Dr Matt Newsletter September 28, 2022
Below are some interesting items I like to share each week and please feel free to send me ideas of your own for the newsletter. Today’s newsletter sections include: Fall Festival and Craft Fair October 8th, Picture of the week: a new book about Mother Teresa, inspirational quotes from Albert Einstein, Family run business of the week: Scott and Pam Krause real estate, Health tip of the week: Simply listening, Musical selections of the week: blasts from the past, Humor of the week: Child art of Pablo Picasso, and Research of the week – Placebo surgery works even better than placebo pills – of course it does!
Yours truly, one moment at a time.
Matt Irwin
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Fall Festival and Craft Fair October 8th in downtown Fairfax City
Last week I included information on Keith Kadish’s handcrafted artisan wood items that will be on display at the Fairfax City Fall Festival on Saturday October 8th. This is a family friendly event with many local vendors, music, and a children’s theater. I plan to attend and visit Keith at around 12 noon. If any of you are going please send me an email as it would nice to see some familiar faces. It is a big event and there is a free shuttle that goes from Fairfax High School parking lot to the fair. This may not be as toddler friendly as our picnic, and also four of the parents who came to the picnic are expecting babies in the coming months, making such events a bit more challenging. Keith’s “Calico Woodcraft” display will be in space #250 near De Clieu Coffee & Sandwiches on Main Street between University Drive and East Street. I will double check the location for next week’s newsletter. Below is a link to the fair and to Keith’s page on Etsy.
https://www.etsy.com/shop/CalicoWoodcraftShop
Picture of the week - new book about Mother Teresa
Inspirational quote of the week: Albert Einstein
Science without religion is lame, religion without science is blind.
Peace cannot be kept by force; it can only be achieved by understanding.
Family-run business of the week
Scott and Pam Krause, The Krause Team Real Estate: (krauseteamrealtors.com) Scott and Pam are two of my adult patients who know the neighborhoods quite well partly because of living here for many years. They also know which ones have lots of kids, and which ones are quiet and “retirement friendly” 😊. They are a fun team can help people buy, sell, or rent homes. Their motto is: "Full time service, first class help." If/when I find myself looking for a home they will be the first ones I call. Below is a picture I asked them to send.
Hand-made custom dog kennels that fit your home:
Previously I posted Jonathan and Brittany’s hand-made custom dog kennels. I asked them to send a picture which appears below. Feel free to reach out to them via email, phone, or Etsy with any questions or inquiries. Email: thegesingathering@gmail.com, Phone: 978-602-2072, https://etsy.me/2S3pRt2
Health wellness tip of the week
Listening can be a spiritual experience that can allow our body, mind and spirit to settle, even when there is frustration and anxiety mixed into the experience. One can listen to the sounds of nature, a beautiful musical piece, or a loved one’s conversation. Sometimes people think intent listening is tuning out, and it is good to remind them that we are “tuning in, and listening and hearing everything”. Try it for yourself and let me know how it goes 😊
Musical selections of the week
This week I am diving back in time for some “easy listening” music from the 18th and 19th centuries. This can be good background music, or can be listened to mindfully, absorbing each note. Last week I had “modern classical” which I love to listen to, but which has roots deep in the past such as the three piano/keyboard sonatas below. The first is by Domenico Scarlatti, who was famous for making 555 keyboard sonatas in his lifetime during the 1700’s. Mozart came along about 80 years later, and wrote many playful pieces: the one below almost sounds like children’s music, except that it is actually extremely difficult to play! Mozart was a virtuoso starting at age 5. Unfortunately he was driven by his father to be a child prodigy, which cost him a normal life and led to later struggles and an early death. A similar fate of child prodigy difficulties fell upon Beethoven, our last musical guest, as well as being an adult child of an alcoholic. Modern child prodigies have had similar struggles in life, such as Michael Jackson and Britney Spears. Beethoven also had health struggles, not the least of which was being completely deaf when he composed many of his most beautiful works. He is more known for his storms and tempests, but he also made some extremely gentle and beautiful music such as the sonata movement below.
Domenico Scarlatti Sonata number 365:
Mozart Sonata # 333, 3rd movement
Beethoven Sonata Pathétique, 2nd movement
Humor of the week – Pablo Picasso’s early struggles
Research summary of the week: Placebo Surgery there must be a better way to generate our healing response…
What would you think if I asked you to join a surgery study where you might just get incisions in your skin with nothing done inside, or you might be in the group that gets actual surgery? I would think it impossible to recruit enough patients, but a study 25 years ago got 180 people to volunteer, and the results, described in the last paragraph below, might just surprise you.
