Cheap placebos (E)

10 years ago, Duke professor Dan Ariely published a paper that demonstrated two things. The first, something we already knew, which is that placebos can work as a pain reliever, that you can take a sugar pill, a pill that does nothing in a double blind study and your pain will go away. But the second thing he demonstrated is that expensive placebos work better than cheap ones. Today, this is Emily in the Bronx and you're listening to a special archived episode of a Kimbo. For those of you who don't know about my obsession with placebos, placebos are really important. Here's the thing, plants do not respond to placebos. They can't tell if you're feeding them bottled water or tap water. When dogs, dogs can't tell the difference between expensive dog food and cheap dog food if they're made out of the same ingredients. Human beings are special. Human beings are special in one giant way, which is that we tell ourselves stories and those stories change our physiology. They actually change the way we interact with ourselves and with the world. One story we're able to tell ourselves is the story of the placebo, that expensive red wine tastes better than cheap red wine, that what a doctor tells us when she's giving us medicine changes the way the medicine works. There's a simple way to think about the power of a placebo. If we give somebody fake malaria medicine, they're not going to get well nearly as quickly as if we give them real malaria medicine. On the other hand, if we give someone fake rhino horn and they believe we gave them real rhino horn, they're going to have exactly the same reaction to it. And the same thing goes in the other direction. If you buy a Birkin bag that is a counterfeit, but you can't tell the difference, it will have exactly the same placebo effect on you as if you had bought a real one. On the other hand, if you buy a parachute that isn't made as well as a real parachute, you're going to discover really quickly that you made a mistake. So once we've discovered the placebo, once we've embraced the fact that there's a difference between a double blind study and real life, that none of us live in a double blind study, once we see that it is possible to amplify the effects of what we do by carefully constructing placebo effects around them, what should we do with that? For example, should we change the way doctors talk to us when they prescribe medicine? Should the sommelier at a restaurant, when we get to go back to a restaurant, wear a certain outfit because it makes the wine taste better? We have so many opportunities to build stories into our lives and the lives of the people around us. And we know, we've proven again and again, that those stories have a dramatic, important impact on us. So what sort of culture do we want to build? What sort of placebos do we want to engage with? Sometimes when we're feeling well and we want to level up and find joy in our lives or often when we're feeling threatened when we are worried about our health, how should we deal with placebos? So now let's consider the rhino. There are about 25,000 rhinos in Africa and every year, 500 to 1500 of them, about one out of 20, are killed by poachers. The poachers are after rhino horn, they leave the rest behind. Rhino horn is the most expensive placebo in the world, basically a giant toenail growing from the face of the rhino. When turned into a powder, it is sold often in Vietnam for two reasons. One because there are myths and rumors that the powder can help with liver trouble, with hangovers or maybe even cure cancer, or perhaps in its unpowdered form as a trophy, as a sign of status, demonstrating that the owner of it is powerful. This expensive placebo costs more than gold. I hope we can all agree that in a double blind study, there is no chance that the fingernail that grows from the face of a rhino is going to have any medical benefit whatsoever. For thousands of years, it was mentioned now and then in Chinese medicine, but there is nothing in the Chinese pharmacopia that says that you should be taking powdered rhino horn. It is a powerless placebo. It's all in our head. Or consider what convicted felon Jim Baker has to say about drinking colloidal silver. He gave this to us about 10, 12 years ago. We have it at our home. We have it in cases. We use it all the time. I have this, and I don't think I'd have made it without silver for my throat and all. Absolutely. I've had this, and this is amazing. Why is silver so so? Would you recommend as a doctor people to have silver in their house for a pandemic? You never want to be without silver. Here's the thing. Colloidal silver is not only a placebo. It's mostly a nocebo in the sense that if you take enough of it, your skin will turn blue. It will make you ill. Your body does not need any silver. You do not have a silver deficiency. Putting silver into a petri dish under certain conditions can kill certain things, but it has no medical benefits. Not only don't we need to take silver, take too much silver, and you will get sick. It will make your skin turn blue forever, and it has all sorts of other side effects. So we shouldn't be taking silver, and we shouldn't be spending money on expensive placebos. So when I talk about expensive placebos, I'm not just talking about the financial cost even though that is real. The second thing that makes some placebos expensive is their side effects, making your skin turn blue, causing a species to become extinct. Third is the crowding effect, that when we make a big deal out of placebos, we are probably crowding out the actions that have high efficacy. We are probably crowding out the discussions that need to be taken about real science or about what gives us actual joy as human beings. And the fourth one, which goes with that, is the expense of the distraction, that all the time we are wasting talking about things that don't actually work is a distraction from the work we actually should be doing. Placebos have been around for a very long time. As long as human beings have been wrestling with joy or pain, we have had placebos in our lives. We are wired to