Correction: An earlier version of this story misidentified Kerry Clark, a medical entomologist who came down with Lyme-like symptoms. The story has been corrected.
In the long, bitterly contentious debate over the long-term effects of Lyme disease, Richard Horowitz is a well-known player. One of the so-called “Lyme-literate” physicians who say the mainstream medical community is failing to recognize the true illness of people whose symptoms don’t respond to traditional treatment, he is board-certified in internal medicine and says he has seen more than 12,000 patients with tick-borne diseases in his 25-year career.
“This book is a compilation of everything I’ve discovered about Lyme disease,” he begins, describing himself as a “medical detective.” And whatever else one might say about this book, it certainly offers enough material to give you an opinion. Beginning at the beginning — with “I remember the first time that I ever heard about Lyme disease. It was a beautiful spring day . . . in 1987” — he fills 532 pages (including 55 pages of references and appendices) with the story of his career, scores of charts and discussions of symptoms and conditions, and lengthy case studies rendered in novelistic detail. (“Dr. H, you must be a psychic,” a patient identified as Mrs. Q says during a 14-page “sample consultation.”)
You can decide for yourself what to make of The Horowitz Sixteen-Point Differential Diagnostic Map or The Horowitz Lyme-MSIDS (multiple systemic infectious disease syndrome) Questionnaire — three pages of questions that let you “determine the probability of a Lyme-MSIDS diagnosis for yourself.”
With a certain hubris, Horowitz concludes his book by saying, “You are now empowered to take control of your health.” People who believe they suffer from “chronic Lyme” or another mysterious illness that traditional doctors fail to recognize or manage may find comfort and perhaps ideas for treatments. Skeptics, however, are unlikely to be convinced.
There’s no controversy about this: In the Northeast, Lyme is endemic and is commonly spread by blacklegged ticks. But reporter Wendy Orent describes a more problematic situation in the South, where Lymelike symptoms are widely reported but never identified as Lyme. Many researchers believe the copycat disease — officially called STARI, for Southern tick-associated rash illness — is spread by the aggressive lone star tick, Amblyomma americanum.
Orent cites experts at the Centers for Disease Control and Prevention as believing that STARI is “relatively benign, presenting only with the rash and flulike symptoms of early Lyme.” But researchers such as Kerry Clark — a medical entomologist who came down with Lymelike symptoms himself in Georgia — say the CDC should change its stance to encourage medical professionals to provide the appropriate care. “Because few doctors recognize their illness, they say, they are treated too late or not at all, and are allowed to slide into chronic illness as debilitating as untreated Lyme disease in the North.”