ME/CFS BREAKING NEWS: From June 28, 1988...

Chapter One: A “Mysterious Illness” Appears—Prelude to a Pandemic

The Other AIDS Epidemic

Frontline Reports on the Chronic Fatigue Syndrome 
and HHV-6 Epidemics, 1988-1991

On April 13, I began republishing my first book on ME/CFS, What Really Killed Gilda Radner? Frontline Reports on the Chronic Fatigue Syndrome Epidemic, as a serial on SubStack. Published in 1991, it is essentially out of print 32 years later.

Sadly, very little has changed since I began covering Chronic Fatigue Syndrome, as it was then named, in early 1988 in the weekly New York Native. The Incline Village outbreak had happened only four years before, which in medical research terms is essentially yesterday. Patients, physicians and researchers were equally puzzled and frustrated; the media ridiculed patients with descriptions like “Yuppie Flu,” “Raggedy Ann Syndrome,” and “a fashionable form of hypochondria.”

I’m republishing this 32-year-old book as The Other AIDS Epidemic: Frontline Reports on the Chronic Fatigue Syndrome and HHV-6 Epidemics because I believe its original, contemporaneous interviews and studies provide insight to the long, sad, infuriating history of ME/CFS and will, hopefully, help to provide a blueprint for the future.

Chapter One
A “Mysterious Illness” Appears—Prelude to a Pandemic

A friend called me late one Friday afternoon in 1988, and she was crying. She is a Chronic Immune Dysfunction Syndrome (CIDS, or CFS) patient with whom I speak almost daily. That day, a woman in her support group had died. It was the first death.

CIDS/CFS may be the most devastating disease to emerge in the final years of this century. It’s estimated, in a single published study, that 21 percent of the American population is affected by CIDS. (1) Yet there have been no statements from Surgeon General C. Everett Koop to alert the public to the threat, nor has the Centers for Disease Control determined its frequency. The New York City Health Department has made no comment on the sizeable locus of CIDS in the city. Media coverage across the country has been sparse and generally dismissive, explaining away the illness as psychosomatic, or as a manifestation of severe depression.

CIDS is a newly defined disease. It has no known cause or progression, and no known cure. It usually begins as a flulike illness with fever, muscle pains and weakness, headaches, depression, and sleep disturbance. These symptoms can be chronic or cyclic, and last for months, sometimes years. Nearly all CIDS patients experience some level of neurologic dysfunction: confusion, forgetfulness, difficulty reading and concentrating, balance disorders, visual problems, and sensitivity to light. Some have seizures. There are rare cases in which CIDS patients develop fatal cancers of the immune system.

In early press reports, CIDS was derisively dubbed “the Yuppie Flu” because the only documented cases were in people who had the education, confidence, and financial resources to pursue medical care. Because CIDS was not an “official” disease until March 1988 (when the Centers for Disease Control published the case definition), physicians either didn’t know how to diagnose it, or were reluctant to do so in the face of a medical establishment that didn’t want to acknowledge it. One physician studying the illness found that one-fourth of his CIDS patients had consulted five or more physicians before being diagnosed. (1)

Increasingly, research indicates that CIDS affects people in every socioeconomic class and occurs in all age groups. It appears to affect women (or is diagnosed in women) somewhat more frequently than men, although there are no hard statistics. CIDS is not a psychoneurotic disorder that is confined to stressed-out overachievers; it is a severe, progressive, putatively viral disease to which an entire, unaware society is vulnerable.

The first described outbreak of CIDS occurred in fall 1984 and spring 1985 in the Lake Tahoe resort community of Incline Village, Nevada. Two primary care physicians, Drs. Paul Cheney and Daniel Peterson, began seeing an unusually large number of people who had an extremely persistent flu. They had recurrent fevers, sore throats, painful lymph glands, headaches, sleep disturbance, dizziness, muscle pain and weakness, and depression. Some had short-term memory loss; nearly all developed cognitive dysfunction of some kind—difficulty concentrating, reading, or writing—a generalized mental “fogginess” that made it difficult to think or create memories.

The illness in Incline Village resembled mononucleosis, which is caused by the Epstein-Barr virus (EBV). Some of Cheney and Peterson’s patients had extremely high levels of antibodies to EBV, and this virus became the first of many suspected causes of the illness. “Chronic Epstein-Barr Virus Syndrome,” or CEBV, was the original name given to this collection of symptoms. (1)

Cheney and Peterson suspected that a new strain of EBV might be causing the outbreak, and they alerted the Centers for Disease Control (CDC), the branch of the Public Health Service that monitors epidemics.

