these people, but based on my own experience I believe it could be something where the mind is involved and addressing it as a possibile contributing factor may be helpful to get them back to feeling better.
To those who seem convinced by the abnormal physical findings on some of the affected individuals, I would add a note of caution. If you do enough tests, e.g. MRI's, you will find things that appear to correlate with a self-reported set of symptoms.
As an immunologist, the most fascinating aspect of these cases to me is their "infectious" nature. Makes me wonder if there is some psychogenic equivalent of a vaccine...
As a medical consulting psychiatrist in several major teaching hospitals I saw many patients with conversion and other somatoform disorders. The diagnoses must be made with caution and with ongoing coordination with the treating medical team. Combinations of psychiatric and physical therapies usually resolve the syndromes. None of that is new to those of us doing that work.
This cluster of State Dept cases following the 11/16 election leads me to label it "Trumpitis". Seriously.
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"As a medical consulting psychiatrist in several major teaching hospitals ..."
'This cluster of State Dept cases following the 11/16 election leads me to label it "Trumpitis". Seriously.'
No "serious" medical professional would mix diagnosis and politics.
You should review the American Psychiatric Association’s "Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry".
If I were to investigate the plausibility of these symptoms being of a functional, psychogenic nature I would determine, through interviews and past statements, the individual diplomat's attitude about Cubans and the Cuban government, whether they personally considered their posting to be one in a hostile nation. It would require a very careful and probing examination of their true feelings and attitudes, not just a reciting of their official mission statement and what diplomats are supposed to say diplomatically to avoid offending anyone. I would also examine the level of group cohesiveness, team player mentality, conformist attitudes among the affected staff. This would include the management style of the leaders who controlled and directed the staff, presumably the ambassador. In other words, the extent of conformist groupthink among the affected staff. It would almost be like a counterintelligence investigation but with a slightly different emphasis.
Groupthink certainly exists in foreign embassies. People develop a siege mentality in a functionally closed society encouraged and enforced through security mandates by upper management and a natural isolation brought about by being a foreigner in a foreign land. I've been to the Canadian embassy in Washington DC and they were downright paranoid, in stark contrast to many other embassies who were not. It was not at all what I expected from our friendly neighbors to the north. I've also been to the Cuban embassy.
I cannot comment on this specific case, but I am very wary of the field of psychogenic disorders. There is a long history in medicine of assigning a psychogenic cause / diagnosis of hysteria to conditions that were not yet identified or could not yet get diagnosed. Multiple sclerosis is a fairly recent example. The introduction of MRIs allowed clinicians to "see" physical differences in the brains of MS patients, who were previously diagnosed as psych cases. Yet, an MRI is still a very rough tool. Misdiagnoses take place too. Psychogenic disorders sometimes turn out to be forms of encephalitis. The field of autoimmune neurology is barely emerging. Scientists and clinicians still have much to learn and are barely scratching the surface. A simple: "we don't know" or "unknown cause" would often serve everyone better (especially the patient) than the assignment of a psychogenic label, which is a diagnosis of exclusion and cannot be proven with any concrete testing.
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Hi LSG, I'm Dan Hurley, author of the article. Actually, as I wrote in the article, functional disorders are not diagnosed by exclusion. They are diagnosed by positive signs and symptoms that either vary and wane (even as a doc is examining them) or are incongruent with known organic, physical illnesses. The U of Pennsylvania team claims the symptoms are consistent with a traumatic brain injury... except there was no trauma, which is a key, essential component to TBI, and there is no known way that microwaves, ultrasound or any other form of energy could cause such a brain injury. Plus, even if these people did suffer a concussion, studies say that 85% of them should have recovered within, at most, three months. Instead, most of them have lingering symptoms, and here's the crazy thing: many of their symptoms got worse as time went by. That's totally inconsistent with a traumatic injury.
I totally agree that docs should be more willing to say "I don't know" when they come across something mystifying. A lot of scientists wish that's what Doug Smith's team at the University of Pennsylvania had done.
