10 - Other approaches: learning, expecting, and conditioning

Summary

I have tried to make a coherent presentation of an argument for meaning in medicine. It should come as no surprise to know that, gently phrased, “others disagree.” This is a highly contentious and rancorous business sometimes. In this chapter, I want to show some areas in healing which are similar to the meaning response, but can't be explained by it. I also want to compare the meaning response with other approaches which might overlap with what I have described, and to suggest that the differences may be as much semantic as anything else. In any case, here are some limitations and challenges to the meaning response.

“Conditioning” placebo effects

Dr. Fabrizio Benedetti has done another quite remarkable experiment (Benedetti et al. 1999). It's not easy to explain, so watch carefully. One of the dangers of narcotic painkillers is that one of their “side effects” is to depress respiration; they reduce your ability to breathe. In this experiment, sixty people with lung cancer were having surgery to remove portions of the lung. After the surgery, they were given a narcotic (buprenorphine) through a saline drip. For three days, they would receive a fairly large dose of the narcotic in the morning, and then a much lower dose throughout the day. Dr. Benedetti measured the patient's respiration each day just before the morning dose of narcotic, and then an hour later; he measured the volume of air (in liters) that the patient breathed in a minute.