The Good Rush
I wish we could use placebos in the ER, if only for our own amusement.I'll never forget the last time I saw one given. The guy was a "chronic pancreatitis" patient who we saw fairly often, without clear evidence of disease. Because he was polite and I'm a softie for that approach, I agreed to order him some Demerol and Phenergan, and I happened to be in the room as the nurse was preparing to give the injection.
As the nurse slowly pushed the syringe full of fluid into his IV, our patient was watching her as intently as a cat stalking his prey. He then laid his head back, sucked in a breath through his remaining teeth, and let out a satisfied "Ahhhhhhh."
"That was just the flush," said the nurse.
posted by scalpel at 5:25 AM
17 Comments:
I happened to suffer some psychosomatic problems. After visiting a psychologist for a totally unrelated issue, she pointed to the fact that those physical problems could be 'unreal'. Soon after that they were gone.
I find brains to be such a weird/amazing thing.
Heh. I once put myself into labor. I showed up for my induction and truly believed that they had started the Pitocin. Imagine my surprise when the nurse came by several hours later to say they'd be starting the Pit soon! (Yeah, you can imagine how happy I was to have been stuck in a room and essentially forgotten about for five hours. Yay military healthcare.) I didn't even want the induction, though.
Yeah, I've seen that phenomenon. Sometimes the patient would start getting a "high" as soon as they spied the syringe in my hand when I walked into the room.
I'm just a dumb med student, but my biochem prof sez Diet Coke can provoke an insulin response even though there's no glucose in it, so there's that.
Anybody surprised by this just has to think back to Pavlov's salivating dogs. The brain unconsciously controls a lot more of us than we like to think.
What is it they say about faith going where meds can't? Faith that you're sick is pretty strong, I'd say. Now, where'd I put my diving rod?
Faith is one word for it. Belief might be more concise. There's some very cool research yet to be done in this area, I think, and it'll play out partly in the nation's ED's.
Hey, cool article, Febrifuge, thanks for sharing. I've always been interested in the placebo effect and its success rate. It says a great deal about our brain's ability/desire/expectation to feel better, doesn't it? I'm curious to know that if a patient's symptoms return after realizing he's been given a placebo. Ah, the brain giveth, and the brain taketh away.
I worked with a guy who would say "this is a very powerful new medicine called ibuprofen. You aren't driving, are you?".
ah the old normazaline. good drug.
Ah, platypus, that sounds like a Navy doctor there! My husband & I used to make jokes about "Motrin the Wonder Drug;" no matter the complaint that was given.
I happened to suffer some psychosomatic problems.
The old law is: If you come in to the ER with more than 3 unrelated complaints, you diagnosis is "depression" or "anxiety".
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Nurse Kelly, it wasn't never as bad as to visit the ER. But you are 100% right, it was depression AND anxiety. That was 3 years ago and I'm much better, but still visiting my therapist every week.
Someday soon I will write about it in my blog, but it's a long story and don't want to depress my readers ;-)
I'm sort of partial to the "Supreno EC" patch to the forehead of a patient complaining of a headache. Also works on combative patients who really need Haldol or Ativan......
(Supreno EC is a brand name of glove that our service puts in our rigs. The patch is usually an EKG electrode or a Tegaderm)
Now that's just frightening... Now I see how doctors really think after being on this site and somehow I can't stand them even MORE NOW than when I was dumb enough to work with them.
As a fresh Intern in 1988 I had a patient in the county health dept clinic who needed a refill of "HT221"..even had her empty bottle. Assuming it was some chemotherapy drug..I searched through the PDR before making the call of shame to the pharmacy to ask what the hell it was. Turns out it was the pharmacy's official placebo..only available with no refills and reviewed by the hospitals chief medical officer.
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