Beyond physically induced trauma via concussive sound waves which can damage internal organs (blast victims exposed to shock waves often die not from burns or from blunt force trauma but from organ failure (kidney and liver), there is also the issue of poisoning with chemical weapons or biological weapons. Certain toxins found in shell fish and reef dwelling fish and certain fungal spores found in tropical environments can disrupt nerve functioning and cause massive CNS problems. Then there is infectious disease which is the most common culprit whether bacterial or viral. Exposures to certain chemicals in water can also cause enormous CNS issues in those people that genetically susceptible (lead and mercury are the most common, but certain people can have reactions to chlorine which can trigger a cascade of autoimmune issues. A perfect example is people are allergic to fabric softener - literally, even a single exposure can cause severe chemical burns, and a host of other issues as the inflammatory response progresses. Then as in all criminal investigations, one has to have context. What roles were the victims performing? Who would profit from disabling these staff members? Were the victims using covers for espionage and counter-intelligence? Lastly, USN sonar has killed marine mammals by damaging their brains - so ruling out an acoustic weapon as the initial cause of trauma is illogical - high frequency burst weapons can damage marine mammals.
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In my view, the State Department's position, that American diplomats in Cuba suffered the result of attack to their brains, will not credible unless and until it releases the results of the medical examinations of those diplomats, makes a convincing case that the conditions observed represent injuries, identifies a plausible mechanism by which those injuries might have been produced, and shows that, in fact, that this mechanism was applied to produce those injuries (without, at the same time, being generally observable or harming other people). Otherwise, it seems to me that the State Department may itself be suffering a kind of psychogenic functional disorder. As things stand now, I find that much more plausible than any secret-weapon scenario.
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Unfortunate that Oliver Sacks is no longer with us.
As a leading neurologist, he handled many patients with these kinds of problems and wrote engaging and informative descriptions in the New Yorker and several books.
He could shed some light in these problems.
As a layman who has followed this story fairly closely since the outset, I'm no closer to having an understanding of what happened here. It seems to me that functional disorder is just an effort at better marketing for what had previously been considered mass hysteria. I just find it to be such a difficult concept to accept, with people becoming greatly debilitated for no apparent reason. And I'm still unclear after reading this as to whether those affected Americans from Cuba actually suffered actual, discernible physical injury, or if they have functional disorder, do they not actually have an injury but suffer its effects? And while I find it hard to believe anything stated by the present U.S. administration, which has proven to have no interest in truthfulness or facts, it does seem as though it is at least remotely possible that there is some sort of previous unknown and still undetectable weapon at play.
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Discernible medical injury was reported in this study:
Dear Dr. Pasquerella,
While sympathetic to the US diplomats who reported symptoms, Professor Markovsky diagnoses them as suffering from mass hysteria.
https://www.nytimes.com/2018/12/12/world/americas/cuba-embassy-attacks.html
and in the paper cited by the NYT:
https://onlinelibrary.wiley.com/doi/full/10.1002/lio2.231
So far no onr has grappled with this report.
There is a well recognized phenomenon called confirmation bias, in which a person latches onto an idea and then consciously or unconsciously structures and interprets evidence to support the favored theory. This is more pronounced when a scientist or academician publishes a hypothesis early in his career to wide notice and high praise, so that his reputation and career is wrapped up in the validity of the theory.
Dr. Hallett fits that pattern perfectly. His theory of "Conversion disorder" has made him the head of a government agency, and the defense of that theory has become an important part of his personality. Most noteworthy is the fact that his theory, which purports to explain symptoms for which no physical evidence can be found, is itself a diagnosis that cannot be physically verified. How convenient.
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Confirmation bias is also what you get when a cop decides that a person has committed a crime, and collects evidence that the person is guilty, while ignoring all the evidence that the person is innocent (or that a crime may not have been committed in the first place).
It sounds like the Trump State Department were looking for an excuse to undo all the progress that had been made in friendly relations with Cuba during the Obama Administration, and to punish Cuba with embargoes and trade restrictions.
They came up with a dubious theory about an unknown weapon, collected dubious evidence to support it, and ignored all the evidence against it. (And they shut up the scientists at the NIH who did understand it, as the story says.)
