Daily Maestroism

DM #155

Tuesday, October 25th, 2016

DM #155: If you google the definition of the the word placebo, the result is as follows: a harmless pill, medicine, or procedure prescribed more for the psychological benefit to the patient than for any physiological effect. The very next definition reads: A substance that has no therapeutic effect, used as a control in testing new drugs.

The discrepancy and contradiction between these two definitions is where the actual problem lies. Somehow we have come to view a “psychological effect” as non-therapeutic. As if when we treat only the mind, we're not having an ‘actual' effect. This is just plain wrong.
We MUST get away from this mechanical model that views treatment of human beings in terms of simply manipulating inert tissue. We are not treating corpses. We are treating a living, breathing, feeling, thinking, emotional, and dynamic system, and as such, we must consider how treatment can affect each of these factors.
Just because we can't “see” the effect, or perceive it as a tissue change, doesn't mean that there was no effect. We can not see or touch wind, yet we do not argue it's existence. One might counter that we know it exists because we can hear it, and we can ‘feel' it. To that I respond, exactly, you've used your other senses to understand its existence. You've used more complex reasoning to understand a complex concept. Similarly, we may not be able to ‘see' the effect a treatment has, but we can use our other senses and hear it in what the patient says, or ‘feel' it how the patient now reacts and responds.
Pain is subjective, and as such, a person's subjective response to a treatment should count towards the validation of the efficacy of a treatment. Unless your patient is a cadaver, you must adopt the biopsychosocial model. Complex systems should be viewed with many different lenses. If you can do it for the wind, you can do it for your patient.
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