Though an inquestĀ might provide some of the answers toĀ questions people areĀ asking today, the truth is that none of us will ever know, even if he left a note, what was going through Robin Williams’ mind in the final moments of his enriched and enriching life.
No two people are the same. No two people’s depressions are the same. But his death shows once more that depression is no respecter of class, race, profession, wealth or talent.Ā
His wife, Susan Schneider, said today: ‘As he is remembered, it is our hope that the focus will not be on Robin’s death, but on the countless moments of joy andĀ laughter he gave to millions.’
It is certainly easy to recall moments of joy and laughter. Every parent can name films that they were made to watch again and again because their children loved to watch them again and again, and Mrs Doubtfire was in that category in our house.
I find it harder, however, not to focus to some extent on his death. We live in a celebrity culture, like it or not. It means that around the world in coming days, people will be talking about this terrible event, reflecting not just on his career, but on the reality of the illness which led him to his death. He will forever be remembered for his acting and comedic skills, and the films are there for all time for future generations to enjoy. But I hope too that he will be remembered as someone whose death was another staging post in the changing attitudes to mental health and mental illness which are desperately required all around the world.
If he had had a heart attack, if he had lost a long fight with cancer, if he had been knocked over by a car, would there be a need for a debate about ‘what this says about the state of heart disease, Ā or cancer care or road safety’? Possibly, but I doubt it. There still needs to be debate about depression as an illness, because there is still a lack of understanding that illness is exactly what it is.
Almost exactly a year ago today, in the same room where I am sitting now, I said to my partner Fiona that I honestly couldn’t see the point of living.Ā It was not the first time I had said it, nor the first time she had heard it. What it meant was that a bout of depression, which I had felt coming on for a few days, had reached its full grisly impact, rendering me physically weak, psychologically drained and emotionally desperate. Fiona had seen it often enough – at least once or twice, sometimes more,Ā in most of the 35 years we have been together – to know it was unlikely I would take that thought to its logical conclusion. Nor do I believe I ever would, though whenever someone does, like Robin Williams, it makes you wonder how many times he survived suicidal thoughts before finally succumbing.
I am lucky to have a supportive and understanding family, a small number of good friends, and a doctor I trust. When finally we spoke, he put me on anti-depressants, and I have been on them ever since, which is the longest period I have ever been on them. The many people I have met since, over the past twelve months, would have no idea, and it is not something I would broadcast unless asked – I t0ok a decision after my breakdown in 1986 always to be open.
Now it may be that I could have come off the medication at some point in the last few months. Between us, my psychiatrist and I decided against. I don’t like being on medication, but it is better than being depressed. And the last time, when I came off after three months, I fell back into a bad depression almost immediately.
SoĀ I have been taking pills to minimise the impact of feelings that lead someone who most of the time has a fairly positive view of the world, who loves laughing and making people laugh, thinking and making people think, to consider that life is not really worth living.
Openness has been a great help to me personally, I know that. I don’t know if Robin Williams was open with others about his depression. But I do know people in many walks of life who find it impossible to be so.
One of the things about being open about having mental health problems, and being an Ambassador for the Time to Change campaign, is that complete strangers talk to you about their own mental health problems. At a recent meeting in Westminster, I was really moved when Tory MP Tracey Crouch said she had decided to be open about her own depressions after hearing me talk about mine on Radio Kent. Another man at the meeting said he had first been open after hearing me speak about depression in Cornwall. Then Alan Howarth, Tory-Labour defector, ex MP now peer, stood up and said he wanted to open up about his depression too.
That is partly what the Time to Change campaign is all about, joining up those dots so that everyone feels they can be open. Because here is the other side of the story: a woman, an NHS nurse no less, a depressive, who said that the last time the dreaded illness hit her, and she was unable to get up, the elder of her two daughters came to see her in her bedroom. ‘I asked her to phone the hospital and say that my younger daughter was off sick and I had to stay and look after her,’ she told me. ‘Then I had to tell my younger girl she couldn’t go to school in case any of the other hospital staff saw her when picking up their own kids, and myĀ lie to her boss would be exposed.’
Just think through all that. In Britain, 2014, one of the most advanced countries in the world with one of the best health services and among the most liberal attitudes, an NHS nurse felt she could not tell the truth about her illness. Worse, she had to draw both of her daughters into the lie, and keep one of them from school as a result.
What would she have said if she had flu? That she had flu. What if she had a cancer scare and had to go for tests? Oh that’s fine. We all understand cancer, it is a ‘proper illness.’
