1 00:00:01,080 --> 00:00:04,520 Speaker 1: Welcome to Stuff you should know from house Stuff Works 2 00:00:04,519 --> 00:00:13,160 Speaker 1: dot com. Hey, and welcome to the podcast. I'm Josh Clark, 3 00:00:13,200 --> 00:00:17,200 Speaker 1: and there's Charles W. Chuck Bryant, and there's Jerry. Jerry 4 00:00:17,880 --> 00:00:25,560 Speaker 1: the placebo do sir? No, No, that was bad, Chuck. Yes. 5 00:00:25,880 --> 00:00:31,320 Speaker 1: Have you ever heard of the word placebo? Do, sir? Yeah? Placebo? 6 00:00:31,680 --> 00:00:36,159 Speaker 1: You know what I mean? I do. Tell everybody I 7 00:00:36,280 --> 00:00:41,159 Speaker 1: shall see, No, I will please, I shall please. That's right, 8 00:00:41,159 --> 00:00:45,120 Speaker 1: met ill see, We'll see about that. I shall please. 9 00:00:45,280 --> 00:00:50,600 Speaker 1: That's what I meant in Latin. Yes, all right, so placebo. 10 00:00:51,520 --> 00:00:55,560 Speaker 1: Everybody's heard of a placebo and very famously the placebo effect. 11 00:00:55,840 --> 00:01:00,040 Speaker 1: You wonder where that comes from? The placebo effect. The 12 00:01:00,040 --> 00:01:06,040 Speaker 1: word placebo um fourteenth century. It referred to hired mourners 13 00:01:06,080 --> 00:01:10,360 Speaker 1: at funerals. What they would hire mourners in place of 14 00:01:10,400 --> 00:01:14,000 Speaker 1: family members, and they would start their morning wailing with 15 00:01:15,000 --> 00:01:17,720 Speaker 1: that mourning. But as in m O, you are with 16 00:01:17,840 --> 00:01:23,119 Speaker 1: placebo domino in region vivorum, which means I shall please 17 00:01:23,160 --> 00:01:26,600 Speaker 1: the Lord in the land of the living. But in 18 00:01:26,720 --> 00:01:30,240 Speaker 1: that it means placebo. Uh. This article said, it carries 19 00:01:30,280 --> 00:01:35,920 Speaker 1: the connotation of substitution. Weird. Yeah, that is fantastic stuff. 20 00:01:35,959 --> 00:01:38,560 Speaker 1: I thought. So this is from Placebo's and Placebo Effects 21 00:01:38,560 --> 00:01:44,600 Speaker 1: in Medicine Colon Historical Overview by Tisson cap Chuck Green 22 00:01:44,880 --> 00:01:50,639 Speaker 1: and Legion Catchuck. That guy is high quality. Oh yeah, yeah, 23 00:01:50,680 --> 00:01:54,720 Speaker 1: a lot of skeptics. He's at Harevard. Let me tell 24 00:01:54,760 --> 00:01:58,160 Speaker 1: you a little bit about Ted Kapchuck. Okay, the coney 25 00:01:58,200 --> 00:02:01,320 Speaker 1: Allen cap Chuck's I just raised a lot of skeptics 26 00:02:01,360 --> 00:02:04,160 Speaker 1: hackles because some people see him as a huckster of 27 00:02:04,240 --> 00:02:08,040 Speaker 1: fraud or everything that's wrong with placebos. These people, um 28 00:02:08,200 --> 00:02:11,480 Speaker 1: would probably have a problem with us even talking seriously 29 00:02:11,480 --> 00:02:14,200 Speaker 1: about the placebo effect in the first place. So I 30 00:02:14,200 --> 00:02:15,800 Speaker 1: don't know that it's a really big deal that I 31 00:02:15,840 --> 00:02:22,079 Speaker 1: just raised their hackles. But Ted Katchuk is a former right, 32 00:02:22,720 --> 00:02:25,160 Speaker 1: let me tell you about capture. Now. He's a former 33 00:02:25,200 --> 00:02:31,440 Speaker 1: acupuncturist and he apparently had some sort of epiphany one 34 00:02:31,520 --> 00:02:36,880 Speaker 1: day when he was he was treating somebody and they 35 00:02:36,960 --> 00:02:40,400 Speaker 1: started to feel better before he even used the acupuncture. 36 00:02:41,000 --> 00:02:44,160 Speaker 1: So he started wondering, like, okay, what's going on here? 37 00:02:44,160 --> 00:02:48,240 Speaker 1: And he started investigating the placebo effect, and in short 38 00:02:48,360 --> 00:02:52,160 Speaker 1: order he ended up as an instructor at Harvard and 39 00:02:52,240 --> 00:02:56,040 Speaker 1: became one of the leading researchers into the placebo effect, 40 00:02:56,639 --> 00:03:01,040 Speaker 1: which is a really strange journey because every medical school 41 00:03:01,280 --> 00:03:05,800 Speaker 1: doesn't usually hire acupuncturists. And he had like kind of 42 00:03:05,800 --> 00:03:07,560 Speaker 1: a rocky road at first, like he didn't know what 43 00:03:07,600 --> 00:03:10,440 Speaker 1: he was doing with clinical trials, and he got publicly 44 00:03:10,440 --> 00:03:12,760 Speaker 1: called out in the New England Journal of Medicine and 45 00:03:13,200 --> 00:03:15,480 Speaker 1: UM over the years, over the decades, I think this 46 00:03:15,639 --> 00:03:18,320 Speaker 1: is the eighties that he really started to look into it. 47 00:03:18,720 --> 00:03:24,200 Speaker 1: He um, like I said, became the foremost researcher in 48 00:03:24,200 --> 00:03:28,280 Speaker 1: in coming up with quality clinical trials for trying to 49 00:03:28,280 --> 00:03:30,680 Speaker 1: get to the root of what the placebo effect is 50 00:03:30,720 --> 00:03:33,120 Speaker 1: and how to use it. What years was that? You 51 00:03:33,120 --> 00:03:36,280 Speaker 1: know he's still doing it, but when was this? When 52 00:03:36,280 --> 00:03:39,320 Speaker 1: he was started all that stuff. He got called out 53 00:03:39,360 --> 00:03:41,760 Speaker 1: and I think a two thousand one issue of the 54 00:03:41,760 --> 00:03:45,200 Speaker 1: New England Journal of Medicine UM basically for not using 55 00:03:45,720 --> 00:03:50,000 Speaker 1: a control group in his placebo study. So you know, 56 00:03:50,040 --> 00:03:52,640 Speaker 1: when you do a study, you have a placebo group 57 00:03:52,760 --> 00:03:56,280 Speaker 1: which is your control group, and that basically is I'm 58 00:03:56,320 --> 00:03:59,960 Speaker 1: giving you real medicine, but I'm giving Jerry a sugar pill. 59 00:04:00,760 --> 00:04:04,080 Speaker 1: And in a proper study, I don't know who's getting 60 00:04:04,080 --> 00:04:06,200 Speaker 1: the sugar pill and who's getting the medicine. It's called 61 00:04:06,200 --> 00:04:10,680 Speaker 1: double blind. Um so in if you're studying just the 62 00:04:10,680 --> 00:04:14,400 Speaker 1: placebo effect, I should be giving you a placebo and 63 00:04:14,400 --> 00:04:17,880 Speaker 1: I should be giving Jerry no treatment whatsoever. To truly, 64 00:04:18,200 --> 00:04:20,679 Speaker 1: I thought you needed three people, one with a real treatment, 65 00:04:20,680 --> 00:04:23,400 Speaker 1: one with placebo, and one with no treatment. It's another 66 00:04:23,440 --> 00:04:25,440 Speaker 1: way to do it, Okay, at the very least, though, 67 00:04:25,600 --> 00:04:30,560 Speaker 1: you need the placebo group and somebody who's receiving no treatment, gotcha. Yeah, yeah, 68 00:04:30,680 --> 00:04:33,799 Speaker 1: if we're skinning cats, well, if you're doing good science 69 00:04:34,000 --> 00:04:38,599 Speaker 1: researching into the placebo effect. But what's ironic is is 70 00:04:38,680 --> 00:04:45,120 Speaker 1: this whole double blind placebo study came about because the 71 00:04:45,160 --> 00:04:50,280 Speaker 1: placebo effect was first noticed by Western practitioner by the 72 00:04:50,360 --> 00:04:53,239 Speaker 1: name of Dr Henry Beecher, who in World War Two 73 00:04:53,640 --> 00:04:57,919 Speaker 1: supposedly saw a nurse give a shot of sailing to 74 00:04:57,960 --> 00:05:01,200 Speaker 1: a soldier because they'd run out a morphine, but the 75 00:05:01,279 --> 00:05:04,400 Speaker 1: nurse told them it was morphine, and the soldier responded 76 00:05:04,440 --> 00:05:07,920 Speaker 1: to this shot of saline like it was morphine, And 77 00:05:08,000 --> 00:05:10,480 Speaker 1: from that Beecher was like, what is going on here? 78 00:05:10,520 --> 00:05:14,080 Speaker 1: Started to investigate the placebo effect and ended up proposing 79 00:05:14,120 --> 00:05:18,520 Speaker 1: the double blind placebo study to prove the efficacy of drugs. 