want to believe, and belief changes the way we interact. But only in the last 50 or 100 years has it become an actual big business. Snake oil salespeople actually sold oil from a snake, or most of the time fake oil from fake snakes. But snake oil didn't do anything to make people better. It didn't stop people from trying to make money selling the story. And as long as it was a cheap placebo, with few side effects and few distractions, I think it's a great idea. Cheap placebos are terrific. If your kid falls down and bangs his knee, and you give your kid a hug and it makes their knee feel better, that's the cheapest placebo of all. And it pays huge dividends because it associates person to person intimacy and care with feeling better. One step along the path, though, is when you put a band-aid on that kid's bruised knee. Because it's a form of giving them a hug, but it's also teaching kids that this item from the drug store is what you need to feel better. And then when we go one step further, or a step after that, and a step after that, and we find people who are putting themselves into financial distress, spending time or money to buy things that don't work because of Ariely's ratchet, that expensive placebos work better than cheap ones, we have a challenge. Add to this the fact that there are people in Congress who have made it ever easier for snake oil salespeople to market their stuff as if it actually does something beyond the magical power of a placebo. To the next level, and Jordan, we're going to talk today about a lot of conditions that people are struggling with, and we want to teach people how to use essential oils as an ancient medicine. Hey, if you are passionate about this topic like we are, take a minute right now, punch that share button, click the love button, help us spread the word on how to use essential oils as therapy for the body. When we do that, what we're also doing is lowering the efficacy of drugs and interventions that do work in a double-blind study. Because those things aren't marketed, sold, hyped nearly as well as the stuff at your local herbal store. Humans are pre-wired to want something certain, and they want something fast. Hypesters showed up and said, "Not only do we have something certain and fast, it's also expensive, which means it's scarce, which means status comes along for the ride, and you should buy it. And we will keep promoting it because we will make money doing so." And so, we create this non-virtuous cycle, where money creates more interruption, creates more hype, creates more money, and around and around it goes. Health benefits. Distilled from the Boswellia tree, it has been used for thousands of years, while the resin from the tree possesses many different properties, it is most highly regarded for the oil it contains. Often referred to as the king of oil, it's highly revered for everything from digestion to beauty. It's truly one of nature's most valued gifts. Rich in alpha-pining, frankincense is soothing and extremely beneficial for skin health. More significantly than any one single compound, however, frankincense is rich in monoturpeans, which have a wide array of benefits, making this oil effective for a variety of uses. I believe this is one of the primary reasons frankincense offers appropriate cell protection and support. This broad spectrum activity can support cells and system function throughout the entire body. Frankincense is for everyone. Essential oils are not essential. They're called essential oils because all they've done is taken out the part that makes them smell like whatever it is, lavender, and left the rest behind. But there's a story to be told. You can buy strawberry oil, essential strawberry oil, for about $800 a gallon. What exactly are you supposed to do with a gallon of strawberry oil, while apparently it has all sorts of magical benefits? It's an expensive placebo. Once again, to repeat myself, placebos are terrific. Cheap placebos are a gift from the universe. But expensive placebos that distract us from the work we ought to be doing to make ourselves healthier or happier or more connected, that's a mistake. So the challenge as we seek to make placebos more powerful, more effective, more widely available, is not to go down the path of denigrating the alternatives, those things we can't substitute, is not to figure out how to charge more so only a few people can get it, not to amplify the side effects. Our opportunity then is to figure out how to use the magic of the placebo effect, the stories we tell ourselves, the trappings, the pricing, the availability, the status that goes with it. Put all of those to work to create fake rhino horn, to create fake essential oils, to create anything that we need to create that has fewer side effects, more uplifting potential, and that helps people put their own minds to work to find the health and the well-being that we all seek. And so, as we shelter in place, as we try to think hard about how to help the people around us, mostly what I'm doing here is ranting about the fact that we need to seek out cheap placebos, person-to-person, human connection, things that don't cost a lot of money, things that open us up to what actually works beyond the story we tell ourselves. And if you find yourself believing an expensive story, that this handbag, which costs $20,000, is the only way to feel fulfilled, that this really difficult to acquire medicine that makes you feel sort of ill is the only way to get better, think really hard about who benefits from selling you this expensive placebo. Because in general, expensive placebos aren't sold on behalf of the recipient, they're sold on behalf of the seller. Thanks for listening. I hope you're well. I hope you're finding peace of mind. We'll see you next time. Hey Seth, it's Maria. Hey Seth, my name's Kyle. Greetings Seth. This is Steven out in Madison, Wisconsin. Hi Seth. I'm Richard from Charleston here. Hi Seth. This is Anupam. Hi. This is Katelyn. Hi Seth. Warm greetings from Kurosawa. Hey Seth. My name is Nick Ryan from Pittsburgh, Pennsylvania. Hey Seth. This is Rex. Hey Seth. Hi. This