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in a course on intelligence and foreign policy is to always be skeptical of what they perceive as reality or truth. McLaughlin urges them to ask questions that challenge conventional wisdom.

      Placebos—Cups and Balls

      Placebo is a Latin verb form that requires a pronoun and two verbs to translate into English as “I shall please.” That makes placebo more than a magic word. It is a magic spell. Doubtless, physicians in ancient times were familiar with the “placebo effect”—the way an inert pill or tincture or sham surgical operation or therapeutic procedure, or even a judiciously administered lie, can cause suffering patients to report amelioration of their condition or even experience clinically demonstrable improvement. The term placebo was not defined in any medical text, however, until it appeared in the 1811 edition of Lexicon Medicum, a medical dictionary published in 1717 by the English apothecary John Quincy, which was both plagiarized and expanded by Robert Hooper, a London physician. Hooper viewed placebos in much the same way as the Platonic philosopher viewed shadows—as a fraud to be scorned, calling the placebo a medicine “adapted more to please than to benefit the patient.” It was not until December 4, 1920, in an article for the distinguished British medical journal The Lancet, that the physician T. C. Graves described the “placebo effect” in more positive terms, as producing “a real psychotherapeutic effect.”

      Modern research shows that not only do 30 to 50 percent of placebos have a positive effect, but that the placebo effect may account for half of the efficacy of “real”—physiologically active—drugs. That is, drugs tend to work about 50 percent more effectively when the prescribing physician tells a patient that she will feel better by taking the medication.8 Rather more astoundingly, placebos appear to be becoming continually more effective, especially in the United States. The reason for this improvement is unclear, but some researchers believe it may be due to saturation advertising of prescription drugs, especially in the U.S., and perhaps also due to the demeanor of the personnel who administer the placebos. Friendly medical personnel tend to be associated with more positive placebo effects.9 Eric Mead, a magician and theorist, cites studies suggesting that the better-looking the placebo is, the better it works. White pills work, but smaller white pills work better. Better still are smaller blue pills with a logo stamp on them. Capsules are generally more effective than pills, and colored capsules work better than plain capsules. The higher the indicated “dosage,” the more effective the inert placebo is. But the biggest placebo effect of all is produced by injection.

      The mere presence of a physician has a placebo effect, for good or ill. A white lab coat confers authority and authority confers confidence, but most people are also familiar with the “white coat syndrome,” whereby the presence of the physician’s lab coat measurably raises a patient’s blood pressure. As the playwright George Bernard Shaw observed, “All professions are conspiracies against the laity.”

      The exterior of a capsule reveals nothing about the chemical composition of the powder or crystals inside it, let alone the physiological or therapeutic effect of the substance. Likewise, the shadows on the cave wall convey little or nothing of the substance of the objects that cast the shadows. Nevertheless, the senses and the mind work together to create a reality known as perception. They don’t start from scratch each time we see a capsule or a shadow. For better or worse, we come to every encounter prepared.

      Penn & Teller, the renowned magic/comedy team, started performing together in 1975 as magical buskers on Philadelphia street corners and at Renaissance festivals. After one gig, they stopped to eat at a New Jersey diner. Raymond Joseph Teller—that is his full original name—sat at the table practicing Cups and Balls, a close-up magic trick at least as old as the conjurers of ancient Rome and a routine that is performed all over the world. It is a series of vanishes and transpositions. In one common version of the illusion, three balls are placed on top of three inverted cups. The magician picks up one ball, vanishing it “into thin air,” only to see it reappear beneath the cup. Experienced magicians will work numerous variations on the pattern, with multiple balls appearing under one cup or with small balls turning into one or more big balls or—as Penn & Teller sometimes do it—the balls becoming several potatoes or objects or pieces of fruit. That evening in the Jersey diner, Teller had no props, so he used what was at hand, wadded-up napkins and clear water glasses. In a traditional performance, opaque cups are used. With clear glasses, anyone watching could follow the wadded napkins as Teller palmed them and moved then from cup to cup. Common sense dictates this would make the illusion impossible. But no. The illusion persisted. As Teller explained later, “The eye could see the moves, but the mind could not comprehend them. Giving the trick away gave nothing away, because you still couldn’t grasp it.” Today, Penn & Teller perform the illusion on stage, using clear glasses. It never gets old because the reality—the source of the illusion—is not in the props, but in the structure and physiology of the human brain.

      We create the reality our brains prepare us for. Most of the time and in most situations, this preparation is useful. There are three opaque cups on a table. You have placed your house keys under the middle cup. You leave the room. You return an hour later. You need your keys—fast. Your memory, together with your life experience (reminding you that inanimate objects don’t move by themselves), prompts you to lift the middle cup instead of wasting time by looking under all three. You lift that cup, retrieve your keys, and are on your way. But if those keys had been placed by a skilled magician well practiced in so-called sleight of hand, your brain might well fail you. The keys you saw the magician put under the middle cup are now under none of the cups. Your brain, prepared to see the keys go under the middle cup, failed to see them disappear into the magician’s hand and thence into his pocket.

      Spotlight Attention and Change Blindness

      Natural selection is a brutally straightforward evolutionary concept. Variation exists within all populations of organisms. Some variations produce characteristics in individuals that promote survival in an environment. Others fail to promote survival. Call the former variations “favorable adaptations” and the latter “unfavorable adaptations.” Over time, more individuals with favorable adaptations survive to reproduce, whereas fewer with unfavorable adaptations survive to reproductive age. Eventually, the result in such a species is a population exhibiting only the favorable adaptations.

      We human beings are equipped with brains that have acquired, through natural selection, certain characteristics that contribute to our survival—at least under most conditions. Among these characteristics is something we might call spotlight attention. The world bombards us with stimuli, potentially and quickly overwhelming us, leaving us vulnerable to harm from a plethora of sources—were it not for our unconscious ability to focus exclusively on (or “attend to,” as psychologists put it) those inputs that are most likely to affect us for good or bad. Without this narrow-beam spotlight focus, we are doomed. When we cross a busy street, we are attuned to traffic—not to the sound of a random bird or the hum of an errant bumblebee. For this reason, we stand a good chance of getting across the road unscathed. Spotlight attention works very well in “normal” situations, but when the status quo is disrupted—as it is when a magician performs—spotlight attention can create what psychologists call change blindness.

      A classic example was videotaped in 2007 by the British psychologist Richard Wiseman. It shows the psychologist performing what he describes as the “amazing color-changing card trick.” Seated at a table, he introduces himself and Sarah, the woman sitting beside him. He spreads the cards out in front of Sarah, face down. The backs of the cards are blue. He instructs her to pick any card and push it toward the camera. Wiseman gathers up the remaining cards, narrating the action all the while. He announces that he is going to ask Sarah to show us the card she selected. She picks it up, turns it toward the camera, and announces that it is the three of diamonds. The magician puts the card back into the deck, which he now holds fanned out in his hand, cards facing toward the camera. He spreads the cards face up on the table and pulls out Sarah’s card, the three of diamonds. He turns it over and shows that it has a blue back.

      “Not particularly surprising,” he says, “but what is more surprising is that all of the other cards have changed to red backs!” He flips them over to reveal this. “And that is the amazing color-changing card trick,” he concludes.

      What

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