By Aneesha Nair July 2010 Physicians and healers who have understood the power of the placebo effect are urging their patients to look inside, and understand the wisdom of their bodies Around the time he turned 60 years of age, my grandfather developed acute asthma. Having enjoyed good health through most of his life, the onset of asthma made him extremely cranky and irritable. He became addicted to using his inhaler to a point where my mother would constantly be hiding it from him. My grandfather would find the inhaler eventually, use it indiscriminately, and in turn hide it from my mother. Every day they argued and bickered. My grandfather complained that my mother did not understand his discomfort, and my mother that he didn’t limit himself to prescribed doses. They reached a truce when my mother made an appointment with a specialist in Mumbai who took scans of my grandfather’s chest and detected a patch on his lung, “See!” my grandfather had said to my mother defiantly, “I knew I was sick.” An operation was performed after which my grandfather instantly felt better. A few days later when my mother went to the clinic to collect some post-operative test results, the doctor informed her that nothing was wrong with my grandfather. The patch was just an error on the scan. All through the journey back home, my mother fumed over the unnecessary surgery. When she got home and noticed the inhaler lying openly on my grandfather’s bedside table, she realised the surgery was necessary, after all. Somehow that sham surgery had convinced my grandfather that he was now okay, because he believed he had been cured by the treatment he was given. We all have similar stories, don’t we? Of people, we know who have recovered from an ailment because they believed they were being cured. Whether it was through a doctor, a sage, an herb, or following certain rituals, the moment it was combined with a healthy dose of optimistic conviction, the ailment simply vanished.The placebo effect is a phenomenon equally celebrated and deliberated by healers everywhere. It is defined as a situation where the mind conquers the illness simply by believing the body is being treated. The treatment in these cases is called the placebo. Even western medicine, which refuted the placebo effect for the longest time, calling it a ‘humble humbug,’ now finds itself at a point where it can no longer discredit the role of the mind in healing. The traditional placebo is usually administered to the patient in the form of sugar pills that resemble the real medicine, saline injections, and in some cases, doctors are even known to resort to sham surgery. The placebo effect is now so well defined that it has its own established contrapositive twin – the nocebo effect, a retrograde situation where negative feelings or expectations harboured by the patient leads to a greater ambit of ill-health.Absence of proof is not proof of absenceThrough their traditional training or by an inherent sensitivity, holistic healers always look at both the mind and the body while treating patients. It is only fair that in establishing undeniable proof of the placebo effect we turn to those that have doubted it the most – modern western medicine. Although Hippocrates, the founding father of modern medicine believed that disease was caused by a state of imbalance in the five humours of the body, allopathic doctors today know of complex biochemical pathways and elaborate disease mechanisms. They base their treatment on diagnosing the exact deficiency or error in the body, as they would a machine, and prescribe medicines to rectify those errors. In the pursuit of new remedies, the allopathic physician needs statistical proof of the efficiency of a treatment. Usually, the placebo effect throws them off their desired goal of proving that a drug or therapy is effective. Western medicine establishes the efficiency of drugs and treatments by performing what they call ‘randomised, double-blind, placebo-controlled clinical trials’. To put it simply, they begin by randomly selecting a large and diverse group of people with the ailment. They then divide them, again randomly, into two groups and administer the real drug to one half of the group and the placebo pill to the other half, which they call their ‘control’ group. While they expect to see improvements in the former, they expect to see no change in the latter. The reason a clinical trial is called ‘double blind’ is because neither the physician giving the drug nor the patient receiving the drug knows which is real and which the placebo. This helps establish in all fairness, that it was the drug and nothing else that was responsible for the cure. The proof of the placebo effect lies in the countless studies, which reject extensively researched drugs and treatment methods, because the group that got the placebo also recovered. This has been seen in the case of pills for ulcers (cimetidine), surgery for osteoarthritis and Parkinson’s disease. The placebo effect isa phenomenon equally celebrated anddeliberated by healers everywhere Frustrating though it might have been for researchers, at the end of the day it is simply a matter of numbers. When the patients who are getting the ‘dummy’ placebos are doing as well or better than folks getting ‘real’ treatment, the only logical conclusion is that whatever is curing them is not the drug. Therefore, while numerous treatments have been discarded because of inconclusive statistical analysis, the placebo effect gained ground with every failed study. The hope effectIn speaking with doctors, it was impossible to interview a patient who had recovered on a placebo. After all, their recovery was based on the belief that they were being treated by the drug of said dosage, which they consumed diligently at specific times in the day. However, there are a few instances where people knew they were being healed by more than just their medicines. Such was the case of Charmaine, an African-American woman who was diagnosed with breast cancer in a hospital emergency room she came to complaining of chest pain. Charmaine and I did not cross paths in that emergency room, but later on in another hospital where she had come for a checkup. By this point, Charmaine had several rounds of successive chemotherapy and she was recovering well. The doctor I was working under introduced me to her saying, “This is Charmaine, and she is amazing.” Charmaine looked at me, her eyes full of life and said, “Yes. Yes I am pretty amazing.” Being a research scholar, I discussed her recovery experience with her. “I was diagnosed at another hospital, but the doctors there were robots,” she added, “Mean robots. To them I was just another woman with a tumour.” Traces of her despair were still visible in her furrowed brow and the hardened lines around her mouth. A calm descended on her face as she spoke about the first time she met Dr So. “I wasn’t showing any improvement so we looked for a second opinion and then I met Dr So.” Now Charmaine smiled brightly and said, “It was love at first sentence,” she reminisced, “He looked at me and said, ‘We can beat this’,” and I believed him. Which is why when he says I am amazing…” she looked at me laughter playing in her eyes, “I believe him!”The miracle in Charmaine’s story lies in the fact that the treatment she received at both hospitals was the same. Both institutions followed a set dose of chemotherapy proven to work in cases similar to hers. What changed was the healer. Dr So made her believe she would get better, inculcating in her mind the hope of success crucial to the healing process.Every illness is a physicianThis almost obsolete proverb attributed to the Irish, speaks of a powerful truth we incessantly ignore today. As you read this, take a moment to consider how amazing your body is. Your own body, the transient home to your soul, your heart, your conscious and subconscious mind. Besides working, performing your chores and so on, think about how much work your body does in a day to sustain itself. It digests, performs maintenance, eliminates, grows, fights stress, germs and illness thereby constantly striving to bring it back into a state of balance. Do you realise how amazing that is? To every imbalance created it has an intelligent, internal mechanism by which it is capable of correcting itself, without so much as half a thought on your part to urge it along. And why shouldn’t there be such mechanisms? After all, nature left to her devices constantly strives for balance. Just like Dr So, physicians and healers who have understood the power of the placebo effect are urging their patients to look inside and understand the wisdom of their bodies. They encourage their patients to stay happy and keep the faith. Optimism is a vital force in healing, and living healthy, and no physician can cure a patient unless they reach inside them and reassure their soul. Like the philosopher Plato said, the physician must never separate the soul from the body, in treatment, “For the part can never be well, unless the whole is well.” We must be gentle with our bodies and nourish it with our optimism, understanding its phenomenal power to heal itself.
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