Under Our Skin

Under Our Skin: The Untold Story of Lyme Disease is a 2008 film promoting "chronic Lyme disease", a controversial and unrecognized diagnosis. The film was directed by Andy Abrahams Wilson, who became interested in the subject after his sister identified as a "chronic Lyme" patient.[1] The film had its theatrical premiere on June 19, 2009 at the IFC Center in New York City.

Under Our Skin
Theatrical poster
Directed byAndy Abrahams Wilson
Produced byOpen Eye Pictures, Inc.
Distributed byShadow Distribution
Release date
  • April 2008 (2008-04) (Tribeca)
  • June 19, 2009 (2009-06-19) (United States)
Running time
103 minutes
CountryUnited States
LanguageEnglish

Controversy

The film argues that persistent infection with Lyme disease is responsible for a variety of debilitating symptoms. The film presents advocates of the position, including "chronic Lyme" pressure group International Lyme and Associated Diseases Society (ILADS). The position is at odds with that of major medical bodies including the Infectious Diseases Society of America and the American Academy of Neurology, who do not recognize "chronic" Lyme disease as a legitimate diagnosis. The film portrays the Infectious Diseases Society of America (IDSA) as "an organization riddled with conflicts of interest," and briefly discusses Richard Blumenthal's antitrust charges against the society.[2][3] Blumenthal's accusations led to an independent review which fully vindicated the IDSA position.[4]

Synopsis

The film follows six individuals, including major league ball player Ben Petrick who report chronic symptoms, which they attribute to persistent Lyme infection. The majority of the film is devoted to the storyline of these patients and their reported recovery. At the same time, the film presents advocates of long-term therapies for chronic Lyme disease and briefly presents the position of the Infectious Diseases Society of America (IDSA).

The second half of the film focuses primarily on state medical board investigations of Joseph Jemsek and Ray Jones, two physicians who prescribe long-term antibiotics for chronic Lyme disease, a practice generally recognized to be dangerous and without provable benefit.[5][6][7] Jemsek was investigated based on the complaints of 10 patients who described "nightmarish experiences" as a result of his treatment; he was supported by a number of patients and advocacy organizations.[8] The board found that Jemsek had departed from standard medical practice and had failed to inform patients that his treatments were unorthodox; his medical license was suspended with stay, allowing him to continue practicing medicine.[9] Facing a lawsuit from an insurance company, Jemsek declared bankruptcy and closed his medical practice.[10]

The final act of the film focuses on Connecticut Attorney General Richard Blumenthal's antitrust investigation of the IDSA Lyme disease guidelines. Blumenthal issued a press release in May 2008 stating that his investigation "uncovered serious flaws" in the development of the IDSA guidelines, although Blumenthal declined to file any charges.[11] Under pressure of mounting legal fees, the IDSA agreed to submit its Lyme disease guidelines to an independent review, which supported the scientific validity of the IDSA guidelines.[12][13] The expert panel's review was published in 2010, with the independent doctors and scientists in the panel unanimously endorsing the guidelines, stating "No changes or revisions to the 2006 Lyme guidelines are necessary at this time," and concluding long-term antibiotic treatments are unproven and potentially dangerous.[14] The case was described in Forbes as "intimidation" of the medical community by the Attorney General,[8] and in JAMA as an example of "elected officials advocating for health policies against the weight of scientific evidence."[15]

The film concludes with vignettes of two patients discussing their claimed recoveries.[3]

Critical reception

The New York Times described the film as a "polemic" and "inflammatory."[3] Variety wrote that the film "sides with those advocating unconventional treatments, [but] gives gatekeepers from Infectious Diseases of America [sic, actually Infectious Diseases Society of America] their say."[16] The Baltimore Sun described it as "full of suspicions, assertions, and anecdotes; it’s low on science and objectivity".[17]

According to review aggregation site Rotten Tomatoes, as of December 2019, the film has received 26 positive reviews and 6 negative reviews for a score of 81% positive reviews from the site's approved critics; the average rating is 6.7/10. The critical consensus reads: "A scathing indictment of the American medical system, Under Our Skin is timely, frightening stuff."[18] On Metacritic, it has a rating of 63/100 based on 13 reviews, which the site categorizes as "generally favorable reviews".[19]

