Category Archives: placebos

Placebo effect on the doctor

Screen Shot 2016-09-01 at 08.39.32Dalrymple relates that in Augy Hayter’s Fit to Be Tied,

a patient who has escaped from an asylum returns to his former office, where he was the boss, and advertises for an employee. A young man applies, but in the middle of his interview a doctor (described as having ‘the arrogance of insecurity’) and a nurse arrive to haul him back to the asylum.

The nurse returns

to the office to reassure the applicant, who asks, ‘Is it true he is being given shock treatment?’ The nurse replies that it is and it isn’t; he goes through the motions of having it, but the apparatus has been disabled so that no electricity goes through his brain. The doctor does not know this but is satisfied with the result.

The play, says Dalrymple,

seems to have been inspired by the commonly repeated story of the electroconvulsive therapy clinic in which the machine had broken down but nobody noticed: to which one can only say they cannot have been very observant.

Sinister side of Harley Street

Waste of everyone's time

Waste of everyone’s time

In 1960, the doctor-barrister John Havard’s The Detection of Secret Homicide came out, while in 1962 the schoolteacher-novelist Anthony Burgess published A Clockwork Orange, about adolescent violence.

The two themes are combined, Dalrymple writes, in Pamela Hansford Johnson’s An Error of Judgement (1962), in which the patient-narrator consults William Setter, a Harley Street specialist, about

simultaneous pain in his right shoulder and the back of his left knee. Setter tells him he could have a cardiograph if he wanted but this would be a waste of everybody’s time. Having paid his four guineas, the patient-narrator is reassured and feels better. Payment is a wonderful placebo.

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Get over it

Setter

starts a club in Soho where he acts in a Mephistophelean manner to bring strangely assorted people together in a discussion group. He decides to give up medicine in the middle of his career, which was certain to have ended in a knighthood.

Johnson’s novel

casts light on the prescribing habits of the time. When the narrator’s mother-in-law dies, Setter prescribes Dexedrine for the narrator’s wife to help her get over her grief quicker than the Diagnostic and Statistical Manual of the American Psychiatric Association can say depression.

Setter prescribes phenobarbitone three times a day for a young man called Sammy Underwood,

That'll quieten him down

That’ll quieten him down

presumably to quieten him down, for Sammy is not epileptic.

Setter

suspects Sammy of being responsible for the kicking to death of an old inebriate woman.

Sammy is guilty and confesses to Setter,

who comes to the conclusion that Sammy is so lacking in remorse, contrition and conscience that he is likely to do it again. So for the public good and because he has always enjoyed inflicting harm (it is one of his reasons for having gone into medicine in the first place), Setter decides to kill him.

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Just what the doctor ordered

Sammy complains of insomnia

and Setter suggests that he ask his own doctor for some sodium amytal to help. He then suggests a small bottle of brandy to be taken with the pills just to make sure he gets a good night’s sleep, though with the stern warning that Sammy should take no more, absolutely no more, than four-fifths of the bottle.

Setter’s

secret homicide goes undetected.

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