Physicians/scientists are a conservative lot. They operate within a paradigm- a construct of ideas the theories which form the basis of the reality or truth from which they operate. Unfortunately, physicians sometimes confuse a working paradigm with absolute truth. A blurring of this distinction makes it easier for physicians to treat patients on a daily basis. A popular metaphor is "the box." People are said to think within the box or outside the box. Physicians who treat chronic Lyme disease are challenging the conventions. They challenge not only the prevailing paradigm, but they challenge the process which creates and massages the paradigms which form the basis of contemporary medical practice. It is also a story of the few taking on the many, a tale of David versus Goliath. Both sides, IDSA and ILADS, can become very determined, arrogant and angry as they posit their points of view. This has the effect of pushing the other side into a defensive posture. The defensive posture does not lend itself to listening or collegiality; instead, it can create a more bellicose tone. I think some readers have a hard time understanding the vitriol found in the IDSA-ILADS paradigm war.
As the war between the IDSA and ILADS has played out, the IDSA has become more dug in. The guidelines have become more rigid, less flexible. The mainstream has clung tenaciously to its Bible. I would argue that the "Bible"- Harrison's textbook of medicine and other iconic sources allows for more lee way than the mainstream opinion would have one believe. History has shown that minority opinions frequently turn out to be correct.
The fight has morphed into a populist movement. Patients and Lyme treating physicians have tried to sway governmental politics. Those who do not know, a prior, that chronic Lyme does not exist, can easily see the "truth" to this side of the argument. Physicians who do not have a dog in the fight, those who don't know enough about the issues to have an opinion, stay mute on the sidelines. The political machine of mainstream medicine, with its certainty and arrogance, sits tight in its opposition, ever convinced that it will prevail. The fate of Lyme patients, many of whom are desperately ill, and their physicians, many of whom are passionate in their mission to heal- hangs in the balance.
Chronic Lyme is a very real medical issue. This is why I push for a mainstream look at the issues, which avoids CAM and other medical practices for which organized medicine has nothing but disdain. Whether or not herbs and accupuncture work is another fight for another day. My fight is about germs, antibiotics, physiology, immunity, molecular biology and medical practice.