The Emperor’s New Drugs – an excellent book about the placebo effect:
One of the best books I have read in the past several years is “The Emperors New Drugs“ by Irving kirsch. His main focus is the placebo effect in antidepressant research studies, but that is just the beginning, and he has very insightful comments about the power of positive belief in a variety of areas. As you might guess, the research he and his colleagues put out met with a firestorm of defense tactics, which he covers well in his book, but people with a reductionist materialist view of the brain seem to have an inability to absorb the information, no matter how clear and detailed the arguments are.
Our underlying beliefs impact us all the time in positive and negative ways, whether we realize it or not. Becoming aware of them is perhaps the first step and can be quite humbling (speaking from personal experience). I wish it was easy to change our underlying beliefs, but even when we see some of them as imbalanced, they can prove very resistant to change. It may take approximately 10,000 hours of insightful practice to make serious headway, whether through counseling, reading, mindfulness practice, or just the school of hard knocks. Much of the “practice” involves experiencing the positive and negative beliefs fully, which is not always a pleasant experience. Fortunately, life includes much more than 10,000 hours to practice, and the journey itself is likely more beneficial than the reward.
Back to antidepressants for a moment, It turns out the vast majority of the positive effects, or perhaps all the positive effects, come from the placebo effect. Of course, this is not true of all medications or other healing modalities, including natural ones, many of which also have a beneficial effect whether you believe in them or not. However, the beneficial effect of these modalities will be assisted significantly if positive beliefs are included in the mix.
When it comes to antidepressants, the odd thing is that their failure to beat placebo has been shown by the drug companies’ own research. Kirsch and his colleagues used the freedom of information act to get all of the research studies submitted to the FDA, not only the ones that they published in the literature. In other words, many of the studies were buried because of their negative results.
I will put a link to his book at the end, as well as to a talk he gave many years ago which includes a dose of his sense of humor. As an introduction I describe his section on placebo surgery.
Placebo Surgery
Several studies have shown that placebo surgery is even more effective at triggering the healing power of belief than placebo pills. This should not be a surprise because of how much more impressive it is psychologically to have someone cut through your skin and rearrange your insides. This is not to say that surgeries are all placebo, but it turns out that at least some of them are. Even when they are not “only placebo”, it still helps to have positive beliefs about the experience, just as it does with other modalities.
Regarding the nocebo effect, if people feel “wrong” about something, it may be best to consider different options. This can at least mean delaying a bit to give time for considering one’s situation in more detail, discussing with family and friends, and a few prayers might also come in handy.
Kirsch reviews several studies where the placebo group actually did better than the surgery group. This is in a section of his book entitled “Placebo Surgery“. Some examples include surgeries for chest pain attributed to heart disease, surgeries for muscle stiffness in Parkinson’s patients, and severe chronic knee pain thought to be from osteoarthritis. Usually the surgery was already being performed in large numbers of people before the study was done which found it was “all placebo”.
In these research studies, a majority of people improved significantly regardless which group they were in. However, improvement was just as good or even better in the placebo group, and also often lasted longer. As you might expect, the people who improved were always very convinced that they had had the real surgery, and credited the surgery for their improvement, even when nothing had been done except an incision in the skin.
The study on osteoarthritis was done in the 1990s and they had 180 patients. One third of them were given a full rinsing and scraping procedure which was commonly done at the time, another third was rinsed but not scraped, and the rest just had little incisions made with no rinsing or scraping of the knee joint. All the groups improved significantly, but the placebo group did significantly better than the other two. Two weeks after the surgery, patients in the placebo group had significantly less pain and showed better results on objective tests such as climbing stairs than the other two groups. One year after the operation patients in the placebo group still walked and climbed stairs significantly better, but by two years after the surgery there was no significant difference between the groups.
As usual, I have gone on a bit longer during this little research summary than I intended. Below are the links that you can use to explore on your own. The section in the book describing the study on osteoarthritis is on page 113, but the first 112 pages before that are also pretty good :-).
Video of Dr Kirsch presentation – he has a short section on placebo surgery starting at minute 6:00.
The Emperor’s New Drugs – a book about a hot and controversial topic until one considers things carefully. Then it doesn’t seem controversial at all…
https://www.amazon.com/Emperors-New-Drugs-Exploding-Antidepressant/product-reviews/046502016X
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