Available tomorrow on streaming (and coming later this month on DVD from First Run Features), The Quiet Epidemic is an enraging, exhaustive and entirely terrifying documentary. It examines the staggering number of lives left to waste due to myriad complications concerning an agreement, by the global medical community, that Lyme disease should not be considered a chronic condition.

Lyme disease is, of course, one of many pervasive and persistent illnesses that finds a vector in that omnipresent microscopic menace known as the tick. The inciting bacteria of Lyme disease (named for the Connecticut town where it was discovered in 1975) is one of the disease world’s greatest “imitators” and “masqueraders” for the surplus of symptoms it spawns (mimicking ALS, multiple sclerosis, Alzheimer’s and more). It’s also considered one of the smartest bacteria, too, able to shift its shape in the body and evade detection in common tests. While it’s estimated that 80% of people who contract Lyme disease can effectively treat themselves with antibiotics, the remaining 20% suffer long-term effects — roughly 2 million Americans today.

Co-directors Lindsay Keys and Winslow Crane-Murdoch take, as their jumping-off point, the controversy behind classifying Lyme disease as a “chronic” illness. This debate has raged in the arena of American medicine for nearly a half-century. Like 2022’s equally upsetting healthcare documentary Aftershock, The Quiet Epidemic illustrates yet another convincing case in which arrogant pride and the aggressive pursuit of profit have pushed aside the rights of American patients, their access to treatment, and their very quality of life.

The discourse surrounding this dilemma is dense, and there is a litany of scientific specifics to consider. But Keys and Crane-Murdoch dole out the details with care, confidence and compassion, largely focusing on two key and two supporting parties.

Julia Bruzzese is a young girl robbed of mobility almost overnight by chronic Lyme disease. The film follows Julia and her father, Enrico, across several years navigating the often-frustrating patient journey of fruitless tests and skeptical doctors (some accusing Julia of faking her illness). At 11, Julia adopted an ardor and armor for self-advocacy, and we see it strengthen into a shield behind which she hopes to shelter those who, by her own admission, suffer in silence because they lack the resources and support available to the Bruzzese family. Perhaps it’s comforting to write off hysteria as the hallmark of a less-enlightened era of medicine. But to hear the Bruzzeses assailed by a small group of authoritative voices insisting they’re wrong asserts that it remains a problem.

“It’s all in your head,” the naysayers tell Julia and Enrico. Neil Spector agrees. The bacteria is in Julia’s head. It’s in her heart. It’s in her ear. It’s in her joints. It’s in Spector’s body, too. This scientific researcher required a heart transplant in 2009 due to complications from undiagnosed Lyme disease. From his Duke University laboratory, Spector pursues breakthroughs in imaging that can more definitively detect the evasive bacterial spirochete that causes chronic Lyme complications. But Spector must also reconcile the rigors of being a public face for this push against his own post-operative wellbeing, which is far from assured. Spector feels acute pressure to live his renewed life “in an extraordinary way for those who don’t have the opportunity,” and Keys and Crane-Murdoch humanize this conquering hero with complexity rather than simply hailing him with hagiography.

The Quiet Epidemic also focuses on the findings of Mary Beth Pfeiffer, an investigative journalist who found herself, as she calls it, at the center of “one of the most controversial, divisive and vicious debates in medicine today.” Rather than agreeing, however disappointedly, with research that revealed their findings to be wrong, the cabal of CDC- and NIH-affiliated doctors whom Pfeiffer interviews dug in its heels and plotted a “sociopolitical offensive” to combat “a war” in which they said it’s time to “start shooting back” — claiming those who disagreed with them were peddling that unfortunately familiar and fetid phrase of “fake news.” Richard Horowitz also gets significant screen time, a clinical doctor whose devotion to clinical treatment of chronic Lyme disease patients like Julia prompted his abandonment by insurance companies and a need for alternative means so he could provide comprehensive care.

The Quiet Epidemic clearly illustrates that Lyme disease is a national and not regional problem, so it has a link back to the Hoosier State; unsurprisingly, it is not a flattering one. Keys and Crane-Murdoch devote one segment of the film to complications created by the Bayh-Dole Act of 1980 — a landmark change in patent law that complicated paths to easier detection of Lyme disease and effective vaccines to address its effects.

In all, The Quiet Epidemic delivers a sometimes dizzying pattern of devious decisions that deprive people of options for care. While the film makes no bones about its advocacy approach, neither does it lose sight of the humanity under perpetual siege by this ravaging disease. Bonus features include a resource guide about Lyme disease.