The Nocebo Effect

Just about everyone knows about the placebo effect, where people given a pill report improvement even when the pill contains only inert material. But you may not have heard as much about its opposite, the nocebo effect, where patients describe negative side effects when they are taking those “sugar pills.”

I bring this up because I was asked about such things by the neurologist at my last appointment. One by one he inquired about my experiences with the several medications I am now taking:

So let’s go through them one at a time. First, the cholesterol medication.

Well, I don’t know for sure, but I think it causes me heartburn, halitosis, and borborygmi.

How about the blood thinner?

I’ve noticed that the cowlick on the back of my head is bigger, my back aches all the time, and I have flatulence that you wouldn’t believe … can’t keep papers on my desk in such a gastrointestinal breeze.

Interesting. What of the blood pressure medication?

Lord, Lord, don’t get me started there. My feet itch, my nose won’t stop running, and every day I have ten new wrinkles on my face.

My, my, Dr. Flom, many of these effects have never been seen with these drugs before. How can you be certain which medication is causing which symptom?

A person just knows these things.

How about the small orange tablet that you chew?

That’s the worst of the lot. It gives me hallucinations. Just yesterday I thought I read that the President was going to pardon all of his children, even though they haven’t been charged with or convicted of anything. Sort of a Get Out of Jail Free Card that’s good anywhere. That couldn’t be happening. It must be the orange pill.

The orange pill is just a baby aspirin.

So you say. But how do you really know what they put in those little bottles? If the government really wanted to mess me up they might put nasty stuff in my pills, wouldn’t they? Stuff that would make me forget what I know about aliens and Area 51. Oh yes they’d love that, wouldn’t they? But, heh heh heh, I still remember everything and one day … what was that noise? I know that I heard a voice coming from behind the bookcase …

Nurse, could you be a dear and give psychiatry a ring for me?

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My old home state of Minnesota is now the worst in the nation re: Covid statistics. I knew it would happen, and I know why. When I was growing up there, I don’t remember ever bumping into a Republican. There were only Democrats, everywhere, and the local version of the party was called the DFL … the Democratic-Farmer-Labor party. What a nice, comfy, and inclusive ring that name had.

But then they fluoridated the water, and over time more and more Republicans began to appear until they actually became a major political force in the good ol’ Land of 10,000 Lakes. Residents of the state were faced with a choice – they could have better politics or better teeth, and to my chagrin they chose teeth. That was about the time that I was drafted into the USAF and sent away to another state, and it’s only gotten worse since then.

So when the coronavirus came along, and only one political party started wearing masks and practicing their social distance pas-de-deux, well, it was just a matter of time.

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Here on the Western Slope the Covid numbers are rapidly getting just as unpleasant as they are anywhere else. Our geographic isolation no longer keeps us out of trouble in this department. The combination of tourists passing through town, increased travel out and back by our own citizens, and poorer mask-wearing performance is bringing our numbers up, and up isn’t the direction anyone with a functioning cerebrum wants them to go.

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Friday Robin and I added a chunk to our usual hiking route. It was a steep stretch, maybe only a hundred yards or so in length, but at an angle where your boots slipped backward a little with every step. Without the trekking poles we use I’m not sure I could have made it to the top. At two very brief points the path wandered to the edge of a modest cliff that I could not look down, but just knowing it was there tickled my acrophobia a bit.

I was interested to try it and now I don’t have to do it again. ‘Twas not worth the fright.

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Gotta love this guy. Telling it straight.