OSU-CHS and Morgellons

Randy Wymore is an associate professor of pharmacology and physiology at Oklahoma State University Center for Health Sciences. He is also the Director of the OSU-CHS Center for the Investigation of Morgellons Disease, a newly formed organization that has grown out of Wymore’s work investigating what is know as “Morgellons”. The CIMD has the following vision statement:

http://www.thenmo.org/CIMD-vs.pdf

Which says in part (emphasis mine):

Morgellons is a multi-system disease of unknown etiology
Morgellons disease is discounted by many public health officials and physicians
Physical and neurological symptoms are often dismissed or ignored
Sufferers are labeled with delusions of parasites or neurotic excoriations
OSU-CHS physicians/researchers have physical evidence of Morgellons Disease
Morgellons is not psychiatric in origin
Morgellons is an emergent disease
The Center for the Investigation of Morgellons Disease will facilitate successful research,
treatment and an eventual cure for Morgellons Disease.

and then goes on to list the ways in which Morgellons will be researched, treated and cured.

Wymore has also released a much longer personal position statement, dated Jun 19, 2007:

http://www.thenmo.org/RWud0607.pdf

Which confirms what was said in the vision statement:

6. There is no clear and simple diagnostic test yet to confirm or rule out
Morgellons. Still, 100% of the patients, that were felt to genuinely have
Morgellons Disease [about 29 patients], have large microscopic-to small macroscopic fibers visible
under their outer layer of skin
. These fibers are not associated with scabs or
open lesions, nor are they under scarred tissue. The idea that Morgellons fibers
are mere fuzz and lint, simply sticking to the lesions and scabs, is not possible
based on the observations that were just described. These fibers are under
“normal-appearing” areas of skin. In contrast, such fibers have never been
observed in even one person who does not claim to have Morgellons
. Clearly,
there is something different in the skin of purported Morgellons sufferers
compared to the non-Morgellons population.

That seems at first glance to actually be a “clear and simple diagnostic test”. 100% of Morgellons patients had fibers, 0% of non-Morgellons patients had fibers. With a 100% success rate, even 29 samples gives you a high degree of certainty. What’s the problem here? Patient sampling is often an issue, so where did these patients come from? Wymore says earlier:

Of the thirty or so patients claiming to have Morgellons disease, that clinical faculty have examined in facilities associated with OSU, only one patient likely did not have Morgellons.

That’s quite an impressive set of statistics. 97% of all patients that claimed to have Morgellons, and were examined by OSU, were found to have visible fibers under unbroken skin, and these fibers have never been observed in people who did not think they had Morgellons. How is this not a “clear and simple diagnostic test”?

Unfortunately, we can’t say, because Wymore will produce no evidence. What do these fibers look like? If they are visible under unbroken skin, then why are there not 29 photographs of fibers under unbroken skin? Why not even one photo? Have these visible fibers actually been examined visually by a dermatologist to make sure it’s not just ingrown hairs, or blood vessels, or nerve fibers, or some symptom of one of the thousands of dermatological conditions with which Wymore is not familiar? Patients who claim to have Morgellons will scratch themselves. Perhaps the scratching results in the fibers becoming embedded in the “unbroken” skin? Or perhaps scratching results in the existing fibers in the skin (hairs, blood vessels, etc) becoming visible. If these fibers are as easily found as has been suggested, then why, after more than a year, has there been no clue released as to their chemical makeup? Not one test result? What is the background of the patients? How were the patients selected? How long have they been scratching themselves? What diagnosis does a dermatologist make of these patients after being presented with the Morgellons evidence?

Wymore might say this lack of evidence is because “The writing of manuscripts, for submission to scientific and medical journals, detailing our observations is a work in progress.” But that’s misleading. Wymore has already published his conclusions. He shouts from the rooftops that “Morgellons is an emergent disease”, and “Morgellons is a multi-system disease of unknown etiology” and “Morgellons Disease is real physical pathology of unknown cause.” He announces these conclusions without evidence. He goes on television to announce these conclusions. He releases “vision statements” and “position statements” that clearly state these conclusions. All without a shred of evidence. After over a year of research, still no evidence.

Wymore is a big fan of the academic process. He spends the largest section of his position paper in mocking “debunkers”, such as myself, calling them “amateurs”, “not scientific” and “laughable”. He decries my web site as “at the very least, a waste of valuable time and at the worst, hurtful”, because I’m not going to talk anyone out of their delusion. Now I’ve had a lot of praise for my web site from individuals, journalists and scientists, and I’ve even had several emails from itchy people who did in fact find lint on their skin, and though they had Morgellons, and only realized what it actually was after finding my web site. Of course, if someone is chronically deluded then nobody can talk them out of it. I have no illusions there, and it should be obvious that that is not what this web site is about.

It seems a little odd to me that Wymore should spend a page devoted to pointing out how non-academic internet debunkers are, and how their amateur efforts will hurt rather than help, and then on the next page says:

I applaud the many
physicians and nurses who ARE attempting to treat Morgellons Disease by trying
different strategies. It will be wonderful if one of them stumbles onto a complete
cure for the disease. In an academic or medical school setting that approach is
not workable. Before human subjects can be used or so-called clinical trial
established, there must be an arguable rationale for the treatment.

So, it’s fine for Stricker and Savely to sell expensive long term antibiotic treatments to people who think they have Morgellons? Treatments have have NO SCIENTIFIC EVIDENCE of efficacy. Treatments that are based on a theory that Morgellons is related to chronic Lyme, and treatments that are so far out of the mainstream that Savely was forced out of her Texas practice for prescribing them? It’s fine for Wymore’s friends to do things that even he says are not workable in an academic setting? Why? Because they care?

Professor Wymore cares a lot about the suffering. I suspect Stricker and Savely care a lot too. The patients desperately want to be believed. By believing them, Wymore makes them feel a lot better, and they are very grateful to him. By believing them and giving them “treatments”, Stricker and Savely also make them feel better, and they are grateful to them (but poorer).

I care a lot. I care for the patients. I care for the people who are sick. I want the people who are sick to get better. I want people who are not so sick to not get worse. I want them to get appropriate medical treatment. I want them not to waste time and money with quack remedies for a disease for which there is not evidence of existence.

What I want, perhaps most of all, is for people to realize that “disease or delusion” is a false choice. When I say that “Morgellons is not a distinct disease”, or even if I were to say “Morgellons is not real”, it does not mean “you are delusional”. If you are sick, I don’t know what is wrong with you. I don’t know if you are delusional or not. I don’t know what is wrong with your skin. I don’t know why you itch. There are thousands of possible reasons for your symptoms, and I don’t know what is behind your particular symptoms. All I know is that nobody has ever produced any evidence that Morgellons is a distinct disease or a “real physical pathology”. Nobody has produced any evidence that the fibers are in any way involved. Yet they continue to talk and act as if they have. They need to put up or shut up. It’s the ultimate in bad science to announce your conclusions with 100% certainty, and then expect people to make health-care choices (and even prescribe treatment) based on those conclusions, without offering any evidence.