“Doc Martin” calls vitamins “placebos”

Following my post yesterday about the British television show “Doc Martin” and the use of placebos, I deliberately avoided revealing what the placebos actually were in order not to distract from the main points I wanted to raise. The “placebos” that Doc Martin and his predecessor gave the patient were vitamins.

Now, if you, like me, are a fan of another doc, “Doc” Abram Hoffer, you may object to calling vitamins, “placebos.” Niacin in very high doses in combination with an equal amount of vitamin C and other B-vitamins, is very effective in reducing psychotic symptoms, anxiety, and increasings one’s focus. Ever since I learned about niacin and started giving it to Chris to help his psychosis, I also put myself on three grams per day of niacin,vitamin C, and I added a B-complex and zinc. I got amazing results in just three days. My ability to focus increased about five-fold, my hair got thicker and my skin got smoother. I was less anxious.

People are unique in their nutritional needs. People under stress need much larger amounts of certain B vitamins than they get from eating an otherwise healthy, well-balanced diet. Smoking depletes vitamin C, alcohol depletes the B vitamins, and so on. Don’t assume that vitamins are worthless just because someone calls it the placebo effect.

Doc Martin

Last night the family (parts of it) watched two episodes from the first season of the British television series, Doc Martin. The show is about a London surgeon, Dr. Martin Ellingham, who has developed an aversion to blood and must seek other work in his profession. He is invited to be the general practitioner in a small Cornish town populated with the usual lovable British eccentrics. His lack of people skills when dealing with the locals is the humorous premise for the show.

Readers of this blog may enjoy Doc Martin. Here’s why. In one of the episodes, the doctor finally goes to see a man who has been asking that the doctor come to see him. (As a former surgeon, the doctor doesn’t make house calls. He expects people to come to his office at a set time on a set date.) Finally, he goes to see man, who lives on a remote farm. The farm house is fenced and gated and there is barbed wire on top of the wall. The man insists that the doctor stay for lunch, but it is becoming clear that he is quite paranoid. He has a friend “Edward,”  who turns out to be a giant invisible squirrel. Edward has been invited to lunch, too, and a place has been set for him. The man tells the doc that the former doctor in the village gave him a steady supply of a certain medication, and he absolutely must have a prescription from the doctor before the doctor leaves. The doctor, rightly sensing that the man is “squirrely,” figures out that that the old doctor gave him benzodiazepines to calm him down. But Doc Martin won’t do this. Instead, he gives him a lecture on the damage that long term use of benzos will do. 

I’m sorry to say I can’t remember what ruse the doctor uses to get off the farm. Further into the episode the townspeople and the doctor come upon the man hacking down some birdhouses in a psychotic frenzy. “He’s got post traumatic stress disorder from being in Bosnia,” say the townsfolk. “Just give him the tranquillizers, doc — Old doc so-and so always gave them to him.”

As it turn out, the doctor discovers that old doc so-and-so did no such thing. Rather than give the man benzos, the former doctor was giving him placebos. They were were working quite well, until after the old doc died and there was stretch of time when the town had no doctor and no way for the man to access the placebos. So, Doc Martin continues to give him the placebos, and he gets the man’s agreement to begin some psychotherapy.

I’m looking forward to seeing more of Doc Martin. It will be interesting to see how much alternative medical thinking will be written into the scrip

The placebo effect and the diagnosis effect

There is an article in the Dec. 19 edition of The New Yorker magazine about how the placebo effect is gaining new found respectability. The Power of Nothing: Could studying the placebo effect change the way we think about medicine? The subject of the article, Ted Kaptchuk, Director of the Program in Placebo Studies and the Therapeutic Encounter at Harvard’s Beth Israel Medical Center, believes that if the patient gets better, not because of a drug, but due to the placebo effect, shouldn’t the placebo be considered a useful took in the medical tool kit, as useful as any drug?

The article states that simply believing in the treatment can be as effective as the treatment itself. In several recent studies, placebos have performed as well as drugs that Americans spend millions of dollars on each year.

The New Yorker article started me thinking about how the placebo effect, which we all tend to positively associate with healing, could also be used in the opposite sense – being told you are not going to get better. The placebo effect is often used to demonstrate how amenable the human mind is to suggestion – if people believe they are going to get better, they often do. What then do we make of the mental illness diagnosis, the label that the psychiatrist hands out? The mental health diagnosis, critics charge, opposes the expectation of recovery. The worst mental health diagnosis, the one with the least prospect for recovery (for people who believe what the doctor tells them) is a diagnosis of schizophrenia.

Patients are told by the doctor that they have a life long illness, that can be managed by drugs. They are told there is no hope of being cured. Therefore, the patient correctly internalizes the diagnosis and his actions henceforth tend to uphold the diagnosis. It is my experience that people who reject the diagnosis and/or do not succumb to the medical model of the so-called disease are the ones who cure themselves. Looking at recovery incentives in the hard nosed context of money, the article states: In several recent studies, placebos have performed as well as drugs that Americans spend millions of dollars on each year, one might logically ask, well, why not give schizophrenia patients the equivalent of a placebo – the expectation of being cured? The patient’s mind will take over from there.

The diagnosis effect is much more sinister than the placebo effect, at least from what little we know of how the placebo effect is being manipulated in drug trials so far. The New Yorker article IMHO shows that in the future, it is possible that the placebo effect can be manipulated for noble and not so noble ends. The diagnosis effect, when it comes to a mental health label, casts a spell over the patient, his family, and anyone who connects the diagnosis to the patient.  I have heard people parrot exactly what the doctor tells them — that schizophrenia is life long, that not taking meds leads to relapse, that the disease itself, not the effect of the meds or the natural course of the illness at a certain point, dulls the mind. The family begins to treat the patient as a mental and emotional cripple. Whatever the patient may believe about the course of his condition is negatively reinforced every day by the family and others who believe that the original diagnosis is scientifically factual, and not something that can be tweaked by the power of suggestion.