Surgeons and Shamans

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Abstract
Surgeons have conducted placebo-controlled double-blind investigations to determine the value of surgical procedures by comparing the results of real operations with sham operations. The sham operation served as a placebo control, permitting analysis of the alleged benefit of the real operation by eliminating the effect caused by the rest of the surgical experience. A modern operation starts with a series of events resembling ritualistic practices used by shamans. Sha- mans are traditional healers in cultures that believe communication with the gods and spirits influence health and well being. Shamanistic healing measures include: journeying to a healing place, fasting, wearing ritual garb, ingesting psychotrophic substances, anointment with purifying liquid, an encounter with a masked healer, and inhaling stupefactive vapors. These steps are followed by a central ritual activity that may include extracorporeal, surface, and penetrative components. Postoperative ritual activities reinforce the suggestive value of the healing. These experiences increase a patient's suggestibility, thereby enhancing the likelihood of a favorable outcome. Any research on the effectiveness of surgical procedures, especially those designed to relieve pain, must consider the strongly suggestive effect of the elaborate perioperative ritual.