Monday, November 15, 2010

Oxford Review of Books on CFS/ME

Dear All

I am happy to report that "The Oxonian: Oxford Review of Books" has today
published a book review of mine entitled "Chronically Wiser" on the subject
of CFS/ME.


Good to see that the traditionally conservative Oxford University is showing
some interest in CFS/ME!

Warmest regards


Chronically Wiser

Herman Salton


Toni Bernhard
How to be Sick: A Buddhist-Inspired Guide for the Chronically Ill and
Their Caregivers
Wisdom, 2010
176 Pages
ISBN 978-0861716265

Roberta Pelletta
Stanchi si diventa: Manuale di soppravvivenza alla CFS
Turin: Seneca Edizioni, 2010
41 Pages
ISBN 978-8861222113

Imagine you are a high-flying law professor at the height of your career.
You have a happy marriage, are involved in the local community, love your
subject, and enjoy working with students. Your socio-economic position is
comfortable, and your family relationships are gratifying. In short, life is
smiling at you, and you are smiling back.

Then you go to Paris—and everything changes. A mysterious bug floors you.
Standing up becomes a struggle, noise bothers you, and you are magnetically
attracted to your bed. Except that you are too exhausted to sleep—too
exhausted, in fact, to do anything at all. You return to the classroom—but
the noise, lights, and interactions are just too overwhelming. You start
writing a paper—but the brain-fog, headache, and impaired memory allow you
to work only for a few minutes. You explain what's happening—but nobody
understands, and since you don't either, how can you blame them? Days go by
and doctors reassure you it will go away. Except that it doesn't, and ten
years later, you are still bed-bound.

This is the perfect storm that hit Toni Bernhard—and the other 17 million
people in the world who are estimated to be suffering from myalgic
encephalomyelitis (also controversially known as CFS, or chronic fatigue
syndrome). At its worst, this Kafka-esque illness is as debilitating as
late-stage cancer, multiple sclerosis, and HIV—but it is not fatal, and so
does not carry the drama (or empathy) associated with them. There is no cure
for it and patients—including children—are largely left to themselves and
their families. It can hit anybody, at anytime, anywhere in the world,
without any warning.

When doctors are baffled, friends desert you, and your life goes
upside-down, where should you turn? Buddhism, Bernhard suggests in this
compact and refreshing guide on how to manage a chronic condition. Illness
does tend to bring out a renewed sense of spirituality, but what is
interesting in Bernhard's case is that hers is by no means an overnight,
illness-induced conversion: she was already a committed Buddhist before
becoming ill with ME/CFS, and she candidly admits that her illness made it
more difficult to adhere to her faith. It also made it harder to write How
to Be Sick—she did so from her bed, laptop on her knees, printer at hand, a
few minutes a day, year after year. The result is an inspiring and
optimistic guide on how to be sick—on how to live a life of equanimity
despite the limitations of a chronic illness.

Bernhard believes that Buddhism can help. Suffering (dukkha) is the First
Noble Truth of the Buddha, while kindness (metta) and joy in the joy of
others (mudita) should be the pillars of our lives. Humans are inevitably
subject to disease and death; our lives are in constant flux and the only
way to prepare for change, so Buddhism dictates, is to cultivate compassion
(karuna) and equanimity (upekkha) for ourselves and others.

Were this the end of the story, How To Be Sick would be interesting but
hardly original. Instead, Bernhard goes on to admit that those Buddhist
tools failed to assist her when she needed them most. She just could not
muster enough energy to meditate. As such, she had to adapt Buddhism to her
specific chronic condition, rather than the other way around. Feeling
compassion for others, she soon discovered, is far easier when you are well
than when you are confined to bed and looking, from your window, at people
happily going about their business. The envy can be overwhelming.

But this can and should be corrected. Frustration about an illness that
doctors don't fully understand should be greeted with the hope that sooner
or later they will. The obvious complaint "why me?" should be countered with
the simple question "why not me?" And physical pain should be tackled with
what the Buddha defines as "patience endurance" (khanti). Bernhard's
approach is far from dogmatic: try this or that meditation practice, she
suggests, and if it doesn't work or you are too fatigued, switch to another.
Her contribution is refreshing because she does not want you to convert to
Buddhism—she just wants you to feel better.

On the face of it, Pelletta's book is shorter and more concise. She looks at
simple everyday problems and her work has little to do with the transcendent
state of mental well-being sought by Bernhard. Where Bernhard takes great
pain to explain her subject and to gain her reader's attention, to the point
of seeming didactic, Pelletta writes in short, deliberate sentences like
precision bullets—hitting the target and holding firm in the reader's mind.

These differences aside, however, the two books are strikingly similar.
Pelletta, too, was hit by the "ME/CFS storm" in a way that reminds us of
Bernhard's Paris trip. A Brussels-based parliamentary interpreter for over
30 years, Pelletta was abruptly forced to abandon her job and is, years
later, still severely limited in her daily activities. Other issues she
tackles will be very familiar to Bernhard's readers: the apathy of the
medical community; the problems experienced in attempting to explain ME/CFS
to family and friends; the loneliness that being house-bound imposes; the
loss of earning and professional gratification; and the frightening
uncertainty associated with a condition that could last for years.

Yet the most visible convergence in these two volumes comes in their
conclusion: accept with equanimity whatever in life cannot be changed. "We
must accept our own endless powerlessness", Pelletta concludes, in
strikingly spiritual terms that Bernhard would likely endorse. For the
Buddha, too, was a common human being and endured severe pain without

There is no doubt that ME/CFS took a heavy toll in the life of both Bernhard
and Pelletta. They have experienced the skepticism of doctors, the
insensitivity of acquaintances, the bewilderment of friends, and the
breakdown of families. But illness has also shown them something new—human
fragility—and given them the tools to better deal with it. It has made them
wiser, sooner. The reader, too, is left wiser by their books and by the
message of courage that they convey.

Dr Herman Salton graduated  from Exeter College, Oxford with an MPhil in
International Relations, which he gained while suffering with ME/CFS. He is
the author of two books on law and politics, and is working on a third one.


roberta said...

I am really grateful to Herman Salton for his review about Bernhard's How to be Sick, and my booklet Stanchi si diventa. He wrote a short brand new story, told by someone who knows what CFS is all about.
many thanks. Roberta Pelletta

Toni said...

Thank you so much, Herman, for writing such an articulate and informative review of my book and of Stanchi si diventa.

With gratitude,