Here is where it is important to take heart from other campaigns. Cancer used to be ‘the big C.’ We didn’t like to talk about it. Now we do talk about it, and that is part of the reason why funding has improved, the treatments have improved, campaigns have been strong and successful.
Mental health remains the Cinderella service in healthcare because it remains misunderstood, and it remains the one nobody wants to talk about.
I can hardly imagine the horror that Susan Schneider is going through right now. It must all seem so senseless. I will join all those who try to remember her husband as a great actor, who could make us laugh and make us cry, and make us think. I will certainly remember, and continue to mimic with my daughter, his Scottish accent in Mrs Doutbfire.
But I hope that his family, those he leaves behind today and those as yet unborn, can one day look back and say not only was he a fine entertainer, but also that his fame, and the debate about depression sparked by his death, led to greater understanding, which meant that others were able to be more open, ask for help when they needed it, know that treatment was there because the politicians and health policy makers knew that it had to be.
We have a long long way to go. I met Health Secretary Jeremy Hunt last year. He wanted to talk about the campaign work I was doing on alcohol abuse. But we also talked about depression and he said that he found it really hard to understand ‘why someone like you, with the life you have, would have depression.’ I was, I admit, quite shocked. But he was relatively new in the job, and I did not explode as my daughter later told me I should have done. He was reflecting an opinion that many hold, and this is the fight we have to win – to understand that depression has nothing to do with who you are, how much you earn, how popular or famous, unpopular or unknown, you are. It just is. Like cancer is. Like asthma is. Like diabetes is. Some people get it, some people don’t. It is an illness, a truly horrible illness, and must be viewed and treated as such.
The most retweeted tweet I have ever done was one I posted when Stephen Fry had talked of another suicide attempt. ‘To those asking what Stephen has to be depressed about,’ I asked ‘would they ask what he has to be cancerous, asthmatic or diabetic about?’
To those tempted today to ask what Robin Williams had to be depressed about, with his success, fame, wealth, lovely home, lovely family, tons of opportunities and great moments in his life, please just stop. If he had died of cancer, would you ask what he had had to be cancerous about? If he had been run over by a car, would you have asked why he went and got himself run over?
Time to Change is a campaign whose time has come. Because it is time to change attitudes to depression and other mental illnesses that frankly belong in the dark ages. One day, we will look back and wonder how on earth we used to believe that depression was a lifestyle choice,Ā only to be debated and taken seriously when an A List film star took his life, and the world filled with people saying how shocked and saddened they were.
Thank you, Alastair, for a really sensitive, helpful article. I remember the first time I admitted to depression, as a teenager to a supportive headteacher, who told me I didn’t need to be depressed because I had a good brain! Since then I’ve had the experience of feeling guilty, in a sense, for being depressed when I feel I have nothing to be depressed “about”. More recently I’ve started to understand that depression doesn’t have to be “about” anything, but I do wish those around me also had that perspective. There’s nothing more insensitive and soul – destroying than being advised to “count your blessings” – as if that somehow had the power to cure depression. There’s a huge need to educate people about this horrible illness.
Thank you for writing this.
Very sad news about Robin Williams, but there is some comfort from how the media is reporting about it – a mental health issue, not another celebrity does from substance abuse issue. Surely that’s progress?
As a sufferer and survivor I would agree that attitudes remain in the dark ages. However what is worse is the modern treatments in the form of antidepressants which at best do no more than manage symptoms and at worst, and oftentimes, deepen depression or trigger mania, psychosis and in some cases lead to homicides and suicides. No two people’s depressions are the same, true, but fundamentally depression is caused by something, whether it be quite apparent such as a great loss, or legal or financial problems, relationship breakdown, job dissatisfaction, poor housing, other health issues or not so obvious, such as previous trauma or even an existential or spiritual crisis. To describe depression as an illness however falls into the trap of the myth of a chemical imbalance or brain misfiring perpetuated by doctors and pharma companies which profit from having a medical model for which drugs are offered as a treatment. The drugs do nothing to cure a nonexistent chemical imbalance and obviously do nothing to cure underlying problems causing the depression. A drugged brain may as a result produce more serotonin and lead to apparent improved mood and functioning, which is what doctors and pharma companies point to in support of these dangerous treatments, but you may as well say taking ecstasy is a cure for an inability to dance to high BPM dance music. Of course practice, improved fitness or simply finding music you do like and can dance would lead to a better outcome without the other dangerous physical and brain disabling effects of taking a drug.
