What is the “Havana Syndrome” that’s been afflicting U.S. diplomats since 2016? Robert Baloh on the range of explanations—and how well the evidence now supports them.

The mysterious ailment afflicting U.S. diplomats around the world—the “Havana syndrome”—is, according to a report released by the Central Intelligence Agency this month, probably not the work of a foreign government. At least in most cases. The CIA is continuing to look into the matter, investigating cases they still can’t explain, but its interim findings reframe a years-long public conversation in the United States about strange and intense symptoms, such as headaches, dizziness, and nausea. Diplomats and other American foreign-service personnel started reporting these symptoms back in 2016 at the U.S. Embassy in Cuba. A lot of the discussion about them since has focused on whether they’ve been caused by a secret weapon, possibly involving microwaves. What’s been going on here?

Robert Baloh is a professor of neurology at the David Geffen School of Medicine, University of California, Los Angeles, and the co-author of Havana Syndrome: Mass Psychogenic Illness and the Real Story Behind the Embassy Mystery and Hysteria. Baloh is one of the leading proponents of the idea that these spreading symptoms are largely psychogenic—the result of people believing they’ve been exposed to a health threat even though they haven’t. He’s quick to emphasize that psychogenic symptoms are real—caused by an alteration in brain connections and chemistry—but he believes “Havana Syndrome” is most likely the consequence of stress, which diplomats regularly endure, or other illnesses. In Baloh’s view, there’s never been any good evidence for the more dramatic explanations, but that hasn’t stopped unsupported government pronouncements, uncritical news coverage, and flawed medical research from driving more sensational narratives for years, which, he says, doesn’t help those who are suffering.

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Graham Vyse: Where does the idea of Havana Syndrome come from?

Robert Baloh: In late 2016, a CIA agent at the U.S. Embassy in Havana reported to the medical clinic complaining of some headaches and ear pain. There was an unusual story that he’d heard some kind of loud, high-pitched sound prior to the onset of these symptoms. These symptoms spread first to another CIA agent at the embassy and then, over the next several months, to several embassy employees and their families. None of these episodes occurred at the embassy. They occurred in these people’s homes and in two major Cuban hotels.

There’s some question about how much communication took place between these individuals. Some people down there said a lot of information was passed by word of mouth. Within the next year, symptoms spread throughout the embassy, affecting more than 20 people. They were initially referred to a physician in Miami, who did some preliminary medical examinations of them as individuals, not as a group. He thought some of their features might suggest a concussion, even though they had no history of head trauma, so he sent them on to the concussion center in Philadelphia, which did a series of tests of general neurological function suggesting that they had concussion-like symptoms—“a concussion without a concussion”—and insinuated that these patients had brain damage, though the evidence for that was rather slim.

This finally led to the submission of a paper to the Journal of the American Medical Association in 2018, which I was sent to review prior to publication. The patients and their symptoms were described in some detail, but there wasn’t really any mention of what may have been causing the damage other than some secret weapon—possibly a sonic weapon—though no weapon was identified. The article kind of suggested the government had classified information it couldn’t provide. My feeling was that these patients had common symptoms I’d seen—headaches, dizziness, forgetfulness, trouble concentrating. It was beyond me why you’d conclude these patients had been attacked by a secret weapon, except that they’d reported hearing a sound—but three had symptoms without reporting any sound. Some reported that symptoms came right after hearing the sound. Some reported a delay of several days. Some got better. For others, symptoms remained chronic and persistent.

More from Robert Baloh at The Signal:

“At least 250 people—and according to some, several thousand—around the world have complained of having the symptoms of “Havana Syndrome.” There’s no clear definition of Havana Syndrome and no criteria for diagnosing it, which is a big problem, including for doctors. The CIA concludes that, except in maybe 20 cases, there was a reasonable explanation for those symptoms—stress, incidental illness unrelated to any weapon. In the vast majority of cases, the CIA said, there was no evidence of an attack or brain damage.”

“Marco Rubio, the U.S. senator from Florida with obvious political interests regarding Cuba, made strong statements that attacks were occurring. He was part of a foreign-relations subcommittee that held hearings and concluded that there were definitely attacks on Americans at the embassy and that it was likely the Cubans. Trump said certainly that it was the Cubans. Anyone who went to the embassy was told to be on alert for unusual sounds or symptoms, which they should report immediately. The State Department and the Department of Defense subsequently emailed their employees around the world saying it was their duty to report these sounds and symptoms if they encountered them. Not surprisingly, since this is a well-known phenomenon in psychology, large numbers of people said they had the symptoms.”

“There’s so much misinformation about psychogenic illness and psychosomatic symptoms of illness, and such a misunderstanding of them, including among doctors. These are real symptoms, and they have nothing to do with being weak or mentally unstable. There are so many examples of mass psychogenic illness and psychosomatic symptoms on a daily basis.”