What I've always wondered is why the physicians who come down so strongly against chronic Lyme only do so to reject the idea of it existing, but never offer any reasonable alternative explanations.

For the sake of argument, let's take the position that assume that chronic Lyme does not exist. That then means that there are tens of thousands of people suffering debilitating symptoms from an unknown or possibly multiple unknown sources. If one believes that chronic Lyme does not exist, this is pretty much the position that one has to take. For whatever reason, that never makes the news; you never see a headline "Doctor Admits Illnesses of Unknown Origin Afflict Thousands", it's always essentially "Chronic Lyme Doesn't Exist And We Don't Know/Care What Else It Could Be."

One emergency room physician saw me during a particularly bad stretch, and after looking at my symptoms he told me pretty much verbatim: "You have these symptoms, but I don't know what's wrong with you. Most likely, neither of us will ever find out, and you may or may not ever get better."
At least he was honest, but that kind of answer is unacceptable for a patient. One can tell from the article that if the professor knew how badly this illness makes people feel he would know that his piddly little warnings about the dangers of long term antibiotics wouldn't deter anyone if there was the slightest chance of symptomatic improvement. From this side of the fence, it really sounds like nothing more than an attempt at professional *** -covering.

I do enjoy his pseudo-concern for the patient and IV antibiotic therapy: "The risks are real, the costs are tremendous." More people probably die each year in the US from lightning strikes than from antibiotic treatment.