The ‘Nocebo’ Effect

John Henry on the insistence of Curt Schilling’s doctor that the Red Sox’ prescribed treatment program is doomed to certain failure:

"I didn’t appreciate that," said Henry. "That’s what you call a ‘nocebo.’ It’s the opposite of placebo. Usually, part of a doctor’s way of dealing with patients is . . . We all know the placebo effect is a huge effect. So giving your patient a ‘nocebo effect,’ to me that’s irresponsible."

I’m no doctor, but what Henry says makes sense. Almost invariably, you hear about dedicated, motivated people dedicated to busting the timetable coming back sooner than expected and better than expected. You certainly don’t hear them making statements like this:

"I don’t have any choice. If their course of action doesn’t work, I don’t pitch this year, I might not ever pitch again."

Forgive me if that leaves me wanting some more assurances about Curt’s motivation to fully commit himself to the Red Sox’ program.

At any rate, it’s certainly ironic that Schilling talked about medical egoes during his comments, in a seeming attempt to discredit the Red Sox’ decision, when the only doctor who feels compelled to repeatedly espouse the certainty of his theories in the press is Schilling’s.

18 comments… add one
  • The nocebo effect is interesting, but for a single case I’m going to defer to the free will of the individual overcoming it. As such, I’ve resigned myself to hoping Curt’s own ego forces him to do everything he can to come back and do well, this acrimonious game of medical chicken notwithstanding. If he has a choice and would prefer to be “hurt” all year to prove a point, then he really may never pitch professionally again. And I have to think even someone like Schilling wouldn’t cut his career short to spite his fate.

    FenSheaParkway February 19, 2008, 4:07 pm
  • Ugly distraction. Go away Schilling.

    LocklandSF February 19, 2008, 4:29 pm
  • Club doctor wants Curt to rehab. Curt’s doctor, who knows Curt’s shoulder intimately, says Curt needs surgery. Instinctively I would probably go with the Doc who knows Curt’s shoulder intimately, operated on it previously, knows his patient based on years of work together.
    The contract isn’t insured, apparently, which is probably why the Sox want to try to extract value from Schilling, meaning innings. The big question is how and why did this happen (I suppose that matters only to lawyers, in the end). Did he pass a full physical? Was there damage that the team knew about that they ignored? If he wasn’t given a full physical, why not? So either the Sox didn’t do their due diligence or Curt did something following his physical that has basically ruined his shoulder.
    Curt, at 38 Pitches, just says “things went south”, and that the team is “out 8 million dollars for a guy who can’t pitch”. He only says that the team was “never in the dark and knew the first day there were problems”, but clearly this means it happened after he signed the deal. So why did his shoulder end up shredded? Typical workouts? Age? Certainly people get hurt, and Curt, at his age with his previous shoulder issues, is a candidate for a problem.
    In the end, it might be that Occam’s Razor works here as an explanation, despite the theories that are sure to run amok. Curt is old. Curt signed a deal. Curt, working out, hurt his shoulder really badly. Pretty simple. I hope, and think right now, that is the truth.

    SF February 19, 2008, 4:42 pm
  • To be clear, I’m not saying I don’t think Curt’s doc is right, I’m saying I don’t want this to dominate spring training.

    LocklandSF February 19, 2008, 4:49 pm
  • I’m a little aggravated in that Schilling says he kept quiet so as to not be a distraction, then spoke because he realized his silence was also a distraction.
    Except that Schilling’s comments seemed unnecessarily inflammatory and became even MORE of a distraction than just keeping quiet.
    I don’t doubt Schilling will try very hard to get back and pitch this season, but subconsciously will he be fully committed? If every time you’re attempting a method you think to yourself that this totally will not work, what chances are there that you will fulfill your own prophecy?
    In that sense, I blame Schilling’s doctor, who certainly could have helped smooth matters over by not injecting his own ego into this situation. Instead, he’s helped foster this black-and-white mentality that seems detrimental to the discourse we’ve seen publicly.

    Paul SF February 19, 2008, 4:49 pm
  • i’m not suggesting anything but…..curt’s gonna miss the first 50 games anyway’s. just saying.

    sf rod February 19, 2008, 4:50 pm
  • Did John Henry just pull a Don King? You don’t hear much from the Sox owner. Maybe he has a whole collection of Henry-Made words.

    Nick-YF February 19, 2008, 5:29 pm
  • Hehe, Henry’s kind of the anti-Steinbrenner. Although Larry Lucchino’s been pretty quiet also, and he used to be good for some major quotes.

    Paul SF February 19, 2008, 5:31 pm
  • Speaking of Hank, from New York Post today…
    “I don’t think they would want to be hollering too loud at Andy up in Fenway,” Steinbrenner told The Post. “They had plenty of players doing this stuff, too. It’s just that those players weren’t mentioned in the Mitchell Report.”
    Never a dull moment…

    LocklandSF February 19, 2008, 5:40 pm
  • Hank needs to start a blog.
    He’s like Mark Cuban but without the class.

    SF February 19, 2008, 5:47 pm
  • Wow. I didn’t think the Yankees could find a bigger jackass than George Steinbrenner. And yet…

    Paul SF February 19, 2008, 5:56 pm
  • > “They had plenty of players doing this stuff, too. It’s just that those players weren’t mentioned in the Mitchell Report.”
    Ouch. That’s embarrassing and irresponsible.

    attackgerbil February 19, 2008, 5:58 pm
  • Yet, most likely accurate. But yeah, definitely not professional.

    AndrewYF February 19, 2008, 7:59 pm
    (No offense, AG.)

    I'mBillMcNeal February 19, 2008, 8:05 pm
  • I personally would like to read a blog written by Hank, although I’m not sure that “blogging” is his thing.
    It would be amusing to see Hank use emoticons or text message lingo like “lolerskates.”
    Even Theo Epstein is into TextSpeak!

    SoxFan February 20, 2008, 1:05 am
  • Of course what Hank said is probably true, but I agree with most of you, totally unprofessional.
    But, let’s look at what he actually said for a second.
    Sports fans at events follow a mob mentality and find any tiny thing they can use as ammo against opposing players. Pettitte is going to get absolutely assaulted outside of Yankee Stadium this year, not just Fenway. Signs, chants, syringes, the whole Barry Bonds treatment. Is it right? Probaly not, but that train has left the station and you can’t really blame opposing fans either.
    Does Hank really think that Yankee fans wouldn’t do the same exact thing and will do the same thing when known users play at Yankee Stadium?
    As far as entertainment factor goes, I’m really glad Little Stein is as much of a blow hard as Big Stein was.

    LocklandSF February 20, 2008, 8:59 am
  • I don’t think Pettitte is going to be treated as harshly as you think. He’ll get the full treatment at Fenway for sure, but I’ve even read several Sox fans saying how they like him still. Frankly, I don’t think the average fan really actually CARES nowadays about who took PEDs. We all kind of know the majority of players were doing it. It’s weird, but baseball fans as a collective probably have the best outlook on the situation.

    AndrewYF February 20, 2008, 11:02 am
  • Andrew,
    I certainly agree with you to some extent, I for one am in the camp of RS fans that still like and respect AP, but we’re not average fans.
    Average fans, for lack of a better term, are idiots.

    LocklandSF February 20, 2008, 11:36 am

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