The Placebo.
In terms of health, much of the magic of Billy’s boots revolves around the expectations of the treatment succeeding. If your Billy Beliefs were to prescribe a drug it would be the most tested drug known to man, the placebo. No drug has ever gone through such rigorous testing on so many occasions as the placebo drug.
The word placebo takes its origins from the Latin word to please, the idea being the patient got better to please the doctor or perhaps, it was the doctor who gave something to please the patient. Either way, with placebo it is the patient’s own beliefs and expectations about the drug that produce the healing effect, rather than any innate chemical properties of the drug itself.
Here’s the really surprising news, it turns out to be a consistently effective treatment for almost anything.
Take pain relief for instance, when you compare placebo with morphine, a very powerful opiate pain-killer, about a third of all patients will receive as much relief from the placebo as from the morphine.
In a study looking at a new form of chemotherapy, carried out at the Queen Elizabeth hospital in Birmingham, by Dr J.W.L. Fielding, 411 patients were told that one of the side-effects would be severe hair loss and what do ya know, thirty percent of people who took the sugar pill (placebo) experienced hair loss.
Even more remarkably, studies of minoxidil, a treatment for male pattern baldness, found a considerable number of men grew hair, despite receiving nothing more than a dose of wishful thinking!
It doesn’t have to be a drug either, anything that mobilises your beliefs and expectations about health can produce similar results.
For example, surgery in the 1950s, one of the standard treatments for angina was an operation to tie off the internal mammary artery in an effort to divert blood towards the heart, thereby easing the pain of angina.
So, one day they decided to see how much of the improvement was due to the placebo effect and how much to the operation itself, by carrying out a carefully controlled study, which today would never get past the ethics committee and I think you’ll understand why when I explain.
They took 17 patients with angina and in the middle of the operation, with the chest cavity already opened up, the surgeon chose an envelope at random, which was either an instruction to carry out the operation or an instruction to merely stitch the patient back up again, an open-close procedure with no surgical benefit.
The results were that 5 of the 8 patients who had the real operation felt significantly better, as did 5 of the 9 who had the sham operation, thus demonstrating the operation was no more effective than Placebo.
Is this surgical witchcraft or is something else at play – the play of Billy Beliefs?
As doctors, you could argue we prescribe belief and hope every day. Eighty percent of the illnesses we see in general practice are termed self-limiting conditions, meaning they will get better without the need for any medical intervention, simply because the body’s own pharmaceutical department and ImmunoTeam is quite capable of dealing with such matters.
The skill of the doctor is knowing which ones to leave alone and which ones to play!
Indeed, often the medicines we do prescribe, should in theory at least, have very little impact upon the infections we treat. As an example, antibiotics are only effective against bacterial attack and do not help to deal with viral infections, which are by far the most common cause of coughs, colds and sore throats we see in general practice today.
Yet, many people have come to expect a prescription and feel a sense of disappointment if they leave the consulting room empty handed, regardless of whether they decide to take the medication or not. It somehow validates their symptoms and acts as justification for the effort they have made to see the doctor.
Which, to be fair, in the current climate of increased demand and limited supply of GP appointments, can be quite an achievement.
I suspect this widespread belief in the power of the prescription pad, stems partly from early childhood experiences when so many of us would visit the doctor or receive the “magic medicine” from parents to make us better.
One of my earliest childhood recollections is going to see my GP, suffering from a bout of tonsillitis. The doctor was an elderly, rather plump gentleman, sat in a comfy black leather chair, with an equally rotund and friendly looking golden retriever dog asleep by his side.
I knew instinctively this was a man of great knowledge and wisdom and whatever he prescribed was going to make me better, which it invariably did. Thus, like so many of us, the association between taking medicine and feeling better, was firmly established in my belief system from an early age.
What explanation can we give for all these examples of healing and the placebo effect?
Only that people’s expectations and beliefs about a treatment or medication are converted into some kind of physiological or biological reality. The hope and belief we have in both the doctor and the medicine is communicated to our ImmunoTeam and helps it to play well, and if you want to make progress through the Premiership Health Leagues in life, you need to pay special attention to those beliefs and expectations that support your health.