Last week, I "went private" with my condition, sending out a long email to every person who has had a significant impact on my life since I was in school.
I had to figure out how to explain M.E. to an audience who had never heard of it, and came up with the following narrative, from which the feedback has been really good!
Feel free to steal any of it if you ever need an explainer for a similar context:
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Think back to how you felt during any infection (like the flu, or COVID). Those symptoms were your body entering a defensive state called the Cell Danger Response, where every cell in your body started screaming "shut down and redirect resources toward the immune system!" That flu-like malaise you felt was your cytokines, that crushing fatigue your mitochondria going dark, and the brain fog and light sensitivity was your nervous system locked into threat-scanning mode. All evolutionary signals, refined over millions of years, that told you: "while we fight this threat, lie down in a dark room and do nothing".
In 99.999% of cases, this threat response resolves, and you go back to your normal life.
Call me the 0.001%. For some of us, due to a combination of genetics and chance, the Cell Danger Response never shuts off, and we don't go back. Ever.
This persistent threat response condition is known as myalgic encephalomyelitis, or ME. And the longer it goes on, the deeper it entrenches, eventually disrupting systems throughout the body until basic functions - sitting, showering, talking on the phone, even digesting food - become so energy-intensive that they are rendered impossible.
Funny, isn't it? A debilitating disease that affects one million Americans, and you've never even heard of it. (Or if you have, it's most likely by an incredibly infantilizing name that we'll never speak of again: "chronic fatigue syndrome".)
M.E. is not new. Researchers have documented post-infection illness outbreaks for over a century. In the 1980s, it was on similar footing as AIDS - both mysterious illnesses ruining young, healthy lives, and both similarly dismissed in the eyes of researchers, doctors, and the public: ME was seen as a condition involving hysterical yuppie women and AIDS was stigmatized as something gay men had brought on themselves.
But slowly, the paths diverged: AIDS patients started dying in large numbers. Activists rallied - sick, but still able to protest, staging die-ins and chaining themselves to buildings. Meanwhile, ME patients were too severely afflicted to court attention or advocate for themselves. They didn't die, they just... disappeared, suffering invisibly in dark bedrooms, forever.
While institutions and researchers forgot about ME, AIDS went on to gain visibility and make history: billions of dollars in research funding, the discovery of HIV, and eventually, a functional cure. We all learned that story in health class, but we never learned about M.E.
But quietly, all those years, people kept getting permanently sick after viral illnesses. Some were able to manage it, others became incapacitated and disappeared from the public eye. Then came the pandemic, and suddenly billions of people started getting serious infections in a way they hadn't before. Long COVID has doubled the number of people with ME, and today, Long COVID and ME have a disability burden greater than AIDS at its peak:
400 million afflicted worldwide. 100 million suffering significant functional deficits affecting large parts of their daily lives. Tens of millions too severe to leave their homes, and 5 million bedridden (yep, that's me.)
Despite these staggering numbers, and even after 70 years of recognition, M.E. has no cure, and not even a single treatment that has been shown to reliably reverse disease progression. The lifetime recovery rate is 7-15%, but most of those are spontaneous recoveries from mild cases within the first two years of onset. At my level of severity, anecdotes show that fewer than 1 in 100 patients recover.
The research funding allotted to M.E. by the US government is at 1% of its commensurate disease burden, the lowest of any disease (AIDS, by the way? 2000%). I follow the research closely, and nothing currently being investigated is anywhere near a cure. We have no clinical biomarkers, no unifying theory, and no real breakthroughs. In my best estimation, we are 10 years out.
This has quietly become the greatest invisible public health scandal no one gives a fuck about solving. Every single group that should care about the plight of their fellow humans, from ordinary people on the street, to governments, researchers, and doctors, are all looking the other way.
Not anymore. I'm going to make everyone look.