Dan Rodricks' article, "MPT's flawed decision on flawed film" (June 19) is on the button. Mr. Rodricks' article may have been about MPT, but it highlights what is wrong with our heath care system.

The MPT film, "Under our Skin: A health Care nightmare" is bound to get under the skin of most Infectious diseases specialists who study and treat Lyme disease. The film's premise, that chronic Lyme disease, requiring treatment with long term antibiotics is an epidemic condition, is neither an objective nor a proven observation but mere speculation and exaggeration by patients who suffer from a hodge podge of nebulous symptoms and doctors who are willing to bet their licenses that those symptoms are related to persistent Lyme disease.


A work-up for Lyme disease is often initiated for signs and symptoms like joint pain, severe exhaustion, diffuse body aches, memory loss, mental fog and heart rhythm abnormalities. Lyme disease lab results are frequently misinterpreted by general practitioners. Affected patients, eager for a reversal of their chronic illnesses, hang on to a misdiagnosis of Lyme disease for dear life. They will tout false positive or weakly positive test results as the ultimate definitive indicators of an unrecognized tick's ravages on their bodies. Many of these patient's have never had acute Lyme disease, but they love wearing the "non-classic unique chronic case" badge for Lyme.

In communities across America, numerous doctors confounded by Lyme disease are nevertheless eager to quell this menace, akin to the black plague in their minds, with potent and prolonged antibiotic treatment. Dubious cases of chronic Lyme disease will somehow get to these doctors. There are many specialty Lyme clinics, staffed by doctors and nurses who don't accept insurance, but mint money, treating Lyme and Lyme only. And indeed, there is money to be made in this fashionable disease, with IV antibiotic treatments extending for weeks and even months.

For sure, there are neurological, joint and heart consequences of Lyme, but they manifest within a few weeks after the primary event, which is the tick bite and the classic skin lesion called erythema migrans. Granted the primary event may not always be recognized, there are definite lab tests that point to Lyme as the culprit in patients with systemic manifestations, which usually occur within a few weeks following the acute tick bite. These manifestations can be dangerous and come to medical attention fast. There is no evidence, as far as the experts can see or document, for chronic, festering Lyme disease that goes on for years before discovery.

Specialists at the frontiers of antibiotic discoveries, in the business of saving folks from ever mutating super bugs, are alarmed with reason about the notion of chronic Lyme disease. As they see it, numerous patients are receiving antibiotics for a condition they don't have, and antibiotics are not harmless. Our medical system is riddled with patients who manipulate, intimidate or cajole doctors into giving them what they want. And what they want is usually the latest fad on the market. Self diagnosis, using the Internet as a guide, has proliferated to dangerous levels. Patients can even order their own lab tests from labs that don't ask for doctors' orders.

Unnecessary antibiotic therapy is a national crisis and threat. Instant gratification is pervasive, and because American workers are expendable, they want quick answers to their ailments. Doctors who obsess about the emergence of antibiotic resistance are not exactly high on the popularity list of their patients. A lot of Americans live burning the candle at both ends, and to them, blaming Lyme disease or some other medical condition for their debilitation and lack of energy is far more appealing than blaming themselves. A perfect storm is brewing and the climate is ripe for the multiplication of more deadly super bugs than the pace of antibiotic discovery can handle.

Do patients and doctors have a responsibility to use our remaining weapons prudently on the disingenuous bugs we face? If the answer to that question is not a resounding "Yes," surely we face extinction. With Lyme disease we should follow evidence-based guidelines for diagnosis and treatment, and if evidence does not point to the existence of persistent Lyme disease, we should bow to this verdict. I am sure folks in the big business of Lyme can dredge up numerous patients to question the experts' stance on chronic Lyme disease, and these patients can boast of cures attained the hard way, with prolonged antibiotic treatments, but the mentioned miracles can be accounted for by what is called the placebo effect. American Medicine spends millions on earning patients the placebo effect as a cure for conditions they never had in the first place.

Much harm can come to patients and communities when pseudoscience is popularized, politicized and disseminated. MPT hurts its own credibility by becoming an instrument of this type of duplicity.

Usha Nellore, Bel Air