is Vasily from Greece. Hi. This is Roberta Perry. My question is... And that completes my question. As you know, I love to hear from you. If you're at home with nothing better to do or even with something better to do, I hope you'll visit akimbo.link, that's A-K-I-M-B-O, dot L-I-N-K, and click the appropriate button. Hi Seth. This is Patrick Lamontang from Canmore, Alberta, Canada. In your monkey selfies episode, you ended it with saying that five years should be enough of a copyright to get something back. I've been making my full-time living as a nationally syndicated editorial cartoonist in Canada for more than 15 years. With the decline in print journalism, I'd be foolish not to explore other avenues of revenue if I want to continue making my living as an artist. In 2009, I painted a detailed caricature of a grizzly bear, which led to many more whimsical wildlife portraits. That effort has since become half of my business and continues to grow. I sell prints, paint commissions, and the images are licensed internationally on many products. That first grizzly bear, painted 11 years ago, is still one of my top-earning images. But it didn't start creating any real revenue until five-plus years after I painted it. During that time, I was building my brand, creating new work, finding my followers and customers. I enjoy that others learn from my work and are inspired to create their own vision, but I would argue that as long as I'm alive, those copyrights from my library of funny-looking animals, those are mine. They're a product of my years of building my skills, trying new things, failing often, and finally creating a series that people enjoy, and from which I can earn a living. You know from experience that a creative's efforts are often only realized after toiling away an obscurity for years. To have the fruits of that labor harvested by somebody else just as it ripens would remove any incentive to try. Could you offer some further clarity about your position on this? Thank you. Thanks for this, Patrick. I think there might be a misunderstanding about what copyright is for. First, thank you, though, for your work, for your creativity, for sticking it out. It's difficult to make it as an independent creator. Let's start with this. Why does our culture, why does government let people own private property? Why not simply just keep the land moving around the way that it might be at a campsite? Well, the reason we let people have private property is so that they will develop the property, turn it into something that contributes for all of us. That is where the idea for copyright came from. It is not about treating the creator of the copyright fairly because if that was the intent, then for example, if a doctor saved someone's life, we might say, "Wait a minute. That doctor deserves millions of dollars because she showed up and did difficult work and now this person isn't dead." We do it. The reason we created copyright was to incentivize creators to make stuff for the rest of us. The goal should be to adjust the rewards for owning a copyright so that we end up with enough creators. Let's compare Canada and the United States for just a minute because in most ways, Canada is a stellar example of how to run a culture. I mean, Tom Thompson, Agonquin Park, I could go on and on, Omer Stringer. Got from 1870 to 1970, give or take 100 years. In the United States, copyright lasted 14 or 28 years. That was it. That's all you got. Canada had a whole bunch of copyright kerfuffles with the United Kingdom and quickly settled on something closer to burn, which as you mentioned, is life plus some extra. The question is, during that 100-year stretch, did Canada or the United States produce more culture that the rest of the world embraced? Well, on a per capita basis, it's probably a close call, but I don't think you can argue that Canada wins on this one. The purpose of copyright is to incent creators, not to reward them fairly, but simply to incent them to create. The vast majority of creators don't make a penny. A huge percentage of the people on iTunes have songs that have only been purchased once or zero times. The vast majority of people who paint paintings or write poems never make a nickel. And still, we've got a lot of them. And then there are a few people who win the lottery. There are people who end up with a hit record or a painting that sells for millions of dollars. And people who seek to make it professionally, they look at these lottery winners as an incentive. But if our goal was to equate pay with creative contribution, we should just tax humanity and pay the creators, but we don't do that. We've created this quasi-private property system where you get to keep something out of the marketplace if you want, but then eventually, you've got to put it back. Thanks to Mickey Mouse, Sonny Bono, and some others in the United States. The copyright here is now essentially forever, and that doesn't help the culture. It hurts the culture. Not only hurts the consumers who can't watch a movie or read a book or its remix, but it hurts the other creators because they are worried about getting sued. William Shakespeare couldn't sue Stephen Sondheim and Leonard Bernstein over Westside Story, even though it's based on Romeo and Juliet, because Romeo and Juliet was back in the public domain. The question is, how much longer before someone can do a remix of a Kurt Vonnegut novel? Well, at this rate, I will be long gone. And so, that's the challenge. The challenge is, how do we balance the need to incent creators with the need for new creators to be able to make stuff so that all of us, the members of the culture, so that all of us benefit? So I'm thrilled that your work has spread. I hope you continue to do well with it. I know that I still get checks from books I worked on 25 years ago. I'm in no hurry to give that money back, not my point. My point is, I would still do it. Most of us would still do it, even if we only had five years. There's a number. I guess the number is different for everyone. Thanks for listening. Stay safe. Good luck with your work. We'll see you next time.