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After the Golden Age by Alvin Schwartz
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AFTER THE GOLDEN AGE for 02/24/2003
Volume 2, #68

Some Thoughts on the Placebo Effect

I have long been fascinated by that mysterious feature in medicine known as the placebo effect. Recently, I have been doing a great deal of reading on the subject and my fascination has only grown. It's not an academic curiosity on my part, but a fully existential one. And because of my history and the nature of my experience, my placebo speculations tend to get tied up with my interest in superheroes. I know quite a number of cultural anthropologists who have been interested in the phenomenon of the rise of the comic book superhero- Superman, Batman, the Flash, Wonder Woman-that whole arcanum that developed out of a period of war and depression at the high point of a civilization that had only recently arrived at a kind of universal leisure, a nearly planet-wide sense of belonging and connectedness, of a universal humanity-which almost overnight, it seemed, spawned one of the most dreadful, widespread and inhumane wars ever experienced on this globe---following the sudden decay into barbarism by one of the highest of our human civilizations-the civilization of Germany.

There have been other ghastly periods in human history-years marked by endless wars, brutalities, plague, famine and unimaginable suffering. But these were merely high points of hellishness in the history of a humanity that was never quite free of some or all of it. Not until the beginning of the twentieth century did a large portion of humanity arrive at a kind of security and physical comfort that was no longer purely local, was, in fact, almost global-at least it had mostly spread over the entire northern part of the globe. Not perfect by any means, but the best we had ever known, coming just before the worst we had ever known-the death camps (not new in themselves) suddenly combining with the rocket-bomb, the fighter plane and the atom bomb in a kind of humanly created, widespread and almost instantaneous plague. At the very nadir of this vast tragedy, the new superhero was born. In previous times of widespread stress new religions and religious heroes, new gods, in fact, suddenly made their appearance. But Superman (and his superhero ilk) was something different in kind. He was utterly superior and yet totally devoid of any numinous quality. In other words, he was not a god and never mistaken for one. Yet he represented a kind of savior, even a messianic one, without the numinous features. How does one explain that? How can there be a savior without salvation? And a commercial success to boot?

It's easy to say that there's always something new in history-that underneath the various cycles-a certain novelty also gets introduced. That's part of it. And it's too big a subject for me to go into here. But now, I'm ready to expand some of my notions of the placebo effect. Mostly, we think we know what it is-the body curing itself because of a non-medicine that the mind has been convinced has healing power. So, really, it's our own healing power that does the work under the right conditions.

Well, yes and no. New research has been demonstrating that the effectiveness of so-called real medicine may, in fact, be no more than the placebo effect itself. There are, furthermore, numerous cultural anthropologists who have claimed that in the history of any isolated people-people in well functioning closed societies-the level of cure at the high point of such societies-has always been about the same. In other words, the medical system of any definable closed social order reaches about the same levels of cure as any other. It's as though a healthy society is, in fact, a kind of organism, that contains its own form of ritualized medicine and healing levels. In such a case, a plague or vast debilitating disease afflicting many people is a sign of societal breakdown and not, as we tend to believe today, the effect of a virus or a bacterium that has broken out of control. Let me add here that with the ongoing decimation of whole populations in Africa and parts of Asia by HIV, I am very much in favor of abrogating the so-called patents of the pharmaceutical companies in favor of a vast free distribution of the various HIV anti-viral formulations. I say this knowing that this simply can't be done. The placebo effect tells us, ultimately, that the ability to heal by believing something, whatever the sources of that belief-a strong social acceptance of a certain notion of medicine, as in our society-is de rigueur for the African situation. Our North-American/European society with its financial foundation would, to begin with, militate strongly against the possibility of providing free drugs to all of Africa. Consider too that a nation like South Africa could have produced its own drugs, and probably would have, except that South Africa never accepted the idea that HIV was a sexual disease. In the nineteenth century, here in North America and Europe, the shame attached to syphilis made a cure impossible for a long time, and prevented the development of what we now call "the germ theory of disease." But once this idea was accepted, the placebo effect began to operate. That is, there came into being the necessary congruity between belief and external action.

I think, in this column, I've bitten off something that I'm not going to be able to present as fully as I'd like in this limited space. The best I can do here is offer some limited ideas and suggestions-somehow to point the way, mark out a direction. Some of you will see it and that's the most I can hope for here.

So now, let's try to clarify the connection between the placebo effect and the unique superhero of the late thirties. I think we must understand first of all that the placebo effect is an aspect of a certain tie to the infinite that is present in the mind of every living thing. I tried to suggest this by referring in my recent memoir, AN UNLIKELY PROPHET, to the physicist's David Bohm's description of the dissolution of an ink drop in a vial of glycerine and its consequent restoration by reversing the procedure that had dissolved it. Bohm was expressing, among other things, that underlying tie between the particular and the infinite. The placebo effect, as I see it, is one of the subtle manifestations of that tie. In infinity, sub specie aeternitatis, horror loses its uniquely negative focus and is diluted by its opposite. Bohm understood what Kierkegaard, quoting Socrates, meant when he said: "The problem is to bring the opposites together." The reality and the healing power lies in that bringing together. The placebo effect is not something in us. It is our link to the infinite and for those of us who dare to examine and understand it-it becomes the rescuer. And while it works even for those who are persuaded that "it's the real medicine"-it will always work for those of us who learn to seek it out. As for the superheroes who rose out of war and depression, they were effectively the "fallout" of a very bad time. They were pointers, reminders, the bright penumbrae of the positive. Haloes of the infinite is a term I like to use. And thinking of them that way made it interesting for me to work on characters like Superman. Years later, just before I left comics, times had changed. The horrors were gone. The haloes needed to be dimmed down. That was when I introduced Bizarro.

Alvin

<< 02/17/2003 | 02/24/2003 | 03/10/2003 >>

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