By Hope Ditto

You don’t have to agree with Congresswoman Gabrielle Giffords’ politics to admire her strength and courage of conviction – her unwavering spirit and refusal to give up throughout both her career and her recovery are emblematic of what it means to be a Disruptive Woman (hence why we bestowed Congresswoman Giffords as an honorary Disruptive Woman a few months back).

While Giffords might not have spent the past year leading our country in Congress, she has spent it leading by example. When Giffords and her family and friends spoke with ABC News’ Diane Sawyer and gave all of us the opportunity to witness her remarkable recovery firsthand, she taught us many important lessons about strength, courage of conviction and refusing to give up on your dreams (not to mention about her remarkable medical and rehabilitation teams and the role of musical therapy, a treatment pioneered by Disruptive Woman Concetta Tomaino, DA, MT-BC, LCAT, all of which we shared with you in a past post).

This weekend, Giffords demonstrated once again what it means to be not only a Disruptive Woman but also a leader, and taught us all yet another lesson, this one in humility, when she announced in a video message to constituents and supporters that she would be resigning from Congress this week.

In the video, posted to her campaign website, Giffords thanked viewers for their support and then broke the news, stating, “I don’t remember much from that horrible day, but I will never forget the trust you placed in me to be your voice. Thank you for your prayers and for giving me time to recover. I have more work to do on my recovery so to do what is best for Arizona I will step down this week.”

Watch the full video here:

Rep. Gabrielle Giffords Steps Down from Congress

Don’t for a moment think that Giffords is calling it quits for good, though (after all, that would NOT be the Disruptive thing to do). As she states at the end of her two-minute message, “I’m getting better. Every day, my spirit is high. I will return and we will work together for Arizona and this great country.”

No matter what she has in store for the future, one thing is for sure – Congresswoman Giffords is an inspiration with an indomitable spirit and we cannot wait to see what Disruptive thing she does next!

Stay tuned for more information on Health in Place Launch, but in the meantime enjoy some photos from the event!

The fabulous and disruptive panelists (from L to R): John Marttila, Pam Cipriano, Halle Tecco, Jack Lewin MD, and Robin Strongin

Robin Strongin and Halle Tecco

Robin Strongin discussing HIP

Disruptive Women is proud to annouce our December Man of the Month Claude Gerstle. Claude was dedicated to patient care for over thirty years before he became disabled in a bicycle accident. He founded a full service ophthalmologic clinical practice that focused on the diagnosis, management and surgical/medical treatment of ocular diseases. Though Dr. Gerstle can no longer serve his patients needs, he still loves medicine and science. He has always been active in MIT, where he graduated in ’68. For the last three years he has been a trustee of MIT’s Corporation.

By Claude Gerstle. I became involved with stem cell research eight years ago after I suffered a spinal cord injury while riding my bicycle. Once I was well enough to travel, my daughter took a leave of absence from work and we spent two years traveling around the country visiting doctors, ethicists and politicians making a documentary about the social issues raised by embryonic stem cell research (TheAccidentalAdvocate.com). I became very excited about stem cell research and its potential to provide treatment for some of our most intractable diseases.

In 2005 Dr. Hans Keirstead atUniversityof California Irvine published some remarkable results demonstrating the ability of a stem cell treatment to enable spinal cord injured rats to walk again. Cheer on Corporation applied to the FDA for clinical studies using his technique. There drug application, over 20,000 pages long, took almost 6 years to receive approval. Despite all their hard work, in November 2011 they announced they were pulling the plug on this research project because they will not be able to afford the money and time needed to make a commercially viable product.

While disappointing, this is not the death knell of clinical stem cell research. As an ophthalmologist I recently chaired a panel of stem cell researchers who have made impressive progress working on retinitis pigmentosa and macular degeneration. Treating an eye disease has some advantages over treating a disease of the nervous system. Cells introduced into the eye are in a more confined space and less likely to migrate out of the area. Treatment can be done in one eye without affecting the other eye and the natural history of the disease is better understood allowing treatment to be started an earlier stage where less damage has occurred. (more…)

By Hope Ditto

For me, November’s Man of the Month needs no introduction (… because he is my father). For the rest of you for whom he is not a genetic relation, here goes…

The Disruptive Women in Health Care team is pleased to introduce our November Man of the Month — Dr. Peter Ditto, Department Chair and Professor of Psychology and Social Behavior at University of California, Irvine and a leading authority on the psychology of advance medical directives and end of life decision making.

