From placebos and ‘kissing it better’ to hypnosis and Lourdes – a level-headed look at alternatives to prescription drugs
There are certain kinds of illnesses that seem to cause great distress to doctors; and there are certain kinds of patients that medicine seems almost incapable of helping. It can seem to some people that doctors are almost hostile to them. We often read in illness memoirs of doctors who have been dismissive, and patients being told: “it’s all in your head”, “you’re imagining it”, “your symptoms aren’t real” (whatever that means).
I have in mind a patient I saw last Monday morning. Mr Hutchens (not his real name) has been depressed for many years, since losing his job because of his chronic back pain, sustained after an apparently minor road accident. His scans and x-rays and blood work are all normal, except for a wee bit of age-appropriate wear and tear. But immobility has caused him to put on weight, and then develop type-two diabetes, and this combination of irreversible events have caused his pain to worsen. He takes tramadol, a powerful, commonly prescribed narcotic painkiller – definitely your go‑to drug if you’re recovering from surgery, which was its original purpose, but now, it seems prescribed for pretty much everything; and gabapentin – a drug originally licensed for epilepsy, but never quite finding a home, until it was relicensed for pain. Now it seems it is prescribed for, again … pretty much anything.
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