"Yet, when we speak, Savely is resolute. "These people are not crazy," she insists. "They're good, solid people who have been dealt a bad lot.""
Smith's exposed skin is covered in waxy scars. Although he still itches, his lesions appear to have healed. If, as morgellons patients believe, the sores are not self-inflicted but caused by fibre-creating parasites, how is this possible? "I absolutely positively stopped picking," he says.
Dr Anne Louise Oaklander, associate professor at Harvard Medical School and perhaps the only neurologist in the world to specialise in itch ... surmises that itch evolved as a way for humans instinctively to rid themselves of dangerous insects. When a mosquito lands on your arm and it tickles, this sensation is not the straightforward feeling of its legs pushing on your skin. It is, in fact, a neurological alarm system; one that can go wrong for a variety of reasons – shingles, sciatica, spinal cord tumours or lesions, to name a few. In some cases, it can be triggered, suddenly and severely, without anything touching the skin.
This, Oaklander believes, is what is happening to morgellons patients. "That they have insects on them is a very reasonable conclusion because, to them, it feels no different from how it would if there were insects on them. To your brain, it's exactly the same. So you need to look at what's going on with their nerves. Unfortunately, what can happen is a dermatologist fails to find an explanation and jumps to a psychiatric one."
That's not to say there aren't some patients whose problem is psychiatric, she adds. Others still might suffer delusions in addition to their undiagnosed neuropathic illness. Even so, "It's not up to some primary care physician to conclude that a patient has a major psychiatric disorder."
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