80 00:05:19,200 --> 00:05:21,760 Speaker 1: That goes back further than that, my friend, let's hear 81 00:05:21,760 --> 00:05:27,560 Speaker 1: it man UH try seventy five the New Medical Dictionary, 82 00:05:27,760 --> 00:05:30,839 Speaker 1: they described the placebo as a commonplace method or medicine, 83 00:05:30,960 --> 00:05:33,320 Speaker 1: and then a short time later, in eighteen eleven and 84 00:05:33,400 --> 00:05:38,719 Speaker 1: Quincy's lexicon uh Medicum, he defined the placebo as an 85 00:05:38,760 --> 00:05:42,880 Speaker 1: epithet given to any medicine adapted more to please than 86 00:05:42,960 --> 00:05:45,960 Speaker 1: to benefit the patient, like heroin. So they were on 87 00:05:46,040 --> 00:05:50,240 Speaker 1: it back in the early eighteen hundreds, which is surprising. Yeah, 88 00:05:50,320 --> 00:05:52,200 Speaker 1: but I mean, like that's the basis of like snake 89 00:05:52,240 --> 00:05:55,000 Speaker 1: oil and hucksterism, right, Yeah, Well they called him bread 90 00:05:55,000 --> 00:05:56,840 Speaker 1: pills back then because I guess it was it was 91 00:05:56,880 --> 00:05:59,599 Speaker 1: probably some sort of like pill made of yeast, as 92 00:05:59,720 --> 00:06:03,200 Speaker 1: my us UH and Thomas Jefferson in eighteen o seven 93 00:06:03,240 --> 00:06:07,039 Speaker 1: even Uh recorded what he called the Pious Fraud, and 94 00:06:07,040 --> 00:06:09,680 Speaker 1: he observed quote that one of the most successful positions 95 00:06:09,680 --> 00:06:12,520 Speaker 1: I've ever known has assured me that he used more 96 00:06:12,560 --> 00:06:16,240 Speaker 1: bread pills, drops of colored water, and powders of hickory 97 00:06:16,279 --> 00:06:21,159 Speaker 1: ash than all other medicines put together. UM, and people 98 00:06:21,160 --> 00:06:23,400 Speaker 1: treated people with bread pills. In the early eighteen hundreds, 99 00:06:23,400 --> 00:06:25,280 Speaker 1: it was a thing and like they were way onto 100 00:06:25,360 --> 00:06:28,960 Speaker 1: the placebo effect and and the fact that it seemed 101 00:06:29,000 --> 00:06:33,640 Speaker 1: to work. Uh. And another dude named John Haygarth in 102 00:06:33,640 --> 00:06:37,400 Speaker 1: the early eighteen hundreds actually started performing the first studies 103 00:06:37,400 --> 00:06:41,600 Speaker 1: on placebo effect, and um, he said it went back 104 00:06:41,600 --> 00:06:45,880 Speaker 1: to the renaissance idea that imagination was the major mediator 105 00:06:45,880 --> 00:06:49,520 Speaker 1: between body and mind, which is starting to be proven 106 00:06:49,640 --> 00:06:52,160 Speaker 1: is possibly correct. Yeah, it's pretty interesting. And in the 107 00:06:52,240 --> 00:06:55,760 Speaker 1: nineties is when they started publishing papers on the placebo 108 00:06:56,040 --> 00:07:01,000 Speaker 1: uh and actually doing clinical trials and um. They said. 109 00:07:01,040 --> 00:07:03,240 Speaker 1: One of their points in the nineteen thirties would confidence 110 00:07:03,279 --> 00:07:07,760 Speaker 1: aroused in a treatment, the encouragement afforded by a new procedure, 111 00:07:07,920 --> 00:07:10,800 Speaker 1: even like just people getting treated in a new way. 112 00:07:11,480 --> 00:07:13,800 Speaker 1: People would say, oh, well, this is gonna work, and 113 00:07:13,840 --> 00:07:15,880 Speaker 1: it maybe he did work. And then we're up to 114 00:07:15,920 --> 00:07:19,840 Speaker 1: the forties where Beacher comes along notices the placebo effect 115 00:07:19,880 --> 00:07:23,640 Speaker 1: himself ultimately comes up with the double blind placebo based study. 116 00:07:24,200 --> 00:07:27,280 Speaker 1: And what's ironic about that is the placebo based double 117 00:07:27,320 --> 00:07:31,120 Speaker 1: blind study ultimately has split back off into the study 118 00:07:31,120 --> 00:07:34,840 Speaker 1: of placebo again because there are so many trials where 119 00:07:34,840 --> 00:07:37,360 Speaker 1: the placebo was more effective than the drug, even though 120 00:07:37,360 --> 00:07:41,080 Speaker 1: the drug worked, but the placebo worked even better. And 121 00:07:41,200 --> 00:07:43,800 Speaker 1: finally in the nine nineties, people were like, what is 122 00:07:43,880 --> 00:07:47,120 Speaker 1: going on here? We need to study this thing in 123 00:07:47,160 --> 00:07:49,520 Speaker 1: and of itself. Well, yeah, because one of the things 124 00:07:49,640 --> 00:07:54,440 Speaker 1: I had no idea. I thought placebos were only used 125 00:07:54,560 --> 00:07:58,520 Speaker 1: in studies for efficacy rates. I did not know that 126 00:07:58,600 --> 00:08:02,160 Speaker 1: they are. There are doctors, always have been, and still 127 00:08:02,200 --> 00:08:07,360 Speaker 1: are prescribing placebos as medicine unknowingly even though they're not 128 00:08:07,400 --> 00:08:10,680 Speaker 1: supposed to. We'll get to that later. No knowingly, no 129 00:08:10,840 --> 00:08:13,800 Speaker 1: unknowingly for the patient, even though they're supposed to tell 130 00:08:13,800 --> 00:08:15,920 Speaker 1: the patient. Yeah, but we'll get to that towards the end. 131 00:08:15,960 --> 00:08:18,560 Speaker 1: But I had no idea that they were prescribing placebos 132 00:08:18,560 --> 00:08:20,800 Speaker 1: to people. Yeah, And in their defense, a lot of 133 00:08:20,840 --> 00:08:24,400 Speaker 1: times doctors are carrying on a tradition where they don't 134 00:08:24,400 --> 00:08:28,720 Speaker 1: have anything else to prescribe. But they can't say if 135 00:08:28,760 --> 00:08:30,800 Speaker 1: they say that to their patients, the patients are going 136 00:08:30,800 --> 00:08:32,800 Speaker 1: to go off and suffer. So at the very least 137 00:08:32,840 --> 00:08:38,160 Speaker 1: they can use the last ditch attempt of saying psychological traitor. Yeah. Yeah, 138 00:08:38,200 --> 00:08:40,240 Speaker 1: and I'm not knocking it. I just was surprised to 139 00:08:40,320 --> 00:08:42,280 Speaker 1: learn that that still happens. And I'm wondering if I've 140 00:08:42,320 --> 00:08:45,640 Speaker 1: ever been given a placebo. And it makes me feel 141 00:08:45,720 --> 00:08:48,360 Speaker 1: dumb as a patient to say, like, yeah, man, that 142 00:08:48,440 --> 00:08:50,360 Speaker 1: whatever you give me really helped. And the doctors like 143 00:08:51,559 --> 00:08:53,959 Speaker 1: because it's the same thing as that prank of like 144 00:08:54,440 --> 00:08:57,440 Speaker 1: giving somebody non alcoholic beer un telling the real beer 145 00:08:57,480 --> 00:08:59,839 Speaker 1: and watching them make a jerk out of themselves getting 146 00:09:00,040 --> 00:09:03,440 Speaker 1: or wrong. It's exactly the same thing. So let's talk 147 00:09:03,440 --> 00:09:07,080 Speaker 1: about placebo. We assume that everybody knows what placebo is, 148 00:09:07,120 --> 00:09:12,480 Speaker 1: but let's define it a little more clearly. The placebo effect, specifically, 149 00:09:13,400 --> 00:09:18,920 Speaker 1: is the very real phenomenon that people, when given a 150 00:09:19,000 --> 00:09:25,360 Speaker 1: pill or a some sort of medical intervention that feel better. Yes, 151 00:09:25,440 --> 00:09:28,120 Speaker 1: they feel better, even though what they've been given is 152 00:09:28,200 --> 00:09:32,400 Speaker 1: not medicine and it was not actually a real intervention. Yeah, 153 00:09:32,400 --> 00:09:36,320 Speaker 1: And the placebo is the pill itself. That that is 154 00:09:36,559 --> 00:09:39,960 Speaker 1: the placebo, and the effect is what you just described, right, 155 00:09:39,960 --> 00:09:41,200 Speaker 1: And it doesn't have to be a pill, can be 156 00:09:41,200 --> 00:09:45,560 Speaker 1: an injection, it can be fake surgery, there's true. And 157 00:09:45,559 --> 00:09:49,520 Speaker 1: it doesn't even have to be uh pharmacologically inert. It 158 00:09:49,600 --> 00:09:53,520 Speaker 1: can be a vitamin or like an aspirin, even though 159 00:09:53,760 --> 00:09:57,480 Speaker 1: some argue that's not a true placebo. But um, sometimes 160 00:09:57,480 --> 00:10:00,360 Speaker 1: that's what the doctor will give you and call it, 161 00:10:00,600 --> 00:10:04,840 Speaker 1: you know, medication, But they're there. Um very often, things 162 00:10:04,840 --> 00:10:09,040 Speaker 1: like a sugar pill. Yeah, like you said, pharmacologically inert 163 00:10:09,480 --> 00:10:14,240 