By the time you read this, I will likely have survived a plane trip to the Bahamas. The fact that I am able to do such a thing without suffering a major, personal in-flight meltdown proves the placebo powers of pharmaceuticals. The placebo effect, of course, refers to mysterious curing powers of sugar pills or plain water; so long as the patient believes that the pills can cure, they do. What I’m talking about in the case of my plane flight is just the opposite: the therapeutic effect of actual medicines even when they are not taken. For years now, I have walked around with a little plastic bottle containing exactly one Valium tablet. A doctor prescribed it years ago when I was about to undergo an MRI. Being claustrophobic, I was concerned about freaking out while inside the tunnel, and asked my doctor for “a little something to take the edge off.” “How about a Valium?” he asked as he scribbled on his prescription pad. And he meant a Valium. After I handed over the prescription, the pharmacist gave me a bottle containing exactly one pill. I held the bottle in my hand during the MRI, knowing I could pop it into my mouth if things got bad enough in that tunnel. (In fact, with my hands tightly at my sides there was no way I could have popped the pill just then, but I didn’t think of that at the time.) I’ve carried the pill in my purse ever since; I consider it a sort of life raft to save me should I ever freak out, panic, lose my self-control, have a major muscle spasm or encounter an old boyfriend when I’m feeling particularly bad about myself. I have been in each of the above situations at least once in the years since that MRI, and yet I’ve never felt enough out of control to actually take the Valium pill. Just knowing it’s there is somehow enough. Obviously, this sort of thing doesn’t work with all medicines. Antibiotic pills, for instance, do nothing to kill bacteria until you actually swallow them. Ditto for things like decongestants and cough syrup. But the reverse placebo phenomenon works for my asthma. I’ll be breathing just fine until it occurs to me that I’m away from home without an inhaler, and the tightness begins immediately. I’ve been known to stop what I was doing and drive home to get an inhaler, only to find I didn’t really need a puff when I finally got it in my hand, my asthma attack miraculously cured simply by my proximity to the medicine. I’m highly suggestible, of course. I stopped reading women’s magazines years ago when I developed the symptoms of every disease featured in an article. Medical programs on TV have been known to give me their featured ailments. Apparently, my mind is inhabited by a flock of sheep prone to following every twinge and tingle all the way down the synapse lane to major catastrophic disease. But I am not a hypochondriac. If I were, I would have taken that first Valium and then asked for a few refills. Instead, I fall into the category of people who worry about their health but not enough to take anything for it. Somehow, that would be caving in, wouldn’t it• To swallow the Valium would be conceding that I was too mentally weak to endure a few moments in an MRI tunnel. To take the Valium pill would be to cash the check on my personal foible. Although I’m looking forward to the trip to the Bahamas with my husband and children, I dread the flight. The hour in the airport before the trip is always the worst, as I contemplate jamming myself into a seat beneath that low ceiling, surrounded by strangers who are breathing my air. My heart rushes forward just writing about it. My deepest fear is that I will become lightheaded at takeoff, place my head between my knees to get the blood flowing, and pass out cold, doing a forward roll under the seat in front of me. And so, when the first rumbles of panic spring up in my chest I will activate my placebo drill. Asthma inhaler• Check. Valium pill• Check. Seatbelt fastened• Check. With all my little life rafts in place, I will sit back and enjoy the ride.

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