Modern psychiatry is unbelievably as backward today as it has always been (only thirty years ago being homosexual was considered a mental illness) but the bad science peddled and supported by the various interest groups is doing nothing to improve understanding of depression but is obfuscating the real issues, not leading to curing anyone, but putting people in a cycle of relapses and a lifetime of medications and in many cases leading to terrible outcomes.
You cannot compare depression to cancer, diabetes or asthma which are real illnesses and conditions, with measurable biochemical or physical abnormalities. Of course you wouldn’t ask someone what they have to be cancerous about but you should be asking what someone is depressed about. Not judging them whether they say “I am unhappy with my home life”, “I hate my two hour commute to work” or ‘I just don’t see what the point is to living” but helping them find the solution to whatever problem is causing the feelings, if solvable, or equipping them with the tools to manage those that cannot such as the loss of a loved one. To not ask these questions is to accept the lie that it is an illness, “It just is” as you put it, and will take the sufferer down the road of chemical treatments and a lifelong failure to address the problems or leave the sufferer with even worse ones.
>but fundamentally depression is caused by something
What makes you so sure of this?
You are very confident in your point of view. Perhaps if you had some actual evidence to back it up, it might be worth something. Right now, the treatments that show the most promise are ones that treat mental disorders as brain disorders – utilizing magnetic, electrical, or aural means to alter neural patterns is producing some striking results. Please see ‘Viewing Mental Disorders as Brain Disorders’, by Thomas Insel, Director of the NIMH, on YouTube for an illustration of how precise neuroimaging shows just how different the brains of mentally ill people are from healthy brains, and his opinion on the matter.
Depression, along with anxiety and many other mental health issues, is indeed dangerously forced underground. But we shouldn’t pathologize such issues by comparing them to physiological diseases like cancer or diabetes. At this point in human history, we’re increasingly besieged by forces – personal, political, economic and technological- that stir up angst. We no longer have the false comfort of religion, tradition, or community to shield us from meaninglessness, doubt and the knowledge of our own demise. The rise of depression, anxiety, eating disorders, autism, ADHD and all such contemporary woes are symptoms of our new reality. If medication can help, great. Certainly openness and discussion will help more. I commend you, Alastair, for promoting both. Yet our task is to find meaning inside ourselves:
an immensely complex and difficult task, as Robin Williams’ tragic passing amply demonstrates.
Unfortunately there is a generational belief that depression is “all in the mind”, that one can “shake it off”. It’s only when it’s compared to cancer, or heart disease, or asthma that people can start to understand the complexity of the illness. There remains a stigma attached to mental health problems, particularly depression, that sometimes feels insurmountable. People who have never experienced depression don’t understand why we can’t “look on the bright side”. When I’m depressed, there is no bright side. There’s black, dark grey and more black. I’m often asked “how can you be depressed? You’re so happy! You’ve got everything you ever wanted!” Medication is the reason that I’m able to function. I’m not that happy. It’s all a mask. It doesn’t matter what you’ve got, or who you’ve got, sometimes it’s difficult to find a way through the blackness. Hopefully some good can come from the sad passing of Robin Williams, and people may start to understand that we really are suffering from an illness, and not just “malingering”.
An excellent article and comments. We need more openness.
Unfortunately there is a generational belief that depression is “all in the mind”, that one can “shake it off”. It’s only when it’s compared to cancer, or heart disease, or asthma that people can start to understand the complexity of the illness. There remains a stigma attached to mental health problems, particularly depression, that sometimes feels insurmountable. People who have never experienced depression don’t understand why we can’t “look on the bright side”. When I’m depressed, there is no bright side. There’s black, dark grey and more black. I’m often asked “how can you be depressed? You’re so happy! You’ve got everything you ever wanted!” Medication is the reason that I’m able to function. I’m not that happy. It’s all a mask. It doesn’t matter what you’ve got, or who you’ve got, sometimes it’s difficult to find a way through the blackness. Hopefully some good can come from the sad passing of Robin Williams, and people may start to understand that we really are suffering from an illness, and not just “malingering”.