CDC epidemiologist Dr. Gary Holmes was unimpressed with what he saw in Incline Village; he was not convinced that an epidemic was occurring. One of the reasons for his skepticism was the lack of correlation between levels of antibodies to EBV and the severity of illness: the sickest patients didn’t always have the highest levels of EBV antibodies. (2)

EBV is described as a “ubiquitous” virus; 90 percent of Americans have been infected with it by the time they reach adulthood, and in most cases it causes no significant illness. People who are infected in early childhood rarely experience any symptoms; if the virus is first encountered in adolescence, the result is mononucleosis, known in teenagers as the “kissing disease.” EBV can cause several types of blood cell cancers, but it’s not understood why these cancers develop in some people and not others.

Holmes’s investigation revealed that patients didn’t have higher levels of EBV antibodies than healthy people, and he concluded that there was no EBV-related outbreak. In the published report of his findings, he stated that the “chronic mononucleosis-like syndrome” needed to be more carefully defined, but he urged physicians to look for other illnesses before diagnosing this syndrome. (2)

His skepticism lingered as time passed. Holmes cautioned the press against concluding that the illness in Incline Village was a new emerging disease. “A lot more is being made of this by the lay press than it probably deserves,” Holmes told the New York Times in July 1987. And in an interview given to the health magazine Hippocrates the same month, Holmes stated, “Physicians get caught up. They think they notice something, then they start seeing it everywhere.” (3)

Cheney and Peterson, however, remained convinced that they were seeing a new chronic illness, and other physicians concurred. In 1987, Dr. Anthony Komaroff at Boston’s Brigham and Women’s Hospital conducted a survey of 500 patients seen in four primary care clinics. He found that an astonishing 21 percent of patients reported major symptoms of CIDS. Forty-five percent of those patients were periodically bedridden. (4)

Cheney, Peterson, and Komaroff were among the very few physicians who believed this new illness was “real”; the medical establishment remained unresponsive, and the lay press was generally hostile. CIDS was dubbed “the Yuppie flu,” and treated as the newest in a series of trendy illnesses, replacing such “fad” diagnoses as hypoglycemia or hyperactivity in children.

Amidst all the contradictory findings from late 1984 to early 1988, CIDS was not an “official” disease, and physicians were understandably reluctant to diagnose an illness they weren’t sure existed. In March 1988, however, CIDS became an officially recognized disease following the publication of the CDC’s working case definition.

Holmes and 15 other physicians (including Komaroff) constructed a guide for the diagnosis of CIDS, which they named Chronic Fatigue Syndrome (CFS). A patient must fulfill two “major criteria”: onset of persistent or relapsing “debilitating fatigue” lasting more than six months that causes a reduction in activity by 50 percent; and other clinical conditions that could be responsible for the fatigue must be excluded—a long list of conditions that includes, among others, cancer, autoimmune disease, and AIDS. (5)

A patient must further meet six or more of the “minor criteria”: fever, sore throat, painful lymph nodes, unexplained muscle weakness, muscle pain, prolonged fatigue after exercise, headaches, stiff joints, sleep disturbance, neuropsychological symptoms (light sensitivity, forgetfulness, visual disturbance, excessive irritability, confusion, inability to concentrate, depression), and the development of these symptoms over the course of a few hours to a few days. (5)

Suddenly developing a chronic illness is disorienting for anyone, but particularly for a child. In Lindenville, New York, Dr. David S. Bell is following a population of 60 children with CIDS. Bell considers CIDS to be identical in children and adults, although the progression of symptoms appear to vary with age among children, teens, and adults. (6)

Bell defined two types of onset in children: insidious and acute. Insidious onset is seen most frequently in children aged 12 and under. It begins with fatigue, recurrent stomach pain, and headaches; after a year or so, muscle aches, sore throat, and painful lymph glands are added to the constellation of symptoms, gradually resulting in reduced activities and decreased school performance. Acute onset involves a severe illness from which the child never fully recovers; this is most frequently seen after puberty, according to Bell.

