Demons, Halos, and the Nocebo Effect

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By Marilyn M. Singleton, MD, JD

Watching the news coverage of this year’s “Women’s March” was more disheartening than inspiring. Some participants wore odd sexually suggestive caps. Many carried signs dominated by anti-President Trump slogans—some displaying obscene language—in front of children, no less. To be fair, “women’s rights are human rights” was more popular than “keep your hands off my #@%^!.”

The normalization of the sport of destructive communication brings to mind the medical nocebo effect. Nocebo effects can modulate the outcome of a given therapy in a negative way, as do placebo effects in a positive way. In short, negative expectations beget negative results.

The political nocebo effect is a sister of the age-old propaganda tool of demonizing the opposition rather than promoting one’s own position. With the Khmer Rouge’s Pol Pot, it was people with eyeglasses (a sign of intellect). With wannabe socialists, it is “the rich.” Ironic, given that the most vociferous are themselves uber-rich or have donors from the elite “one percent.” Of late, the demon is a far less discrete group: all men, with a special place in political hell for white men.

Ah, the numinosity of womanhood! If women were in charge, all of our problems would be solved; there would be no more boorish behavior. Ogling the gender of one’s preference would be subject to civil fines and public obloquy. There would be no Chippendales, Thunder Down Under, or People magazine’s “Sexiest Man Alive.”

To be sure, having a woman at the top does not guarantee virtuous outcomes. There was England’s Queen “Bloody” Mary I, who killed thousands of Protestants and Spain’s Queen Isabella I who appointed Tomás de Torquemada as the first Inquisitor General of the Inquisition.

In modern times, India’s Indira Gandhi used an unstable political climate to quash constitutionally protected civil rights by declaring a state of emergency allowing her to arrest political opponents and censor the media. Former Argentine President Cristina Fernandez de Kirchner was arrested last year for allegedly covering up Iranian involvement in a 1994 bombing that killed 85 people at a Jewish community center. Nobel Peace Prize winner State Chancellor Aung San Suu Kyi, the de facto leader of Myanmar, has been criticized for her refusal to discuss the plight of the Rohingya Muslims and her failure to condemn indiscriminate force used by troops (over which she has no control). South Korean president Park Geun-hye was put on trial for pressuring companies to paying millions in bribes in return for business favors.

Clearly, that old adage, “power tends to corrupt” is not gender-specific.

Many women carried signs demanding healthcare for all women. Wasn’t women’s health one of the 26 essential women’s benefits in ObamaCare? Further examination of the “Women’s March” website reveals that the beef was “open access to safe, legal, affordable abortion and birth control for all people.”

The marchers missed a golden opportunity to bring awareness to the general public serious health issues that affect all women. An American Heart Association study found that after a heart attack, women age 55 or younger have worse outcomes than males. Women have poorer physical and mental functioning and more chest pain. These findings may be because these women tend to have delayed diagnosis, and thus receive later treatment for heart disease.

Instead of dwelling on vilifying others, use the platform to tell women to take care of themselves. At least 45 percent of cancer deaths and the top three causes of preventable deaths are due to things within our power to change: smoking, obesity, and drinking alcohol. Although smoking is the leading preventable cause of disease and death in the U.S., “light” smoking is increasing among women.

The marchers should not let the fear of “fat-shaming” accusations shut down the discussion about the rising obesity rate in women. Obese women are at higher risk for heart disease, depression, infertility, musculoskeletal pain, and endometrial, cervical, and breast cancer. Obesity pre- and during pregnancy contribute to pregnancy-induced hypertension, preeclampsia, gestational diabetes, cesarean sections, and neonatal death.

As a physician, I treat each patient as unique. Similarly, the marchers should remind each other that their pioneering sisters were fiercely independent and looked forward, not back. Instead of wearing silly hats, study to be the next Marie Curie, Helen Taussig, or Virginia Apgar.

The marchers should encourage women to jump off the bandwagon of negativity, shed the mantle of group victimhood, and see themselves and others as individuals, not members of a tribe.

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