Donna, I don’t think anyone whose depressed is malingering, but I’m sorry but the comparison to cancer and other real diseases doesn’t help anyone, except give patients an excuse that it’s not their fault and that it can be cured or treated easily with drugs. It’s a debilitating state of mind that needs work and time to address. Have you ever tried to break down your life and examine each area to identify the source of your depression? I’m sorry but medication in my experience does nothing except mask the issues because you stop thinking about them, gives you energy and puts you out of touch with your reality which ends up feeling like wellbeing. You feel like you are functioning better but you won’t address the underlying issues that way if you don’t think about them or reach the wrong conclusion if you do because your mind is drugged. You do not feel the way you do because your brain is lacking the chemicals the medication provides! That is a myth, and is the equivalent of saying that people who get headaches have a deficiency of aspirin. I know everyone is different but I speak from experience, I got “depressed” a few years ago because of relationship problems, and was conned into believing the chemical imbalance BS by a doctor who prescribed antidepressants. They made me hypomanic and manic over 4 years during which I lost everything, home, job, savings, friendsThere is no way I would do what I did if it wasn’t for the drugs! Only when I came off the drugs did I realise that the drugs had effectively been a chemical lobotomy and with the devastation in my life I became incredibly depressed about the situation I am left in. Now I am rebuilding my life without pills. I’m incredibly unhappy and angry about what happened but I’d rather be myself and deal with my problems without resorting to drugs which do more harm than good and in all likelihood a chemical lobotomy now would lead me to killing myself. They are responsible for thousands upon thousands of suicides that could have been avoided by people in despair getting help other than brain disabling drugs.
Linking back to the original story – I strongly suspect that Robin Williams may well have recently been started on medication, or had his dosage increased or changed, and the result was the normal functioning in his brain which told him that suicide would devastate family was impaired by these drugs. It happens all the time, but the media mostly don’t report the link and doctors, big pharma, mental health services and coroners all blame the patient, the “illness” and not the drugs.
supporter agreeing here –
and my own blog touches on the issue of fame being the greatest delusion – one people should not aspire towards as if it was a goal in itself… it never helps with these basic things – depression, fear, loneliness, or the need for real love
http://www.smileofthedecade.co.uk/newblog/?p=1103
Thanks for your great post, Alastair. I am a recovering alcoholic and drug addict. I have been sober for 8 years and have battled depression most of my life. It is a true dis-ease. And disease. I am grateful for my trusted therapist that has seen me through some horrible valleys in my treatment. I feel once I spoke my truth to her about what happened to me as a child, all the shame and despair left me. Not overnight, but the grip of my demons was loosened tremendously once someone else was helping me heal. I began to hope again. I began to believe that life was worth living. She made me believe in love again. And that is truly what was missing from me. Not that people didn’t love me – that I didn’t believe I was worth loving. I knew I was damaged and broken and that if anyone ever really knew EVERYTHING about me, they wouldn’t love me. Like you said, we live in a celebrity world where everyone looks beautiful and everyone looks like they have the world by the tail. I thought I needed outside forces (money, lots of friends, a great house, nice car) to be happy. I had all of those things and I was miserable. What I realized in recovery was, I needed me. I needed to love myself. I needed to be my best friend. And all of that stems from within. I didn’t know how to attain that love. But I learned and now, I have a wonderful husband, a normal life with very few trusted friends, and the most prized possession I have is the love for myself. I finally learned how to do that. I learned that old saying was true – if you don’t love yourself, you can’t love anything or anyone else.
Your Time to Change campaign sounds incredible. I would love to be a part of it. I’m not sure how I could be, but I am forever in the trenches with you in this life and someone who will always be here for you if you need someone to help bear your burdens. Thank you for putting yourself out there. It takes courage to be vulnerable and tell the truth. Your truth is a great reminder to me that I am never alone. Thank you.
Alastair, this is a very sad day and your comments on depression are of course completely valid and important, but I can’t help but wish you were writing posts demanding a recall of parliament too. Why is labour being so weak in the face of this genocide in Iraq? Sorry to digress but aren’t we at a cross road here?
Another one has been caught out by it again. As when someone eventually listens…
The mask of the clown,
hides his frown.
Nagging at him when alone,
with no crowd.
No faces to see they’re pleased,
just blank walls appeal.
Just ceilings to scream at bare,
with a far off stare.
Desperate to hang on here,
from calls of there.
Looking forward to the best,
and for the rest.
Thoughts provoke which way,
while I stay.
Until that weak moment arrives,
to go away.
Thank you for this. I’ve been suffering from depression for 20 years and I live in Singapore where attitudes towards mental health are less progressive. I have also adopted a transparent and open attitude but find that it gets people more uncomfortable and judgmental. Had a recent bout (am still trying to get out of it) and was asked to be admitted to a facility. Robin William’s death shook me up but as a depressive, I understand. We need more public awareness and understanding.