CIDS-associated neurological dysfunction in a child is often perceived as a learning problem. One-third of the children in Bell’s group have severe academic problems and failure. Neurological dysfunction can disrupt their education and development. “I personally feel very comfortable that there is no primary emotional or psychiatric overlay that is causing these problems,” Bell says. “These children were doing well in school before they got sick, and now they’re just falling apart.” (6)

Bell thinks the prognosis for adults with CIDS is fairly positive; he estimates that 80 percent of adult patients will improve significantly within two years. He expresses less optimism about the children: “Now, the prognosis is difficult,” Bell says. “And this is really the most worrisome thing for me in terms of the pediatric survey.” (6)

How well a child recovers from CIDS correlates with how quickly he or she recovers. Children who have been ill for less than two years have the best chance to regain health, although only eight percent of those in Bell’s group have had complete resolution (disappearance of all symptoms). Another eight percent have become more severely ill, and the health of the rest of the group remains poor but unchanged.

More than half of the children in Bell’s group have had CIDS for more than two years, and the statistics about their conditions are sobering. None of these children has regained total health. Fifty-one percent are improving slowly, although Bell is not sure whether they’re actually improving or if they’re simply learning to cope with their illness. The symptoms have remained stable in 35 percent of the children, while 14 percent are, in Bell’s words, “clearly getting worse.”

Bell is not hopeful that the children (or adults) who have been ill for more than two years will ever regain full health. He stresses that if the disease is to be fully resolved, it must happen quickly. ”Recovery is much less common after somebody has had CFS for two years,” Bell says. (6)

In adults as well as children, CIDS leeches away vitality, the ability to participate fully in life and maintain successful relationships. The mental capabilities of adults are also affected by CIDS: Confusion, forgetfulness, and inability to concentrate result in interruptions of careers and, sometimes, loss of income.

CIDS is frequently confused with depression. Harlan Ellison, the author of popular “magic realism” novels, spent ten years and more than $30,000 struggling with a malady he was told was endogenous depression before he was diagnosed as having CIDS. Now he is working again and learning to manage his symptoms, which for him recur in a random, cyclic fashion. (7)

CIDS is not always a chronic, manageable illness, however; it can produce debilitating neurological disease. CIDS patient Jan Montgomery spent two months in a cognitive netherworld. She was unable to walk because of spatial disorientation, muscle weakness, and pain. She could not speak properly; when she remembered what she wanted to say, the words that she spoke were different from what she meant. She had severe light sensitivity, headache, and nausea. (8)

Montgomery first became ill with a flu that never went away. One year later, she experienced rapid deterioration in leg strength, which progressed from difficulty in walking up stairs to “terrible pain” when she walked even one block. She developed aching, numbness, and tingling in her arms and legs, as well as cognitive problems. Montgomery became unable to read or watch television because she couldn’t absorb and interpret information. She couldn’t write; when she tried, her hand soared uncontrollably up the page.

In December 1987, Montgomery was struck with ataxia—she couldn't coordinate her muscle movements. She had constant, severe headaches, nausea, and sensitivity to light. Montgomery’s doctor performed an EEG (electroencephalogram) to measure the electrical activity in her brain. Repeated EEGs showed Montgomery’s brain to be in a permanent state of seizure, which lasted almost two months and ended only after she was given a combination therapy of an anti-seizure medication and a thyroid supplement. But from mid-December 1987 to mid-March 1988, Montgomery was, in her own words, totally disabled. (8)

Five years before becoming sick, Montgomery had worked full time as a community organizer and fundraiser, a high-energy profession.

“I used to run all over town,” she remembers. “Now I can walk one block or two—six on a good day—before the terrible pain and weakness starts. But I don’t care about that. I have 90 percent of my brain function back. Now I can at least work again.” (8)

Montgomery is not alone in experiencing disabling neurological symptoms. Cheney recently described the neurological symptoms seen in his 200 CIDS patients. He finds that 90 percent of them exhibit “soft” neurological symptoms, which he defined as symptoms in which the physician is “struck more by the description than by the exam.” (9)

Soft neurological symptoms include cognitive and spatial dysfunction, difficulty with concentration and memory, burning and/or numbness of arms and legs and sometimes the face. CIDS patients can develop a particular type of disequilibrium called truncal ataxia. Cheney explained how truncal ataxia is diagnosed: The patient stands, feet together, arms at the side, and closes his or her eyes.

