Friday, September 14, 2012

Placebo/Nocebo/Bad(?) Science

Just a quick post today. Article to finish. Classes to plan. Dissertation to write.

Somehow through the snarl of articles and news and live-tweeting of random events that is Twitter, I've encountered two intersecting items of interest lately that I think warrant further discussion.

The first is this, a Ted Talk that I had somehow never heard of, by Ben Goldacre. Not only is Goldacre great to listen to (as are all Ted Talks, right? You're laughing, you're learning, it's all great fun), but he makes an excellent point about the fuzziness of science, particularly pharmaceuticals. I don't know that I actually realized before that pharmaceutical companies conduct trials not against existing treatments but against placebo. I agree with him--that doesn't seem right. If you're proposing an alternative drug, shouldn't you measure its effectiveness against the current recommendation? Even more problematic and ethically fuzzy is the idea that companies can skew the effectiveness and preferences for the drug by administering existing medications at the higher end of the recommended dosages, artificially increasing the incidents of side effects and adverse outcomes.

Goldacre ends on an interesting point, which reminded me of an article my friend Virginia sent me about a month ago on the "nocebo effect." We all know about the placebo effect--I take a sugar pill in a clinical trial, I feel better because my brain tells my body that it might be getting medicine that makes it feel better. It's an amazing phenomenon that, I agree with Goldacre, we almost take for granted. It is amazing how much the simple availability of medication skews our interpretations of our bodies so much. But lesser known is the nocebo effect, where people experience false side effects from sugar pills. So, the operation is the same but the outcome is different--I take a sugar pill in a clinical trial, and I feel worse because I think I'm experiencing the side effects of the medication.

I can't say much more than summary and awe for right now, but I do think the placebo/nocebo effects are worth some more study, and by rhetoricians in particular. The NYT article about the nocebo effect shows--as have many studies in rhetoric on the discourses of patients and doctors--that the ways that side effects are described situate the expectations of the patient in certain ways. If pain is downplayed, patients feel less pain; if it's emphasized, patients feel more. Certainly the rhetorics we're given, in clinical trials and in popular media, about the benefits and drawbacks of medications are affecting our own perceptions of health and pain as well as how medicine figures into maintaining or avoiding symptoms.

Monday, September 10, 2012

Micro-post: On Crutch Words

I came across (okay, Twitter alerted me to the presence of) this article, "Actually, Literally, What Your Crutch Word Says About You" in The Atlantic tonight, and I was both astonished and disappointed in myself that I use almost all of the major catch phrases on this list.

My biggest offenders:

Actually ("Literally," only with attitude, which is true to how I mean it, so fair enough.)
Basically (I had to edit "basically" out of my previous parenthetical and instead say "true to.")
At the end of the day (Just another version of "basically," right? As in, "cutting to the chase." Whatever. I like it)
For what it's worth (More emphasizing, summarizing. I guess I have a problem with this?)
Seriously and Honestly (To be fair [another one of my crutch phrases], I say "seriously" more on its own. Like, "Seriously? He seriously said that?" Which feels different than the example given. And I always mean "honesty" with sincerity.)
Apparently (You got me there. Use it all the time, probably unnecessarily.)
Like/um (everyone uses those. Get over yourselves, The Atlantic.)

So, the only one I don't really use is "literally," which I guess is a good thing, because at least that makes me more linguistically adept than Joe Biden. Though, for what it's worth, that still isn't actually saying much, at the end of the day. Honestly, and apparently.