Second Session: Simmering Controversy
Students were more proactive than we anticipated. They found many
new references that are not listed in the case study, including some
recent research studies. They also found that there was a recent attempt
to rename CFS/ME as “systemic exertion intolerance disease.” Some
students appeared to be skeptical about this endeavor, since researchers could not agree upon the various definitions of the disease and
there were no definitive medical tests that could be used for diagnosis.
Students applied their course knowledge to describe symptoms of
CFS/ME affecting various body systems, such as the immune system
and nervous system. The case study reinforced concepts learned in
the lecture. For example, the group focusing on vaccination applied
the mechanism of immune response. During their presentation, students explained (1) what a vaccination is, (2) how it impacts the
immune system in humans, (3) which cells are triggered by immune
responses, and (4) how antibodies are generated. They even found a
court case in the United States in which a young patient won
$250,000 compensation for having developed CFS/ME after being
given a hepatitis B vaccination. They also brought up relevant data from
the the Canadian Laboratory Center for Disease Control that show no
evidence to support that finding of causation.
Students who focused on CFS/ME treatment elaborated on neurotransmitters, on antidepressant medications given to CFS/ME patients,
and on the role of antioxidants in improving patients’ condition.
Students were also aware of the challenges of treatment. For instance,
antidepressants could give a patient suicidal thoughts. Some students
knew about side effects of these medications from their own life experience and brought valuable arguments to the classroom. There was an
exciting discussion on this topic.
Most students realized that there might be a correlation between
CFS/ME and the proposed “pathogenic agents.” In the classroom,
students inquired why some people who have been infected with
the same viruses or who have received the same types of vaccine
do not have CFS while others do. They were confident in articulating
their opinions. For example, they argued that those agents themselves might not cause the disease; the patient might have other
underlying, contributing medical conditions, such as HIV, or a combination of various agents might trigger the disease. They cited relevant research to demonstrate their findings. Students distinguished
between “correlation” and “cause,” indicating that they comprehended fundamental aspects of pathology in medicine. However,
students usually were unsure how to further their discussion.
The group assigned the last topic – on future directions of CFS/ME
research – did not fully understand their challenge. They mostly gave an
overview of CFS/ME research rather than offering possible perspectives.
It was a difficult topic to present, since the students were not experts
on CFS/ME; however, they did find some useful information in research
on CFS/ME. For example, they found that there is 200× more funding
for HIV than for CFS/ME. They explained that this is due to the lack of
definite explanations of the nature of CFS/ME. Students advocated
for more patient sample analysis and the search for biomarkers.
Students showed that they were capable of conducting independent research using credible resources such as peer-reviewed research
articles, patient pictures, court cases, and others. All groups included
figures and graphs from such reference materials in their presentations.
In presenting these scientific analyses, students demonstrated their
When given the case study, students started with an uncertainty
about CFS/ME. To them, a person with this syndrome seemed more
or less like a person who does not want to work, who just feels tired
all the time. However, after their own research on CFS/ME, many of
the students had revised their opinions on the disease. In the end, students were asked in a survey whether they believed that CFS/ME is an
actual physical disease or rather a psychological problem. Half of the
class believed that it is a real disease and the others did not.
Interestingly, we also found that students justified their opinions
using anthropology and sociology studies from other disciplines.
For example, to explain why most of the patients diagnosed were
white women in the United States, some students suggested that
women are more outspoken than most men. Meanwhile, the white
population has more access to good health care than minority populations. However, that does not mean that CFS/ME does not exist in
minority populations. Approximately 3.9 million minority individuals
were potential CFS/ME patients, based on the students’ findings.
The painting reproduced here as Figure 1 captures the frustration and despair of a CFS/ME patient, putting a human face on the
problem. Our college has an Arts Across the Curriculum program
Figure 1. Defeated, an oil painting on canvas by Igor V.
Zaitsev. This painting was created for the May 12th
International Awareness Day for Chronic Immunological and
Neurological Diseases: Myalgic Encephalomyelitis, Chronic
Fatigue Syndrome, Fibromyalgia, Gulf War Syndrome, and
Multiple Chemical Sensitivity. These diseases affect both men
and women, regardless of their race, nationality, and age.