Thursday, August 14, 2008

Black Holes and the Placebo Effect

Being a scientist -- and an astronomer in particular -- means that I was brought up to view the world in a rational, linear way. In this world view, every condition observed in the Universe is the result of circumstances which can be explained based on physical laws. And these physical laws become clear as a result of observation, experimentation, model building, and theorizing, and then making additional observations to test the theories and models.

Each branch of science, whether astronomy or geology or biology, is a study of a particular class of objects, be it stars or rocks or living organisms. And while scientists build intellectual models to explain what they see -- whether it be a model of the Universe and the Big Bang or the Earth's interior or the nucleus of an atom -- it is important to remember that the model is not reality. It is simply a model.

I decided to become an astronomer the day I learned about Black Holes. I was a senior in high school, and I was taking an astronomy course along with AP chemistry; at the time, I had already applied for college and decided to major in chemistry. But on the day that I learned about black holes, I was presented with a science which accepted the existence of something which could never be proven to exist. That was what intrigued me about astronomy. A black hole has a field of gravity so strong that nothing can escape, not even light. So it is not possible to see one, because no light is emitted or reflected. Not a single photon. And if one could get close enough to **know** that one was visiting a black hole, one would be too close to get away and convey the information. I loved the idea that astronomy accepted the existence of black holes simply on the basis that theoretically such things **could** exist.

Of course, astronomers do see evidence in the Universe of what they think are very likely black hole candidates -- systems with one star orbiting something that cannot be seen, with gas swirling around that something, and as that gas gets closer to the center, strong X-rays are emitted. And although no one will ever **prove** that a black hole is there, most astronomers accept that conclusion. It amuses me that in my astronomical career, I never did study black holes. I just liked that they could exist.

When teaching introductory astronomy at the University, one of the statements I make to get the students' attention is "Black holes don't suck," even though there is a common misconception to the contrary. If the Sun were to be magically and instantly replaced by a black hole of the same mass at the center of the solar system, we would not be sucked into it -- we would continue to orbit the center of the solar system just like we do now. The main difference would be that it would be dark.

Today, I understand my initial attraction to astronomy and black boles as being one of those subjects where science and spirituality meet. And I continue to be interested in the crossroads of the scientific and spiritual ways of looking at the world.

It is curious to me that so much of what scientists accept as true is actually based on faith, although most scientists would deny it. Faith in the assumptions. We assume that the physical laws we discover here on Earth also apply on the Sun, the planets, and throughout the Universe, and that the elements that make up the Earth are the same elements found throughout the Universe. And many of the assumptions that we make are testable and verifiable. But some are not. And yet, the truth of these assumptions is taken on faith.

Because I am interested in the subject of healing, it too provides a topic which is at the crossroads of science and spirituality. And that topic is called the placebo effect. It is well known in medicine that some patients will get better if a doctor says to a patient that a particular drug is very effective, while it is actually made of sugar. In some cases, if a patient believes the pill can be effective, it will be, even if there is nothing in it. The placebo effect is the power of the mind to heal, or healing which manifests based on the belief that healing is taking place. How magical! That the body can heal based on a belief in the mind!!

When I first learned about the placebo effect, I wondered why doctors didn't take advantage of it. After all, if the mind is so powerful, it seems to me that it should be fully engaged in healing. I find it curious that the medical establishment has given this magical effect a label -- the placebo effect. Then doctors and researchers try to find the effectiveness of drugs by doing double blind studies so the mind will not be engaged in healing. And in doing double blind drug trials, they imply that the mind's role should be circumvented, and that it is the drugs that are important.

But in true healing, the mind is continuously engaged. I would like to see drug trials which are triple trials. That is, add to the double blind studies an additional trial to fully engage the power of the mind -- tell people that they are taking a drug and that it is very effective. But science and medicine ignore this potential, this magic, this power of the mind to heal, and they try to find how good their drugs are.

But no drug will ever come close to doing the healing that the body is already very capable of doing on its own.

I say bring on the healing power of mind. Bring on the magic. Bring on the curing. For we are beings with unlimited potential, and anything is possible in this amazing Universe of ours.


#1 Dinosaur said...

There are two problems with testing placebos the way you propose.

One is scientific: as you know, an important part of scientific experimentation is to minimize the number of variables you test at one time. If you want to see what new chemicals (drugs) do for a condition, it makes more sense to look at only its physical effects at first without the potential confounding of the placebo effect. Once those physiological and biological effects are well understood, I agree with you: bring on the magic!

The other problem is ethical concerns about lying: That third study arm you're talking about involves doctors actively lying to patients (by telling them the drug is very effective when they don't really know that.) It's pretty hard to accomplish that in a uniform manner. Perhaps one investigator is much more persuasive than another; again, it's an issue of uncontrolled variables.

That said, I think the placebo effect is routinely used in clinical medicine on a case-by-case basis to very good effect. My only fear about trying to use the placebo effect this way is that if it doesn't work well enough, the patient may come to feel at fault for "not believing hard enough" in its efficacy.

Joyous Judy said...

Dear Dinosaur,

Thank you for your comments.

I understand what you are saying, and yet I do not see a problem with testing the placebo effect. If a drug gets to clinical trials because it worked on animals, it is not lying at all for a doctor to tall a patient, "Here is a very promising new drug." And to be very positive about it. In addition, it would be possible to provide uniformity by making a video, for example, of a researcher describing the promising nature of a drug, and by showing that video to all patients, so they would all get the same positive doctor-based encouragement.

I find it interesting that researchers are not really interested in examining the placebo effect in detail and are more focused on drugs. As described in Depak Chopra's Quantum Healing, it is very possible that the placebo effect is much more powerful than drugs. It is the body's ability to heal that we should be spending more effort in understanding.

And in the end, to me it is the magic of the placebo effect that I find it so amusing that researchers ignore. Since they can't understand it, it isn't factored into the equation of healing. And yet, it gives the medical system room to grow!

Joyous Judy