Changing your brain for health?
A study reported in the New England Journal of Medicine concludes that brain surgery works better than medication for controlling seizures. Of 40 patients receiving surgery, 58 percent benefited from it, and 10 percent had "adverse effects" from having a chunk of their brains removed. Only 8 percent of the 40 patients receiving medication improved.
If 58 percent of 40 patients had benefited from laying on of hands, medical science would insist that their health was only apparently restored, not really mended. The improvements would have been dismissed as "the placebo effect," because a placebo (Latin for "I please") -- a treatment with no active ingredient -- is thought to effect the patient’s perceptions rather than have any actual effect on their physical problems. However, perception is often everything when it comes to health.
Surgery is known to have the most powerful placebo effect of any treatment. Studies of the placebo effect have ranked the perceived potency of various treatments to find that capsules are thought to be more powerful than tablets, and particular colors of medication are assumed to be more influential over specific conditions. Having to take medication several times daily is thought to be more effective than placebos that only have to be taken once a day. Injections rank higher than capsules in perceived power to cure. And surgery is the highest regarded placebo of all. Brain surgery, one would guess, would be the placebo pinnacle of surgical interventions.
If it turns out that brain surgery for epilepsy works by influencing the patient’s expectations for cure, it would not be the first time that surgery has shown itself to be a powerful placebo. In 1953, before the coronary bypass era, those suffering from chest pain related to heart disease were treated with a newly devised surgery that intended to increase circulation to the heart by tying off—ligating—the mammary artery. Results of mammary artery ligation were highly successful, with 70 percent of patients reporting good to excellent results. Reader’s Digest touted the wonders of the surgery in 1957.
Although the surgery showed good results, no one could quite understand how it worked. Finally a surgeon tested the theory by performing sham operations on some patients, doing the same surgery, but leaving the mammary artery untouched. Of the group who got the sham surgery, 100 percent reported improvement.
Approximately 10,000 people underwent mammary ligation before it was discovered to be a placebo and phased out of use in the late 50s.
Arthroscopic surgery for arthritic knees has also been found to have a powerful placebo effect. In 1994, ten men with painful knees were involved in the first test of the possible placebo effect of this surgery. Half had only the skin of their knee penetrated by a scalpel to mimic the surgical wounds produced by the procedure, three only received a water rinse of the joint after their knees were opened, and two had the usual surgical procedure. Except for the procedure used on them, all of the men were treated exactly the same, and sent home with crutches and painkillers. All ten reported good results, all were satisfied with the surgery, and none could tell whether they had received the "real" surgery or the sham. Larger trials of the placebo effect of this surgery have been conducted since this first one with equally pleasing results whether the patient receives "real" or sham surgery.
What conclusion do you draw from this? You might think it’s outrageous or alarming that so many people go through surgery before anyone discovers it isn’t really working. But the lesson you should take away is that nothing effects your body and your perceptions of your health more than your expectations. Expect excellent results and you are likely to get them, whatever the agency of cure.
If you respond to the placebo effect, it is not a sign that you were just imagining things. It does not mean you weren’t really sick, nor does it mean that you didn’t really get well. What it means is that the real power for healing is always in your mind. What could be more pleasing than that?