Dr. Ditto is best known for the series of studies he conducted examining key psychological assumptions underlying the effective use of advance medical directives, so much so that he was one of the few psychologists invited to participate in the 1993 Squam Lake conference convened to establish a national agenda for research on advance care planning. He is also a member of the Advisory Panel for the American Psychological Association’s Ad Hoc Committee on End-of-Life Issues.

I sat down with Dr. Ditto (who I more commonly refer to as Dad) to learn more about the psychological aspects of end of life decision making, his research on the subject and more.

You often use the Terri Schiavo case  as an example of the decision making challenges families who must make choices about the use of life-sustaining medical treatment for an incapacitated loved one face. In what ways does the Schiavo case encompass your “traditional” case? In what ways does it diverge?

In many ways, the Terri Schiavo case is not at all typical.  She was a young woman who was struck down unexpectedly in her 20’s. Most end-of-life decision making occurs with elderly people, often with a lot of advance warning that a situation is approaching where the person is going to lose decision making capacity. It is actually interesting that the cases that have most captured the public’s attention and most shaped law and policy on end-of-life decision making have involved these quite rare and unusual cases of young people left in persistent vegetative states (Schiavo, Karen Ann Quinlan, Nancy Cruzan). This is likely because these are cases where the issues are displayed most poignantly – a person who has lost the ability to speak for themselves, about whom everyone is uncertain what the incapacitated person would want done if they could speak, and where family members (and public opinion more broadly) have strong and differing opinions about what is the morally appropriate course of action.

But it is important to point out that these are exactly the problems that occur writ small – in less dramatic and less poignant forms – in homes, hospitals and hospices every day in the US. It is typically older people who have become too sick to speak for themselves, have not completed a little will or conveyed their wishes in any way to their loved ones, and this uncertainty can easily lead to family conflict because people have differing beliefs about the person’s likelihood of recovery, and bring different moral views and emotional vulnerabilities to the situation.

You say that, while many think the presence of a living will would have negated what quickly disintegrated into an ugly situation for the Schiavo and Schindler families, it is not always that simple. What steps can people take to avoid (to the extent it is possible) leaving their loved ones in a similar situation?

In many ways, my scientific work on end-of-life decision making can be seen as a psychological critique of living wills. The problem with living wills isn’t the idea – it is a wonderful and noble concept to try to honor people’s wishes near the end of life by having them record those wishes while they are still able – it is the execution. Quite simply, it is just a really difficult situation to find oneself in, and there are no simple band aids that are going to fix it all up. (more…)

By Glenna Crooks. It’s hard enough to be a parent these days, right? It’s harder still if your kids are ill. And really difficult when – as is increasingly the case – their condition is chronic and you, they and the adults who are there when you are not there must manage a regimen of care.

An increasing number of kids need some sort of special care: dietary management, medication management and ‘rescue’ strategies for medical crises and allergies. Some of these conditions are life-threatening and improper management can be deadly.

It’s hard enough to make modifications, even at home. Imagine what it’s like at school. If you don’t have a child in school, you may not realize how incapable schools are of meeting special needs. Worse yet, many schools have zero tolerance policies where medications are concerned. This means that even if a child is capable of managing their own medications, they may not have ready access to them.

So what happens when a school has a zero tolerance policy? I’ll never forget the experience of a youngster, who at the end of a focus group we conducted to explore asthma issues with poor children in Atlanta, cried. The tears came because the focus group facilitator hugged him in thanks for giving up his Saturday morning cartoons to come. Asked why, he told us that because he had to go to the nurse’s office to get his medication other kids thought he had HIV and so would not play with him. No one, he said, would touch him. My heart aches for that boy.

