Tuesday 20 June 2006

Pic of the day: Magical healing as imagined in the Japanese TV series "Ah my Goddess". In real life, the healing magic of love is a much slower force, but still not to be ignored. Sadly, it is not available by prescription... yet.

Placebo, prayer, magic

Not long ago I read an interesting article about placebo in the Norwegian magazine Illustrert Vitenskap (Illustrated Science). It turns out that placebo is more versatile that most of us thought. Of course, when I grew up, few thought it was really real at all. If placebo worked, it must be because people were not really sick, just their imagination making them feel ill. But test after test showed that placebo really made a difference to a wide range of obviously real illnesses, including the speed of healing for visible wounds. Today no one doubts the placebo effect, I think. But it is still a mystery.

For instance, some people (children, I hope) need growth hormone. If you give them a salt water solution instead, it has no effect. If you give them growth hormone, it has effect. But the treatment is not done in one shot. You have to repeat it regularly. If you now replace some of the later injections with salt water, the body will react to the growth hormone it did not receive! So the body learns how to use placebo. Perhaps the reason it almost always works with pain is that we all know how pain feels and how it feels to not have pain. Perhaps the placebo effect can learn pretty much everything, if you only survive long enough for it to work.

But there is still more to placebo than the article detailed. There is also the "double-blind" factor. Today all tests of new drugs must use this method. The real drug is given a label, and the placebo is given a label, but they look and taste the same. The label is not put on by the doctor or nurse that give the medication. They must not know which is which either. If they know, it will have placebo effect on the patient even if they don't say a word, even if they honestly believe that they don't give it away in any way. Only when they truly don't know is the test free from lopsided placebo effect.

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So the belief of the patient counts, and the belief of the doctor or nurse counts, even if they don't talk about it. But what about other people? Does it matter what your family believes, for instance? Almost certainly, but it is very hard to measure. Does it matter what your colleagues believe? Your church? You see where this is going. Perhaps there is no sharp line between the healing power of prayer and placebo.

This sounds like a blasphemy if you still have the mindset that placebo is for people who think they are sick but are just hysterical. But if the modern view of placebo is correct, then the opposite is true. Then placebo may simply be a small subset of faith healing. And in that case, faith healing is not superstition or even supernatural. It is a poorly documented feature of reality. Something science ought to have studied in great detail, but has neglected out of fear and shame. Perhaps it should be given a more scientific name so scientists can study it without being ridiculed and without losing their grants.

Since I began writing this journal in 1998, our view of the cosmos has changed drastically. We thought that it was being blown apart by the Big Bang but would gradually slow down, perhaps fall back in a point and explode again. Now it is taken for granted that some unknown energy is making the universe expand faster and faster. We thought the cosmic constants were, well, constant. Now there are signs that they may vary slightly over time. We can now only account for about 4% of the universe, the rest is unknown: Dark mass and dark energy which we do not know what is.

So does that mean that everything is possible and particularly my God, who incidentally is much better than your God? Not exactly. I mention it because cosmologists feel little shame or remorse when their theories are blown apart. They shrug and start making new theories, or new variants of the old theories, that fit better with the facts. Shouldn't the medical establishment do the same? If prayer, magic and placebo all work to some degree, then it makes sense to test them all by whatever means possible. To ignore it because it does not fit our models would be like ignoring cosmic expansion because it did not fit our old theories. And yet some in the medical establishment still think like one of them said about healing by prayer: "I would not believe this even if it was proved."

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I don't want doctors to be replaced by clerics, shamans and witches. Well, not most doctors at least. What I want is that we learn how the different pathways of healing work together (and when they don't) so the highest number of people can survive with the highest quality of life. And if that means some have to stop scoffing at others, so be it.

You have heard it is said: "Sufficiently advanced technology is indistinguishable from magic." But I tell you: Sufficiently researched magic is indistinguishable from technology.