You Are the Placebo
Sam Londe, a retired shoe salesman living outside of St. Louis in the early 1970s, began to have difficulty swallowing. He eventually went to see a doctor, who discovered that Londe had metastatic esophageal cancer. In those days, metastatic esophageal cancer was considered incurable; no one had ever survived it. It was a death sentence, and Londe’s doctor delivered the news in an appropriately somber tone.
To give Londe as much time as possible, the doctor recommended surgery to remove the cancerous tissue in the esophagus and in the stomach, where the cancer had spread. Trusting the doctor, Londe agreed and had the surgery. He came through as well as could be expected, but things soon went from bad to worse. A scan of Londe’s liver revealed still more bad news: extensive cancer throughout the liver’s entire left lobe. The doctor told Londe that sadly, at best, he had only months to live.
So Londe and his new wife, both in their 70s, arranged to move 300 miles to Nashville, where Londe’s wife had family. Soon after the move to Tennessee, Londe was admitted to the hospital and assigned to internist Clifton Meador. The first time Dr. Meador walked into Londe’s room, he found a small, unshaven man curled up underneath a mound of covers, looking nearly dead. Londe was gruff and uncommunicative, and the nurses explained that he’d been like that since his admission a few days before.
While Londe had high blood-glucose levels due to diabetes, the rest of his blood chemistry was fairly normal except for slightly higher levels of liver enzymes, which was to be expected of someone with liver cancer. Further medical examination showed nothing more amiss, a blessing considering the patient’s desperate condition. Under his new doctor’s orders, Londe begrudgingly received physical therapy, a fortified liquid diet, and lots of nursing care and attention. After a few days, he grew a little stronger, and his grumpiness started to subside. He began talking to Dr. Meador about his life.
Londe had been married before, and he and his first wife had been true soul mates. They had never been able to have children but otherwise had had a good life. Because they loved boating, when they retired they had bought a house by a large man-made lake. Then late one night, the nearby earthen dam burst, and a wall of water crushed their house and swept it away. Londe miraculously survived by hanging on to some wreckage, but his wife’s body was never found.
“I lost everything I ever cared for,” he told Dr. Meador. “My heart and soul were lost in the flood that night.”
Within six months of his first wife’s death, while still grieving and in the depths of depression, Londe had been diagnosed with esophageal cancer and had had the surgery. It was then that he had met and married his second wife, a kind woman who knew about his terminal illness and agreed to care for him in the time he had left. A few months after they married, they made the move to Nashville, and Dr. Meador already knew the rest of the story.
Once Londe finished the story, the doctor, amazed by what he’d just heard, asked with compassion, “What do you want me to do for you?” The dying man thought for a while.
“I’d like to live through Christmas so I can be with my wife and her family. They’ve been good to me,” he finally answered. “Just help me make it through Christmas. That’s all I want.” Dr. Meador told Londe he would do his best.
By the time Londe was discharged in late October, he was actually in much better shape than when he had arrived. Dr. Meador was surprised but pleased by how well Londe was doing. The doctor saw his patient about once a month after that, and each time, Londe looked good. But exactly one week after Christmas (on New Year’s Day), Londe’s wife brought him back to the hospital.
Dr. Meador was surprised to find that Londe again looked near death. All he could find was a mild fever and a small patch of pneumonia on Londe’s chest x-ray, although the man didn’t seem to be in any respiratory distress. All of Londe’s blood tests looked good, and the cultures the doctor ordered for him came back negative for any other disease. Dr. Meador prescribed antibiotics and put his patient on oxygen, hoping for the best, but within 24 hours, Sam Londe was dead.
As you might assume, this story is about a typical cancer diagnosis followed by an unfortunate death from a fatal disease, right?
Not so fast.
A funny thing happened when the hospital performed Londe’s autopsy. The man’s liver was, in fact, not filled with cancer; he had only a very tiny nodule of cancer in its left lobe and another very small spot on his lung. The truth is, neither cancer was big enough to kill him. And in fact, the area around his esophagus was totally free of disease as well. The abnormal liver scan taken at the St. Louis hospital had apparently yielded a false positive result.
Sam Londe didn’t die of esophageal cancer, nor did he die of liver cancer. He also didn’t die of the mild case of pneumonia he had when he was readmitted to the hospital. He died, quite simply, because everybody in his immediate environment thought he was dying. His doctor in St. Louis thought Londe was dying, and then Dr. Meador, in Nashville, thought Londe was dying. Londe’s wife and family thought he was dying, too. And, most important, Londe himself thought he was dying. Is it possible that Sam Londe died from thought alone? Is it possible that thought is that powerful? And if so, is this case unique?