Confirmation bias.
I've been following the story in Science magazine and JAMA. (This story is a good contribution.) If this were any other disease theory, we would say that it's speculative and unproven. We should put it on the shelf along with the theory that vaccines cause autism.
There's no evidence to these claims. It's anti-Cuban propaganda, by people with declared political goals -- and no understanding of scientific method.
Mel, I think you have it backwards. It's really the State Department that decided from day one that this was a case of an "attack." First they sent the diplomats to an otolaryngologist, who said the "attack" resulted in damage to their inner ears. When the diplomats insisted that wasn't right, State sent them to the University of Pennsylvania's center for brain injury, and the head of that center, Doug Smith, then said, yep, they've got brain damage all right. When his group published its report in JAMA, even the accompanjying editorial said, "Whoa, wait a minute, might not be brain damage, could be a functional disorder." Then a bunch of letters to the editor of JAMA were published saying similar things. And only when the State Department was at the end of its rope, two years into this with no credible answer as to what really happened, did they ask for help from NIH, which has included Dr. Hallett as one of the people examining these folks. And if you go back and re-read the article, you'll see that these disorders are not a diagnosis of exclusion, but have positive findings. First, they have to vary, to wax and wane, in peculiar ways, even during a doctor's examination. Then there are aspects that have to be inconsistent with any known physical disorder. And it's totally inconsistent with the known history of a concussion that most people would still be sick years later. If that were the case, the entire NFL would be out sick.
"...Even just seeing a news item on multiple sclerosis can be the trigger for some individuals to develop similar symptoms.'"
I remember attending a lecture in the 70's in my pathogenic microbiology course. The subject was cerebral spinal meningitis. A stiff neck was a classic symptom and a lot of us walked out with one.
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I don’t believe that psychogenic disorders were little known in much of the 20th century. When I was a small town GP in the ‘80s, I had a case of a 9 year old girl who had no sensation in her right arm and was unable to move it, symptoms which had developed suddenly and without known injury. Indeed, she was unable to feel a pinprick in her entire arm including the hand, until I got within a couple of inches of her shoulder, where she had normal sensation. My suspicions were aroused by the distribution of the abnormality, which was not in a dermatomal pattern. I asked her to move her arm, and she couldn’t. I then lifted her arm up to “examine” it. When I let go, her arm stayed up. I then sent her out of the room and told her mother that I thought that this was clearly a functional disorder; asked her if anything was going on at home. It turned out that she and her husband had been arguing, and at the same time the parents of a friend of the daughter were divorcing. My treatment was “the drug doctor” in the words of Michael Balint. I reassured them that this was nothing serious and that it would gradually improve over a few weeks. It did.
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The medical community simply does not have the integrity to say "we don't know" when it comes to diagnosis difficult issues like this. Admitting they don't know would put them on a path to finding solutions.
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bh - Apparently you don't know any doctors. They are well aware of what they don't know or can't find solutions for.
Apparently you also never read the "Diagnosis" series that appears in the magazine section. It gives a good idea of how hard it is to come up with a definitive explanation of a case, and how often doctors may have to change their tentative diagnosis when the patient's disease takes a different course.
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This article interests me very much because as the spouse of a diplomat, I have seen a similar phenomenon happen to my partner when we were serving in a particularly remote post where reliable health care was accessible only via medevac to Europe. In our situation, a run-of-the-mill case of diahrrea turned into a two year struggle with g-i issues, mental cloudiness, extreme fatigue, knee pain, sinus problems, and depression. My feeling about this episode, as it went on, was that there was a psychological component related to the stress of being far from home in a place without clean water, with endemic malaria and assorted unfamiliar diseases, and with barriers to receiving sound health advice. I think these circumstances caused feelings of vulnerability that intensified and perhaps transformed the symptoms into what they became, which in the end was a collection of symptoms that no doctors in London or the U.S. could put a name to. I am wondering whether people like diplomats may be particularly susceptible to functional/psychogenic disorders because of the stress of being far from home and feeling vulnerable to surveillance, potential attack, unknown bacteria or diseases, and other threats, perceived or real. I wish the author would have explored this angle.
