Homeopathy, Skeptics & Chinese Food: A Placebo Effect Cul De Sac, Featuring Tina Fey & Her New Book, Bossypants

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When I am not busy trying to make the world safe for homeopathy, I am often busy reading books and reviewing them for the New York Journal of Books—and, in doing so, I am busy trying to make the world safe for readers as well.

In the book I am now reading for my next review, Bossypants by Tina Fey, I came upon a short chapter that resonated with me.  Called “I Don’t Care If You Like It,” the chapter had to do with the concept of whether it is right or wrong for women to be comedians.  But there was something in the universality of people having the right to do or think as they like that hit close to home with me.  So I thought I’d share it with you.

First a few chapters from Bossypants:

“Amy Poehler was new to SNL and we were all crowded into the seventeenth-floor writers’ room, waiting for the Wednesday read-through to start.  There were always a lot of noisy ‘comedy bits’ going on in that room.  Any was in the middle of some such nonsense with Seth Meyers across the table, and she did something vulgar as a joke.  I can’t remember what it was exactly, except it was dirty and loud and ‘unladylike.’

“Jimmy Fallon, who was arguably the star of the show at the time, turned to her and in a faux-squeamish voice said, ‘Stop that!  It’s not cute!  I don’t like it.’

“Amy dropped what she was doing, went black in the eyes for a second, and wheeled around on him.  ‘I don’t fucking care if you like it.’  Jimmy was visibly startled.  Amy went right back to enjoying her ridiculous bit.  (I should make it clear that Jimmy and Amy are very good friends and there was never any real beef between them.  Insert penis joke here.)

“With that exchange, a cosmic shift took place.  Amy made it clear that she wasn’t there to be cute.  She wasn’t there to play wives and girlfriends in the boys’ scenes.  She was there because she wanted to do what she wanted to do and she did not fucking care if you like it.

“I was so happy.  Weirdly, I remember thinking, ‘My friend is here!  My friend is here!’ Even though things had been going great for me on the show, with Amy there, I felt less alone.

“I  think of this whenever someone says to me, ‘Jerry Lewis says women aren’t funny,’ or ‘Christopher Hitchens says women aren’t funny,’ or ‘Rick Felderman says women aren’t funny…Do you have anything to say to that?’

“Yes.  We don’t fucking care if you like it.

“I don’t say it out loud, of course, because Jerry Lewis is a great philanthropist, Hitchens is very sick, and the third guy I made up.

“Unless one of these men is my boss, which none of them is, it’s irrelevant.  My hat goes off to them.  It is an impressively arrogant move to conclude that just because you don’t like something, it is empirically not good.  I don’t like Chinese food, but I don’t write articles trying to prove it doesn’t exist.”

Which all goes to show that cosmic shifts can happen anywhere, any time.  They can happen while reading the next book that you are to review.

So thanks Tina Fey for setting me straight, for letting me see just how arrogant it is of the Skeptics to not only decide that homeopathy is not for them, but to also take the next step and, like Chinese food, start writing articles and making videos announcing that it does not exist.

If I have had not just one but multiple healings through the use of homeopathy, then, say the Skeptics, either it was all a coincidence and my symptoms were going to go away anyway, or I am just too much of an idiot to know that I have been tricked and fooled, again and again.  Because I am ssssoooooooooo easily lead that I can believe that I have been healing just because someone waves a wand at me and says that I have been healed.  (Funny how that never seems to work with allopathic drugs, no matter how many wands are waved and now matter how much I believe in them as well.  But placebo effect is a wacky old thing, it just comes and goes, comes and goes…)

So let me say this to the Skeptics (and, by the word Skeptic, let me note that I am not addressing those who are generically skeptical, those who are actually asking questions with the intent of getting answers, no I am addressing those who have more formally named themselves Skeptics and who have made it their business to be more or less the medicine police for a world that neither needs not wants such a service), in Tina Fey’s vernacular, when it comes to homeopathy, those of us who have spent our lives studying it, practicing it and/or being treated by it “don’t fucking care if you like it.”

You can take it or leave it.  As can I.  And I choose to keep it.  I choose to continue being treated by it, and writing about it, and studying it and seeing to it that it remains a legal form of medical treatment in my own country and in countries around the world.

Because this is where you really make me mad, Skeptics, when you don’t just satisfy yourself stamping your feet and shouting.  When you take it upon yourself to try and see to it that the laws change and that I no longer have the right to have the medical treatment of my preference.  And that is where you are making your mistake, Skeptics.  You should have stuck with your phony “Oh, look I overdosed by taking homeopathic remedies incorrectly in a way that would never actually cause an overdose for a homeopathic remedy, although, were it an allopathic drug, it likely would have killed me!” videos.  Because when you seek to take away my legal rights, you get me mad.  And millions of others just like me.

