The Placebo Effect and
Health sheds light on some of the nooks and crannies of the edifice housing
the enigma laden placebo effect.  The author, W. Grant Thompson, is a Professor
Emeritus of Medicine at the University of Ottawa, who has amassed an expansive
reservoir of medical knowledge and insight as a general practitioner, gastroenterologist,
clinical researcher, academic physician, and clinical trials consultant. 
Drawing on this cask of medical eclecticism, Thompson grapples gamely with a triad
of core objectives.  Namely, explore the placebo effect, including its role in healing;
secondly, show how the placebo effect has enabled medical researchers to
collect data through the medium of randomized clinical trials, thus
facilitating the practice of evidence-based medicine; and thirdly, explain how
the placebo effect and evidence-based medicine are integral parts of good
medical care. 

   Thompson warrants
felicitations for effectually penetrating the thick haze enshrouding the
placebo effect with brilliant pinpoints of enlightening insight and analytic
perspicacity.  Unquestionably, Thompson’s impeccably crafted tome contributes
invaluably to enhanced understanding of many of the befuddling profundities of
the placebo effect.

   The text, structurally, is
configured into three parts, divided into eighteen chapters.  A goodly number
of well-designed "tables" buttress the textual strength.  The
characteristic endings of the respective chapters with pithily worded conclusions
are welcome.  "Notes", in the form of a considerable multitude of
academic references, adjoin the textual body; and these conduits, to additional
study of the placebo effect, should gladden readers eager for the exhaustive
challenge of research.  Further adjoining the text is a "glossary",
tersely annotating multifarious terms connected, if tangentially, to study of
the placebo effect.

   Guided by unwavering
conscientiousness of purpose, and aided by superbly honed writing and research
skills, Thompson has composed a text which embodies placebo centric knowledge
and insight, suffused with delectably uplifting intellectual wholesomeness. 
The book is fairly steeped in reconditeness, substantively, and firmly
academically grounded, stylistically.  The relative abstruseness of the
substantive material may perhaps be discomfiting to layreaders.  And likewise,
the academic style embraced by Thompson may misfit layreaders.

   Throughout the length and
breadth of this engrossing and highly instructive book, Thompson is unabashedly
uncompromising and relentless in his insistence on the need for good
doctor/patient relations, evidence-based medicine, and proper understanding of
the placebo effect.  Thompson forthrightly alerts readers that placebos,
historically, have traversed a tortuous path strewn with conceptually
nettlesome concerns.  And importantly, Thompson argues that intellectual energy
should principally be expended on correctly deciphering a placebo’s effect,
rather than the placebo itself.  In this vein, Thompson suggests that there can
be no reasonable doubt that a true placebo effect exists.  It is the further
strong sense, of Thompson, that medical data emanating from randomized, double
blind, placebo controlled clinical trials are the sturdy bricks used, by modern
day researchers, to construct the scientific fortress of evidence-based
medicine.

   In the book’s first part,
Thompson expounds expertly on nuanced meanings of so-called
"placebos".  Also in this part, Thompson, in intellectually
energizing fashion, discourses on some of the historic roots of placebos as
well as selected facts and myths fused to placebo research.  As espied through
the discerning lens of Thompson, facts pertinent to placebo research are,
lamentably, incomplete; and myths enveloping the placebo effect are a hindrance
to properly understanding it.  Instructive examination of elements which
importantly may be associated with the placebo effect is the prime task
undertaken in another chapter.  The first part’s concluding chapter shows an
artful etching, by Thompson, of the salient features of the so-called
"nocebo effect".

   Vital interconnections
cementing together medical evidence, randomized clinical trials and the placebo
effect cut deeply to the core of the substance comprising the book’s second
part.  In this absorbing part, intellectual artisan Thompson, showing very
considerable skill, assiduously draws the principal lineaments of randomized
clinical trials.  The penetrating intellectual gaze of Thompson further reaches
to thoughtful comment, focusing on some of the potential advantages, as well as
disadvantages, of using data, garnered from randomized clinical trials, as a
way to evaluate medical treatments.  The phenomenon of powerful placebo effects
flowing from surgery is also broached in the second part.  In other chapters in
this part, Thompson strives hard to:  unravel knotty issues entwining the
placebo effect and psychotherapy; fathom vexing concerns residing at the
interface of complementary and alternative medicine and evidence-based
medicine; rivet enthralling attention on the doctor as placebo; and slash
through the thicket of thorny, ethics-related concerns enmeshing placebos. 

   In the last part, Thompson,
displaying his customary sharply-hewed acumen, ponders pensively, in one of the
chapters, on some of the modern forces tugging and pulling on the relationship
binding doctors and their patients.  The third part also includes a chapter
commenting on burden of proof centric questions.  Additionally, Thompson
adroitly dissects and examines major anatomic features of selected national
healthcare systems.  The unequivocal philosophic mentality of Thompson is that
healthcare systems, irrespective of their national origins, should be implanted
securely in the soil of evidence-based medicine, and display solid
understanding of the placebo effect.  In the book’s last chapter, Thompson,
amidst the cacophony and disharmony resounding in variant healthcare systems
worldwide, endeavors to strike some jubilant chords,  and exhorts healthcare
professionals to re-ignite medical engines fueled by empathy, idealism, and
compassion.

   The inscrutability of the
placebo effect traditionally has been resistant, if not impervious, to full
comprehension.  And indeed, the intrigue of the placebo effect remains elusive
of consensual understanding in the medical scientific world.  But Thompson
deserves much credit for toiling laboriously to deconstruct the mystery
burdened edifice encasing the placebo effect.  A legion of readers may be
enriched  greatly by Thompson’s praiseworthy toils, including:  medical
investigators, scientists, clinicians, bioethicists, healthcare administrators,
health policy makers, philosophers, and epidemiologists.

© 2006 Leo Uzych

Leo Uzych (based in Wallingford, PA) earned a law degree, from Temple University; and a master of public
health degree, from Columbia University.  His area of special professional
interest is healthcare.

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