Placebos, not pills The Anatomy of Hope:
How People Prevail in the Face of Illness
By Jerome Groopman
Random House, 2004, $14.95 The Role of Complementary and Alternative Medicine:
Edited by Daniel Callahan
Georgetown University Press, 2002, $29.95 The western medical establishment and drug industry have an uneasy relationship with the placebo effect. Both acknowledge that patients often benefit from their own expectations. But neither seems willing to support efforts to study the underlying physiology of the effect.
After reading Jerome Groopman’s The Anatomy of Hope and Daniel Callahan’s The Role of Complementary and Alternative Medicine, and much of the body of peer-reviewed research on the biological basis of the placebo mechanism, one begins to understand why placebo-enhanced healing gives doctors pause. There is growing evidence of its existence but little conclusive data as to how and why it works. And there is even less research on how to best manipulate the effect for the welfare of patients.
Groopman is a Harvard Medical School physician and a New Yorker writer whose articles offer a rare glimpse of the difference between the way medicine is taught and the manner in which it is practiced. For almost 20 years, Groopman suffered chronic and debilitating back pain. As we come to learn in Groopman’s memoir, the placebo effect, set into motion by the encouragement of a straight-talking yet exceedingly empathetic doctor at a small physical-therapy clinic near Boston, played a pivotal role in his recovery. Anatomy of Hope describes Groopman’s road to recovery and the lessons he learned from it that now inform his work as both a teacher and a clinician. The book is a testament to the power of the human spirit – and to the health and economic value of the placebo effect – from a highly credentialed member of the medical establishment.
Callahan approaches the issue of healing from a different vantage. He is not a physician but a philosopher. Callahan is cofounder of the Hastings Center in Garrison, NY, which is devoted to the study of bioethics. He is very much outside of the medical establishment but has featured prominently in every major biomedical debate in the United States in the last 35 years. This book is a collection of essays and reviews on the subject of alternative medicine and the placebo effect. Callahan says in his introduction that he compiled the book in an attempt to understand why a “large and prestigious group of clinicians and biomedical researchers seems so utterly hostile to [alternative medicine] while a large portion of the public (and the educated public at that) seems so attracted to it.”
These two authors each have their own reasons for being intrigued by the power of the placebo effect. But a common theme can be found in both books – namely that the placebo effect is not a figment of a patient’s imagination. And there are now technology and studies to prove it.