It aches and rages for the family whose 11-year old son died for lack of the inhaler he needed for his asthma. Though the school had a policy of making exceptions for inhalers, his parents had not been informed, the inhaler was in the admistrator’s office and the delays in medication administration cost his life. I doubt the $2.2 million negligence award was sufficient to ease his Mom’s suffering. (more…)

Briefing Transcripts Available

Please take a look at the transcripts for the Alliance for Health Reform briefings below. The webcasts and podcasts from these briefings are also available, brought to you courtesy of the Kaiser Family Foundation.

The Innovation Center: How Much Can It Improve Quality
and Reduce Costs – and How Quickly?

The new Center for Medicare and Medicaid Innovation seeks to test innovative health care payment and service delivery models that can potentially enhance quality of care for beneficiaries while reducing costs. How is the center planning to administer its $10 billion in funding? What early projects is the center undertaking? These questions and others were addressed at this briefing cosponsored by The Commonwealth Fund.

Click here for the transcript, webcast and podcast, as well as individual speaker videos and resource materials, including speakers’ PowerPoint presentations.

Preventing Chronic Disease: The New Public Health

The nation is facing an epidemic of chronic disease. To try to stem the tide, many efforts are underway in local communities to support healthier lifestyles and help people make long-lasting and sustainable changes that can reduce their risk for chronic diseases. Can this focus on the new public health be sustained in light of budget constraints on the federal, state, and local levels? How are resources in the $15 billion Public Health and Prevention fund, set up under the ACA, being deployed? This briefing, cosponsored by the Robert Wood Johnson Foundation, addressed these questions and more.

Click here for the transcript, webcast and podcast, as well as individual speaker videos and resource materials, including speakers’ PowerPoint presentations.

Caring for People Covered by Both Medicare and Medicaid:
A Primer on Dually Eligible Beneficiaries

This was an introductory session designed to inform the staff of new members of Congress both in Washington and in district or state offices about the people who receive benefits from both the Medicaid and Medicare programs (often called “dual eligibles”). Who is dually eligible for Medicare and Medicaid? What are the characteristics and needs of this population? How do Medicaid and Medicare coordinate payment and care for this population? What federal and state barriers complicate these efforts? The briefing, cosponsored by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured, answered these and other questions.

Click here for the transcript, webcast and podcast, as well as individual speaker videos and resource materials, including speakers’ PowerPoint presentations.

Keeping Coverage Continuous: Smoothing the Path
Between Medicaid and the Exchange

A key design challenge for those tasked with implementing the health reform law is how to manage this “churning” phenomenon — when people cycle in and out of public programs as their income varies — so that care is not interrupted. What approaches are states and the federal government taking to minimize the disruption from churning? Will people be able to keep their provider as they move across the Medicaid – exchange divide? How can private insurers and Medicaid overcome possible technical and cultural barriers to a cooperative working relationship? What issues must states consider as they establish “no wrong door” eligibility determination processes for Medicaid, CHIP and health insurance subsidies? This briefing, cosponsored by The Commonwealth Fund, answered these questions and more.

Click here for the transcript, webcast and podcast, as well as individual speaker videos and resource materials, including speakers’ PowerPoint presentations.

The Alliance for Health Reform is a nonpartisan, not-for-profit health policy education group. We are committed to helping journalists, elected officials and other shapers of public opinion understand the roots of the nation’s health care problems and the trade-offs posed by various proposals for change. Our aim is quality, affordable health coverage for all in the U.S., although we do not lobby or take positions on legislation. Sen. Jay Rockefeller (D-W.Va.) is our founder and honorary chairman; Robert Graham, MD, of George Washington University, is our board chairman.

By Glenna Crooks. In February, just in time for Valentine’s Day, I wrote about chocolate and how countries with higher rates of chocolate had greater levels of satisfaction with health care. As one reply noted, it’s not a perfect correlation and causation can’t be established, but I was intrigued when the disparate bits of data showed up in my mail that week and couldn’t resist. Besides, it was partly blogged in jest, though I do look under ever rock to see if we can improve US health care.

If you want to refresh your memory about it, you can check it out at http://www.disruptivewomen.net/2011/02/07/chocolate-a-new-secret-weapon-for-health-care/#comments.

