Product Review – “Never Bet Against Occam”


I have been given this product as part of a product review through the Chronic Illness Bloggers Network. Although the product was a gift, all opinions in this review remain my own and I was in no way influenced by the company.

I am going to say right off the start, this is by far the hardest review that I have done so far. That is not to say that there are no positives, there are many.

“Never Bet Against Occam” is a book by Lawrence B. Afrin, MD. The subtitle is “Mast Cell Activation Disease and the Modern Epidemics of Chronic Illness and Medical Complexity”. Does that make it clearer for you? No, it didn’t for me either. However, the terms Chronic Illness and Medical Complexity drew me to it.

The first 263 pages are dedicated to describing, through patient case studies and research, How Dr. Afrin was able it isolate and treat MCAS (Mast Cell Activation Syndrome and other Mast Cell conditions. Appendix 1, spanning pages 264 to 450, is a very thorough index of all terms used in the book. Appendix 2 is “Diagnostic Criteria for Mastocytosis and Mast Cell Activation Syndrome (MCAS) on page 451. Lastly, pages 452-456 contain Appendix 3, “Idiopathic Diseases, Syndromes, and Symptoms Which Since 2009 I’ve Come to Wonder Might Be (In At Least Some Cases) Assorted Variants of, or At Least Indirectly Due To, Mast Cell Activation Syndrome”.

So why did I painstakingly list everything that is in the book by the number of pages? First of all, I found that the Appendices were very much needed to get through the book. When I read the first chapter the first time, my mind got hung up on all the big medical terms. I have proofed medical papers and thought I was very good; however, once I found the Appendices, and started over, I was hooked! Could there be any answers here for me? I hoped so.

So what is a mast cell? They are white blood cells that contain histamines and are crucial to the immune system. says

“Mast cells are “master regulators” of the immune system. They come from bone marrow and go into all tissues of the body. Each mast cell contains secretory granules (storage sacs), each containing powerful biologically active molecules called mediators. These can be secreted when mast cells are triggered, leading to allergic and inflammatory diseases.”

This reference to “inflammatory diseases” is discussed in the book. Dr. Afrin describes several case studies of patients who were being treated for one thing, but they had outlying symptoms that brought that diagnosis into question. I love the title of Chapter 6 – The Constitutional Symptoms of MCAS, or, “I Feel Like Crap and I Can’t Put it Any More Specifically Than That”.

I have felt that way too many times.

Once MCAS was established as a diagnosis, the book goes through various symptoms and how they are being treated. This includes sight, hearing, and much more.

Dr. Afrin is a doctor who specialized in internal medicine with research and clinical Afrin_Lawrencefellowships in hematology/oncology. His concentration on mast cell disease began around 2008 and this journey is what makes up the book.

So, what is Occam?

Occam’s razor (or Ockham’s razor) is a principle from philosophy. Suppose there exist two explanations for an occurrence. In this case, the simpler one is usually better. Another way of saying it is that the more assumptions you have to make, the more unlikely an explanation is. Occam’s razor applies especially in the philosophy of science, but also more generally. (From Simple Wikipedia) In the case of MCAS, Dr. Afrin uses it to describe the fact mast cell diseases have many symptoms which can make diagnosis difficult.

Which is what brings me to why this book is important to me. While I am not running around saying that okay, this is what is wrong with me, I see so many comparisons to my health conditions. Almost every symptom or diagnosis I have ever had is mentioned somewhere in the book, whether in the text or any of the appendices.

In conclusion, I did find the book very difficult to read, even with the help of the appendices; however, I am certainly going to keep it as a great reference tool. I would recommend it to anyone who has questions about their chronic illness/symptoms.


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