“Then,” said Cheney, “they fall over. This is very common among my patients.” (9)

“Hard” neurological dysfunction (in which the doctor is struck more by the patient’s exam than the description) affects five to ten percent of Cheney’s patients. Hard neurological symptoms include seizures, encephalitis, loss of muscular coordination, and weakness on one side of the body.

The cause of CIDS has been a topic of controversy since the first outbreak in Incline Village. CIDS is classified as a syndrome, an association of symptoms that are suspected, but not proved, to be a single disease.

CID’s neurological symptoms may be caused by a viral agent interacting directly with the nervous system as happens in other viral diseases, herpes simplex encephalitis and AIDS-related dementia being two of the most dramatic. A virus also may interact indirectly with the central nervous system via an immune regulator like gamma-interferon. (10)

In 1984-1985, Cheney and Peterson thought they were seeing an outbreak of chronic mononucleosis caused by EBV. It’s now been shown that EBV may be an opportunistic infection in some cases of CIDS. And in 1988, there was a published report of three patients with “chronic Epstein-Barr virus infection” in Colorado who developed fatal blood cell cancers caused by EBV. (11)

Many agents have been suggested as possible causes of CIDS, singularly or in concert: EBV, cytomegalovirus (CMV), human B-lymphotropic virus (HBLV/HHV-6), exposure to environmental toxins, underlying immune system deficiency, and stress. (3) EBV and HBLV are found, together and alone, in CIDS patients’ immune system cancers (Burkitt’s lymphoma, Hodgkin’s disease, and non-Hodgkin’s lymphoma). (12)

One of those agents, the new virus HBLV, was first isolated from AIDS patients in 1985 by Dr. Dharam Ablashi and colleagues in the NIH laboratory of Dr. Robert Gallo, a co-discoverer of HIV. (14,15)

HBLV/HHV-6 has since been isolated from CIDS patients, some of whom have extraordinarily high levels of antibodies to this virus. (12)

HBLV is an extremely efficient killer of immune system cells; after 15 days in tissue culture with the virus, according to Ablashi, 95 percent of the cells are dead. In their published paper, they wrote, “The virus has the capability of growing in, and killing, the cells of the T-cell and megakaryocyte lines; these are the hemopoietic [blood cell generating] cells. Plus, it has a degenerating effect on the glial blastoma cells [a nervous system cell line].” (12)

Cheney also suspects that HBLV/HHV-6 may be implicated in CIDS. He believes that cases of “post-viral fatigue” have probably existed as long as people and viruses have maintained their uneasy coexistence. However, he feels that the disease seen since the mid-1970s is a new entity, as he told the CFIDS Chronicle in 1988:

One possibility may be that, since the 1970s, a new agent is creating a
pandemic of CFS superimposed on a constant baseline production of
similar-appearing cases of post-viral fatigue syndrome. ... Outbreaks of
this syndrome have been reported and strongly suggest that a novel agent
or set of factors is at play in a virgin population. Indeed, the best candidate
as a novel cause of CFS may be the newly discovered Human Herpes Virus-6
or HHV-6 [first named HBLV]. The apparent laboratory behavior of HHV-6 could, if present in this condition, allow it to eclipse EBV as an associated if not causal factor in CFS. (13)

Cheney and Ablashi are not alone in suspecting that the recently discovered HBLV/HHV-6 may play some role in CIDS and other immune system disorders. (4,5) Gallo has suggested that HBLV may be a co-factor in the development of AIDS because of its extreme efficiency in killing immune system cells. (16)

At a scientific conference in May 1988, Gallo reported unpublished data suggesting that HBLV might be an AIDS cofactor; he also linked the virus to CIDS. “Gallo said the new herpes virus...might be associated with Chronic Fatigue Syndrome—the so-called ‘Yuppie disease,’ ” reported on May 11. (16)

“Because it [HBLV/HHV-6] can infect the same target cells as HIV, it may enhance some effects in the AIDS patient by killing the target cell and suppressing the immune system,” Ablashi explained in the Miami Herald article. “One of the routes of the virus coming from the body is via the throat, very similar to EBV.” (16)

In other words: Ablashi suggested that HBLV/HHV-6 can be transmitted casually, by coughing or sneezing.

