The Crisis Deepens

  • Robert W. BalohEmail author
  • Robert E. Bartholomew


This chapter documents the continuing political reaction to the outbreak of illness among American and Canadian embassy staff in Cuba between 2016 and 2018. We examine the controversial findings of American embassy patients in two medical journals. A study in the Journal of the American Medical Association involving specialists in head trauma, found evidence of mild brain damage. A second study, in the journal Laryngoscope Investigative Otolaryngology, was conducted by ear specialists who found evidence of inner ear vestibular injury, namely damage to the otolith organs which regulate balance, gravity perception and sense of linear motion. Both studies have critical flaws including the selection of inappropriate controls, inflated conclusions, and a lack of evidence for exposure to an energy source or toxin. Furthermore, they do not adequately test the hypotheses they propose, while promoting exotic explanations that are not grounded in conventional research methodology or supported by the evidence.


The politics of illness diagnosis Peer review Ethics in medicine Mass psychogenic illness Mass sociogenic illness Collective unexplained symptoms Conversion disorder Mass hysteria Functional neurological symptom disorder Anxiety Public health Nocebo effect Contested diagnoses Cuba-American relations Social panics 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Neurology and Head and Neck SurgeryDavid Geffen School of Medicine at UCLALos AngelesUSA
  2. 2.Psychological MedicineUniversity of AucklandAucklandNew Zealand

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