If you have read the book OSLERS WEB or are enrolled in the NIH
Intramural Study, here's an article from today's Washington Post that
might interest you.  Straus is an "expert" in chronic fatigue and in
Lyme disease.  He was the project director on the NIH Lyme disease
Intramural study.
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Examining the Alternatives
NIH Official Brings Research to Bear on Nontraditional Medicine
By Susan Okie
Washington Post Staff Writer
Wednesday, March 29, 2000; Page A23
Stephen E. Straus, the man leading the federal government's newly
expanded effort to evaluate alternative medical treatments, once
volunteered to rub an extract of red pepper on his lips three times a
day.
It was agony for the sake of science: Straus, a National Institutes of
Health virologist studying chronic herpes infections, wanted to find
out whether a particular chili pepper component impaired the cold sore
virus's ability to spread along nerves.
The outcome? "As far as I was concerned," said Straus, "it hurt a lot
more than it helped."
Last October, the career NIH researcher became the first permanent
director of the National Center for Complementary and Alternative
Medicine (NCCAM). With a budget this fiscal year of $68.7 million, the
center, established by Congress, is charged with finding out whether
the alternative therapies so popular with the public really work.
That question has major medical and economic ramifications. Forty-two
percent of Americans used such treatments in 1997, spending an
estimated $27 billion. With consumers, alternative practitioners,
doctors, dietary supplement companies and members of Congress all
eagerly awaiting scientific verdicts on alternative therapies,
observers say Straus's job requires, if anything, more political
agility than those of other institute directors at the NIH.
"It's kind of like having one foot on the pier and one in the boat,"
said David Spiegel, a psychiatrist who directs Stanford University
School of Medicine's complementary medicine clinic. "If you're really
strong, you can keep it together--but it's really easy to go in the
wrong direction."
Although some colleagues were initially surprised when Straus accepted
the post, the Brooklyn native says he welcomes the challenge of trying
to put alternative medicine on a scientific footing.
"The opportunity would provide me with a greater chance of affecting
public health than anything I had been allowed to do yet at the NIH,"
he said.
Straus's career has combined medical practice with rigorous laboratory
research. He has specialized in studying chronic infections, including
hepatitis, herpes, Lyme disease and AIDS. He is credited with
discovering the first inherited autoimmune disorder, a genetic disease
in which cells of the immune system attack body tissues.
But he is best known as an expert on chronic fatigue syndrome (CFS), a
mysterious and controversial condition that produces overwhelming
fatigue, headaches, difficulty concentrating and various other
symptoms. Victims are sometimes so severely affected they can't work or
function properly.
Although some researchers had suggested that a virus caused the
syndrome, Straus concluded that while viruses can trigger the illness,
they probably don't produce its long-lasting symptoms. "I don't believe
there is a specific cause," he said. "I think it results from some
final common pathway of insult."
For suggesting that psychological factors might contribute to CFS,
Straus took political heat from the patient community, said John R. La
Montagne, deputy director of the National Institute of Allergy and
Infectious Diseases.
"He did a marvelous job . . . putting [CFS] on a stronger scientific
basis," said La Montagne, Straus's former boss. "He's a person of
tremendous integrity and objectivity."
Straus has outlined ambitious goals for the NCCAM, including the
support of nine specialized alternative medicine research centers
around the country and the funding of a series of large studies to test
some of the most popular therapies. His priorities, he said, are those
treatments that show the greatest promise and those likely to affect
the most people.
"We don't want lots of little {*filter*}y studies," he said. "It won't
provide the American public with a definitive answer."
Already underway are studies of St. John's wort for depression,
acupuncture for arthritis, ginkgo for the dementia of Alzheimer's
disease and shark cartilage for lung cancer. Slated to begin this year
or next year are trials of milk thistle for liver diseases, melatonin
and valerian for insomnia, saw palmetto for benign prostate enlargement
and echinacea for colds.
Straus noted that, from the perspective of other NIH institutes,
NCCAM's approach to research is "upside down." The center will start by
testing treatments in patients rather than first studying "molecules
and mice." But as a physician who cares for people with chronic
illnesses, he said he feels comfortable with that way of proceeding.
As a doctor, "I developed a very nonjudgmental, empirical approach," he
said. "If something could be beneficial, if it seemed to be nontoxic
and if my patient could afford it, I'd say, 'Try it. We'll examine this
together.' "
Spiegel said he thinks Straus's research credentials are just what the
new NIH center needs to gain credibility as the arbiter of scientific
standards in alternative medicine.
"He's highly thought of as a medical researcher [and] he's open enough
to complementary treatments that he's willing to take the job," Spiegel
said. "It's much better at this stage to get that kind of person than
to get somebody who's highly regarded in the complementary world but
doesn't know the science very well."
Players
Stephen E. Straus
Title: Director, National Center for Complementary and Alternative
Medicine, National Institutes of Health.
Age: 53.
Education: Bachelor of science in life sciences, Massachusetts
Institute of Technology; medical degree, Columbia University College of
Physicians and Surgeons; internship and residency in internal medicine,
Barnes Hospital, St. Louis; specialty training in infectious diseases,
Washington University, St. Louis.
Previous jobs: Chief of the Laboratory of Clinical Investigation,
National Institute of Allergy and Infectious Diseases (NIAID); other
positions at NIAID.
Family: Married, two daughters and a son.
Hobbies: Reading, woodworking and scuba diving.
? Copyright 2000 The Washington Post Company

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