Speaker 1: um and astoundingly, depending on the size of the pill, 164 00:10:14,360 --> 00:10:16,200 Speaker 1: the shape of the pill, the color of the pill, 165 00:10:16,960 --> 00:10:20,760 Speaker 1: people will have different effects and responses to these things 166 00:10:20,800 --> 00:10:25,360 Speaker 1: that are just sugar. Um. So there's some really strange 167 00:10:25,840 --> 00:10:31,120 Speaker 1: psychological things going on here. And at first, for a 168 00:10:31,160 --> 00:10:35,160 Speaker 1: long time, everybody just kind of assumed it was just psychology, 169 00:10:35,200 --> 00:10:38,679 Speaker 1: that we were tricking ourselves into feeling better, or we 170 00:10:38,760 --> 00:10:41,880 Speaker 1: hadn't really felt bad in the first place, and we 171 00:10:41,880 --> 00:10:46,040 Speaker 1: were being tricked into not feeling bad any longer, or 172 00:10:46,120 --> 00:10:49,840 Speaker 1: not thinking we were feeling bad. In any hypochondria, maybe 173 00:10:50,040 --> 00:10:54,120 Speaker 1: very much. So. Yeah, Um, they this article says they've 174 00:10:54,120 --> 00:10:56,160 Speaker 1: been shown to work in about thirty percent of patients, 175 00:10:56,840 --> 00:10:59,480 Speaker 1: and that was actually that's based on Beacher's finding. It 176 00:10:59,559 --> 00:11:02,240 Speaker 1: was like alretty, thirty five point two. Yeah, that's what 177 00:11:02,320 --> 00:11:04,240 Speaker 1: he found out in nineteen fifty five. That's what they're 178 00:11:04,240 --> 00:11:07,560 Speaker 1: still basing that on. Yeah, but there's been other studies 179 00:11:07,600 --> 00:11:11,360 Speaker 1: that have gone back through beat your studies and said no, no, no, 180 00:11:11,600 --> 00:11:14,319 Speaker 1: that's not that much. Other people have found up to 181 00:11:15,559 --> 00:11:19,120 Speaker 1: respond to it, right, And basically one of the big 182 00:11:19,200 --> 00:11:22,720 Speaker 1: questions is is it a psychological effect or are there extual, 183 00:11:22,920 --> 00:11:27,040 Speaker 1: actual physical responses that are going on. And there's been 184 00:11:27,040 --> 00:11:29,600 Speaker 1: a lot of research lately that's pretty interesting. I think, 185 00:11:30,800 --> 00:11:33,360 Speaker 1: like we're saying that the the initial idea was that 186 00:11:33,440 --> 00:11:37,559 Speaker 1: it was all psychological, right, Yeah, Like, uh, well, I 187 00:11:37,600 --> 00:11:40,440 Speaker 1: guess we can talk about the two effects. The subject 188 00:11:40,480 --> 00:11:45,559 Speaker 1: expectancy effect, which is basically, if you know the result 189 00:11:45,600 --> 00:11:47,080 Speaker 1: ahead of time and the pill you're gonna take, you're 190 00:11:47,080 --> 00:11:51,240 Speaker 1: gonna end up feeling that result. Right. That's what a 191 00:11:51,280 --> 00:11:55,920 Speaker 1: blind study seeks to prevent, is a subject expectancy effect, 192 00:11:56,240 --> 00:11:59,240 Speaker 1: and also the observer expectancy effect, which is what a 193 00:11:59,360 --> 00:12:02,160 Speaker 1: double blind studies seeks to prevent. Yeah, and that's important 194 00:12:02,160 --> 00:12:05,480 Speaker 1: because it's are different because it's all self reported, right, 195 00:12:05,679 --> 00:12:08,880 Speaker 1: which is always a little you know, right. So the 196 00:12:08,960 --> 00:12:11,880 Speaker 1: other idea, if it has a psychological basis, is that 197 00:12:11,920 --> 00:12:15,520 Speaker 1: it's classical conditioning that we are raised from birth to 198 00:12:16,120 --> 00:12:19,760 Speaker 1: think that if somebody gives you a pill, you're going 199 00:12:19,840 --> 00:12:23,400 Speaker 1: to respond to it because it has medicine and that 200 00:12:23,559 --> 00:12:27,959 Speaker 1: is not self reported. That is actually seeing physical responses. Right. 201 00:12:28,200 --> 00:12:33,640 Speaker 1: And with classical conditioning established very famously by Pavlov and 202 00:12:33,720 --> 00:12:40,400 Speaker 1: his dogs, right, um, you are you're having You're responding 203 00:12:41,240 --> 00:12:46,800 Speaker 1: physically to a psychological stimulus. Right, So you are getting 204 00:12:46,800 --> 00:12:51,040 Speaker 1: a physiological response. So classical conditioning eventually kind of came 205 00:12:51,080 --> 00:12:55,360 Speaker 1: to be viewed as the more um reasonable explanation for 206 00:12:55,440 --> 00:13:00,000 Speaker 1: what was going on because, uh, study after study, if 207 00:13:00,000 --> 00:13:04,040 Speaker 1: the study has shown that we are having a physical 208 00:13:04,080 --> 00:13:07,880 Speaker 1: reaction to these inert placebos. Yeah, one of them. In 209 00:13:07,920 --> 00:13:11,239 Speaker 1: two thousand two from u C. L As Neuropsychiatric Institute, 210 00:13:11,520 --> 00:13:14,360 Speaker 1: they had a couple of groups of patients and a 211 00:13:14,400 --> 00:13:19,400 Speaker 1: lot of the placebo studies are uh for mental conditions. Um, 212 00:13:19,440 --> 00:13:20,880 Speaker 1: not all of them, but a lot of them are 213 00:13:21,360 --> 00:13:25,880 Speaker 1: in um like the clinical trials. Yeah, yeah, exactly. Um. 214 00:13:25,960 --> 00:13:29,400 Speaker 1: So this one was for any depressants and they had 215 00:13:29,400 --> 00:13:34,440 Speaker 1: two groups that got um experimental drugs like real drugs, 216 00:13:34,760 --> 00:13:37,320 Speaker 1: and then the third was given the placebo. Uh. They 217 00:13:37,360 --> 00:13:39,800 Speaker 1: spent a few weeks on these pills and monitored their 218 00:13:39,840 --> 00:13:44,800 Speaker 1: brain activity with the old E G. Wonder machine and well, 219 00:13:44,800 --> 00:13:48,240 Speaker 1: it's not the wonder machine. It's it's a wonder machine, 220 00:13:48,280 --> 00:13:51,440 Speaker 1: not the wonder machine. Uh. And the patients on the 221 00:13:51,440 --> 00:13:55,040 Speaker 1: placebo reported positive effects and showed greater increase of brain 222 00:13:55,040 --> 00:13:59,440 Speaker 1: activity than those who had responded to the drug. You know, 223 00:13:59,520 --> 00:14:04,760 Speaker 1: I remember or that it was, Yeah, totally undermined people's 224 00:14:04,760 --> 00:14:08,000 Speaker 1: faith in antidepressants because it was on the other end 225 00:14:08,040 --> 00:14:11,560 Speaker 1: of like the whole nineties where everybody was on antidepressants, 226 00:14:11,600 --> 00:14:15,360 Speaker 1: and this study came out and was like people were saying, like, 227 00:14:15,400 --> 00:14:17,959 Speaker 1: do these things even work? It was it was kind 228 00:14:17,960 --> 00:14:20,680 Speaker 1: of taken the opposite way. Rather than wow, the placebo 229 00:14:20,720 --> 00:14:26,120 Speaker 1: effect is really something, it was wow and indepressance or fraudulent. Well, 230 00:14:26,160 --> 00:14:28,360 Speaker 1: I wonder what they were trying to It was a 231 00:14:28,360 --> 00:14:31,320 Speaker 1: placebo study though, right, so kind of backfired or did 232 00:14:31,360 --> 00:14:34,080 Speaker 1: they even care? No, I think it very much carry 233 00:14:34,120 --> 00:14:37,320 Speaker 1: because there when compared to place with the whole point 234 00:14:37,520 --> 00:14:41,200 Speaker 1: of a drug trial is to show that this drug 235 00:14:41,240 --> 00:14:44,359 Speaker 1: is more effective than placebo, it's more effective than the imagination, 236 00:14:45,280 --> 00:14:47,840 Speaker 1: and if it's not, then that means that drugs shouldn't 237 00:14:47,840 --> 00:14:51,040 Speaker 1: be brought to market. Even though now the thinking is 238 00:14:51,080 --> 00:14:53,880 Speaker 1: more like m that's not necessarily true. Because we're coming 239 00:14:53,920 --> 00:14:58,160 Speaker 1: to understand the placebo effect can be very powerful, especially 240 00:14:58,240 --> 00:15:01,840 Speaker 1: depending on the individual too. Yeah for sure. Uh. The 241 00:15:01,920 --> 00:15:04,160 Speaker 1: interesting thing about that study is when the E e g. 242 00:15:04,400 --> 00:15:07,120 Speaker 1: Lit up um, the activity was in different parts of 243 00:15:07,120 --> 00:15:11,160 Speaker 1: the brain. Um. I think that the placebo patients said 244 00:15:11,160 --> 00:15:15,000 Speaker 1: the preformal cortex was lighting up, and basically that says 245 00:15:15,040 --> 00:15:18,840 Speaker 1: that the brain isn't being fooled, it's just doing something different. Yeah, 246 00:15:18,880 --> 00:15:23,720 Speaker 1: they responded better to the treatment then the people who 247 00:15:24,160 --> 00:15:27,680 Speaker 1: responded to the drug. So some people did respond to 248 00:15:27,680 --> 00:15:30,240 Speaker 1: the drug, but different parts of their brain were activated 249 00:15:30,240 --> 00:15:32,320 Speaker 1: by the drug than the people who responded well to 250 00:15:32,360 --> 00:15:36,240 Speaker 1: the placebo, even though they felt better. Yeah, that's mind boggling. 