Are AIDS and CIDS different points on the same spectrum of disease? It isn’t known but NIH researchers like Gallo and Ablashi have implied that might be the case. The presence of HBLV/HHV-6 in both patient populations doesn’t prove it causes either illness, but certainly raises questions. (3)

If AIDS and CIDs are different points of illness on the same continuum, yet another newly discovered agent may be implicated in both. Dr. Shyh-Ching Lo at the Armed Forces Institute of Pathology has isolated a “virus-like infectious agent” from AIDS patients, which he discussed for the first time at the Fourth International Conference on AIDS (Stockholm, Sweden). When injected into monkeys, the animals exhibited “transient lymphadenopathy [lymph node disease]...and suggestions of CNS [central nervous system] disease with tremors and imbalance,” Lo reported. (17,18)

Although many CIDS researchers believe it’s a virally induced illness, there is by no means agreement among them. Most outspoken against the viral theory is Dr. Stephen Straus (Head, Medical Virology Section, at the National Institute of Allergy and Infectious Diseases), who asserts that patients with CIDS have pre-existing psychoneurotic conditions.

“Ultimately, any hypothesis regarding the cause of the Chronic Fatigue Syndrome must incorporate the psychopathology that accompanies and, in some cases, precedes it,” Straus wrote in 1988. (19)

The history of medicine includes other neurologic disorders that were once thought to be psychosomatic which, with increasingly sophisticated technology and understanding of the brain’s biochemistry, have been shown to be organic diseases. One fascinating example was described by British neurologist Dr. Oliver Sacks in his book The Man Who Mistook His Wife for a Hat. (20)

A century ago, Tourette Syndrome—a disorder characterized by excess nervous energy, ticks, jerks, and shouting obscene language—was described by French neurologist Gilles de la Tourette in 1885. Immediately after his description in the medical literature, “many hundreds of cases were described—no two cases ever being quite the same,” Sacks reported.

By the turn of the century, the disease (which Tourette described as “a possession with an organic basis”) fell into disfavor with the medical establishment, which dismissed it as a “mythical” disease, a “product of Tourette’s colorful imagination.” (20)

But as new technologies resulted in the discovery of neurotransmitters, Tourette Syndrome was found not to be a figment of Tourette’s imagination but caused by an overabundance of dopamine (the neurotransmitter that is lacking in Parkinson’s Disease).

Tourette syndrome was incorrectly dismissed as imaginary by the medical establishment, Sacks wrote, because it “could not be accommodated in the conventional frameworks of medicine” in the early twentieth century. (20)

Like Tourette Syndrome, CIDS will probably be found to have a definitive cause, discoverable by future technologies. Until then, CIDS should not fall between the cracks of scientific inquiry simply because it does not fit easily into the “conventional frameworks” of today’s medicine.

Chapter One was first published in CityWeek, June 27, 1988.

For a longer discussion about what has changed and what remains of the original book at its 30^th Anniversary publication, please see “ME/CFS BREAKING NEWS: From 1991... A new serial republishes one of the first books to investigate ME/CFS” on SubStack.