Awards and honors

References
  1. Beckman, Rachel (June 17, 2008). "Film Focuses on Lyme Patients". Washington Post. Retrieved September 12, 2008.
  2. Feder HM, Johnson BJ, O'Connell S, et al. (October 2007). "A critical appraisal of "chronic Lyme disease"". N. Engl. J. Med. 357 (14): 1422–30. doi:10.1056/NEJMra072023. PMID 17914043.
  3. Holden, Stephen (June 19, 2009). "Ticked Off". New York Times. Retrieved January 6, 2009.
  4. IDSA Final Report of the Lyme Disease Review Panel of the Infectious diseases Society of America
  5. Wormser GP; Dattwyler RJ; Shapiro ED; et al. (November 2006). "The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America" (PDF). Clin. Infect. Dis. 43 (9): 1089–1134. doi:10.1086/508667. PMID 17029130.
  6. Halperin JJ, Shapiro ED, Logigian E, et al. (July 2007). "Practice parameter: treatment of nervous system Lyme disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology". Neurology. 69 (1): 91–102. doi:10.1212/01.wnl.0000265517.66976.28. PMID 17522387.
  7. ""Chronic Lyme Disease" Fact Sheet". National Institute of Allergy and Infectious Diseases. April 17, 2009. Archived from the original on June 11, 2015.
  8. Whelan, David (March 12, 2007). "Lyme Inc". Forbes. Retrieved January 7, 2010.
  9. Stephen Barrett, M.D. (2009). "Joseph Jemsek, M.D. Charged with Unprofessional Conduct". Retrieved May 19, 2017.
  10. O'Hehir, Andrew (June 20, 2009). "Beyond the Multiplex: Under Our Skin". Salon.com. Archived from the original on June 28, 2009. Retrieved January 7, 2010.
  11. "Attorney General's Investigation Reveals Flawed Lyme Disease Guideline Process, IDSA Agrees to Reassess Guidelines, Install Independent Arbiter" (Press release). Connecticut Attorney General Office. May 1, 2008. Retrieved January 7, 2010.
  12. "Agreement Ends Lyme Disease Investigation by Connecticut Attorney General" (Press release). Infectious Diseases Society of America. May 1, 2008. Retrieved May 19, 2017.
  13. Lantos PM; et al. (2010). "Final Report of the Lyme Disease Review Panel of the Infectious Diseases Society of America". Clin Infect Dis. 51 (1): 1–5. doi:10.1086/654809. PMID 20504239.
  14. Singer, Stephen (April 22, 2010). "No changes to Lyme disease treatment". Associated Press.
  15. Kraemer JD, Gostin LO (February 2009). "Science, politics, and values: the politicization of professional practice guidelines". JAMA. 301 (6): 665–7. doi:10.1001/jama.301.6.665. PMID 19211474.
  16. Alissa Simon (May 2, 2008). "Review: 'Under Our Skin'". Retrieved May 19, 2017.
  17. Auwaerter, PG; Bakken, JS; Dattwyler, RJ; Dumler, JS; Halperin, JJ; McSweegan, E; Nadelman, RB; O'Connell, S; Shapiro, ED; Sood, SK; Steere, AC; Weinstein, A; Wormser, GP (2011). "Antiscience and ethical concerns associated with advocacy of Lyme disease". Lancet Infect Dis. 11 (9): 713–9. doi:10.1016/S1473-3099(11)70034-2. PMC 4489928. PMID 21867956.
  18. "Under Our Skin (2009)". Rotten Tomatoes. Retrieved December 3, 2019.
  19. "Under Our Skin (2009)". Metacritic. Retrieved December 3, 2019.
  20. https://www.csindy.com/coloradosprings/theres-a-lot-of-money-being-made/Content?oid=1146287 // Colorado Springs Independent, January 15, 2009.
  21. "Sonoma International Film Festival News & Updates". www.sonomafilmfest.org.
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