Now, comes a study from the British Medical Journal of findings presented at the European Society of Cardiology Congress recently in Paris that might explain (at least in part) why chocolate and satisfaction might be related.

Perhaps people in higher chocolate-consumption countries are happier with their health care system because they don’t use it. I wonder?

According to the article, high levels of chocolate consumption appear to be associated with a 37% reduction in heart disease and a 29% reduction in stroke. Both are major causes of admission to hospitals in this counry.

Frankly, I’m pretty happy about the US health care system when I don’t have to use it. Now I know a European secret…eat more chocolate and stay out of the hospital. I can’t think of a more palatable form of prevention.

Earlier this year, author and Huffington Post contributor Brienne Walsh wrote an impassioned essay entitled, “An Open Letter to the Women Who Are Telling Me It’s My Fault I’m Not Married,” much to the pleasure of single women across America. In it, Walsh suggests that it is women’s lack of expectations for men and their dating behavior that creates the uneven power structure so prevalent in relationships – and fictional portrayals of relationships – today and therefore prevents women from feeling fulfilled in relationships, which in turn then leads to more and more women remaining single. She blames a culture that will go so far to accommodate a man’s “fear and insecurity” of marriage, among other things, for the growing trend of women never making that much-anticipated trip down the aisle.

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The following is a guest post by WomanCare Global CEO Saundra Pelletier. Besides serving as the founding CEO of WomanCare Global, Saundra is an international marketing expert, published author, keynote speaker and executive coach.

By Saundra Pelletier. In 1965, Griswold v. Connecticut gave a married woman the right to use birth control to prevent or delay pregnancy as she saw fit. This guarantee of a basic human right led to other reforms that allowed millions more American women to decide the direction of their own reproductive lives.  This summer, we are proud to see another key reform go through: starting next year, the Affordable Care Act will allow even more women in the United States to be in charge of their own health by requiring new health plans to provide free birth control without a co-payment. These are hard-fought wins for women’s health and for women’s rights of which we can all be proud, but sadly the ability of a woman to choose when and whether to become pregnant is far from assured in other parts of the world.

Pause for a moment and imagine you’re not American, but from Sub-Saharan Africa – Ethiopia for example. You are 20 years old and have four children – the first of which you had when you were 15 and newly married. You’re worried about becoming pregnant again. You tried to get birth control once, but arrived at the clinic only to find the shelves bare and no way to access any form of birth control.  The thought of another pregnancy, whether by a husband who won’t take no for an answer, or by a stranger who might force his way upon you while making your way to fetch water for the family is overwhelming. You’re not in great health, and another pregnancy would take its toll on your weakened body. The chances are high that you might not survive pregnancy or labor to be able to take care of your family.

Globally, 215 million women would like to be able to prevent or delay pregnancy, but do not have access to the supplies that would allow them to take control of their lives. As American women, we know from our own experience that the ability to make our own fertility decisions has made an immeasurable impact on our own lives. For women in the developing world, access to reproductive health supplies would save lives and improve health, as well as the economic and social well-being of families and communities.

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It is estimated that women make up about 14 percent of the armed services and of the roughly 2.2 million troops who have served in Iraq and Afghanistan, more than 255,000 have been women. They are at-risk for a variety of serious and intriguing mental and physical conditions that are not well understood.

The 2011 SWHR X-Conference will highlight the sex-differences in a number of conditions that affect female veterans who have been exposed to military combat. Topics will include Post-Traumatic Stress Syndrome (PTSD), Depression, the Musculoskeletal System, Urogenital Issues, and Traumatic Brain Injury (TBI). The nature of the conference will be translational and will feature talks from basic scientists, as well as military health professionals. Panelists will discuss the biological basis for the specific sex-based differences, and then describe the clinical features of these conditions to a diverse audience of scientists, policy makers, practitioners from both within and outside the Veterans Administration, and the media.

Conference highlights include:

• the state of the art on military combat exposure for female veterans,
• the available data on the biological and clinical features of selected health problems,
• a dialogue for designing basic and clinical research studies to address the above challenges.