251 00:15:36,320 --> 00:15:38,880 Speaker 1: It is. So they had they reached the same conclusion, 252 00:15:39,120 --> 00:15:41,120 Speaker 1: but using a totally different region of their brain and 253 00:15:41,120 --> 00:15:45,120 Speaker 1: they actually felt better. Um. That wasn't the first study 254 00:15:45,120 --> 00:15:48,560 Speaker 1: to prove that there is a physiological response to placebos 255 00:15:48,800 --> 00:15:51,840 Speaker 1: or last there's a dental study from the seventies that 256 00:15:51,880 --> 00:15:54,600 Speaker 1: I think was the first that showed that if you 257 00:15:54,680 --> 00:16:01,040 Speaker 1: blocked endorphins, which are nature's pain relievers, you can also 258 00:16:01,120 --> 00:16:06,120 Speaker 1: block the placebo effect. So the people weren't responding to 259 00:16:06,120 --> 00:16:09,080 Speaker 1: the placebo like you would expect them to a pain 260 00:16:09,160 --> 00:16:14,280 Speaker 1: reliever placebo because they weren't able to release their natural 261 00:16:14,320 --> 00:16:16,840 Speaker 1: pain relievers. Yeah, and that's backed up I guess by 262 00:16:16,880 --> 00:16:20,000 Speaker 1: this two thousand four study from the University of Michigan 263 00:16:20,880 --> 00:16:26,840 Speaker 1: uh Go wolverines. They basically demonstrated that it is related 264 00:16:26,880 --> 00:16:30,560 Speaker 1: to endorphins specifically. Uh, So that I guess that backs 265 00:16:30,640 --> 00:16:33,440 Speaker 1: up that study because if you can block them. So 266 00:16:33,480 --> 00:16:36,920 Speaker 1: here's the thing. It's not that study was related to 267 00:16:37,080 --> 00:16:40,440 Speaker 1: endorphins specifically. Other studies have found that it can be 268 00:16:40,480 --> 00:16:45,160 Speaker 1: related to how much a person expresses dopamine specifically. So 269 00:16:45,400 --> 00:16:48,040 Speaker 1: there's like this idea that there's a genetic basis to 270 00:16:48,080 --> 00:16:53,480 Speaker 1: our predisposition to UM placebos. But I think that it's 271 00:16:53,560 --> 00:16:58,800 Speaker 1: depending on the drug or the effect that you're trying 272 00:16:58,840 --> 00:17:01,800 Speaker 1: to induce using the placebo effects. Because think about it. 273 00:17:02,640 --> 00:17:07,160 Speaker 1: If you are somebody who naturally produces more endorphins than 274 00:17:07,240 --> 00:17:13,320 Speaker 1: somebody else, Uh, you're going to naturally produce more endorphins 275 00:17:13,320 --> 00:17:17,040 Speaker 1: when it's UM triggered by a placebo than somebody who 276 00:17:17,080 --> 00:17:21,200 Speaker 1: doesn't produce more endorphins naturally. Yeah, So there's a genetic 277 00:17:21,240 --> 00:17:23,160 Speaker 1: basis to it, I guess, But I think the genetic 278 00:17:23,160 --> 00:17:26,520 Speaker 1: basis is that the individual must be predisposition to be 279 00:17:26,640 --> 00:17:32,000 Speaker 1: able to have that genetic response UM to the drug 280 00:17:32,160 --> 00:17:35,879 Speaker 1: or the placebo and have that that um that I 281 00:17:35,880 --> 00:17:38,640 Speaker 1: guess response to it. Yeah, And it's like you said, 282 00:17:38,680 --> 00:17:42,680 Speaker 1: it's also personal because they found that it is even 283 00:17:42,720 --> 00:17:47,639 Speaker 1: affected by a person's personal experience with past pills. The 284 00:17:47,680 --> 00:17:49,840 Speaker 1: color of the pill, the shape and size of the 285 00:17:49,840 --> 00:17:53,960 Speaker 1: pill will have a different reaction because the person had 286 00:17:54,000 --> 00:17:57,560 Speaker 1: maybe took another little blue pill for something else. Sure, 287 00:17:57,680 --> 00:18:00,760 Speaker 1: And actually blue pills in in particular, they are known 288 00:18:00,800 --> 00:18:04,640 Speaker 1: to be um to have sedative effects as placebo's. Red 289 00:18:04,680 --> 00:18:08,160 Speaker 1: pills are known to have stimulating and pain relieving effects 290 00:18:08,440 --> 00:18:12,440 Speaker 1: as placebo. That's odd that they made by agraab blue. Yeah, 291 00:18:12,640 --> 00:18:16,040 Speaker 1: like in Heavinaly marketed it as the little blue pill. 292 00:18:16,840 --> 00:18:21,400 Speaker 1: Interesting sedative effect, Yes, I don't think so. So. Chok, Well, 293 00:18:21,720 --> 00:18:27,160 Speaker 1: not that i'd know. Well, we've got more stuff about 294 00:18:27,160 --> 00:18:29,120 Speaker 1: all this coming up. But I don't know what we're 295 00:18:29,119 --> 00:18:32,240 Speaker 1: gonna talk about next. It's a grab bag right now. Yeah, 296 00:18:32,560 --> 00:18:39,080 Speaker 1: but we're gonna come right back after these messages. All right, 297 00:18:39,320 --> 00:18:40,879 Speaker 1: we're back, buddy, And I tell you what we're going 298 00:18:40,920 --> 00:18:43,160 Speaker 1: to talk about. Something that I had never heard of, 299 00:18:43,160 --> 00:18:46,760 Speaker 1: which I think is super interesting, the no sebo effect. 300 00:18:47,560 --> 00:18:49,960 Speaker 1: It is super cool, and that is when well, it's 301 00:18:50,119 --> 00:18:51,800 Speaker 1: there's a couple of things. That is, when you are 302 00:18:51,840 --> 00:18:56,840 Speaker 1: taking a placebo and you experience maybe the effects of 303 00:18:56,840 --> 00:19:00,439 Speaker 1: the pill, which is great, and the side effec of 304 00:19:00,440 --> 00:19:03,920 Speaker 1: that pill that you think might be but you're supposed 305 00:19:03,960 --> 00:19:06,840 Speaker 1: to have, right, you're actually experiencing side effects that aren't 306 00:19:07,160 --> 00:19:09,399 Speaker 1: shouldn't be there, right, and then a sugar bill. They 307 00:19:09,440 --> 00:19:12,520 Speaker 1: noticed this in clinical trials too, because when you're carrying 308 00:19:12,560 --> 00:19:14,760 Speaker 1: out a clinical trial, you have to warn the patients 309 00:19:15,400 --> 00:19:19,320 Speaker 1: this drug may give you these terrible side effects. And 310 00:19:19,359 --> 00:19:22,240 Speaker 1: so they started noticing like people who were who were 311 00:19:22,240 --> 00:19:26,080 Speaker 1: on placebo were still experiencing the side effect like physical 312 00:19:26,119 --> 00:19:31,240 Speaker 1: reactions like hives and itch in things. Right, So there 313 00:19:31,320 --> 00:19:34,120 Speaker 1: is a there's a negative side to placebo as well, 314 00:19:34,119 --> 00:19:36,760 Speaker 1: and no cibo means I shall harm like placebo means 315 00:19:36,800 --> 00:19:42,160 Speaker 1: I shall please yeah um. And they found that this 316 00:19:42,240 --> 00:19:45,560 Speaker 1: is definitely backed up by the idea that it's classical conditioning. 317 00:19:45,920 --> 00:19:49,560 Speaker 1: They found that people who have gone through chemotherapy UH 318 00:19:49,840 --> 00:19:52,840 Speaker 1: can become nauseated when they enter a room that's painted 319 00:19:52,880 --> 00:19:56,120 Speaker 1: the same color as the room where they received chemo before. Yeah, 320 00:19:56,200 --> 00:19:58,840 Speaker 1: that makes sense. Yeah, so there's all sorts of ways 321 00:19:58,880 --> 00:20:01,080 Speaker 1: that the no cebo effect can pop up, but it's 322 00:20:01,200 --> 00:20:04,200 Speaker 1: pretty mind boggling as well. Yeah, and then no sebo 323 00:20:04,320 --> 00:20:06,639 Speaker 1: can doesn't even have to be just with the placebo. 