BIBLIOGRAPHY
1.     Deborah Barnes; “Mystery Disease on Lake Tahoe Challenges Virologists and Clinicians”; Science 234:541, 1986.
2.     Gary P. Holmes et al.; “A Cluster of Patients with a Chronic Mononucleosis-like Syndrome: Is Epstein-Barr Virus the Cause?”; Journal of the American Medical Association 257:2297, 1987.
3.    William Boly; “The Raggedy Ann Syndrome”; Hippocrates, July/August 1987, p.31.
4.     Debra Buchwald, John L. Sullivan, and Anthony L. Komaroff; “Frequency of ‘Chronic Active Epstein-Barr Virus Infection’ in General Medical Practice”; Journal of the American Medical Association 257:2303, 1987.
5.     Gary P. Holmes et al.; “Chronic Fatigue Syndrome: A Working Case Definition”; Annals of Internal Medicine 108:387, 1988.
6.     David S. Bell; “Clinical Presentation of Chronic Fatigue Syndrome in Pediatrics.” Lecture given at the 1988 Heart of America Medical Seminar, May 21, 1988. Battenfield Auditorium, University of Kansas Medical Center, Kansas City, MO.
7.     Personal Communication with Harlan Ellison’s office, July 1988.
8.     Personal Communication with Jan Montgomery, March 1988.
9.     Personal Communication with Dr. Paul Cheney, March 1988.
10.  E.M. McDonald et al.; “Interferons as Mediators of Psychiatric Morbidity”; The Lancet, November 21, 1987, p. 1175.
11.  James E. Jones et al.; “T-cell Lymphomas Containing Epstein-Barr Viral DNA in Patients with Chronic Epstein-Barr Virus Infections”; New England Journal of Medicine 318:733, 1988.
12.  Dharam V. Ablashi; “Immunological and Biological Aspects of HBLV.” Lecture given at the 1988 Heart of America Medical Seminar, May 21, 1988. Battenfield Auditorium, University of Kansas Medical Center, Kansas City, MO.
13.  Paul R. Cheney; “CFIDS: A Real Clinical Entity and Possible Pandemic?”; CFIDS Chronicle, November/December 1988, p.7.
14.  S. F. Josephs et al.; “Genomic Analysis of the Human B-Lymphotropic Virus (HBLV)”; Science 234:601, 1986.
15.  S.Z. Salahuddin, D.V. Ablashi, P.D. Markham, et al. “Isolation of a New Virus, HBLV, in Patients With Lymphoproliferative Disorders”; Science 234:596, 1986.
16.  Rosemary Goudreau; “Highly Contagious Herpes Virus Linked to Cancer, AIDS”; Miami Herald, May 11, 1988, p. 1.
17.  Shyh C. Lo et al.; “A Newly Identified Infectious Agent Derived From a Patient With AIDS”; Presented at the 4th International Conference on AIDS, June 12-16, 1988, Stockholm, Sweden.
18.  Shyh C. Lo. et al.; “Fatal Infection of Non-human Primates With the Virus-like Infectious Agent (VLIA-sb51) Derived From a Patient With AIDS”; Presented at the 4th International Conference on AIDS, June 12-16, 1988, Stockholm, Sweden.
19.  Stephen E. Straus; “The Chronic Mononucleosis Syndrome”; Journal of Infectious Diseases 157:405, 1988.
20.  Oliver Sacks. The Man Who Mistook His Wife for a Hat. Harper and Row, 1987.

ABOUT THE AUTHOR
Neenyah Ostrom was the first reporter in the United States to report weekly for a decade on ME/CFS. Her reporting on the Chronic Fatigue Syn­drome epidemic from 1988-1997 is getting increased atten­tion thanks to Robert F. Kennedy, Jr.  He discusses her work exten­sively in his 2022 best seller, The Real Anthony Fauci. Ostrom’s groundbreaking reporting on Chronic Fatigue Syn­drome and AIDS appeared in the New York Native from 1988 to 1997.

Ostrom wrote the Foreword to the recently published THE REAL AIDS EPIDEMIC: How the Tragic HIV Mistake Threatens Us All by Rebecca Culshaw, Ph.D.

Ostrom is the author of four books about the Chronic Fatigue Syndrome epidemic: What Really Killed Gilda Radner? Frontline Reports On The Chronic Fatigue Syndrome Epidemic (1991; TNM Inc., New York, NY), 50 Things Everyone Should Know About The Chronic Fatigue Syndrome Epidemic And Its Link To AIDS (1992; TNM Inc. and St. Martin’s Press, New York, NY; published in Japanese by Shindan-to-Chiryo, 1993; and in French by Les Edi­tions Logiques, 1994), and America’s Biggest Cover-Up: 50 More Things Everyone Should Know About The Chronic Fatigue Syn­drome Epidemic And Its Link To AIDS (1993; TNM Inc., New York, NY); and America’s Biggest Cover-Up: 50 More Things Everyone Should Know About The Chronic Fatigue Syn­drome Epidemic And Its Link To AIDS, Updated 2^nd Edition(2022, available as a Kindle ebook and paperback on Amazon.com). Her most recent book, Ampligen: The Battle for a Promising ME/CFS Drug (2022) is available as a Kindle ebook and paperback on Amazon.com

 In 1995, Ostrom and New York Native were rec­ognized as having reported one of the top 25 most-censored stories in the U.S. press by 1995’s Censored: The News That Didn’t Make The News And Why (The 1995 Project Censored Yearbook by Sonoma State University Professor Carl Jensen, introduction by Michael Crichton; pub­lished by Four Walls Eight Win­dows, New York, NY, 1995).

Ostrom is ghostwriter/editor of seven popular science books. Additionally, she was an editor of Total Breast Health: The Power Food Solution For Health And Wellness by Robin Keuneke, which was chosen as a Publishers Weekly “Best Book of 1998” in the category of Breast Health (Kensing­ton Publishing Corp., April 1998).