Havana Syndrome: Medical, Scientific & Policy Perspectives, UT Southwestern Symposium
7:50-11:51, Dr. Kenneth Dekleva:
And it started with about
two dozen US diplomats and family members at the US embassy in Havana in 2016 and 2017. But
later cases have grown to over 250 to 300 US diplomats and family members around the world, in China. And later in embassies in Asia, Europe, Latin America, and Africa, and even persons working in Washington, DC, near the White House. And
the cardinal symptoms of this include or can include, dizziness, balance problems or unsteadiness, tinnitus often starting with a feeling of fullness, pressure in the ear, or pain in the ear, or facial pain. And these symptoms have been reported by many, if not all of the patients that have been studied, as being directional, coming from a certain particular direction. And also headaches, cognitive complaints, hearing loss, and for those patients with more chronicity, a psychological or even neuropsychiatric overload.
And this has been a real puzzle because it's a syndrome that had not been seen ... I certainly, in my 14 years of work as a diplomat physician, had never seen a syndrome like this, nor had any of my colleagues, because if we would've seen it, it would have been reported appropriately. And these patients would've been medically evacuated to academic medical centers in the US for further evaluation and treatment.
Welcome and Symposium Introduction (UT Southwestern, Feb 10, 2022)
1) In 2017 everybody still talked about
diplomats. In 2022, however, everybody knows that the 'Havana Syndrome' sufferers are diplomats, CIA spies and security officials and their families. Why keep up the charade?
2) Three weeks after the CIA interim report, which reduced the number of cases that hadn't found other explanations to approximately two dozen, Dr. Kenneth Dekleva, Associate Professor of Psychiatry, UT Southwestern, still seems to consider 250 to 300 to be relevant cases of the alleged symptom.
3) How the hell can symptoms like dizziness, balance problems or facial pain be
directional - unless somebody is pushing you or punches you in the face? He doesn't say so, but he is obviously referring to the
sound again, which was obviously coming from the direction where the crickets were sitting. Notice how this directionality has become increasingly important along with the idea of
directed-energy weapons (Wikipedia). So first, the US diplomats and spies in Havana heard crickets, which they interpreted as a health attack, and when the idea of sonic attacks were dismissed, they and the alleged experts surrounding them resorted to the idea of directed microwaves in order to maintain the idea of a directional attack.
So I think one of the things we've learned in our approach and the Mayo Clinic, Dr. Staab will talk about, and has been recommended by the National Academies of Sciences report, is a multidisciplinary approach is the best approach for these patients involving people from many disciplines here at UT Southwestern and other similar academic centers, as Dr. Tamminga mentioned. One of the things that this may represent is a paradigm for neuro-vestibular or neuropsychiatric illness. And one of our speakers, Dr. Chad Lane, is going to talk about this.. this is important to us and others at UT Southwestern because we're one of four centers in the country that has a combined, a joint neurology psychiatry residency training program.
And in talking about these syndromes such as PPPD (persistent postural-perceptual dizziness), it's very interesting because these are non-psychiatric conditions, but they respond to treatment with psychiatric treatments, including antidepressants and cognitive behavioral therapy. And it's thought that this may represent what we call a neuroprotective effect. We see this in other medical conditions such as irritable bowel, stroke, both with depression, but also stroke without depression. If you give people antidepressants, they have better outcomes, chronic headache syndromes, chronic pain conditions. So that's intriguing and intersting.
4) Yes, it's true,
"non-psychiatric conditions ... respond to treatment with psychiatric treatments." But so do
psychiatric conditions, and I bet MPI conditions respond to them, too. But mentioning only
"other medical conditions" supports the narrative that 'Havana Syndrome' is
physiological rather than
psychological. (I would also bet that the 'syndrome' patients will respond to almost
any kind of placebo treatment - they have already responded to the
nocebo cricket sounds - but I am not in a position to conduct a test.)
And the other thing that has been talked about a lot are these functional disorders, the neuro-vestibular disorders, such has PPPD, and the National Acacemy of Sciences committee, which Dr. Staab was also a member of, and he's going to talk about, sees these as a kind of new paradigm, a functional paradigm. They're not psychiatric illnesses, they're not psychogenic, they're not mass hysteria, they're not malingering. I think that's an important statement to make because in this cohort of diplomats and family members with Havana Syndrome, if you will, typically these patients, and I know this type of patient well, because I treated them and my colleagues did. They don't seek a patient role, there's no primary gain. And there's certainly no secondary gain to becoming impaired, unable to work, and in some cases severely medically disabled. Some of the patients, diplomats with Havana Syndrome, have had to medically retire.
But a functional approach, this may explain some of the chronicity and how we look at these patients.
5) Kenneth Dekleva
claims that
"they're not psychogenic, they're not mass hysteria," but his argument is that they
"don't seek a patient role, there's no primary [or secondary] gain." I.e. they're 'not in it for the money', but that has nothing to do mass psychogenic illness of mass hysteria. The same argument has been made over and over since the Penn study, and it only shows that these alleged experts confuse mass hysteria with malingering. That is, to them, no malingering = not psychogenic!
As for not 'seeking a patient role', I don't know how that can be dismissed. After all, it all started when Patient One contacted health care professionals about his symptoms, and later others followed suit. They may not be in it for the money, but they seem to be more than willing to appear in the role as victims of the 'Havana Syndrome' in the media. (And he media loves to portray them in this role!)
