A good friend of noi, he generated a lot of interest with a previous post and recently sent us another very interesting piece
A recent story on 60 minutes piqued my interest and sent me searching the internet for more information on a drug called Etanercept.
The video below shows the treatment of a woman who has suffered 9 months of reasonably severe back and leg pain (I have no reason to doubt her story). In desperation, she attends a specialist medical clinic where she is injected with Etanercept and her pain disappears in 5 minutes. Have a look. There’s many similar videos on Youtube.
Impressive. How does this happen?
Blockbuster drugs only come along once in a blue moon, so the odds that Etanercept is a blockbuster in the making are extremely small (possible, but small). In fact a 2012 independent trial found Etanercept not even as effective as placebo in the treatment of sciatica. Given this, we can make a safe bet that this patient’s outcome represents a very rapid and powerful placebo response.
Many factors are assisting a placebo response:
-Etanercept is expensive
-Etanercept is not widely available (exclusive clinic setting, off label use)
-Etanercept is injected
-The procedure is being filmed (very powerful)
-Lots of suggestive language, build up, white coat etc.
-Last but by no means least, Flavor Flav in the background holding the clock!
It works out very well for the patient, which is great. No one could complain about the outcome, and I’m not suggesting any impropriety on behalf of the doctor or the clinic. I think the cost is around $1000 from what I can find on the net. That’s not too bad considering she has avoided the inconvenience and trauma of surgery.
We’ve all seen patients like this. It’s very easy to automatically expect that such a case might take weeks to recover. What about if we change our expectations? As clinicians, how can we go about regularly creating miracles like the one seen in the video? Can we comfortably entertain the notion that such rapid and powerful outcomes are even possible? What tricks can we use to ‘power up’ suggestion? Can such outcomes be achieved in 30, 15, 5 minute consultations? How far can we push the boundaries?