Carlyle said “a lie cannot live.” It shows that he did not know how to tell them.

— Mark Twain

There is an infamous hoax from last century called The Protocols of the (Learned) Elders of Zion, an anti-Semitic text purporting to describe a plan to achieve global domination by the Jewish people. Despite the fact that the Protocols is a work of fiction, there have been and still are folks who believe it to be real, from Hitler on down. (Or is that “on up”? Can one be lower than Hitler? And have I already committed a breach of Godwin’s Law?)

Inventing apparently legitimate information is a useful propaganda device not limited to anti-Semites. Having people appear evil or uncaring using their own words is far more effective than calling them evil and uncaring.

There are many in the community who suffer from a variety of complaints that I cannot diagnose, and, as people do not like uncertainty about their health, they will find someone who will give them a diagnosis. Not infrequently they will come upon the idea of chronic Lyme disease.

I do not think that the data supports the concept of chronic Lyme disease, and being a Tool of the Medical Industrial Complex (TMIC®), that is just what you would expect me to say. But despite the paucity of data to support chronic Lyme, there is a contingent of patients and doctors who feel that the disease is real.

In the battle to win the hearts and minds of those who are unconvinced about chronic Lyme, those in favor of the syndrome have several options.

1) They could argue the science. That would be a losing technique as the totality of the published literature is against them.

    I would rather tell seven lies than make one explanation.

    — Mark Twain

    2) They could demonize the opposition. If the speaker is an evil TMIC, then the speaker’s message is evil as well. You are more likely to dismiss the message if you can dismiss the messenger. Certainly anything Rush Gore says is automatically nonsense since Rush Gore is a moron at best and evil at worst. It is a simple and common mental shortcut.

      But doctors still have a degree of respect, deserved or not, in society. I think mostly deserved. Most of the people I work with are caring, compassionate people who work hard for the betterment of their patients. Not all. But most.

      So you can call me a TMIC, but it will not stick most of the time. The process of calling people names can make the caller look petty, especially of they do it without cleverness. I am made of rubber, you are made of glue, what bounces off of me, sticks to you. It is true at 5 and at 50.

      The glory which is built upon a lie soon becomes a most unpleasant incumbrance. How easy it is to make people believe a lie, and how hard it is to undo that work again!

      — Mark Twain, Eruption

      It would be better is to find examples of your opposition being a TMIC and display it for all the world to see. Hoist them on their own petard (a Star Trek reference; you have not enjoyed Hamlet unless you have read it in the original Klingon). What if you can’t find examples?

      That is where you become a lying liar using lying lies. The Internet era makes it easy to rapidly transmit information. What often seems to be lacking is the ability for people to take just a little bit of time to fact check the information they get. People do not bother to double check the truthiness of the information they get. Hoax’s propagate endlessly on the interwebs, ranging from Captain Kangaroo’s war record to Nigerian money transfers. All easy to fact check. It is easier to believe what you read, especially if it supports you prior convictions. And lies are forever.

      One of the most striking differences between a cat and a lie is that a cat has only nine lives.

      — Pudd’nhead Wilson

      PalMD received an open letter from the IDSA about Lyme disease and he thought it smelled funny, and not ha ha funny. More like boiling melana funny. PalMD has a good nose, and a quick email to the IDSA confirmed the letter is a hoax. I am sure that many will get a copy of this letter and be angered at their suffering being called delusional. If I thought I had chronic Lyme and read the tripe that follows, it would fry my bacon. Most will not bother to check the legitimacy of the letter. It is, in a word, a lie.

      A lie can travel halfway round the world while the truth is putting on its shoes.

      — Mark Twain

      What follows is a hoax, lying lies from a lying liar.


      Open Letter to the Mental Health Community from the Infectious Diseases Society of America

      May 24, 2010

      Delusional Chronic Lyme Syndrome (DCLS) affects tens of thousands of new victims every year. This debilitating mental illness is destroying the emotional and financial livelihood of families across our country.

      As the Infectious Diseases Society of America (IDSA), we see firsthand the damage inflicted by this illness. Its sufferers frequently seek medical help from our member’s practices; however, we are powerless to cure its underlying roots, as this mental illness exists well outside our domain knowledge of pathogens and human infection. Therefore, we are strenuously imploring the mental health community to take up research action in earnest. After our Lyme disease treatment review panel concluded last month, it is now indisputably self-evident that DCLS has reached epidemic proportions and its yearly growth rate is alarming.

      The historical duration, demographic breadth, and geographical extent of this mass psychogenic illness is a fascinating and unprecedented event in the history of our country, perhaps in the history of mankind. It has persisted for four decades, affects all ages, and exhibits an intriguing geographic clustering phenomenon. The intensity of its delusions drives sufferers to such extremes as self-mutilation via catheterization and sometimes suicide. Currently, there is no formal diagnostic classification or treatment regimen for DCLS. Meanwhile, this is empowering opportunistic medical doctors to prescribe improper and costly pharmaceutical treatment. This only furthers delays patients from seeking out the mental health professionals they so desperately need. Unfortunately, general awareness within the mental health field is virtually nonexistent.

      As president of the IDSA, I bear some responsibility for this ignorance, by not encouraging more cross-discipline pollination of our medical information. As this crisis has illuminated, the IDSA has not been true to its stated core value to “promote collaboration and cooperation among other professional colleagues.” In response, I passionately pledge to our members and public constituents to reverse this myopic trend within our esteemed organization.

      IDSA member, Dr. Gary Wormser, has been a tireless crusader in promoting awareness of this emerging illness. I owe him immense gratitude for keeping true to his values as a physician in the face of sometimes caustic opposition to his fresh ideas. We beseech mental health researchers to carry on the torch ignited by Dr. Wormser and create pervasive, national recognition for this destructive disorder. By doing so, you will bring hope and compassion to those afflicted by this strange and insidious illness.

      To actualize this crucial transfer of information, the IDSA will be hosting free workshops on DCLS for mental health professionals at our upcoming annual meeting. This meeting will be hosted on October 21st through 24th, 2010 in Vancouver, Canada. We look forward to bringing the mental health community up-to-date on all relevant research and known data for DCLS. For more information, please contact the DCLS workshop coordinator at (xxx) 299-0200.


      Richard J. Whitley, MD


      If only those were real HTML tags.

      The most outrageous lies that can be invented will find believers if a man only tells them with all his might.

      — Mark Twain


      • Mark Crislip, MD has been a practicing Infectious Disease specialist in Portland, Oregon, from 1990 to 2023. He has been voted a US News and World Report best US doctor, best ID doctor in Portland Magazine multiple times, has multiple teaching awards and, most importantly,  the ‘Attending Most Likely To Tell It Like It Is’ by the medical residents at his hospital. His multi-media empire can be found at

      Posted by Mark Crislip

      Mark Crislip, MD has been a practicing Infectious Disease specialist in Portland, Oregon, from 1990 to 2023. He has been voted a US News and World Report best US doctor, best ID doctor in Portland Magazine multiple times, has multiple teaching awards and, most importantly,  the ‘Attending Most Likely To Tell It Like It Is’ by the medical residents at his hospital. His multi-media empire can be found at