324 00:20:06,720 --> 00:20:09,680 Speaker 1: You can experience side effects that aren't on the list 325 00:20:09,720 --> 00:20:12,520 Speaker 1: of a real drug because of what we were talking about, 326 00:20:12,560 --> 00:20:16,080 Speaker 1: because it looked like another pill you might have had before. Man, 327 00:20:16,160 --> 00:20:20,959 Speaker 1: the brain powerful stuff. So going back to kat Chuk, 328 00:20:21,280 --> 00:20:24,880 Speaker 1: who I'm I'm just kind of a fan of. Yeah, 329 00:20:25,480 --> 00:20:28,840 Speaker 1: I think if you're into like a long form articles, 330 00:20:28,960 --> 00:20:33,600 Speaker 1: which I love, go to Harvard Magazine and search for 331 00:20:33,800 --> 00:20:36,439 Speaker 1: the placebo phenomenon and it's a profile of him and 332 00:20:36,520 --> 00:20:40,479 Speaker 1: his work. It's really interesting stuff. But he was saying 333 00:20:41,000 --> 00:20:44,280 Speaker 1: that kind of in line with the idea that like 334 00:20:44,320 --> 00:20:45,760 Speaker 1: the color of the pill or the shape of the 335 00:20:45,760 --> 00:20:48,200 Speaker 1: pill will have an effect, will either on the no 336 00:20:48,359 --> 00:20:51,960 Speaker 1: sebo or the placebo effect. Um. He was saying that 337 00:20:52,400 --> 00:20:56,000 Speaker 1: it seems like the basis of the placebo effect is 338 00:20:56,359 --> 00:21:00,320 Speaker 1: what's called ritual yea, and ritual is it involves everything 339 00:21:00,400 --> 00:21:04,360 Speaker 1: from like the physician's bedside manner to how expensive the 340 00:21:04,400 --> 00:21:08,240 Speaker 1: patient thinks the pill is to how effective the patient 341 00:21:08,280 --> 00:21:11,560 Speaker 1: thinks the pillars and um. He did a study where 342 00:21:11,800 --> 00:21:15,480 Speaker 1: he carried out what was called schmaltzy um like a 343 00:21:15,520 --> 00:21:20,520 Speaker 1: smalty care to where he was just lavishing attention on 344 00:21:20,600 --> 00:21:24,159 Speaker 1: the patient and telling him how badly he felt that 345 00:21:24,200 --> 00:21:28,280 Speaker 1: they were going through this. But this pill is really 346 00:21:28,320 --> 00:21:32,879 Speaker 1: effective with your condition. And apparently not just this study, 347 00:21:32,880 --> 00:21:36,320 Speaker 1: but other studies show that there's a positive correlation between 348 00:21:36,760 --> 00:21:43,080 Speaker 1: the ritual and response to the placebo effect. So the 349 00:21:43,160 --> 00:21:46,000 Speaker 1: more you think that this drug is expensive, that this 350 00:21:46,080 --> 00:21:50,359 Speaker 1: drug is effective, that this physician cares about you, the 351 00:21:50,600 --> 00:21:54,360 Speaker 1: greater of a placebo response you're going to have. Yeah, 352 00:21:54,600 --> 00:21:56,639 Speaker 1: you know, I have you ever been accused of being 353 00:21:56,640 --> 00:22:00,520 Speaker 1: a hypochondract by anyone? Know, it's got to be very demeaning. 354 00:22:02,119 --> 00:22:05,480 Speaker 1: It is because it happened to me. And yeah, I 355 00:22:05,480 --> 00:22:07,199 Speaker 1: went to the emergency room in New York, as you know, 356 00:22:07,760 --> 00:22:09,879 Speaker 1: when we were up there recently for a trip. I 357 00:22:09,920 --> 00:22:14,240 Speaker 1: went to the e R and uh, it was something 358 00:22:14,320 --> 00:22:17,399 Speaker 1: and it was a result of it was it was 359 00:22:18,760 --> 00:22:23,359 Speaker 1: throwing up in uh nausea from UM I learned from 360 00:22:23,760 --> 00:22:26,679 Speaker 1: anti inflammatory pills I was taking at the time for 361 00:22:26,800 --> 00:22:28,440 Speaker 1: something else I had nothing to do with being sick, 362 00:22:29,119 --> 00:22:32,480 Speaker 1: and they figured that out, but they kept you know 363 00:22:32,560 --> 00:22:34,320 Speaker 1: this guy, I called him Nurse Jackie. He was just 364 00:22:34,320 --> 00:22:36,720 Speaker 1: like Nurse Jackie, except he was a dude. He kept 365 00:22:36,720 --> 00:22:38,520 Speaker 1: coming by and treating me with things and giving me 366 00:22:38,520 --> 00:22:39,840 Speaker 1: the I V. Drip and I was like, dude, I'm 367 00:22:39,840 --> 00:22:42,840 Speaker 1: not feeling better and I'm not a hypochondrac in any way. 368 00:22:42,880 --> 00:22:45,879 Speaker 1: I didn't go to the doctor for like eighteen years straight. 369 00:22:46,320 --> 00:22:48,600 Speaker 1: And uh, I could tell he was looking at me 370 00:22:48,640 --> 00:22:51,919 Speaker 1: like I got one of these guys. Yeah, And I 371 00:22:51,960 --> 00:22:53,680 Speaker 1: was like, no, no, and I could tell. I could 372 00:22:53,880 --> 00:22:56,439 Speaker 1: could sense it. And so he finally gave me this 373 00:22:56,760 --> 00:23:00,359 Speaker 1: thing to drink that um knocked me out, woke up 374 00:23:00,359 --> 00:23:04,920 Speaker 1: like twenty minutes later and felt felt better. I can't remember. 375 00:23:04,960 --> 00:23:07,720 Speaker 1: It was something to gatorade now. It was like three 376 00:23:07,720 --> 00:23:10,640 Speaker 1: different things. It was like a cocktail of stomach pleasing 377 00:23:10,680 --> 00:23:14,200 Speaker 1: things and what's the stuff that like numbs you numb 378 00:23:14,280 --> 00:23:20,480 Speaker 1: my throat and I can't remember light to can I think? Um? Yeah, 379 00:23:20,520 --> 00:23:22,040 Speaker 1: it worked. I woke up and I felt better. I said, 380 00:23:22,160 --> 00:23:24,360 Speaker 1: you know, I don't feel so naxious now, and they 381 00:23:24,359 --> 00:23:25,840 Speaker 1: were checking me out and I reached up and I 382 00:23:25,880 --> 00:23:29,640 Speaker 1: felt behind my ear for some reason, and it felt 383 00:23:29,640 --> 00:23:32,239 Speaker 1: like a golf ball behind my ear and it had 384 00:23:32,840 --> 00:23:35,119 Speaker 1: popped up in the last twenty minutes, and so I 385 00:23:35,160 --> 00:23:36,520 Speaker 1: was literally leaving. I was like, oh, wait a minute, 386 00:23:36,560 --> 00:23:38,440 Speaker 1: I got this thing behind my ear all of a sudden, 387 00:23:39,000 --> 00:23:41,359 Speaker 1: and this guy looked at me like h and he 388 00:23:41,440 --> 00:23:43,320 Speaker 1: called the doctor over and she was like, yeah, it's 389 00:23:43,400 --> 00:23:45,880 Speaker 1: it's very swollen at your limp node. But he wasn't 390 00:23:45,880 --> 00:23:47,639 Speaker 1: there for that, so he came back over. It's like, 391 00:23:47,840 --> 00:23:49,399 Speaker 1: what did she say. I said, well, she said the 392 00:23:49,440 --> 00:23:52,399 Speaker 1: swollen and he said that you're a hypochondriac. And I 393 00:23:52,440 --> 00:23:55,320 Speaker 1: was so mad at nursed Jackie. I was like, dude, 394 00:23:55,960 --> 00:23:58,560 Speaker 1: look at it. It's huge. I'm not making this up. 395 00:23:58,600 --> 00:24:00,960 Speaker 1: And I started defending myself like I never go to 396 00:24:01,040 --> 00:24:03,640 Speaker 1: doctors and I'm not one of those people. And he 397 00:24:03,680 --> 00:24:05,119 Speaker 1: was just he was like, I was just kidding. I 398 00:24:05,119 --> 00:24:07,119 Speaker 1: was just kidding, and I was just kidding. Yeah, but 399 00:24:07,160 --> 00:24:10,120 Speaker 1: it made it totally made me feel like a jerk. Yeah, 400 00:24:10,560 --> 00:24:12,720 Speaker 1: I mean imagine if like you, if that happened to 401 00:24:12,760 --> 00:24:14,919 Speaker 1: you a lot too, I mean, well that means you're 402 00:24:14,920 --> 00:24:18,960 Speaker 1: a hypocontract right. But now it definitely made me felt 403 00:24:19,640 --> 00:24:21,119 Speaker 1: and I know he was kidding, but it made me 404 00:24:21,119 --> 00:24:24,760 Speaker 1: feel really bad, like I'm in there just uh, what's 405 00:24:24,800 --> 00:24:29,239 Speaker 1: what's the syndrome? Is that it? Yeah, we did an 406 00:24:29,280 --> 00:24:33,359 Speaker 1: episode on that too. Yeah. Uh anyway, sorry about that. Yeah, well, 407 00:24:33,480 --> 00:24:36,240 Speaker 1: I'm sorry that that happened to you. I mean, that 