Click Here to View the Agenda

To Register: Registration fee for the conference is $35 per person, $20 for students. SWHR, in partnership with the National Association of Nurse Practitioners in Women’s Health (NPWH), is offering 5 CE credits, including 1 pharmacology credit, for attending this conference. The fee for receiving CE credit is an additional $100. Click here for more information.

By Archelle Georgiou. There have been several blogs and articles written on the grammatical appropriateness of “health care” versus “healthcare.”  In Michael Millenson’s post on The Health Care Blog, he explains that the Associated Press (AP), which dictates journalistic style standards, says the correct usage is “health care.” Two words. Most major journals, newspapers, and media sites follow this convention, but it may not be the end of the debate.

There is an equally accepted convention that says that “health care” is correct when there is reference to a provider’s action, and “healthcare” is used when it is an adjective to modify another noun or verb—healthcare system or healthcare marketing—for example. And, there are many sites that shift, very consistently, between these two approaches depending on the sentence structure.  

I can live with 2 different literary conventions … but here is what is keeping me up at night and: literary styles change. 

“Airline” used to be “air line” and “website” was formerly “web site.” Similarly, there is pervasive evidence that the “health care” is turning into “healthcare.” In my own cursory review of sites that I respect–WebMD.com, Kaiser Family Foundation, the Institute of Medicine, I found that “health care” and “healthcare” are used interchangeably without grammatical rhyme or reason.

So, why do I care? And, why should you care that the adjective, “healthcare,” is well on its way to becoming a noun or a verb? In fashion, style changes drive revenue. On Twitter, eliminating the space creates capacity for one more character. However, in health care, eliminating the space and turning two words into one, will have a negative impact on people, their well-being, and thereby, worsen an already deteriorating system.

Take a moment to do an experiment:

1)    Write the following sentence on a piece of paper: Healthcare is important.

2)    Show the paper to a few different people, and ask them to explain what the sentence is referring to when it says “healthcare.” Listen for the meaning they ascribe to the word “healthcare.” What is the first thing they say? Most likely, they refer to insurance, access, costs, and/or health reform.  Do any even refer to the quality of care that they receive from doctors or other care providers? Do they refer to the importance of their own lifestyle behaviors? Probably not. In my experiment en route from Minneapolis to San Diego yesterday, with an n=5, only XX said anything about care, and only as an after thought.  (more…)

FutureMed, the first program of its kind, is an executive program for physicians, healthcare executives, innovators and investors that focuses on exploring the impact of rapidly developing technologies. FutureMed will be held May 10-15 at Singularity University on the NASA-Ames Research Park in Silicon Valley.

Few fields have the potential to evolve more dramatically through disruptive, exponential technologies than healthcare. Low cost genomic sequencing and proteomics, ever-faster and higher-resolution imaging, artificial intelligence, telemedicine, stem cells, robotic surgery, smaller and more capable implantable and wearable devices, ubiquitous mobile applications, nanotechnology and synthetic biology–these and other game-changing technologies and innovations have tremendous implications for medicine, healthcare and the biomedical industry in the decade ahead, including the potential enablement of better, more accessible care at lower costs.

The five-day, intensive FutureMed program includes lectures, workshops and site visits that are led by notable faculty from the fields of medicine, biotechnology and innovation. CME credit is available for clinicians. In attendance will be world-class innovators and thought-leading faculty across multiple disciplines.

Some of the FutureMed faculty include:

• Peter Diamandis MD, Chairman of the X-PRIZE and co-founder of Singularity University
• Tim O’Reilly, Founder and CEO of O’Reilly Media
• Dean Ornish MD, Founder and President, Preventative Medicine Research Institute
• Thomas Goetz MPH, Executive Editor WIRED, Author of ‘The Decision Tree’
• Dan Barry MD PhD, 3 time Space Shuttle NASA Astronaut and Roboticist
• Catherine Mohr MD, Director of Medical Research, Intuitive Surgical
• David Ewing Duncan, Author of ‘Experimental Man,’ and the ‘Personalized Medicine Manifesto’
• Randy Scott PhD, Founder and Chairman of Genomic Health
• Roni Zeiger MD, Chief Health Strategist, Google
• Christopher Longhurst MD, Chief Information Officer for Packard Children’s Hospital, Stanford Medical School
• Michael Gillam MD, Director of the Microsoft Medical Media at Microsoft Health
• Allan May, CEO of Life Sciences Angels
• Michael West PhD, Founder of Geron and BioTime Pharmaceuticals

A full list of faculty is on the FutureMed web site.

