Tuesday, December 28, 2010

Placebo is the Medicine of the Masses

I just read a very interesting article on the placebo effect that you can read here if you want. It's not really anything new about placebos other than the fact that they seem to be working to greater effect lately.

But this got me thinking...there's a serious catch-22 with the placebo effect.

On one hand, a placebo that replaces an actual drug will alleviate any possibility of negative side-effects related to whichever drug was replaced. That's obviously a good thing. Plus it shows the power our minds and bodies have to alleviate symptoms without the use of powerful and potentially dangerous chemicals. Plus a placebo hardly costs anything considering that it will usually be made out of sugar and water (along with minor costs from faux-branding and coloring). This means positive results with less risks for less money. It's a win-win situation!

But on the other hand, a placebo doesn't work if the patient knows it is a placebo. Obviously. And a dead giveaway is the cost. If I go in to pick up an anti-depressant and I am handed a bill for $10 with no insurance, I am going to wonder if what I am taking is actually a helpful drug. To our consumer culture, expensive = quality (much like wine drinkers experience a perceived better taste when drinking more expensive wine regardless of actual quality). Solution? Jack up the price! Insurance will cover it! But wait, then we're charging people tons of money for sugar and water and the insurance carriers won't pay for that because it won't be medically necessary.

So we're at a standstill. A working placebo cannot be given in anything but a clinical trial because there is no way to distribute it without breaking the effect. Either the patient is told it is a placebo and it stops working, or the patient is lied to and somebody has to pay much more than sugar and water is actually worth.

And that's not taking into account the possible lawsuits from any patient who harms himself/herself or someone else while on a placebo, the possible lawsuits from patients who were lied to and found out (even if the placebo worked), the fact that the pharmacies would have to be in on it as well as the insurance carriers, and the fact that the Rx world is a big business and they would do everything in their power to stop placebos taking over their drugs.

It seems like the only solution would be to take those patients who responded positively to placebo and send them to therapy to try and convince them that their symptoms are almost all psychological and that they have the power to overcome said symptoms sans-drugs. But that would likely fail.

Basically we have a potentially powerful answer to all the drugs prescribed and all the side-effects those drugs result in and all the cost that people are stuck with because there is no other way to alleviate symptoms...but we can't use it.

Friday, December 10, 2010

A Treadmill World

A Probably Unnecessary Analogy

So imagine, if you will, that the world is actually an infinite plane. This plane is completely unremarkable in that is has no definitive color or texture; it is simply an infinite surface that everything sits on. What we call sky would blend in completely with this plane, resulting in a "floating" sensation if no point of reference is available. In other words, picture the "lots of guns" scene from the first Matrix film where everything is white, no shadows, no horizon.

Now imagine that at a certain point in life you are given a setting partially designated by you, and partially designated by your life decisions up to that point.

Some people would end up with a cubicle, an ancient computer, and lots of motivational posters featuring kittens all dressed up like humans.

Others would be surrounded by gurneys, I.V. stands, hypodermic needles, and thousands of clipboards.

You get the idea.

Now here's where you need to use that wonderful imagination of yours because this might be confusing with just words. Everything that makes up who you are would be within a small radius and everything would move in relation to you.

For a visual, imagine that you are an apple (just go with me here), your connections to things like work are metal rods, and those things that partially define you (like the cubicle) are oranges. Now stick a whole bunch of metal rods into the apple at various angles and lengths. Now stick an orange onto the end of each rod. As you move the apple, each orange moves perfectly in sync with it.

Don't worry, this is going somewhere...I think.

So there you are, on this infinite plane surrounded by tangible pieces that make up your life. As you take a step forward, all your "stuff" moves with you. Whether you walk, run, jump, or spin around in circles your setting would remain constant. In fact, it wouldn't feel like you were moving at all. Sure, your legs might be making the motion you now associate with walking; but how would you know you were moving?

All that...that big, confusing analogy, is how I feel about middle-class working Americans.

And Now an Attempt to Connect Those Two Things!

Let's use a generic office-job and some guy named Joe as an example. Joe gets the lowest qualification, lowest paying job at Generic Office Inc. He has a certain set of skills that he enhances, all the while tacking on new skills to supplement his original ones. Soon, Joe is king of the bottom of the totem-pole workers! His skills far surpass everyone he works with and he begins to feel a real sense of accomplishment.

But what's this? Joe now feels like he is too good for the job he has and the pay he receives. So he uses his newly refined skills to land a new, better job. This new job is much like his old job, only it requires a higher level of competence and more refined skills. But as Joe takes a seat at his desk, his previously growing sense of accomplishment is ripped from him. He realizes that everyone he works with now knows more than him. They are better, faster, and smarter than him. So he does what anyone would do in that situation, he begins honing his skills again.

This would be followed by a growing sense of accomplishment, another similar, yet better job, and another loss of feeling special because he once more knows nothing compared to his co-workers.

In a sense nothing changes for Joe. He might be replacing some of his setting with newer, nicer pieces, but it's still the same setting. And it seems like Joe only has a few options:

1) To forever climb higher and higher in status/wealth/etc without feeling much in the way of accomplishment because it's not like there's an end to this game unless he reaches upper class status (and even that would be unlikely to satiate the desire of a person who lives for climbing higher in class/status).

2) To reach the pinnacle of his trade at some designated level and then choose to stay at that level because he would surely feel some meaningful accomplishment if everyone around him looked up to him. Or would this leave him feeling like he settled and didn't live up to his personal expectations?

3) To make a drastic change and head off in a new direction. To try and find a job that would allow for a real sense of accomplishment without pushing him to move up. But does that job exist?

So What?

I see so many people around me who are surrounded by "defining things." They walk around and go to parties and get married and make friends, but they have no direction (other than "up" for many). And the only reason I'm saying any of this is because it's happening to me. Well, sort of. I'm finding myself looking around to see where I can make another dollar instead of looking for opportunities to do something I love.

So I guess the real question is, "What is it that gives us the ultimate sense of accomplishment?" Hopefully the answer is not "more money" or we'll spend every waking breath chasing infinity. Maybe the answer is, "Doing something you love." To be honest, I'm not exactly sure.

But I do know that in our horizon-less world we need something to help us keep perspective, to give us a focal point, and to force us to leave some of those oranges behind allowing us to step out and define ourselves by something other than "stuff."

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P.S. I changed my site design. You might have noticed.

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