408 00:24:36,440 --> 00:24:40,000 Speaker 1: is b S. But you mentioned the I V guarantee 409 00:24:40,000 --> 00:24:43,760 Speaker 1: you that was just sailing, and that's a placebo in itself. No, 410 00:24:43,840 --> 00:24:45,920 Speaker 1: I mean they told me that. I mean they didn't 411 00:24:45,920 --> 00:24:49,480 Speaker 1: say like this is the wonder bag, but there's basically 412 00:24:49,720 --> 00:24:53,320 Speaker 1: I'm no reason to give you sailing solution. Well to 413 00:24:53,400 --> 00:24:56,600 Speaker 1: hydrate me, I guess if i'd been throwing up. Oh yeah, okay, 414 00:24:56,640 --> 00:24:59,320 Speaker 1: but um yeah, I guess you're right though to see 415 00:24:59,359 --> 00:25:01,200 Speaker 1: like something dripping into your arm, like surely that's got 416 00:25:01,200 --> 00:25:05,640 Speaker 1: to be doing something. Yeah. Uh. Well, one interesting thing 417 00:25:05,840 --> 00:25:09,520 Speaker 1: is back to placebo's, there have been studies that have 418 00:25:09,640 --> 00:25:12,480 Speaker 1: shown that, uh, if you don't tell the patient what 419 00:25:12,560 --> 00:25:15,320 Speaker 1: they're supposed to do, that they don't work as well. Yeah. 420 00:25:15,359 --> 00:25:17,600 Speaker 1: They even found that with drugs that they know for 421 00:25:17,760 --> 00:25:21,280 Speaker 1: a fact work, if you don't tell them it won't work. Yeah. 422 00:25:21,280 --> 00:25:25,639 Speaker 1: They did a placebo based trial with a pain killer 423 00:25:26,240 --> 00:25:30,159 Speaker 1: and the pain killer proved more effective than placebo. And 424 00:25:30,200 --> 00:25:33,560 Speaker 1: then they did another trial with the same pain killer, 425 00:25:33,760 --> 00:25:38,160 Speaker 1: didn't tell anybody what it was and it didn't work. Interesting. 426 00:25:38,520 --> 00:25:40,879 Speaker 1: And then conversely, this is the one that gets me 427 00:25:41,600 --> 00:25:45,480 Speaker 1: to study where they so crazy? Where you're going. They 428 00:25:45,600 --> 00:25:49,520 Speaker 1: used an injection that they put into patient's jaws in 429 00:25:49,560 --> 00:25:53,480 Speaker 1: the study, which me to induce pain Like that was 430 00:25:53,520 --> 00:25:56,200 Speaker 1: the point. They were trying to induce pain in somebody's 431 00:25:56,280 --> 00:26:02,399 Speaker 1: jaw using harmless but pain full jaw injections, and they 432 00:26:02,400 --> 00:26:06,200 Speaker 1: would inject sailine into the jaw um to keep the 433 00:26:06,280 --> 00:26:10,760 Speaker 1: patient's self reported pain level steady throughout the study. And 434 00:26:10,800 --> 00:26:14,399 Speaker 1: then they used another injection and gave them sline but 435 00:26:14,480 --> 00:26:18,600 Speaker 1: told them this was a pain reliever, and everybody's pain 436 00:26:18,680 --> 00:26:22,080 Speaker 1: across the board dropped as a result in the study. 437 00:26:23,480 --> 00:26:26,840 Speaker 1: Unbelievable placebo effect. I could just sit around and rattle 438 00:26:26,880 --> 00:26:29,280 Speaker 1: off studies all day. It's pretty interesting. What do you 439 00:26:29,280 --> 00:26:34,280 Speaker 1: think about obacalp Yeah, it seems kids are done. You 440 00:26:34,359 --> 00:26:37,400 Speaker 1: could just call it placebo anyway, I think it's unnecessary. Well, 441 00:26:37,520 --> 00:26:41,720 Speaker 1: obacalp is placebo spelled backwards obviously, and that in two 442 00:26:41,800 --> 00:26:45,560 Speaker 1: thousand eight was I guess sort of invented or not 443 00:26:45,680 --> 00:26:49,440 Speaker 1: invented but coined and packaged by a mother I think 444 00:26:49,440 --> 00:26:54,960 Speaker 1: Australian named jin Boutner. She Australian, I don't know. I 445 00:26:54,960 --> 00:26:57,240 Speaker 1: think so is that an Australian last name? And then 446 00:26:57,400 --> 00:27:00,159 Speaker 1: I don't think there's such a thing. Um, And so 447 00:27:00,920 --> 00:27:04,000 Speaker 1: that's basically Placebo's for kids. It's marketed. You can you 448 00:27:04,040 --> 00:27:06,600 Speaker 1: can buy a bottle of obacalp and it's for when 449 00:27:06,600 --> 00:27:11,000 Speaker 1: your kid isn't feeling good. But um, you but you 450 00:27:11,040 --> 00:27:13,800 Speaker 1: know your kids not sick, that kind of thing, and 451 00:27:13,880 --> 00:27:15,240 Speaker 1: so you give the kid the pill and it makes 452 00:27:15,280 --> 00:27:17,359 Speaker 1: them feel better. And some people have problems with this 453 00:27:17,480 --> 00:27:21,399 Speaker 1: and say you're teaching your child that you get relief 454 00:27:21,520 --> 00:27:24,640 Speaker 1: from pills only when they're you know, I don't necessarily 455 00:27:24,680 --> 00:27:28,000 Speaker 1: need to be taking pills all the time. And proponents say, 456 00:27:28,040 --> 00:27:29,840 Speaker 1: you know what, it's it's the same thing as putting 457 00:27:29,840 --> 00:27:33,600 Speaker 1: a bandage or kissing a boo boo. It's like you said, 458 00:27:33,640 --> 00:27:36,399 Speaker 1: these are dumb little kids. Well, I remember growing up 459 00:27:36,400 --> 00:27:40,360 Speaker 1: with the children's aspirin, the orange aspirin. I'm pretty sure 460 00:27:40,400 --> 00:27:42,359 Speaker 1: those were just sugar pills. You think I had a 461 00:27:42,359 --> 00:27:45,400 Speaker 1: whole bottle of them, and I was fine, but those 462 00:27:45,400 --> 00:27:48,520 Speaker 1: are vitamins. It was children's aspirin. Oh I think they 463 00:27:48,520 --> 00:27:52,159 Speaker 1: were orange flavored. Yeah, I totally remember those. Yeah, I 464 00:27:52,160 --> 00:27:56,560 Speaker 1: think those are probably place I remember the taste, like 465 00:27:56,600 --> 00:27:59,439 Speaker 1: I can still sense that they're good, the whole bottle 466 00:27:59,440 --> 00:28:01,000 Speaker 1: of them once because I was a little fat kid, 467 00:28:02,160 --> 00:28:04,800 Speaker 1: you didn't eat and get sick sugar pills. I have 468 00:28:05,040 --> 00:28:07,680 Speaker 1: I think so, because I even remember I was old 469 00:28:07,760 --> 00:28:09,800 Speaker 1: enough thinking like I probably shouldn't have eaten that whole 470 00:28:09,800 --> 00:28:12,720 Speaker 1: bottle of those things because it's medicine, and watched it 471 00:28:12,760 --> 00:28:14,879 Speaker 1: down with the sky and I was right and that 472 00:28:15,000 --> 00:28:18,600 Speaker 1: was fine. Afterwards, Well, they do have legit baby aspert 473 00:28:18,600 --> 00:28:25,320 Speaker 1: now though, they I'm starting to doubt everything, so starting 474 00:28:25,320 --> 00:28:28,800 Speaker 1: to talk about doubt. There are plenty of criticisms of 475 00:28:28,840 --> 00:28:31,199 Speaker 1: all this, and we'll talk about him right after this. 476 00:28:41,560 --> 00:28:44,440 Speaker 1: So Chuck, I'm a big time into the placebo effect. 477 00:28:45,080 --> 00:28:48,520 Speaker 1: Your big time into the placebo effect. There are people 478 00:28:48,560 --> 00:28:52,200 Speaker 1: who are not that's true. There Uh, it raises plenty 479 00:28:52,200 --> 00:28:54,520 Speaker 1: of skepticism, which again is one of the reasons why 480 00:28:54,560 --> 00:28:57,280 Speaker 1: my hat is off to Ted Katchuk because he has 481 00:28:57,320 --> 00:29:00,720 Speaker 1: responded to the criticism. He's adjusted his methodolog g he's 482 00:29:00,760 --> 00:29:04,160 Speaker 1: doing really good science in the investigation of the placebo effect. 483 00:29:04,400 --> 00:29:08,200 Speaker 1: I like that guy. Still, skeptics say, there are a 484 00:29:08,200 --> 00:29:10,960 Speaker 1: lot of things that you can use to explain away 485 00:29:11,120 --> 00:29:15,560 Speaker 1: the placebo effect. For example, it's possible the person was 486 00:29:15,600 --> 00:29:20,080 Speaker 1: actually a hypochondriac, they weren't actually sick in the first place. Yeah, 487 00:29:20,160 --> 00:29:24,080 Speaker 1: It's possible that some people get better with no treatment. 