Jo Marchant on “the beer goggles of medicine”

9 May
Jo Marchant

Dr. Jo Marchant. Photo ©Calyx Picture Agency

I can remember the exact moment I first became fascinated by the idea of the mind being able to cause physical changes in the body. I was eleven, and I’d just watched Michael Ironside use his brain to force a man’s head to explode in the movie Scanners. The following day I went in to school and squinted really hard at the teacher. He asked me if I needed new glasses.

Real life often finds a way to be both less exciting and more interesting than Hollywood fantasy and it turns out that our brains contain a hidden and little understood power after all.

Jo Marchant has a BSc in genetics, a PhD in microbiology, and a black belt in jiu jitsu. I have a Scottish ‘O’ Level in Biology. Fortunately the science ninja also possesses a storyteller’s knack for unfolding a narrative in way that makes it easy to follow. She’s written a book called Cure: A Journey Into the Science of Mind Over Body which is essentially an examination of the placebo effect and the scientific study of this phenomena.

Our journey begins with a woman who couldn’t play golf anymore because she’d fallen over and jiggered up her back. Jo has an X-ray of a spine and a description of the injury which I completely remember but am choosing not to use for some reason. Anyway, some doctors injected special cement into this woman’s spine which allowed her to play golf again. Except they didn’t. They pretty much just straight up lied to her face, or at least to her back, faking the procedure and turning the operating theatre into an actual theatre. Surprisingly, she was OK with this and carried on golfing regardless.

But scientists don’t just experiment on old lady golfers. Most of the research is actually done on rats. Jo tells us how the researchers got a bunch of rats and fed them their favourite sugary drink but laced it with a drug which depleted their immune systems. There is audible tutting around the auditorium. Really, Swindon? Where was your compassion when they were pushing a crippled old woman onto the fairway and shouting at her to swing?

Anyway, most of the rats died on account of not having an immune system any more. What was a bit more surprising is that they continued dying even after they were just being given normal sugar-water again. Since rats shouldn’t be able to understand the placebo effect, it seemed their brains now associated sugar-water with a particular physical condition so strongly that they would suppress their own immune systems without the presence of the drug which was supposed to do that for them.

This proved the placebo effect is a real thing and not just humans convincing themselves they feel a bit better but don’t really.

This has huge implications on medical treatments and costs. We now know some drugs can be just as effective at lower doses topped up with saline. I’m mostly sure Jo said that this is now proven in human trials but I confess I was momentarily distracted by why we still refer to human guinea pigs when more research is done on rats. Is the idea of human rats too insulting? Also because I was making notes in the dark and wrote over the same line three times.

The topping up with saline is probably important because the placebo effect, while real, is also influenced by human psychology. For example, red placebos are more effective at treating aggressive diseases and blue placebos have a greater calming effect. Size matters too, with larger pills being more effective than smaller ones. Even the bedside manner of the doctor has a measurable effect on the success of a placebo treatment, with warm and fuzzy doctors being more successful than cold science-bots.

Perhaps the most surprising thing of all is that the placebo effect is still present even when the patients are told they are getting the placebo. That’s right, you can tell a sick person they’re getting tictacs instead of medicine and they’ll still get better at a faster rate than those who get no pills at all.

Whatever your treatment it’s important to accept it with a smile, as patients with positive attitudes tend to have better outcomes than the ones who get all stressed out.

So, are our brains chemical factories which can be tricked into making the same helpful chemicals that are produced by expensive drugs? More research is needed. Unfortunately most medical research is sponsored by drug companies and most of them are reluctant to invest in research which might reveal their expensive drugs to be about as potent as a saline drip administered by a smiling doctor. There is a sliver of hope though. One German drug company actually called Jo in to get her feedback on a new programme they were setting up to study the placebo effect.

In the meantime, you can already buy placebos online. They’re made of vegetable cellulose and purified water so even vegans can pretend to be taking medicine. Personally, I don’t know why you’d go to that expense. If you’re going to lie to yourself why not just write “Important Liver Medicine” on a bottle of beer before you drink it. Just remember to buy the large ones, they’re more effective.

Jo Marchant spoke as part of the Swindon Festival of Literature at Swindon Arts Centre, 8 May 2016.

Chronicle written by Dave McGuffog.

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