Book Review: Megan O’Rourke’s, “The Invisible Kingdom” and the Potential of Long COVID to Revolutionize Medicine

If you’ve struggled with chronic illness or an autoimmune condition, you may know this story all too well…

You start to feel a little off – some fatigue and vague symptoms that come and go. You can ignore it for some time until it gets so bad that you can’t. You go to your primary care doctor and get a few rounds of labs that all come back normal. 

Then you’re passed around to different specialists, most of whom see you for 15 minutes at a time and don’t ask you about your history. Your symptoms continue to get worse, but your labwork remains normal and no one seems to have any answers…so it must be in your head, right?

As your laundry list of symptoms gets longer, you begin to see that question reflected back to you in the eyes of your doctors. They ask questions about your stress level or if you’ve considered speaking with a mental health professional. You start to wonder if it's truly all in your head

In her recent memoir, “The Invisible Kingdom: Re-Imagining Chronic Illness”, Megan O’Rourke gives voice to the lonely and difficult journey of those struggling with chronic illness – a population that’s growing faster than ever.

These days, more and more people are facing chronic illnesses and especially autoimmune diseases. Our conventional system of healthcare is failing at providing answers to this population. This has become even more evident with the rise of long COVID, a disease process that seems to share similar characteristics as autoimmune disease.

O’Rourke sheds groundbreaking light on mainstream medicine's problematic methods and paradigms in treating chronic illness. She conveys the need for a massive shift – a shift that will be demanded by the patients.


Chronic Illness and Gaslighting Culture in Medicine

Women, in particular, are often at the brunt of medicine's culture of gaslighting.¹ In her book, O’Rourke likens this to the “hysteria” of the 1920s, in which many doctors held the attitude that women’s undiagnosable symptoms could be chalked up to a mental disorder. 

Today, autoimmune conditions are twice as common in women than in men.² And because these conditions are not well-understood by modern science, they can be difficult to diagnose and treat. Conventional doctors are often uncomfortable with the murky waters that fall between the black-and-white areas of hard science and lab values. Research often centers around men, and so many autoimmune conditions remain poorly understood.³ There’s a commonly-held attitude that if it’s not yet thoroughly defined by evidence, the illness must not be real, and it cannot be proven scientifically if women aren’t included in medical research.⁴

O’Rourke states in her NPR interview, “When you’re at the edge of medical knowledge, the lack of evidence is treated as evidence that the problem is you, in your mind.” ⁵

But the problem is not you or your mind. You know your symptoms are real. You know that something is not right. The real problem is conventional medicine’s failure to diagnose and treat these complex conditions.


The Potential of Long COVID to Revolutionize Healthcare

In recent decades, there has been a significant jump in autoimmune conditions. Because of this, O’Rourke encourages taking a look at the wider context of chronic illness. This is hardly an individual problem and is likely due to modern-day environmental and lifestyle factors.

As chronic illness becomes more widespread, it’s becoming clear that medicine needs to make huge shifts in the understanding, diagnosis, and treatment of these conditions. O’Rourke discusses the potential of long COVID to be revolutionary in bringing attention to this problem.

Like autoimmune conditions, long COVID is not yet well understood by science. It’s possible that the initial COVID infection causes its own brand of immune dysfunction. It may also contribute to our own’ body’s burden of infections and environmental toxicity in which the immune system continues attacking the body’s own cells. Many long COVID sufferers are in the same boat as those with chronic illnesses.⁶ They aren’t finding answers or treatment in our conventional system of care.

As more people get sick, we’ll inevitably hit a tipping point, and long COVID seems to be moving up that timeline. The methods, attitudes, and paradigms surrounding chronic illness will have to rapidly change. This change will begin with the individuals who are fighting tooth and nail for their own health.

“The Invisible Kingdom” does a phenomenal job at shedding light on this need for change, and is a must-read for anyone invested in the health of our society and future generations.


Learn More and Purchase the Book: Meghan O’Rourke