I’m sorry but I can’t empathise with suicides (or with those who disappear voluntarily).
Is the opinion that everyone will be better off without their gloom (as if that’s their only quality) really more important than what the bereaved will actually feel – for years and years and years?
I know it sounds selfish to urge depressed others to think about the hole they leave in friends’ and family hearts and lives (and even more stupid to suggest comparing their lot with others – people in Gaza for instance), perhaps it was the effects on family members that my auntie’s suicide had, especially (obviously) on the relative who found her.
Dear Mr. Campbell,
Depression can be caused by an imbalance of catecholamine (1) sequestered by microbes like the ubiquitous Bartonella (2) – in parasitised blood invade the brain, every system and space. Bartonella are pleomorphic: now classed Proteobacteria, Barton considered protozoan, in 1993 Rochalimaea species were removed from the Rickettsiales to the Bartonellaceae. Infection can be conferred at conception. Bartonella and their L-forms (3) appear to be largely ignored by he medical industry even though there are thousands of research articles on the internet. Your interest could raise public awareness to demand address of cause not just relief of symptoms – could take the money and mystery out of chronic/so called genetic disease.
1. Google “depression and catecholamine”, Dewhurst.
2. Comparative Vertebrate Endocrinology, PJ Bentley, pg 1,
“protozoan Tetrahymena …possesses adrenaline”.
3. Isolation of L-forms of Bartonella bacilliformis, 1968, JT Sharp,
Baylor University School of Medicine
Bartonella bacilliformis moved out of the Andes when Pizzaro invaded Peru in 1530 to establish Spanish trade colonies, is now brought out by visitors. Dirk Elston, Brooke Army Medical Center, Texas, notes: “…bartonellosis spread by a louse has different manifestations from bartonellosis spread by a flea or biting fly”. Environment can/does change the characteristics of microbes – vectors; host diet; in particular, current practice to culture w CO2 at 37 centigrade, not the pre 1970, aerobic at 26-28 centigrade.
FH Sood et al, Microbes and sequestered substances as mechanisms for disease: Bartonella and L-foms as common global etiological agents, Med Hyp (1999)52(4)293-296
Very interesting. Our bodies are full of bacteria, whether it is in the gut or elsewhere, naturally. And it mainly is set up at birth, and with immediate environment, and later lived it one. It affects body and mind systems. It is said that some people naturally thrive when they go and live in an area 5,000ft and above altitude, due to lower microbes in the environment. And in corollary, some do not naturally.
Another blurt.
I’m sure most people who commit suicide do so because they regret the possibility of being a burden to F&Fs and feeling that it will never change.
Patience is valuable (she says, having none of the stuff).
We’ve read tonight that Robin Williams’ suicide is suspected of having been caused by fear of bankruptcy.
What a crying shame (I hope those ex-wives will suffer the guilt they should – but that they won’t prove it by killing themselves).
I’ve really never understood the attitude that a wife is entitled (should have used caps) to half of a husband’s wealth.
The lawyers must have made mints from the lovely man ‘o.b.o.’ women they pretended to think worthy of halves of ever-diminishing fortunes :-(.
Get out and earn your own livings ‘girlies’ – BE equal.
Well said Alaistair. Depression is an awful illness. I have been on medication for 6 years now and will be for the rest of my life. I am very happy to be so. As my psychiatrist said, ‘ why should we expect your brain to ‘work’ again? We wouldn’t expect a diabetics pancreas to fix itself and take them off insulin.’ This is fundamentally what society needs to understand. Yes, I have strategies to help me continue with life on a daily basis, but are they all a case of ‘picking myself up’ or ‘appreciating what I’ve got’? I appreciate what I have – depression. Life long, at times debilitating, unforgiving and always challenging. I am very open about my illness and try to be as much as possible. The discomfort others show when I mention it is remarkable. The unspoken message of ‘I don’t want to know’ is at times inhumane.
I’m proud that others like you speak out about mental health. I’m not happy that we have to. I have friends with cancer. Do they have to discuss every minute detail of their illness? Do they have to share their thoughts on death, their children, their pain? They need not do any of these things because society accepts their illness and that means they can share at whatever level they are comfortable with. I, like you Alaistair, Stephen Fry, or anyone with depression don’t have that choice yet. We have to share to bring that understanding.
I really like your article and my point is that part of why depression is a problem to so many people is that we don’t fully understand the human brain or human psychology.