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I too am the spouse of a diplomat--and a former diplomat myself who was stationed in Havana before the attacks and who personally knows one of the individuals affected very well. Clearly, psychological stress can compound health issues, but the likelihood of a group of this size developing nearly identical symptoms (of varying intensity) in a short time frame due to mass psychogenic illness is highly unlikely. Why were only adults from the US and Canadian missions affected? If this were truly merely mass hysteria, one would expect children and those from other missions to be affected as well.
As for there being no known weapon that could produce these symptoms, one only has to look at the history of our own secret weapons to realize that the public is usually the last to know.
Another diplomat spouse here. One question: Did the symptoms disappeared when your husband left the post? Also, from what I understand in the Cuban case, not only the officers were affected, but also their families.
Hi, this is Dan Hurley, the author of the article. So there was this article published in the Washington Post. There's no question that many of the postings are in isolated, difficult places. Stress is sometimes a precipitating factor in the development of a functional disorder. And event affecting a large group of people are much more likely to occur in tightly-knit groups.
STRESS TAKING TOLL ON FOREIGN SERVICE
By Robin Wright
Washington Post Staff Writer
Wednesday, June 20, 2007
At least 40 percent of State Department diplomats who have served in danger zones suffer some symptoms of post-traumatic stress disorder, Steven Kashkett, vice president of the American Foreign Service Association, said in congressional testimony yesterday.
It seems to me that whenever there are physical manifestations (symptoms) that don't have an easy explanation, the first trick in the grab bag of medicine is "psychogenic". Symptoms of hypothyroidism are vague and often are overlooked for this reason. Symptoms of mid gut neuroendocrine tumor are vague and often dismissed until metastasis. Both are more common in women, which may influence the dismissal. Of course, "attack" isn't in that grab bag. That's the grab bag of politicians.
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Thank you, Dan Hurley, for a much more thorough, informative and balanced article than much of the other coverage. I am still struck by the fact that JAMA editors saw fit to publish a "take this with a big grain of salt" editorial alongside their publication of the University of Pennsylvania study vetted by the State Department. The President of Cuba's Academy of Sciences, Dr. Luis Velazquez, has called for an international meeting of scientists to get to the bottom of the US diplomats' health issues. Seems a logical, scientific approach. See his call in MEDICC Review at http://mediccreview.org/the-enigma-of-us-diplomats-health-symptoms-in-havana-call-for-a-global-scientific-meeting/
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It is sad that in this day and age when we know so much about mental disorders we still dismiss these as not being "real" unlike physical disorders.
When it was finally concluded that Gulf War Syndrome was a result of the stress of military service in the war zone rather than environmental toxins, many people didn't want to believe it. However, none of them was willing to call for a study of the indigenous population in Kuwait and Saudi Arabia where, if it was caused by a toxin, the syndrome would have been far more prevalent due to ongoing exposure (as for example in Agent Orange in Vietnam where childhood deformities frequently occurred as a result of it).
The embassy people in Cuba who reported the symptoms have had extensive work ups yet no one as yet has found a single objective finding on any of the multiple tests they've undergone.
And, of course, we have the question of why the Cuban government would want to do something that might harm its relations with the U.S. irreversibly. I know that things are bad now because of the crazy policies of Trump but no doubt they can see things returning to the level where they were with Obama once Trump office. If you're going to accuse some of a crime, at least find a motive.
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Would the State Dept. have labeled this an "attack" if it had happened in a friendly country? Why did it start in a country that the new trump administration had issues with? Then additional cases pop up in China, another country which trump considers a "foe". I just don't know how we can ever trust anything that comes out of certain govt. agencies, including the State dept. That being said, I wish nothing but speedy recovery to any govt. worker that is suffering any ill effects from their service to our country.
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The problems started when Obama was still president. They were only made public after Trump became president. But if these symptoms are psychological, and not the result of an "attack," then why have they only appeared in Havana (there are 16 in Havana and only 1 in Guangzhou)? Why are there no other diplomats in all other US missions in the world affected?
