He and his wife exchanged uncertain glances as I explained that doctors don’t know what sets off most autoimmune inflammatory diseases: It’s likely a complex interplay between genetics, environment, and bad luck. But we do know how to treat them. At the next visit, his wife asked me about the potential causes of chronic inflammation that she’d read about online—tick bites, heavy-metal exposures, nutritional deficiencies—as well as anti-inflammatory treatments including herbal supplements, acupuncture, and energy healing. I began to worry that framing the conversation around inflammation—a word that clearly meant one thing to me and quite another to this couple—had been a mistake.