The Biology of Belief - Bruce H. Lipton [60]
A Baylor School of Medicine study, published in 2002 in the New England Journal of Medicine evaluated surgery for patients with severe, debilitating knee pain. (Moseley, et al, 2002) The lead author of the study, Dr. Bruce Moseley, “knew” that knee surgery helped his patients: “All good surgeons know there is no placebo effect in surgery.” But Moseley was trying to figure out which part of the surgery was giving his patients relief. The patients in the study were divided into three groups. Moseley shaved the damaged cartilage in the knee of one group. For another group, he flushed out the knee joint, removing material thought to be causing the inflammatory effect. Both of these constitute standard treatment for arthritic knees. The third group got “fake” surgery. The patient was sedated, Moseley made three standard incisions and then talked and acted just as he would have during a real surgery—he even splashed salt water to simulate the sound of the knee-washing procedure. After 40 minutes, Moseley sewed up the incisions as if he had done the surgery. All three groups were prescribed the same postoperative care, which included an exercise program.
The results were shocking. Yes, the groups who received surgery, as expected, improved. But the placebo group improved just as much as the other two groups! Despite the fact that there are 650,000 surgeries yearly for arthritic knees, at a cost of about $5,000 each, the results were clear to Moseley: “My skill as a surgeon had no benefit on these patients. The entire benefit of surgery for osteoarthritis of the knee was the placebo effect.” Television news programs graphically illustrated the stunning results. Footage showed members of the placebo group walking and playing basketball, in short doing things they reported they could not do before their “surgery.” The placebo patients didn’t find out for two years that they had gotten fake surgery. One member of the placebo group, Tim Perez, who had to walk with a cane before the surgery, is now able to play basketball with his grandchildren. He summed up the theme of this book when he told the Discovery Health Channel: “In this world anything is possible when you put your mind to it. I know that your mind can work miracles.”
Studies have shown the placebo effect to be powerful in treating other diseases, including asthma and Parkinson’s. In the treatment of depression, placebos are stars. So much so that psychiatrist Walter Brown of the Brown University School of Medicine has proposed placebo pills as the first treatment for patients with mild or moderate depression. (Brown 1998) Patients would be told that they’re getting a remedy with no active ingredient, but that shouldn’t dampen the pills’ effectiveness. Studies suggest that even when people know they’re not getting a drug, the placebo pills still work.
One indication of the power of the placebo came from a report from the United States Department of Health and Human Services. The report found that half of severely depressed patients taking drugs improve versus thirty-two percent taking a placebo. (Horgan 1999) Even that impressive showing may underestimate the power of the placebo effect because many study participants figure out they’re taking the real drug because they experience side effects that are not experienced by those taking the placebo. Once those patients realize they’re taking the drug, i.e., once they start believing that they’re getting the real pill, they are particularly more susceptible to the placebo effect.
Given the power of the placebo, it is no wonder that the $8.2 billion antidepressant industry is under attack by critics who charge that drug companies are hyping the effectiveness of their pills. In a 2002