Core tracks include those which will explore the exponential trends in Information & Data-driven and Internet-Enabled Health Care, Genomics and Personalized Medicine, Regenerative Medicine, Robotics & Future Interventional Approaches, NeuroMedicine, Device & Drug Development, and Entrepreneurship.

Click here for more information or to register. Follow FutureMed on Twitter @futuremedtech and at facebook.com/futuremed.

The following was published online by Nature on April 21st.

By Anu Acharya. With careful due diligence, help from financiers and a keen eye, even small companies can grow through mergers and acquisitions.

The word ‘merger’ often is associated with a big company buying a smaller one or two large companies coming together. But it is not only large companies that can succeed through acquisitions—even startups can use mergers as an effective way to grow their businesses. As a small team leading the startup Ocimum Biosolutions, based in Hyderabad, India, a decade ago, my colleagues and I could have opted to grow the company internally. But early on, we decided to take the path of mergers and acquisitions (M&As) to expand our company.

We had difficult choices to make as our business grew, and we learned invaluable lessons. Here, I share some of my experience and show how Ocimum evolved from a small company into a globally integrated genomics firm.

Ocimum’s long evolution

Ocimum Biosolutions currently offers informatics solutions, wet lab genomic services and products for sample storage, processing and visualization of gene expression data, sequence data organization, small interfering RNA (siRNA) design, genome analysis, gene patterns, in silico gene optimization and customized biological databases. But a decade ago when Ocimum was just getting started, biological research had not yet comprehensively embraced ‘omics-based approaches, and our business was based on a different model.

We started by collaborating with pharmaceutical and biotech research organizations, solving their challenges and increasing the productivity of their R&D efforts through the application of our in-house informatics expertise. While doing this, we unearthed several places in the R&D value chain that could be streamlined with informatics, but in our first few years, we grew organically. We maintained a positive cash flow by licensing bioinformatics and enterprise software solutions like laboratory information management systems and by providing bioinformatics training.

Within a few years, we had built a thriving business with a steady pipeline. Money was coming in, and it would have been easy to be content with the direction of the company. However, Ocimum aspired to be more than a bioinformatics company—we wanted to be a ‘lab next door’ that could provide a researcher with services across the spectrum in a timely and cost-effective manner. To do this, we knew we would have to break out of our comfort zone and expand beyond the perceived limitations of our small team and startup company. We looked at our goals—a strong presence in the US, expansion of our portfolio of services to include biomarker discovery, and a customer base in Europe—and realized growth through acquiring assets seemed like a great way to build a large, scalable and sustainable company, so long as the pieces fit with our proprietary Research-as-a-Service (RaaS) business model. Ultimately, we achieved these goals through a combination of organic growth and three mergers (See table). (more…)

By Jane Sarasohn-Kahn. Wellness and disease prevention were the meta-themes at Health 2.0′s Spring Fling held earlier this week in San Diego. where the discussions, technology demonstrations, and keynote speakers were all-health (as opposed to health care), all-the-time. Dr. Dean Ornish told the attendees in the standing-room-only ballroom space that the joy of living is a greater motivator than the fear of death. And the 1.0 version of managing health risks has been more the latter than the former. As a result, Ornish’s two decades of research have shown that health is more a function of lifestyle choices than it is drugs and surgery. In fact, people have a “spectrum” of choices to make based on their personal preferences — not a one-size-fits-all “diet,” Dr. Ornish has learned.

While genes are our predisposition, they are not our Fate: good news for every human being. Furthermore, he said that, “healthcare needs more connection and community. It’s as important as food and water.” He and other researchers have learned that a person’s greater social connectedness (friends, family, community) contributes to better health. People who are lonely and depressed have 3 to 7 times greater mortality, Ornish told us. The largest unmet need is for intimacy and connection.

