Part One: Words from Memory Lane.
Part Two: Who controls the rhetoric?
The Scientist’s article “Worried Sick” confirms that nocebo and placebo are a primary drivers in medical practice, by their statement: “In places like primary care, people are swimming in placebo and nocebo effects.”
Placebo is defined as: “a usually pharmacologically inert preparation prescribed more for the mental relief of the patient than for its actual effect on a disorder”
A placebo could also be defined as “There there Dearie, you’ll be fine. This is simple to fix….”
“Worried Sick” also says, “nocebo effect may be induced by mere information” because “there’s too much detail and too much emphasis about things that could go wrong” and “negative expectations can actually cause harm”.
We are also told that; “nocebo effect is having a substantial negative impact on clinical research, medicine and health.”
This article treats “nocebo” as if it’s some white rabbit just pulled out of the magician’s hat in the last five years. They say, “We’re in such a primitive state of understanding this phenomenon, particularly in a clinically oriented way, that we just need to do more research.”
“Nocebo” or… negative expectation, is actually having a huge impact on a person’s health - but not in the way this article even touches on. And yes, in places like primary care, people ARE swimming in nocebo effects. By design, not by accident. "Primitive state" has to be the biggest load of hot air I've every heard. What the person sitting in front of the doctor often doesn't realise is how nocebo (and placebo) has been PERFECTED by the medical system.
Nocebo message: “If you don’t have your flu vaccine, you could get sick and die, because the flu virus isn’t something to mess around with. You’re over 65, you know, and your immune system isn’t what it used to be, and if you let the flu get you, you’ll be sorry, because we can’t help you treat the flu other than with Tamiflu, and the flu sucks.”
Fear. Kaching. Nocebo.
Result? If the person hearing this message is ignorant about the fact that they are being lied to (that there is no effective treatment other than tamiflu, which does suck!) they become filled with fear inside, they start trembling, and saying, “Oh doctor, how can I prevent such a nasty horrible thing happening!”
Placebo answer from Doctor: “Well, as it happens…..we just happen to have this vaccine which will prevent you getting the flu.” Which is a lie, but never mind (sarcasm, intended).
Fear creation is a fundamental tenet of medical practice. Without fear there is no reaction.
The ignorant patient who doesn’t know what they don’t know…. with an undying look of gratitude in their eyes, swoons at the doctor’s feet, and says, “With undying gratitude I accept your most gratifying gift” and worships at the alter of Jabman.
Never mind that every single Cochrane study shows the flu vaccine doesn’t work.
Never mind that several studies that show that AFTER 100 days receipt of the vaccine you have MORE chance of getting the flu than if you hadn’t had the vaccine.
Never mind a new study mentioned in this blog (under the picture of the metal man with his head concreted into the pavement….) , which shows that IF you get the vaccine, you are between 4 – 6 times MORE likely to get an influenza LIKE infection, so unlike a placebo, the vaccine actually CAUSES illness. So much for the flu vaccine.
So when the person comes back a week after the flu vaccine with a respiratory infection and says, “That damned vaccine!” the doctors gets out the risk management placebo words with nice smooth voice and loving facial expression, and says, “Oh come now, we know vaccines can’t do that, it will have been another virus, or a type of flu not covered by the vaccine.” Muggins patient refinds gullible belief, and to the relief of the doctor is reigned back into conformity and compliance.
Whew! Close call that. Fortunately for doctors, most people are that malleable. But not all.
And every second of every day, fear filled “nocebo” predictions of death, and dire destruction are dished out happily by doctors, or on TV advertisements, for all manner of drugs, yet is the medical profession really oblivious to that?
Don’t you believe it. They know exactly what they are doing:
“Your baby has a fever? Loving mothers use PAMOL, ” shows the magazine advertisement… ….twinkly fairy sprinkles magic dust and grizzly baby is suddenly all smiles and back to normal.
The capture message was, that mothers who don’t love their babies, won’t do anything.
Fear. Gotcha. Nocebo. Kaching.
