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Rheuminations: The Power of the Placebo

Simon M. Helfgott, MD  |  Issue: October 2013  |  October 1, 2013

Celebrity Medicine

For some, a quick, easy, and safe fix for whatever ails us is generally preferable to more traditional, riskier therapies, even if the scientific evidence for the former is lacking. In the past, there was Franz Anton Mesmer who, in the 1700s, claimed to have discovered a healing fluid that, when applied to the body, would heal any disease. About a century later, Samuel Hahnemann introduced homeopathy, based on the belief that very small amounts of the same substances that can cause disease can heal it as well. Copper bracelets, magnets, bee stings, and molasses have each had their heyday as treatments for arthritis, and they still generate periodic spikes of intense interest.

Garnering a celebrity endorsement virtually assures the popularity of a remedy. For example, in 2004, Teresa Heinz Kerry, the wife of John Kerry—who was, at the time, running for president—advocated a folksy treatment for arthritis while attending a campaign rally in Reno, Nevada. “You get some gin and get some white raisins—and only white raisins—and soak them in the gin for two weeks,” she explained. “Then eat nine of the raisins a day.”1 Really! How about if I substitute dark raisins for white? Or soak them in vodka instead of gin? Surely the remedy’s specificities add to its mystique.

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Perhaps the most popular dietary manipulation today is the gluten-free diet. There is no doubt that this diet can be extremely effective in managing patients with celiac disease. The problem with the diet is how it is being touted as the panacea for virtually any ailment. Just Google the word gluten, together with the name of any disorder, and you will find links to a world of testimonials confirming the diet’s amazing success. For example, the phrase gluten and lupus generates 2.6 million links, which is about double the number generated by gluten and RA.

Many celebrities have endorsed the gluten-free diet, including the world’s number-one men’s tennis player, Novak Djokovic. In 2010, he was in a rut, frequently losing critical matches. While watching Djokovic struggle through a set at the Australian Open, a fellow Serbian, Dr. Igor Cetojevic, believed he could diagnose his problem. Never mind that Dr. Cetojevic was at home in Cyprus, watching the match on television, 8,700 miles away from Melbourne. He deduced that Djokovic’s breathing difficulties were likely caused by, of all things, a digestive problem. Through a mutual friend, he arranged to visit the tennis star a few months later. What happened next is well summarized in a recent article about Djokovic in The New Yorker.2

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Filed under:OpinionPractice SupportRheuminationsSpeak Out Rheum Tagged with:patient careplaceborheumatology

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