Week 11 Biochemistry

1) The article “Side Effects Could All Be In The Mind,” discusses research about placebo and nocebo effects. Studies show that it is not uncommon for people to develop side effects from a placebo or miraculously heal from chronic low back pain after a sham surgery. Many people discount the validity of such symptoms arguing, “it is all in the mind,” as if that were an obvious rational for a dismissive conclusion. People have no trouble believing that stress, which derives from a mental state, eventually presents physical symptoms such as, hypertension, stomach ulcers, tension headaches, or heart attack. If a mental state can produce measurable and often irreversible physical symptoms why shouldn’t we believe that the mind can also produce measurable and long term healing from physical symptoms? Bravo to to the author of this article for suggesting we harness the power of the placebo effect, which is really to say that we should pay more attention to the mind as a force for healing.     

        Chinese medicine has understood the integral connection between the body and mind for over 2000 years. Of the 8 branches of Chinese medicine qi gong and meditation are considered the highest forms of healing where as the more physically tangible medicine of acupuncture and herbology are considered the lowest or crudest branches of medicine. Chinese medicine doctors do not distinguish between healing that is due to a psychological versus a physical response and in fact generally believe that one cannot occur without the other.

In the article, “Most family doctors have given a patient a placebo drug,” by Michelle Roberts, it was interesting to note that a treatment with no established efficacy was equated with a placebo. Included in this category were supplements, probiotics, and complementary  medicine. This implies that if we don’t yet understand the mechanism of action for a healing response then it must be a placebo. Placebo is defined by the Oxford dictionary as, “A medicine or procedure prescribed for the psychological benefit to the patient rather than for any physiological effect.” This definition suggests that psychological and physiological responses are mutually exclusive. What hubris to suggest that if we do not understand a healing response it must be, “all in the mind,” as if our minds had nothing to do with our bodies.

Western doctors may recognize the existence of the placebo effect and may even prescribe a placebo from time to time, yet the common notion still seems to be that if a placebo effect occurs then the symptoms must have been imagined in the first place. Perhaps this is a simple case of denial. If people were to accept that they may have some control over their bodies they would actually have to start taking some control over their bodies and doctors might have a lot less business.

         2) Biochemistry can be defined in whatever way makes it useful to those who rely on having it defined, but in the end the subdivisions between scientific disciplines are artificial. I suppose I prefer a broad definition such as, “Biochemistry is the chemistry of life.” Biochemistry is where living and non-living processes meet. They are interdependent which reflects a Chinese Medicine understanding of existence. The processes of our own lives are reflected in the movements of the planets, the weather, and seasonal cycles. Perhaps living and non-living is a continuum rather than a binary state, which is reflected by the fact that Biochemistry is one word.