Dressed in a white gown and hairnet, 61-year-old Ana Maria is wheeled into the operating room of a private clinic in Mexico City where Dr Jose Luis Mosso Vazquez is on hand to supervise a surgery to excise a lipoma, a fatty lump, from her thigh.
In a riveting piece for an online science journal, award-winning science journalist and author Jo Marchant describes how Ana, whose blood pressure reading is 183/93 – normal reading is 120/80 – is prepped for surgery.
Under normal circumstances, a patient like Ana would be sedated to cope with the pain and anxiety of the surgery. But Dr Jose instead opts for a different technique. He slips a virtual reality headset over Ana’s eyes and as the surgery progresses, Ana gets immersed in a three-dimensional recreation of the ruins of Machu Picchu, a destination that is high on her bucket list.
Although emergency medication is there in case the patient needs it, the surgery proceeds without a hitch and, 20 minutes later, after the surgeon has excised the lipoma and sutured the wound, Ana is all smiles. Thanks to virtual reality, she says, she barely felt the scalpel slice her flesh and was completely relaxed, so unlike her usual stressed self. Best of all, her blood pressure actually dropped during the surgery.
Techniques to divert the mind when under stress, placebos, honest placebos and harnessing the power of virtual reality in pain management are just a few highly debatable topics that Jo’s most recent book Cure: A Journey Into the Science of Mind Over Body, delves into.
‘The development of reality games and how they can help with pain is something I talk about a lot in the book,’ says the author.
Jo, who is in Dubai for the Emirates Airline Festival of Literature, argues that the brain has only limited capacity for conscious attention. ‘So researchers thought that if they could create a compelling, immersive 3D virtual reality game that could grab people’s attention, then the patient will pay less attention to the pain they may be suffering.’
The VR games were tested on patients with severe burns, including on war veterans from Iraq and Afghanistan who, says Jo, ‘have seen the worst pain in medicine. ‘Trials revealed that when patients are playing those VR games while undergoing extremely painful wound care sessions, it reduced their pain by up to 50 per cent, in addition to the pain relief they get from drugs. That’s a dramatic result of the mind and it is helping people who are in very severe pain.’
So what was the catalyst for writing about the mind’s influence on the body?
‘Placebos and their effects have always interested me,’ says Jo, who has a doctorate in genetics. ‘If placebos works, we need to understand how it works, and why not make use of it?’
Another subject she wanted to explore was hypnosis. ‘I also wanted to research mindfulness and depression,’ she says. ‘I realised that a lot of different things that I was interested in were actually all different aspects of the same subject – they all had to do with the influence of the mind on the body.’
But perhaps what tipped the scales for her was that ‘it was such a debatable topic – the role of the mind on the body.
‘It’s such a polarised one. Some alternative therapists claim the mind can do anything while sceptics, often from the field of science and medicine, hate the very idea and will say it is dangerous quackery. It’s hard to have a sensible debate in the middle. So I wanted to look at this topic from a scientific standpoint to see what the mind can do and can’t.’
To begin with she attempts to redefine ‘medicine’.
‘As a noun, medicine is a physical substance like a drug that you give somebody [for the treatment or prevention of disease],’ she says. ‘But that shows how narrow-minded we are; that we have to give someone a physical substance to make them feel better.’
While she admits that it is an important part of medicine ‘there is a lot more to it – like the way that substance is delivered, the way care is given, the way we treat human interactions between caregiver and patient… all of these things play into physical and mental health as well,’ says Jo.
She insists that we need to be thinking broadly about all of these things when it comes to curing people of a condition or preserving health.
To that end, Jo, for her book Cure, travelled across the world researching and exploring virtual reality therapy, the health benefits of friendship and social connections, the power of meditation and faith, hypnosis and placebos and how they can be used to improve wellbeing.
‘There’s a big interest right now in placebos. One area is honest placebos - the idea that you can take a placebo and know that it is a placebo and it can still have a significant effect on you,’ says the author, whose first book Decoding the Heavens was shortlisted for the 2009 Royal Society Prize for Science Books.
Jo details a trial conducted in Portugal with patients suffering from lower back pain. ‘They had been on different drugs for years and had recorded no change. This group was given honest placebos and they recorded significant improvement compared to those on regular treatment. In fact some of them reported dramatic improvement. So it was nice to have confirmation that honest placebos do have an effect.’
In the same vein, Jo is also happy that using virtual reality games to divert patients’ attention away from their pain is proving to be beneficial.
‘Of course, it doesn’t mean that pain is going to go away [if these techniques are used] but [games] certainly dramatically improve people’s quality of life and make pain more manageable and the condition that they have,’ she says.
So despite so much evidence, why is the science community reluctant to accept that mind could have an effect on the body?
‘There are a lot of things leading to that – deep-seated biases, prejudices and attitudes that scientists have... There is an unspoken feeling that anything related to the mind is flaky and not scientific and a lot of scientists have a gut reaction against it. They don’t like it. Also there are so many extreme claims being made and it is dangerous to put too much trust in the mind. It doesn’t cure everything and if people reject conventional treatments that they need, then they can die.’
Are pharma companies downplaying the role of the benefits of mind on health?
‘I don’t think they are purposely doing that,’ says Jo. ‘I think it’s a problem when the medical system becomes too reliant on the money they are putting into clinical trials.’
She says that pharma companies ‘are actually very interested in the role of the mind and the body. They are aware of huge improvements in patients in placebo trials.’
Since she has discovered proof of mind’s beneficial effects on health, has she junked western medicine?
‘Not really,’ says Jo, with a laugh. ‘I think alternative therapies [and placebos] probably can in some cases be very helpful to people… particularly for chronic pain. These therapies can be better than drugs.’
Jo wants to see more research that teases out, in an evidence based way, the real ingredients of such alternative therapies so that they can be incorporated into mainstream medicine.
Instead of focussing purely on drugs all the time, she suggests concentrating on length of appointment time, the attitude of the practitioner, the words the doctor uses, the human aspect of care, the interaction and relationship between therapist and patient, and ‘long personalised consultations, which are happening less and less in conventional medicine’.
Is it easy to write science books for a general audience?
There are hurdles, she admits. ‘The biggest challenge to science writing is to put forth complicated ideas in a simple, clear way but not too simple and without making people feel that you are talking down to them and without being vague or ambiguous,’ she says.
‘I’m keen to encourage more people to read about science and science related features.
‘Often people also are put off by science and reading about it, thinking “it’s not for me” so it is about reaching out to those people. And the key to that is to keep it about people and their stories. For me that’s what comes first and the scientific content just comes in behind to support their stories.’
Jo Marchant’s session at the Emirates Airline Festival of Literature about Cure: A Journey Into The Science Of Mind Over Body, is on March 10, 10-11am
She’s also on the Wonders of Science panel discussion with Ben Miller on March 10 at 3pm.