488 00:29:24,880 --> 00:29:29,480 Speaker 1: It's possible that some diseases do treat themselves, just get 489 00:29:29,560 --> 00:29:32,800 Speaker 1: better over the course of time. And if if you 490 00:29:32,880 --> 00:29:36,720 Speaker 1: overlay a placebo effect or a placebo and and you 491 00:29:36,880 --> 00:29:39,240 Speaker 1: put that over the same course of time, it's gonna 492 00:29:39,240 --> 00:29:41,200 Speaker 1: look like it was the placebo that did it, when 493 00:29:41,240 --> 00:29:44,280 Speaker 1: really it's just heal itself. Yeah, which is why they 494 00:29:44,640 --> 00:29:48,520 Speaker 1: critics call for studies where there is one UH group 495 00:29:48,560 --> 00:29:52,080 Speaker 1: that has not given any medication whatsoever exactly, which makes sense. 496 00:29:52,320 --> 00:29:57,200 Speaker 1: So UM. One of the other criticisms, though, is that 497 00:29:57,400 --> 00:29:59,920 Speaker 1: if a doctor is is saying and there are, like 498 00:30:00,080 --> 00:30:03,160 Speaker 1: you said, plenty of doctors who do this, UM. There 499 00:30:03,160 --> 00:30:06,000 Speaker 1: there were studies that found that UM. A two thousand 500 00:30:06,040 --> 00:30:11,600 Speaker 1: seven study from the University of Chicago found doctors surveyed 501 00:30:11,640 --> 00:30:15,760 Speaker 1: in the Chicago area had prescribed placebos before at some 502 00:30:15,840 --> 00:30:18,080 Speaker 1: point during their career. In two thousand and eight, they 503 00:30:18,080 --> 00:30:20,560 Speaker 1: did a little more robust when six hundred doctors all 504 00:30:20,600 --> 00:30:23,840 Speaker 1: across the US and half of them said that they 505 00:30:23,880 --> 00:30:27,040 Speaker 1: had prescribed placebos. So this is like, this is still 506 00:30:27,080 --> 00:30:30,400 Speaker 1: going on the thing. It's pretty widespread, and the criticism 507 00:30:30,440 --> 00:30:33,040 Speaker 1: is well, that means doctors are lying to their patients. 508 00:30:33,280 --> 00:30:38,360 Speaker 1: They're using deception to practice medicine, and that's unethical. So 509 00:30:38,440 --> 00:30:40,920 Speaker 1: the A m A came out with it's a guideline 510 00:30:41,000 --> 00:30:43,280 Speaker 1: that's kind of flies in the face of the placebo 511 00:30:43,320 --> 00:30:45,880 Speaker 1: effector of the idea that if you give somebody a 512 00:30:45,920 --> 00:30:49,080 Speaker 1: placebo and tell them it's a placebo, that it shouldn't work, 513 00:30:49,520 --> 00:30:52,640 Speaker 1: which is not necessarily true. Yeah, in two thousand six, 514 00:30:52,680 --> 00:30:56,760 Speaker 1: the AMY came out and said, uh, quote, physicians may 515 00:30:56,880 --> 00:31:00,400 Speaker 1: use placebos for diagnosis or treatment only if they patient 516 00:31:00,440 --> 00:31:03,400 Speaker 1: is informed and agrees to it. To me, that means 517 00:31:03,400 --> 00:31:06,479 Speaker 1: it's not a placebo. I mean I guess it is, 518 00:31:06,520 --> 00:31:09,800 Speaker 1: but if you know it is, I don't get it. Like, 519 00:31:09,880 --> 00:31:11,560 Speaker 1: what's the point of a doctor coming in and saying, 520 00:31:11,800 --> 00:31:14,280 Speaker 1: I'm going to give you the sugar pill? Would would 521 00:31:14,280 --> 00:31:16,720 Speaker 1: you like a prescription for sugar pills, and you say, yes, 522 00:31:16,760 --> 00:31:21,040 Speaker 1: I would. Supposedly, there are um studies that show the 523 00:31:21,080 --> 00:31:28,000 Speaker 1: placebo effect is still works sometimes, but the across the board, 524 00:31:28,040 --> 00:31:31,160 Speaker 1: pretty much everyone believes that if the placebo effect is 525 00:31:31,160 --> 00:31:33,000 Speaker 1: a real thing, the cats out of the bag. It 526 00:31:33,120 --> 00:31:36,360 Speaker 1: is part of the imagination, and that you do kind 527 00:31:36,360 --> 00:31:38,760 Speaker 1: of have to fool the person into thinking that it's 528 00:31:38,800 --> 00:31:43,720 Speaker 1: a real thing. That expectation coupled with imagination provides the 529 00:31:43,760 --> 00:31:46,560 Speaker 1: placebo effect. Yeah, and this article points out to we're 530 00:31:46,560 --> 00:31:51,720 Speaker 1: not just saying these doctors are lying liars um. Apparently, 531 00:31:51,760 --> 00:31:55,760 Speaker 1: one one tech that a doctor can take is to say, uh, 532 00:31:55,920 --> 00:31:59,120 Speaker 1: I have something that I think can help, but I 533 00:31:59,160 --> 00:32:01,280 Speaker 1: don't know exactly know what the deal is with it 534 00:32:01,600 --> 00:32:03,640 Speaker 1: or how it works, but i'll give it to you 535 00:32:03,680 --> 00:32:05,840 Speaker 1: if you want to try it. And you know how 536 00:32:05,840 --> 00:32:07,520 Speaker 1: people are a lot of people are like, sure, I'll 537 00:32:07,560 --> 00:32:11,200 Speaker 1: try anything. Right Exactly, that's not really deception because if 538 00:32:11,240 --> 00:32:14,440 Speaker 1: the doctors are prescribing a placebo he or she obviously 539 00:32:14,520 --> 00:32:17,280 Speaker 1: does believe in the placebo effects, so here she does 540 00:32:17,360 --> 00:32:20,479 Speaker 1: think it could work but doesn't know how, or if 541 00:32:20,520 --> 00:32:23,960 Speaker 1: it only really does work in of the population, then 542 00:32:24,200 --> 00:32:27,719 Speaker 1: you've got a seventy chance of striking out anyway with 543 00:32:27,760 --> 00:32:31,560 Speaker 1: this course of treatment. Uh so you're back to where 544 00:32:31,560 --> 00:32:33,720 Speaker 1: he started to begin with. Yeah, and again it's got 545 00:32:33,720 --> 00:32:36,640 Speaker 1: that falls into what's the point category? Now again, we 546 00:32:36,640 --> 00:32:39,680 Speaker 1: should say that a lot of physicians who do prescribe 547 00:32:39,800 --> 00:32:42,360 Speaker 1: placebos aren't just doing it to toy with their patients. 548 00:32:42,360 --> 00:32:46,640 Speaker 1: They're doing because they think that their patient will suffer 549 00:32:46,760 --> 00:32:51,040 Speaker 1: more without it, or they just don't have anything that 550 00:32:51,120 --> 00:32:54,200 Speaker 1: could be used to address the patient's problem, like they 551 00:32:54,240 --> 00:32:58,160 Speaker 1: can't find anything medically wrong with the patient, but just 552 00:32:58,160 --> 00:33:00,560 Speaker 1: saying that the patient's not going to help. So here's 553 00:33:00,560 --> 00:33:03,720 Speaker 1: a sugar pill. UM. The other tech that a doctor 554 00:33:03,760 --> 00:33:07,800 Speaker 1: can take to chuck is um to say, hey, new patient, 555 00:33:07,840 --> 00:33:10,240 Speaker 1: welcome to my practice. Let me tell you about the 556 00:33:10,280 --> 00:33:13,800 Speaker 1: placebo effect. And in the course of me treating you, 557 00:33:14,240 --> 00:33:17,400 Speaker 1: sometime during your lifetime, I may find that a placebo 558 00:33:17,440 --> 00:33:19,760 Speaker 1: will be the best thing to use. Are you okay 559 00:33:19,840 --> 00:33:22,760 Speaker 1: with me doing that to you at some point possibly 560 00:33:23,040 --> 00:33:26,760 Speaker 1: basically like signing up for my own personal U long 561 00:33:26,840 --> 00:33:29,720 Speaker 1: term study kind of as a doctor. But wouldn't you 562 00:33:29,800 --> 00:33:31,520 Speaker 1: from that point on be like you just gave me 563 00:33:31,560 --> 00:33:34,920 Speaker 1: the placeboy, it's a placebo. I know it's a placebo. 564 00:33:34,920 --> 00:33:36,800 Speaker 1: I wouldn't know which way was up, Like, I don't 565 00:33:36,800 --> 00:33:41,640 Speaker 1: know how to feel. That's the better worse side effects? None, yep. 566 00:33:42,360 --> 00:33:45,120 Speaker 1: And the other tech doctors can take is to knock 567 00:33:45,160 --> 00:33:47,760 Speaker 1: off early and go hit the golf course, which they 568 00:33:47,800 --> 00:33:50,560 Speaker 1: do that one a lot on TV. That's a that's 569 00:33:50,560 --> 00:33:53,160 Speaker 1: a that's such an old bit trope. It's like, yeah, 570 00:33:53,240 --> 00:33:56,040 Speaker 1: cops in their doughnuts? Is that doctors in golf? I 571 00:33:56,040 --> 00:33:58,400 Speaker 1: think that was pretty accurate. I mean in Caddyshack, the 572 00:33:58,440 --> 00:34:03,160 Speaker 1: doctor was Dr Beeper. He was the one who just 573 00:34:03,240 --> 00:34:06,080 Speaker 1: got mad all the time, right now. That was Judge Smailes. 