You see, people don’t like being told what to do, especially by an arrogant group of loudmouths.  You may get some media attention just for the novelty of it all, but I think that you will find that, in trying to drive homeopathy into the ocean, you actually get many people who have no intention of actually taking homeopathy themselves, upset enough to see to it that your measures don’t work.

Why?

Because just like Tina Fey, millions of people agree that “just because you Skeptics don’t like something, does not mean that it is empirically not good.”

And we don’t have to convince you of anything.  We don’t have to prove a damned thing to you.  And we have the right to choose when it comes to our own medical care–not you, never you.  Honestly, and we mean this from our holistic little hearts, we just don’t fucking care if you don’t like it.

Homeopathy exists.  And homeopathy is loved by millions.  Just like Chinese food.

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Medicine, Healing & The “Placebo Effect,” Part One

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I’ve been doing a lot of thinking lately about the “placebo effect.”

I warn you up front, this is likely to be long, likely published in pieces as I find the time.  But I can’t help it.  I find this whole topic to be damned interesting.

Mostly because I have noticed that the Skeptics—that crazy-quilt of organizations in the English speaking world who are making such a noise on the internet when it comes to something near and dear to my heart, homeopathy—tend to use the term “placebo effect” as those being cross-examined in court use the Fifth Amendment, as way of putting an end go conversation and a means by which they can always claim “victory,” even if it is of the Pyrrhic sort.

I think we are all aware of the idea of what a placebo is and what the placebo effect must therefore be, but, when you stop and think about the manipulation of reality that the blanket term “placebo” covers, you have to reconsider both what the term means and what the implication of its existence—and no one doubts its existence, apparently, not even the Skeptics themselves (and they doubt everything it is possible to doubt, as we shall see)—means.

First, though, a note on the Skeptics.

If you haven’t had the pleasure, you should look into the activities of the various groups that comprise the movement, sort of a Tea Party of the medication, philosophical and metaphysical realm.

I have recently become quite enamored by one of the Grand Old Men of the Skeptic’s movement, one Robert T. Carroll, PhD, who hosts the site The Skeptic’s Dictionary, on which he gives his viewpoint—and, more important, the reasons for his viewpoint—on topics ranging from, as he puts it, “Abracadabra to Zombies.”

Carroll’s academic background serves him well in his Skully-ish search for the “Truth.”  He was, until his retirement four years ago, a professor in the philosophy department of Sacramento City College—a position he held for thirty years.  Somewhere along the way—he is kind of cagey about his personal evolution as “skeptic”—he got downright skeptical and, as a result has built a very interesting website.

Because the purpose of that website is skepticism—it is called The Skeptic’s Dictionary, after all—he has quite a lot to say about religion, science and, of course, “alternative” medicine.

Now, regular readers of my blog and of my books all know how I hate the term “alternative” medicine, it that the term itself establishes allopathy as the thing that homeopathy, et al, are alternative to—in other words, allopathy is medicine, and everything else is an alternative.  My belief is that either it is medicine or it is not.  Hippocrates spoke of both homeopathy and allopathy (not by name, of course, but by philosophy) two millennia ago, either establishing both as systems of medical treatment, or setting himself up as a target for the Skeptics to go running after…

But the hated “alternative” term aside, Carroll has much to say about the topic at hand, “placebo effect,” in his Skeptic’s Dictionary.

Here’s a taste:

“A person’s beliefs and hopes about a treatment, combined with their suggestibility, may have a significant biochemical effect, however. Sensory experience and thoughts can affect neurochemistry. The body’s neurochemical system affects and is affected by other biochemical systems, including the hormonal and immune systems. Thus, it is consistent with current knowledge that a person’s hopeful attitude and beliefs may be very important to their physical well-being and recovery from injury or illness.

“The psychological explanation seems to be the one most commonly believed. Perhaps this is why many people are dismayed when they are told that the effective drug they are taking is a placebo. This makes them think that their problem is “all in their mind” and that there is really nothing wrong with them. Yet, there are too many studies that have found objective improvements in health from placebos to support the notion that the placebo effect is entirely psychological.

“Doctors in one study successfully eliminated warts by painting them with a brightly colored, inert dye and promising patients the warts would be gone when the color wore off. In a study of asthmatics, researchers found that they could produce dilation of the airways by simply telling people they were inhaling a bronchodilator, even when they weren’t. Patients suffering pain after wisdom-tooth extraction got just as much relief from a fake application of ultrasound as from a real one, so long as both patient and therapist thought the machine was on. Fifty-two percent of the colitis patients treated with placebo in 11 different trials reported feeling better — and 50 percent of the inflamed intestines actually looked better when assessed with a sigmoidoscope (“The Placebo Prescription” by Margaret Talbot, New York Times Magazine, January 9, 2000).

It is unlikely that such effects are purely psychological.”

