Daar Marion,

Thank you for your telephone call last night, and for your
patience with all my idiosyncracies. Today again, I spent
some hours shoveling heavy snow, which turned to rain as
I worked. My granddaughter Leah appeared when I had cleared
3/4 of the driveway. She completed the job while I went 
indoors for a cup of hot soup and a hot shower. I sat down
at the computer and tried to identify stocks that might
prove a reasonable investment. My skepticism interfered.
In the end I bought nothing but two month US Treasury Bills.
Next I started to reread the chapter (No. 43) in my novel
which I'm trying to complete.  It isn't as brilliant as I
would like, but it might be worse, and the words and phrases
have a beauty of their own, even if the images and thoughts
they convey are less inspired than I would wish.

Thank you also for forwarding the study about Placebos without
Deception, which raises many issues that I have encountered in
my own practice over the years. Without belittling the conscientious
methodology of the authors, I can't avoid the comment that
I have observed what they describe so often, that it seems
obvious to me. The patients were told "that they would receive
either placebo (inert) pills, which were like sugar pills which
had been shown to have self-healing properties or no-treatment."
The assertion that the "inert" pills had been shown to have
"self-healing" properties - whatever that was intended to mean,
is no less "deceptive" than a statement that the intraocular
injection of anti-VEGF monoclonal antibodies has been shown
to be beneficial in 25 percent of patients with macular
degeneration. Each of the statements and each of the treatments
has a "placebo" effect, the difference being not the characteristic
of the medications but the beliefs of the physicians who are
convinced that "inert sugar pills" can have no medicinal effect,
and convinced on the other hand, that with monoclonal antibodies
medicinal effects are inescapable.  In both situations patients
are led to believe the treatment to be effective and can be expected
to report beneficial results.

A second comment is that in my experience, feelings and experiences
to not lend themselves to arithmetic expression. If you ask me
to state on a scale of one to ten, how hungry, or how tired, or
how happy, or how creative or how inspired or how depressed I am,
I'll hang up the phone before you get to the end of your sentence.
I admit, there's something wrong with me, but I can't escape my
conviction that the presumption to calibrate feeling is inane or
silly or both.

Jochen