Now you were once and influential figure in UK politics and maybe you still are so I have to say that even in politics and war the lack of understanding of human psychology has been instrumental in causing instability as we see in recent times in the Middle East especially.
Both at the personal level , when dealing with cases of depression and at the macro level when dealing with conflicts in a post nuclear world things should be handled with extreme care and sensitivity because our understanding of human psychology is incomplete.
I fear the recklessness of people who oversimplify and don’t understand the complicated state of affairs but I hope that we will as human beings on this planet not be so reckless in the future and come to a deeper understanding of the human brain and ourselves.
Your post is right on the nose – I think a lot of the intolerance and fear surrounding mental illness comes from our ignorance of the vast complexity of the brain. One thing that gives me optimism about the future is how knowledge of the brain is rapidly advancing – neuroscientist V.S. Ramachandran has said that, “We have learned more about the brain in the past 20 years than in all of history before that.” If this trend continues, in another generation people will look back on today with the same shock that we look back on the days before antibiotics or painkillers.
Off topic …. sigh.
It’s looking to me as if most of our media is in dire need of serious Directors of Comms š
WHY are they referring to ‘Islamic State’ (or state?) and ‘Caliphate’ as if these terms are written in something respectable (as opposed to in blood)?
I do not believe in states named after religions and doubt that even Christians of any denomination would want England or UK referred to, internationally and as if an assumption, as ‘Christian state’.
Neither to I believe in a body that thinks we should all quiver at the mention of its own preposterous chosen pose-y title.
Why are our media people not using appropriate prefixes?
‘The group that calls itself Islamic State’ as opposed to ‘the Islamic state’.
‘The group that calls itself the Caliphate but which is not understood as such in the modern world’.
Let’s not give these thugs such revolting quasi-support.
—————-
Yup, I do realise the precedent has been set for them by earlier ex-terrorists now claiming Israel as a religious state even though its real / long-term and practising Jewish community were the descendants of those that lived happily in Israel among Muslims and Christians throughout history and would be happy continuing to do so instead of having been usurped by Zionists.
Ok well at least you posted this one Alastair, and left in the reference to my post on your rebuttal blog which still hasn’t appeared – this is enough for me to give the benefit of the doubt and assume it was technical/mistake on the other ones.
Sadly, although writing does create awareness about depression it does little to actually get anything done about it. My son died after a four year battle with depression and we got virtually no help from the NHS. His GP seemingly had but one string to his bow – anti-depressants. I heard about the charity Depression Alliance after Jason died and how their Friends in Need initiative brought sufferers together to help alleviate the stigmatisation, isolation and loneliness that tends to exacerbate the problem. If you really want to do something my friend, you could do a lot worse than give some publicity to this charity
Dear Mr. Campbell,
It has been known for fifty years that imbalance of catecholamines cause manic depression (internet 20,000+ articles). And, that microbes, e.g., protozoan Tetrahymena, have catecholamines (adrenaline, noradrenaline), Microbes sequester substances by passive uptake of substances in blood – during plasmolysis and turgor. In parasitized blood, Bartonella (Barton considered protozoan) and L-forms, variants, invade every space and system. Bartonella catabolize amino acids, account for still growing list of species and diseases, e.g., angiogenesis (cancer), cardiovascular disease, neurobartonellosis. Bartonella spp cause clinically relevant co-infections resistant to treatment – seen as “antibiotic resistant”. Your interest will benefit everyone now at risk: Dame Sally Davies says antibiotic resistance is a threat greater than terrorism or global warming. Bartonellosis is a global disease of man, domestic and wild animals, routine laboratory practices obscure identification. pre 1970, easy to see and culture from the FIRST small drop of blood from a fingertip puncture (live in the adventitial cells surrounding the subcutaneous capillaries). Reduce microscope light to see red of blood and purple microbes in ethanol fixed UNstained films – cannot be dismissed as stain particles and thick cell walls. Protocols for diagnosis and treatment (molecular medicine, multiple substance therapies) can make national health care an effective and affordable service. The health of the people has to take precedence over preserving the interests of the medical industries that create chronic care cases by sanctioning inappropriate use of beta lactam drugs for humans, livestock and in feeds. Data in the many many thousands of internet articles on bartonellosis, beta lactams inducing microbes to produce L-forms with potential to evolve to variant forms like mycoplasma, need practical application. ONE microbe to MANY L-forms with potential to evolve to MANY original and variant forms like mycoplasma – to escalate infection, deplete nutrients. In hope for your interest that can make a difference, to benefit the health and welfare (economy) of the British and others..