…. What mother wants to be left feeling she doesn’t love her baby? Doctors and nurses say the same thing to parents who don’t want to immunise. “If you love your baby, you will immunise.” Even worse was a public health nurse who called up a child with a "no" consent form, and asked her, in front of her classmates, “Doesn’t your mother love you?”
So... said mother with baby, rings doctor’s surgery frantic about a fever (and why are mothers FRANTIC about fevers??? Who placed that fear in them? After all, pamol didn’t exist before 1950.) What does the practice nurse say? “Just use pamol and baby will be just fine.”
There is your placebo answer.
While we are on the topic of “nocebo” have a look at this for a classic example of 2007 paracetamol “information”. Plainly designed for those who are considered functionally illiterate; capable of being deceived into thinking that all who do yoga, make this wonderfully wise choice. Information? You have to be joking. It's all placating placebo.
The mother with the baby isn’t told that fever is a vital immune function designed to improve your baby’s survival and fine tune the functioning of the immune system. The doctor never points out that paracetamol products are the leading cause of accidental drug overdose, and hospital admission reported to CARM…..
Exposing the truth, might negate worry, calm the mother down, and deprive Johnson and Johnson of yet another needless and potentially harmful sale.
“But Mr Bloggs, your white coat syndrome blood pressure must be “managed” by us. The form says so. I would be negligent in my duty if I didn’t put you on blood pressure drugs and statins, because high blood pressure can wreck your kidneys and cause heart problems. You don’t want to land up with a stroke, or be put on dialysis do you???…”
Fear. Kaching. Nocebo. Except 80 year old Mr Bloggs laughed, walked out, “managed” his own white coat blood pressure (which raises it’s head because he hates being there anyway) and unlike everyone else his age that he knows…. is taking NO DRUGS.
Mr Bloggs, is plainly a medical enigma wrapped in a mystery in this day and age.
“You mean, it can be done?”
.... “But Mrs White, you’re 75, so you need to be put on Fosamax so that your bones don’t disintegrate into nothing” (Never mind that the reason her bones are disintegrating into nothing, is because Mrs White has been on warfarin for years, and they never bothered to tell her that Warfarin stops the vitamin K cycle and prevents bone from laying down essential minerals required for bone density and strength. )
And why was Mrs White put on Warfarin?
Because she had atrial fibrillation, which MIGHT result in a stroke. (Never mind that AF can be caused by simple mineral deficiencies of magnesium and potassium which will be the first things adjusted, but ONLY at the hospital when the patient is about to potentially die…!)
FEAR….. Kaching. Nocebo.
Patient complies and spends the rest of her life, going to the doctor every month to have INR tests and other reviews which keep the practice income ticking over very nicely, thank you..... Yet in the meantime, she now has no appetite, difficulty swallowing, her bone density is falling fast, she’s as skinny as a rake and the doctor can’t see that this patient isn’t doing well at all. After all, this is “gold standard practice”, we’re talking about here. Besides which at that age, and getting old, you’d expect to “decline” like that wouldn’t you?
"But Mrs Delaney, your baby must have these vaccines, because chickenpox is such a serious disease, and your baby could be so seriously ill, or get encephalitis, which could cause brain damage which might result in permanent disability for the rest of his life".
FEAR ………… Kaching. Nocebo.
Oh yes, primary care, at every turn, is full of fear-filled nocebo messages with the sole aim to get you to take their anxiety-reducing drugs, for a complication that might never occur, and could have been managed another way.
Oh yes, primary care is saturated with “nocebo” and “placebo” situations designed to target all ages groups, to create “doctor dependency” which helps pay the bills and keep everyone employed.
For the medical system to claim such a primitive state of knowledge about nocebo is quite astonishing - particularly with such a concept that is so important to every strategy they use. Plainly they assume readers are stupid, and that they can get away with such a claim. However, the message that their understanding is primitive is essential for the reader to believe.... if the reader and patients are to be sucked into their next step.....
To be continued.