Intended for healthcare professionals

Clinical Review ABC of psychological medicine

Fatigue

BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7362.480 (Published 31 August 2002) Cite this as: BMJ 2002;325:480

More science and less opinion, please.

Apart from a patient's question, “Is it all due to a virus?” raised
under the heading “Identifying unhelpful beliefs”, no other reference was
made to infection in the article entitled “Fatigue”. One wonders,
therefore, why David Wilks, consultant in infectious diseases at Western
General Hospital, Edinburgh, would contribute to this scientifically
unsubstantiated article.

It seems somewhat arrogant and indeed, dangerous, for Sharpe and
Wilks to take such a dogmatic stance while still having to acknowledge
that “…fatigue remains poorly understood and has hitherto probably been
not been (sic) given adequate attention by doctors.” The implication is,
perhaps, that only the authors and others who belong to the same school of
thought, have a “unique understanding” of fatigue. What a pity they
didn’t share the secret and back it up with scientific evidence.

Very relevant to this article, is the case of Ray Nimmo who, in June
of this year, was awarded the sum of 40,000 pounds. Mr. Nimmo consulted
his doctor in 1984 with a dental infection. An allergic reaction to the
antibiotic led to severe abdominal pain and a prescription for the
benzodiazepine, Xanax, to deal with his “muscle spasm”. The pain
continued and other similar drugs were prescribed, resulting in years of
side effects including suicidal depression, agoraphobia, insomnia, panic
attacks and, of course, addiction. Given these side effects, fatigue no
doubt figured quite substantially as well.

Now that his doctor has had to pay out compensation, it is to be
hoped he will, in future, be less dogmatic about pushing inappropriate
treatments and pinning psychiatric labels where they do not belong.

The general media considered the story of Ray Nimmo highly
newsworthy. It was picked up by several newspapers and Mr. Nimmo was
interviewed on both radio and TV. The case is expected to trigger a
number of similar law suits in the UK.

It is hardly unreasonable to have expected this very relevant news
item to have have picked up by the BMJ, but for some strange reason, it
wasn’t. Indeed the BMJ, is most reluctant to even mention the word
“benzodiazepine”. But then it is part of an inglorious and shameful
aspect of medicine, involving in particular, the branch of it to which
Sharpe belongs.

Given that millions during the last 30 years in the UK have been
affected as Nimmo was, would Michael Sharpe please be kind enough to
explain why the lay community should trust a medical opinion when it makes
no sense whatsoever? After all, the medical profession has shown itself
to be every bit as fallible as the rest of society.

Gurli Bagnall, Patients’ Rights Campaigner, New Zealand.

1.Why doctors must be wary of prescribed drug case, Butterworths Legal News,
July 22, 2002.

2. Benzodiazepine guidelines routinely ignored, Transcript, You and Yours,
BBC Radio 4, July 16, 2002.

3. Landmark Clinical Negligence Victory, Transcript, BBC Look North, June
28, 2002.

4. £40,000 for Valium dad, The Sun, June 28, 2002.

5. Interview with BBC Radio Humberside, Transcript, June 27, 2002.

6. 'Valium ruined my life' claimant wins £40,000 damages from ex-GP,
Yorkshire Post, June 27, 2002.

7. 'GPs made me into zombie', Scunthorpe Telegraph, June 25, 2002.

8. Keeble Hawson wins £40,000 settlement, June 24, 2002.

9. Valium addict wins pay-out of £40,000, The Observer, June 23, 2002.
Breaking news story about the owner of this site.

10. Log on to drug help, Scunthorpe Evening Telegraph, Monday, May 28, 2001.

Competing interests: No competing interests

02 September 2002
Gurli Bagnall
Patients' Rights Campaigner