First, let me encourage everyone to read the whole of Carroll’s long consideration of the placebo effect at his website.  I cannot include the entire article here due to its length, but I do think it is one of the better articles on his site.  (Some, like his article on Naturopathy are both factually incorrect and academically weak due to Carroll’s biased stance.  Like most of the Skeptics, he proves himself far from being actually skeptical about anything other than the specific topics that define their group focus.  About allopathy, for instance, he shows no skepticism at all, no matter how toxic various forms of allopathic treatments have been clinically shown to be.)

I want to borrow one more bit from Carroll’s article on placebo effect before sharing my thoughts on the matter.  Consider H. K. Beecher, who brought the concept of placebo into the modern age.  Indeed, he is credited with coining the term “Placebo effect” in his 1955 paper entitled “The Powerful Placebo.” Mid-twentieth century, he was intrigued by the fact that more than half of patients with certain conditions—common complaints like heart trouble and digestive disorders—could be significantly helped by doing nothing other than suggesting that they had been helped.  To explore the idea, he set up a number of studies.  Carroll comments on what happened next:

“Beecher started a wave of studies aimed at understanding how something (improvement in health) could be produced by nothing (the inactive placebo). Unfortunately, many of the studies have not been of particularly high quality. In fact, it has been argued by Kienle and Kiene (1997) that, contrary to what Beecher claimed, a reanalysis of his data found “no evidence of any placebo effect in any of the studies cited by him.” The reported improvements in heath were real but were due to other things that produced “false impressions of placebo effects.” The reanalysis of Beecher’s data claims that the improvements were due to:

“Spontaneous improvement, fluctuation of symptoms, regression to the mean, additional treatment, conditional switching of placebo treatment, scaling bias, irrelevant response variables, answers of politeness, experimental subordination, conditioned answers, neurotic or psychotic misjudgment, psychosomatic phenomena, misquotation, etc.”

(Now, it should also be noted that Beecher (1904-1976), who was born Henry Unangst in Peck, Kansas, took the name “Beecher” as a young man in order to align himself with the New England Beechers, perhaps with famed preacher Henry Ward Beecher (not the similarity of the names), although he had not actual relation to them.  And it should be noted that Beecher is known to conspiracy theorists internet-wide because of his alleged involvement with the CIA in human drug tests, most notoriously on post-WW II German prisoners.  Apparently no placebos were used in these tests.)

Moving forward, let’s try to find some meaning in this mess.

Let’s start from the place of agreement:  the placebo effect exists.  There may be some disagreement as to exactly what it is, how it works and how effective it is (what it’s limits are in terms of health and healing), but all sides agree that there is some validity connected with the idea of the placebo effect.

Now to get some sort of working definition.  My computer’s built-in dictionary defines the term as:  “a beneficial effect, produced by a placebo drug or treatment, that cannot be attributed to the properties of the placebo itself, and must therefore be due to the patient’s belief in that.”  Not the greatest definition, but what do you expect from the dictionary that comes built in on your computer for free?  Much as dislike definitions that use the term itself or any aspect thereof in defining the term, let’s use this, at least for now.

The key word, for me, in that definition is “belief.”

Which brings to mind something that Carroll wrote in this consideration of the topic:  “Patients suffering pain after wisdom-tooth extraction got just as much relief from a fake application of ultrasound as from a real one, so long as both patient and therapist thought the machine was on.”  While we are not given full information here and do not know the differential between those therapists who did not think the machine was one and those who did, the point is made.  For the pain to be relieved, both patient and therapist had to believe the machine was one. Again, belief seems to be the key.

This summons a scripture from some lobe or other.  Matthew 18:20.  “Where two or three are gathered together in my name, there I am in the midst of them.”  There’s a great deal of power to be had in the gathering of twos and threes, especially when they gather in a state of belief.

I know that the Skeptics would be choking on their Saltines if they were reading where this is going, because I have noted how often the path of skepticism leads to atheism and have seen how many of the groups of Skeptics are connected with groups of atheists.  And I know the issue that many Skeptics have with medicine that will not stay in the box labeled medicine that they have constructed for it, but instead expands to include the idea of healing, even to the point of placing it over the concept of curing, a simple change that leads to huge consequences.  Especially as one looks again at medicine from the viewpoint of healing and not curing.  (More on that another day.)

Nearly two thousand words in and all we have so far is that we are all agreeing to one degree or another that the placebo effect exists, even if the scientific proof of its existence seems scanty at best (making your wonder why the Skeptics are so quick to grab hold of the phenomenon as the blanket explanation for why homeopathic and other “alternative” therapies work).  And the only other thing we have established so far is my own addition that, in the center of the concept of the placebo effect is the idea of belief.  But what the definition of “belief” is and the revelation as to exactly what that belief is based on and targeted to, well, that will have to wait until another day.

For now, I’ll stop here.  But I await hearing from some of you, to know what you think so far and what your beliefs are where the placebo effect is concerned.