The Element of Ritual

From the NY Times May 4, 2010
...one idea would be to deliberately increase the element of formal ritual in medicine. Studies of “alternative” therapies show that strong placebo effects can be induced by ritual. Indeed, in mainstream medicine, surgery is the treatment most surrounded by ritual; perhaps this is one reason it appears to be the most powerful placebo.

      Nurse Smithers straightened Dr. Baumgartner's feathered head dress. it had slipped down below the caduceus so carefully painted on his forehead by the medical ritual staff. The MR (Medical Ritual) dressing room looked more like the backstage at a Broadway show— racks of costumes, shelves piled high with musical instruments, makeup artists and hair stylists scurried about helping physicians prepare their illusions. It was a far cry from the old days before doctors finally understood what healing was all about—illusion. It was illusions that kept the patient's belief system functioning and if the patient really believed, they were practically cured.

Ritual was Placebo General's way of maximizing the curative powers locked away in each patient's own belief system. Modern medicine was all about placebos much to the chagrin of big pharma. There was precious little money to be made from a science fiction set and a shot of salt water. These days medical treatment was more show than substance. If the patient believed he was being cured, his mind took care of the rest. His attending physician, Dr. Baumgartner, knew that the contents of the syringe he was holding was not nearly as important to the patient's recovery than the ritual that preceded it.

In this case, the patient, Mr. Louis Silverblank, a portly 60 year old from New Jersey, was just waking up from his placebo heart surgery and was expecting a shot of painkiller. His pre-surgical work up revealed that Mr. Silverblank was superstitious and distrusted modern medicine. He tended to a strong belief in more primitive forms of treatment. As a result, his surgical team dressed for the occasion in a combination of Haitian Voodoo and Amazon rain forest garb. His surgeon, Dr. Numsey, performed the operation in a sterile loin cloth and body paint. Numsey was highly regarded throughout the region as a master of the elaborate and effective primitive scenario.

Nurse Smithers, herself dressed in a flowing muumuu with a colorful tropical theme and a hat filled with colorful fruits, began a rhythmic beating on a small drum hung around her neck. Dr. Baumgartner accented her rhythm with staccato shakes of a rattle made from a tortoise shell. Together they entered Silverblank's room in a shuffling Samba chanting in a language no one present understood. A semi conscious Silverblank seemed impressed by the ceremony and felt much improved just watching the medicos working so hard to stimulate his trust. Nodding his head to the rhythm he gave nurse Smithers a shy smile.

His smile increased as Dr. Baumgartner raised the syringe high in the air and called upon the mystic forces of healing to flow into it. Nurse Smithers beat a furious crescendo on the drum. Dr. Baumgartner turned around three times, produced a puff of smoke from his palms and injected the saline solution into Silverblank's enormous rump. Mr. Silverblank heaved a blissful sigh and lapsed back into sleep.

Dr. Baumgartner and Nurse Smithers turned and left the sleeping Silverblank's room and hurried down the corridor to the MR ready room. They had to change out of their feathers and beads into a futuristic costume consisting entirely of chrome and plastic prosthetics. Nurse Smithers donned an android mask while Dr. Baumgartner slipped into a breastplate filled with flashing lights and gauges and hurried off to operating theater 4, the Doctor From Tomorrow set. Mrs. Hackman was having her gall bladder removed or at least thought she was.