"[Psychogenic disorders] happen in that gray area where the mind and the brain intersect.]
What scientific or philosophical basis is there to make a distinction between mind and brain? It sounds like a version of the term qualia. We simply do not understand enough about the brain. Philosopher David Chalmers refers to "hard problem of consciousness."
Perhaps it will turn out to be impossible for the human brain to fully comprehend itself. I think not but it is legitimate to wonder what are we really capable of knowing?
In the meantime, I think practicing insight meditation should be part of the way forward.
This makes me ponder something. What would happens to people with functional disorders who ingest psilocybin, DMT, or LSD on proper guidance? Could temporarily changing their perceptions in a entirely different way "fix" the issue by teaching them, and/or the brain on a subconscious level, that it can create different perceptions? And if so how long lasting would the "fix" last?
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At this point you might as well say their problems were caused by Santeria.
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If you’ve read anything about psychogenic (for lack of a better word) disorders, the diagnosis would have jumped out at you. The idea of brain-damaging sound waves, short of a heavy-metal concert, is absurd. Stressful work, unfamiliar and possibly hostile surroundings, and eerie noises—hello, Mr. Poe. How did you feel the first time you heard cicadas?
Some of us are old enough to recall yellow rain, the mysterious toxin that fell on Vietnam. Turned out to be bee droppings.
Has the State Department has done a larger study of Foreign Service officers and family members who report health problems and seek disability leave and benefits? We have no knowledge from this article about the health of Foreign Service personnel more generally.
There are many high stress jobs within the Service, especially in embassies, missions or consulates that are in countries the US considers adversaries. The State Department also moves people regularly -- every two years in one's early career. You then have to bid for positions. This coupled with the dramatic changes in foreign policy which can accompany "regime" change (certainly between Obama and Trump), not to mention the need to mediate between American concerns and those of the host country, can put tremendous pressure on officers.
Just as military personnel suffer from PTSD, should we not consider that the disorders reported by FSOs are another type of stress disorder?
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In the days of Trump and Pompeo, we should also ask "What State Department?" It's been decimated of skilled personnel (through voluntary retirement without replacement) in a way not seen since the McCarthy witch-hunts.
This is what we can expect from a political party gone rogue, where "religion" ignores its Sole Commandment and ideology (or is it idiotology) trumps science and fact.
Hi historyprof. This is Dan Hurley, the author of the article. I looked for information about the general health status of diplomats, particularly when they are in an isolated post under stressful conditions. I found this article in the Washington Post from 2007. Pretty interesting:
STRESS TAKING TOLL ON FOREIGN SERVICE
By Robin Wright
Washington Post Staff Writer
Wednesday, June 20, 2007
At least 40 percent of State Department diplomats who have served in danger zones suffer some symptoms of post-traumatic stress disorder, Steven Kashkett, vice president of the American Foreign Service Association, said in congressional testimony yesterday.
Paranoia, the insularity of Americans working for the government living abroad in countries historically regarded as adversaries, political and medical fears, some of them confirmed by experts working for the government (and not their patients), all seem to have come together to perpetuate these functional illnesses.
Very sad to see that the State Department would prefer to maintain an image of toughness by saying that these conditions are a result of an external attack caused by some sort of superweapon over actually trying to diagnose these people properly.
The problems here are strange but the State Dept. has definitely made them worse by placing image over well-being.
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Okay, I'm way "on the outside", but an outbreak of functional disorder was the first thing I thought of when I heard of this.
Also, if it was a physical force that caused these symptoms, why was there such a quick leap to labeling it an "attack"? Why could it not have been something in the environment that accidentally cause the effects? I guess it just fit too well into an anti- Cuba agenda.
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Excellent summary of the situation. A neurobehavioral disorder emerging out of a psychosocial stress setting has always been the most likely process here. It's unfortunate that a team of respected neurologists worsened the impact on those reporting symptoms. Plaudits to the author for good medical journalism.
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