While Dr. Ornish’s research continues to demonstrate the power of lifestyle changes on health and longer, more joyful living, sponsors of health plans are now getting into a next generation of wellness and prevention in the context of value-based benefit design. With health premium increases that now have a family of four’s coverage indexed at nearly $20,000 per year based on the Milliman Medical Index, fewer employers are confident they’ll be able to cover employee health benefits a decade from now as the chart’s declining red line illustrates.

Thus, employers in 2011 are looking to link benefits with health and productivity, based on the Towers Watson and National Business Group on Health’s survey  into employer-based benefits in the post-reform era. While companies will continue to offset increasing health costs to employees (with a 45% increase in employees’ share of health costs since 2006), they’re also using incentives more aggressively to motivate lifestyle behavior changes in a new-and-improved approach to wellness and prevention. (more…)

By Glenna Crooks. Over a decade ago, researchers noticed an interesting finding: women who believed they were subject to heart disease were four times more likely to die than women with similar risks who did not hold similar fatalistic views.

Some people called this a ‘nocebo’ effect. The Washington Post called it the ‘evil twin’ of the ‘placebo’ effect, which most everyone knows by now is a treatment that produces a positive effect for patients even when it shouldn’t because is isn’t real.

Nocebos, like placebos, are ‘self fulfilling’ prophesies at work. Apparently, the brain (and body) cooperates with the deception.

A study just published in Science Translational Medicine takes this to new levels.

Healthy people agreed to participate in a pain experiment. Heat applied to their leg caused pain and a baseline of their tolerance determined. On a scale of 0-100, the average pain rating was 66. Placed in an MRI with an IV inserted, they were administered a powerful pain-relieving drug…but not told so. Pain levels dropped to 55, so apparently the drug had some effect. That was Stage One of the study.

Stage Two started when the research subjects were told the drug was now being administered. Average pain dropped to 39, mmmmmm.

Stage Three came next. Even though the drug was administered still, the researchers lied… subjects were told it was stopped. Average pain intensity rose to 64. Very close to the baseline. Wow. Tell the person – the patient – there is no help on board and the nocebo takes over.

These were not just subjective reports. The MRI’s confirmed that the brain’s own pain networks responded in ways that matched the subjective ratings.

Change the expectations…change the response.

So what does this have to do with politics and media? Plenty maybe. You decide.

I’ve been thinking about this for a long time. Here’s why: Long ago and far away, I trained for the Olympics. My sport was Karate. There’s more.

In a training accident, a sparring partner kicked me in the head, bones in the left side of my face were fractured and reconstructed. After successful surgery, for nearly six months I spent the first hour of every morning in a dental chair to get the refining, pain-relieving work done. 

How might other patients be like me?

What if I had not liked my dentist? What if I had not trusted him?  Could I have gotten up every morning and made the drive to see him? Would I have shown-up? Or not? Cancelled my appointments? Not been adherent to the regimen? Walked away angry and disappointed? Litigious?

I can’t even remember his name today, except he was a really nice, funny, skilled, terrific guy. Eventually there was no more pain. I went on my way.

Sometimes, as I watch the anti-healer drumbeat from politicians and the media (old and new) I wonder about other people who need help.

What would it be like to be admitted to the hospital and believe that the surgeons, nurses or hospitalists there were uncaring, incompetent and likely to cause my death, not my recovery?

What would it be like to have a chronic condition and believe that my doctor had no interest in me and my health but only her own selfish interests and income? That she lacked the intelligence or ethics to stave off the influences of the many forces that make it hard to put my interests first? To believe that a pizza for lunch would influence her choice of therapeutic option?

What would it be like to get up every morning to take a medicine and believe that the company who discovered and developed it employed people only in it for the money? And that it was probably poison to boot, likely to cause bad – even fatal – side effects?

While those of us who are patients and those of us who are healers are trying to make healing  happen it seems to me there are others whose interests are not about healing.

It seems to me there are those - politicians – with interests to drive a wedge between patients and their healers in order to get media attention. It makes for flashy hearings.

Likewise it is in the interest of the media to drive that wedge to sell news.

You decide. For yourself. For those you love.