Power in Medicine

There I was in an mass of 1,000 kids. Most wearing a blue shirt & a gold bandana at the annual Scout-O-Rama. I was clueless to the fact that something I would learn that day would leave me in pain writhing on the ground and ultimately changing my approach to religion.

Let's talk about one of the most powerful things in science. It is so powerful that every experiment is set up to make sure this force doesn’t mess up the results. For now let's just call it x.

Back to Scouting. I was ~12, for years I'd been inspired by seeing that zipline at the Scout-O-Rama. Kids zooming down the cable & landing safely on a padded mat. I'd finally assembled a crude version using a tall pine tree in my backyard, but I was missing the pulley. Impatiently, I'd put one together using a silver pipe and some white electrical wire (it was an engineering marvel - but not in a good way). As I leapt out onto the rope with my new creation friction brought me to an abrupt halt 15 feet above the hard grass below. My 2nd attempt to get myself moving down the rope snapped the pulley replacement and left me in a free fall. If you've never fallen from 15 feet it is impossible to describe the force that your body hits the ground with. Numb with shocking pain in my shoulder, I twisted on the ground trying to find relief. My parents shuttled me into a bed while they discussed what to do.

Meanwhile, while I suffered, I began to think of scriptures. As a turbo religious kid, I was well-versed in the miracles from the Bible. I thought of Peter, who was willing to step onto the water before he knew it would be solid. I thought of the scripture to ask and you shall receive. I concluded that if I had the audacity to ask I had to have the ambition to act. With one more prayer, I determined to show my faith by doing a pushup that would, like Peter stepping on the water, facilitate the miracle of healing my arm. I breathed deep, clenched my stomach and my hands hit the floor. Electricity shot through my injured arm and pain like a bigger-than-expected ocean wave washed over me.

I did not experience a miracle of healing.

I did, however, experience a miracle of learning.

In Africa, there are people who have lived for extreme lengths in the same locale. Much of what they did to heal their people could be lost to history, but you can imagine what it might have been like to live there 20,000 years ago...

You're sick. Bent over, your forehead grinding in the hot sand. It has been a furiously long day. As the sun draws near the distant horizon, your people begin to gather and you know the healer in the tribe will give you medicine from the gods. As the ritual begins the central fire illuminates the faces of all the people you know. Positive emotion floods your body as each of these people lays their hands on you and sings, chants, wishing for your healing. Finally, the healer applies his medicine and you feel relief flood your body. As the hours deepen and the fire fades the pain continues to subside until sleep carries you to the morning. The sun wakes you, full of relief as you stretch your arms and swell with gratitude.

I can imagine (for many) a ritual like this, even today, would be a powerful & healing experience.

So what?

If you could remove the label from the placebo effect for a moment, what else would you call it? Magic? Faith? Power?

Whatever you call it it is a real force and it costs piles of money just to reduce its effects as we conduct clinical studies.

Yet, as I painfully learned as a kid, there are limits. Like many things, it follows a "goldilocks" curve. Not too much, not too little, but just the right amount. Perhaps something like this:

It is fascinating to note that the Placebo Effect also:

• Works even if you don't believe it all the way
• Works in reverse (nocebo) to make things worse
• Works better for optimists

In the end, the Placebo effect is both powerful and limited in power.

Therefore, we should harness its potential along with the extraordinary fact that there are medications and treatments that "beat" this powerful phenomenon in our pursuit of health.

Here are some direct applications:

• Find something you can believe in and lean into it.
• Find something that you don't believe in and lean into it anyway (since it still works even if you don't fully buy it)
• Watch out for things that don't acknowledge that placebo is powerful and limited. (no one is growing lost limbs from placebo effect)
• Actively exercise rational optimism, great to be believing - not great to be so believing that you skip the doctor when you need it.

I can see a world of high-tech medicine. One that is individualized. One that is extremely effective and uses science to its utmost potential.

But in that future, I can also imagine the power of the human connection and the intelligent use of placebos to bring us closer to our beautiful individual and collective human potential. Here's to that future!