tag:blogger.com,1999:blog-1812431336777691886.post1972475762022126964..comments2024-02-29T03:57:00.088-05:00Comments on The Mermaid's Tale: On Being MortalAnne Buchananhttp://www.blogger.com/profile/09212151396672651221noreply@blogger.comBlogger7125tag:blogger.com,1999:blog-1812431336777691886.post-33171245643815917702015-10-06T16:58:08.238-04:002015-10-06T16:58:08.238-04:00Thank you, Ed, for reminding us of these lectures ...Thank you, Ed, for reminding us of these lectures -- we've listened to them, and that was one reason we wanted to read the book. Anne Buchananhttps://www.blogger.com/profile/09212151396672651221noreply@blogger.comtag:blogger.com,1999:blog-1812431336777691886.post-63567167014076435642015-10-06T16:38:59.105-04:002015-10-06T16:38:59.105-04:00For me to recommend, even mention, the Reith Lectu...For me to recommend, even mention, the Reith Lectures from the BBC to you two is something I should re-consider but I just heard one I'd heard before again (NPR). It is almost always you reminding me to check the BBC's website, a jab I don't at all mind but seem not to learn from.<br /><br />This is a remarkable series--great talks, beautifully moderated and the questions from the audience allow Gawande to amplify ideas he mentioned (or didn't have time to talk about).<br /><br />So, here is the link ( < http://www.bbc.co.uk/programmes/b00729d9/episodes/downloads >)Ed Hesslernoreply@blogger.comtag:blogger.com,1999:blog-1812431336777691886.post-38360909577542199442015-09-30T20:25:55.605-04:002015-09-30T20:25:55.605-04:00Thank you. I will take a look. Thank you. I will take a look. Anne Buchananhttps://www.blogger.com/profile/09212151396672651221noreply@blogger.comtag:blogger.com,1999:blog-1812431336777691886.post-48811404134404663582015-09-30T17:58:47.471-04:002015-09-30T17:58:47.471-04:00A timely publication.
JAMA Psychiatry. Published o...A timely publication.<br />JAMA Psychiatry. Published online September 30, 2015. doi:10.1001/jamapsychiatry.2015.1335<br />Association Between Placebo-Activated Neural Systems and Antidepressant Responses<br />Neurochemistry of Placebo Effects in Major Depression<br /><br />Placebo demonstrated in psych. field and a mechanism for placebo uncovered.<br /><br />Thank you for your comments.<br />A. Hotti MDAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-1812431336777691886.post-33132613136034549702015-09-26T16:11:56.515-04:002015-09-26T16:11:56.515-04:00I second Anne's response to your interesting c...I second Anne's response to your interesting comment. I might add (and refer to our recent post before this one, on Lourdes, that many turn in desperation to 'quack' cures or to prayers or other religious types of sources. These probably would have at least some placebo effect. Actually, Zola seems to relate such things (not in placebo terms, of course) in his novel, but I don't know if it has been tested. A Nobel prizewinner in medicine, Alexis Carrel, caused quite a stir when he reported witnessing two cures at Lourdes, around 1910.Ken Weisshttps://www.blogger.com/profile/02049713123559138421noreply@blogger.comtag:blogger.com,1999:blog-1812431336777691886.post-20756404980640829632015-09-26T13:18:05.656-04:002015-09-26T13:18:05.656-04:00Thanks very much for your comment. I imagine it is...Thanks very much for your comment. I imagine it is fascinating to you to see this move toward a return to the way things used to be, in important ways. I remember many times riding with my father, a pediatrician, as he made house calls to his sick patients. Most of what he would ever need was in his black bag, which he still has. But of course that stopped long ago. The end of house calls signaled, I think, a huge change, and not for the better! <br /><br />Very interesting, your comment about placebos. Perhaps placebos will have a place if we really do move in the direction of demedicalizing aging and death. <br /><br />Anne Buchananhttps://www.blogger.com/profile/09212151396672651221noreply@blogger.comtag:blogger.com,1999:blog-1812431336777691886.post-40230382809963573242015-09-26T13:03:26.517-04:002015-09-26T13:03:26.517-04:00I can affirm from personal experience much of what...I can affirm from personal experience much of what you write.<br /><br />I started out many years ago as a physician where there was still overhang from the days when nothing much could be done (except surgery for some conditions) but give comfort. All of my grandparents and many of my parent’s generation died at home, in the years that I was in medical school. <br />Physicians were more universally empathetic, knowledgeable about their patient’s personal lives, and willing to give emotional support by their presence and putative knowledge. They regularly made house calls. I made house calls, often just to soothe the anxiety of a new mother with a feverish child. This was all normal and accepted.<br /><br />The miracle of antibiotics was evolving, and drove the notion that medical diseases could actually be cured! The mode in Medicine changed. <br /><br />The scientific basis for medicine started in the ‘30’s and was beginning to bear fruit in the ‘50’s. I heard only bits and pieces about studies/research during med school. Medicine was still experiential and dogmatic. It wasn’t until my postgraduate years at a notable Medical School, that medicine was taught with the use of “scientific studies”. An obeyer to science was emphasized.<br />Sadly, younger physicians became more distant from their patients, emotional support as therapy was used sparingly, because now science provided that which the physicians assumed the patient wanted and needed, a cure (or at least physical relief). Physicians easily relieved themselves of the emotional (and time/financial) burden of providing “personal emotional care” and all that that entails.<br />Dr Gawande, it appears, started and grew up in this latter medical climate. He never had any experience with the old model. He, as much of Medicine is, is now going through the epiphany that he describes. <br /><br />What I feel is missing from much of discussion is the powerful effect that Placebo has. When individuals are experiencing mental distress like pain, hopelessness, anxiety etc. placebo pills can provide relief in as much as 25- 50% of the cases. This is apparent in studies on the efficacy of new drugs for mental illness, when the results show that regularly 25% (or more) of patients receiving placebo control respond favorably. <br />A caregiver’s “personalized” presence is a powerful tool to mitigate distress.<br />Anonymousnoreply@blogger.com