574 00:34:06,920 --> 00:34:09,920 Speaker 1: Dr Beeper was he was just one of the guys, 575 00:34:10,160 --> 00:34:14,520 Speaker 1: one of the foursome, okay that I think he played. 576 00:34:15,760 --> 00:34:19,439 Speaker 1: Was it Buck Henry? Was he the doctor? No? I can't, 577 00:34:19,440 --> 00:34:23,440 Speaker 1: I can. I can picture the guy. It's Buck Henry, right, 578 00:34:24,440 --> 00:34:27,200 Speaker 1: I don't think so we'll figure this out offline. How 579 00:34:27,200 --> 00:34:29,640 Speaker 1: about that? Yeah? All right? If you want to know 580 00:34:29,640 --> 00:34:32,120 Speaker 1: more about the placebo effect, and believe us there is 581 00:34:32,200 --> 00:34:34,879 Speaker 1: plenty more to know about it, you can type those 582 00:34:34,880 --> 00:34:36,879 Speaker 1: two words in the search part how stuff works dot 583 00:34:36,960 --> 00:34:40,320 Speaker 1: com and uh, since I said that, it's time for 584 00:34:40,320 --> 00:34:45,359 Speaker 1: a listener mail. I'm gonna call this Australian last name. 585 00:34:45,920 --> 00:34:49,719 Speaker 1: This is, he says, dear Josh, Chuck and Jerry and 586 00:34:49,800 --> 00:34:52,680 Speaker 1: anyone else I should think, And I think we never 587 00:34:52,719 --> 00:34:55,080 Speaker 1: mentioned other people that support us. Didn't we already talk 588 00:34:55,120 --> 00:34:59,000 Speaker 1: about in Australian last name? Yeah, that was the joke. Okay, 589 00:34:59,120 --> 00:35:02,680 Speaker 1: let's call the call back, gotcha. I just felt like 590 00:35:03,520 --> 00:35:05,440 Speaker 1: this listener mail, though, made me realize that we don't 591 00:35:05,440 --> 00:35:07,879 Speaker 1: think other folks a lot besides Jerry and like Noelan Matt. 592 00:35:08,239 --> 00:35:14,360 Speaker 1: But um, let's do that noway. Like Rebecca h Rebecca 593 00:35:14,480 --> 00:35:16,360 Speaker 1: is uh, what's her official title? I don't even know 594 00:35:16,400 --> 00:35:20,640 Speaker 1: what titles are around producer web producer maybe yeah, I 595 00:35:20,640 --> 00:35:23,520 Speaker 1: mean she handles our website. It makes everything look great. 596 00:35:24,000 --> 00:35:26,440 Speaker 1: And Sherry, even though we do our own social media, 597 00:35:26,480 --> 00:35:28,759 Speaker 1: Sherry does social media for how stuff works. And she 598 00:35:29,000 --> 00:35:30,719 Speaker 1: throws to us a lot, throws to us and helps 599 00:35:30,760 --> 00:35:33,880 Speaker 1: us out a lot. And Joe, our buddy, Joe is 600 00:35:33,880 --> 00:35:37,440 Speaker 1: a huge help um, and that's kind of the crack staff. 601 00:35:37,480 --> 00:35:41,280 Speaker 1: I mean, we're answering our own emails and we're doing 602 00:35:41,280 --> 00:35:43,719 Speaker 1: a lot of our own stuff, but it doesn't mean 603 00:35:43,719 --> 00:35:45,160 Speaker 1: we don't have help. You know what I'm saying. We 604 00:35:45,200 --> 00:35:46,440 Speaker 1: have tons of help, so you know, I just want 605 00:35:46,440 --> 00:35:48,200 Speaker 1: to say thanks to this. It's very nice if you 606 00:35:48,280 --> 00:35:51,080 Speaker 1: chuck thanks everybody. I figured six years and seven years 607 00:35:51,120 --> 00:35:52,879 Speaker 1: and we might as well shout out some of our help. 608 00:35:53,680 --> 00:35:55,359 Speaker 1: Uh So this from Alex and he said to thank 609 00:35:55,400 --> 00:35:57,760 Speaker 1: anyone else he doesn't know about. And he's from Perth, 610 00:35:58,120 --> 00:36:03,239 Speaker 1: Western Australia, which is nothing like Eastern Australia. I'm a 611 00:36:03,320 --> 00:36:06,719 Speaker 1: nineteen year old aspiring electrician trapped in the depths of 612 00:36:06,760 --> 00:36:10,359 Speaker 1: Western Australia's mining downturn due to layoffs in the mining sector. 613 00:36:10,400 --> 00:36:13,520 Speaker 1: Have been unable to find an apprenticeship and I would 614 00:36:13,520 --> 00:36:15,520 Speaker 1: have lost hope if it weren't for you guys. I 615 00:36:15,600 --> 00:36:17,719 Speaker 1: was just after New Year's It was just after New 616 00:36:17,760 --> 00:36:22,200 Speaker 1: Year's January six when I came across the magical production 617 00:36:22,239 --> 00:36:25,160 Speaker 1: called Stuff You Should Know um As. At the time 618 00:36:25,200 --> 00:36:28,440 Speaker 1: of this writing, it is May tent uh and I 619 00:36:28,480 --> 00:36:32,440 Speaker 1: have finished the epic adventure of six hundred episodes plus. 620 00:36:33,480 --> 00:36:36,120 Speaker 1: That's in a very short time, my friend. It's been 621 00:36:36,160 --> 00:36:38,520 Speaker 1: an amazing journey and I want to thank you for 622 00:36:38,560 --> 00:36:41,160 Speaker 1: pulling me through the hard days of resume writing and 623 00:36:41,200 --> 00:36:44,800 Speaker 1: delivering long days of waiting. Uh Previously we're mind numbing, 624 00:36:44,840 --> 00:36:47,520 Speaker 1: but have since been filled with interesting, insightful, and overall 625 00:36:47,560 --> 00:36:52,600 Speaker 1: incredible enjoyable content. My favorites gene patents, lobotomies, and the 626 00:36:52,719 --> 00:36:57,399 Speaker 1: masterfully dictated Halloween episodes. We like those two. Those are 627 00:36:57,600 --> 00:36:59,919 Speaker 1: some of my favorites. Christmas. I think it's the best 628 00:37:00,400 --> 00:37:03,680 Speaker 1: uh so que the exist existential crisis. After um, you 629 00:37:03,680 --> 00:37:06,399 Speaker 1: guys forming such an integral part of my life over 630 00:37:06,440 --> 00:37:08,120 Speaker 1: the past five months, I don't know I'm going to 631 00:37:08,160 --> 00:37:11,960 Speaker 1: acclimate myself to just to a week. Um. And we 632 00:37:12,000 --> 00:37:14,399 Speaker 1: hear that a lot from people who mainline the show. Yeah, 633 00:37:14,480 --> 00:37:18,920 Speaker 1: there's like a withdrawal period. Yeah, and I've done that 634 00:37:18,960 --> 00:37:21,799 Speaker 1: with TV shows, you know. I do that for sure. 635 00:37:22,560 --> 00:37:26,320 Speaker 1: You mainline it and then you're like, well I need it. Yeah. Um. 636 00:37:26,360 --> 00:37:28,239 Speaker 1: I would just like to sincerely say thank you to 637 00:37:28,280 --> 00:37:30,200 Speaker 1: both of you and Jerry and anyone else for pulling 638 00:37:30,200 --> 00:37:32,440 Speaker 1: me through these times, and hope the future contains a 639 00:37:32,480 --> 00:37:35,520 Speaker 1: stable job for myself, more content for yourselves to pass 640 00:37:35,560 --> 00:37:37,359 Speaker 1: on to the stuff you should know, Army, and an 641 00:37:37,360 --> 00:37:39,360 Speaker 1: ever growing fan base that you can both woo with 642 00:37:39,400 --> 00:37:43,000 Speaker 1: your dulcet tones. And then lightening information. Yours faithfully, That 643 00:37:43,120 --> 00:37:48,680 Speaker 1: is Alex gettings from Peth. Thanks Alec, Alex, Yeah, yeah, 644 00:37:48,880 --> 00:37:50,960 Speaker 1: thank you very much. Will you get a job buddy, 645 00:37:51,320 --> 00:37:53,640 Speaker 1: Yeah for sure. If you're in Perthon you're looking for 646 00:37:53,719 --> 00:38:00,359 Speaker 1: an electrician, contact Alex. He's shockingly good. Nice sit there. 647 00:38:00,480 --> 00:38:02,960 Speaker 1: We're ending on that one. If you want to get 648 00:38:02,960 --> 00:38:04,880 Speaker 1: in touch with us, you can tweet to us at 649 00:38:05,000 --> 00:38:07,000 Speaker 1: s y s K podcast. You can join us on 650 00:38:07,000 --> 00:38:09,359 Speaker 1: Facebook dot com, slash stuff you Should Know. You can 651 00:38:09,400 --> 00:38:12,720 Speaker 1: send us an email to Stuff Podcast at how stuff 652 00:38:12,719 --> 00:38:15,080 Speaker 1: works dot com, and as I always join us at 653 00:38:15,120 --> 00:38:22,680 Speaker 1: at home on the web, Stuff you Should Know dot com. 654 00:38:22,680 --> 00:38:25,160 Speaker 1: For more on this and thousands of other topics, is 655 00:38:25,160 --> 00:38:33,279 Speaker 1: that how stuff Works dot com