Under Our Skin is a rigorously researched and highly thorough piece of investigative reporting on the silent epidemic that is Lyme disease. Director Andy Abrahams Wilson, whose twin sister was diagnosed with the illness, painstakingly profiles a vast array of sufferers—everyone from a “usual suspect” park ranger whose doctor wouldn’t diagnose Lyme even though he’d proffered the tick that bit him as evidence, to a young, pretty, often wheelchair-bound blonde and a hipster chick, an event producer for U2 who offers, “The hardest thing is everybody thinks I’m normal.” And through montages of talking heads divulging the many different diseases they were misdiagnosed as having, their outrageous out-of-pocket expenses, and the startling diversity of their symptoms, Abrahams has managed to create a film that flows with the same head-spinning feel that informs these victims’ frustration with both their debilitated bodies and the medical establishment at large.
Indeed, the sheer number of physicians and patients willing to address Abrahams’s lens should give pause. Why is this hugely underreported disease that statistically is much more widespread than AIDS—not to mention much more of an equal-opportunity infector—such a relative mystery? Why are so many sufferers told that there’s no such thing as “chronic” Lyme? Though it’s obvious Abrahams is on the side of those who believe they’ve contracted the bacteria that was first reported by a woman in Lyme, Connecticut (who appears in the film along with the scientist who made the discovery), to his credit the director does seek out those doctors and scientists who claim with a straight face that Lyme can’t be transmitted from a pregnant woman to the fetus, that children just don’t get chronic Lyme. (And, yes, Abrahams does appropriately cut to the mother who had numerous miscarriages, Lyme bacteria found in the placenta, and to the brain-damaged teenager with the illness whose deterioration began at birth.)
Even more fascinating is the disease’s many parallels to HIV (one doctor likens the current sense of an imminent explosion in cases to that at the start of the AIDS epidemic, while another explains that the Lyme bacteria most resembles is the one for syphilis), as well as the politics surrounding the illness. While the visual juxtaposition of straightforward interviews, soft piano and string music playing lightly in the background, with animation (even a clip from The Simpsons) and overhead shots of tick-ridden forests keeps Under Our Skin moving swiftly, it’s the story of the strong-arming HMOs, who file the majority of the complaints against physicians, that make it riveting.
Similar to the damage done to society when environmental researchers are in the back pockets of big energy, this silent epidemic seems to be muted as a result of Lyme diagnosis guidelines written by a medical board funded by insurance companies averse to paying for any lengthy antibiotic treatment. As even Connecticut’s attorney general notes, there’s a dangerous conflict of interest when most of the medical board is taking money from HMOs with a vested interest in an illness remaining “controversial.” Indeed, as long as the public remains confused about Lyme, as long as sufferers are misdiagnosed, there will never be enough informed citizenry to even form a powerful lobbying group. And that’s a sad thing. But that mounting evidence of Lyme’s probable links to Alzheimer’s, ALS, Parkinson’s, and MS—all diseases with a smoking gun yet to be discovered—is being swept under the rug is nothing short of a tragedy.