[Music]
well thank you for welcoming me to this
meeting – placebos anonymous you look
like a real audience you really do you
look like a real genuine audience
unlike the cardboard cutouts basically
making the mock spectators in the
cartoon behind me so I should probably
introduce myself in the vernacular and
template that is reserved for these kind
of meetings let me do it hi my name is
dr. Roz and I am addicted to placebos
yes I kid you not I really am I
systematically study placebos I read and
write about them I experiment with them
I take them on occasion and I even think
that I know a little bit about them
there you have it in a way I’m a placebo
scientist if you’d like to think about
it that way now the crux of what I’m
about to tell you is that you – if
you’re human that is
foster a strong predilection for placebo
effects and placebo responses you need
not be feeble-minded gullible uneducated
not at all you need not be a fan of Star
Trek you don’t need to be deeply in love
by virtue of being a member of our
species
if you imbue them with meaning placebos
will move you even better than that for
some of you in certain situations
placebos will actually rock you they
will and what better place than Montreal
to talk about these mind-body
interactions because here unlike many
other places you can walk up to many
a pharmacy and for a very reasonable
price you guessed it get your own
personal stash of pharmaceutical e
engineered kosher placebo tablets and
Montreal placebos are crazy in the sense
that they work equally well in English
and in French but we’re not going to be
talking here about sugar pills or about
saline injections not at all we’re much
more high-minded than that as a matter
of fact we’re so high minded we’re going
to be talking about top-down processing
we’re going to be talking about top-down
phenomena we’re going to be talking
about top-down control top-down
regulation what does it mean it starts
with what bruise between your ears your
thoughts your expectations your ideas
your reflections it all marinates into
this complex soup that then trickles
cascades downstream to influence mold
and shape physiological systems at a
lower tier confused yet
don’t be let me give you an example of
what a top-down process is if I asked
you to pay attention to the way that you
blink will I continue to talk okay even
if I asked you to continue blinking in
the same way that you had blinked before
neither more nor less then you had
blinked usually weird things are gonna
start happening can you feel it
frankly you would draw a blank blink as
though I get a Blanc before I made this
request but an automatic process that
effortlessly keeps your eye moist and
clean and ready to see turns into a
toilet full semi voluntary experience
why because of my request I think you’re
beginning to understand what I mean when
I say top-down and placebos are but one
example of a top-down process now
sometimes we infuse a healthy bit of
parenting deception
in cue our top-down innuendo let me give
you an example when I taught my oldest
son how to ride his bicycle I would do
what a lot of parents do I I would grab
the backseat and I would sort of you
know run with him making sure that he’s
all right as he got better I would
sometimes let go just to see how he’s
doing and I would grab it again and I
would do it and at the end it was my
running presence not my dropping hand
that was actually doing the trick he was
riding on his own unbeknownst to him I
was not holding now this kind of
parental deception or educational
deception I think most of us would agree
is okay if not downright justifiable
it’s certainly very acceptable
how about parental deception when it
comes to medical issues we’ll see that’s
where things become a little bit more
objectionable don’t they well the other
night for example my elementary school
daughter complained about a tummy ache
and without thinking about it too much I
reached for one of those in different
moisturizer I have around the house and
I started rubbing it around her belly
saying you know all kinds of things in
theory here listen sweetie this stuff is
very strong it comes straight from
Switzerland it’s going to make you feel
better before you know it it worked like
magic it really did but I felt a little
bit uncomfortable why because we have
very strong feelings about lying not
just to our children and certainly
certainly we have some reservations
about mixing deception with medicine
right now deception is very tricky and I
think we agree that deception is a
general currency is probably a bad form
but I am a former magician I’m a former
conjurer a trickster an actor who is
playing the role of a wizard an artist
and in time I’m going to show you some
interesting things about deception
particularly I’m here to tell you that
not all deception is bad for you as a
matter of fact sometimes a little bit of
dishonesty is good for you
let me talk to you a little bit about
hypnosis hypnosis is something that I’ve
been using in my lab for several decades
now and in hypnosis we refer to a
process that is called a non deceptive
placebo why is it non deceptive because
in most typical hypnosis experiences
people come into the lab you tell them
that there’s a helium balloon attached
to their wrist of course there isn’t but
you tell them that there is and as the
result their hand begins to levitate and
elevate and do all kinds of things and
they’re under the impression that this
elevation is happening because of the
human balloon that isn’t there but they
know that it isn’t there there’s
something weird about this situation but
it’s not deceptive because in hypnosis
there is suspension of disbelief pretty
soon I’m going to show you how I study
these kind of experiments this kind of
top-down control in my lab I’m going to
show you in a minute
a visual paradigm that is going to
involve lines that are going to be
dancing around in this case we’re going
to use four lines only these lines are
going to be dancing around and it’s
going to be difficult for you to tell
what geometric shape they make it’s
going to be difficult for you to tell
until I introduce these occluders these
kind of masks that are going to cover
the corners once I introduce the corners
it’s going to be very easy for you to
see the shape and whether it’s going
counterclockwise or clockwise I mean
depending on the shape now I’m going to
play it for you so you can actually see
it and as you can see with the lines
moving about you’ll see the two lines
are moving together and the other two
lines are moving together it’s very
difficult to see what’s going on here
exactly but as soon as I’m going to
introduce these occluders you’re gonna
see that this is actually a what that’s
right a diamond that is moving you know
in a particular direction it’s very
important that you understand that once
I take the kut’rs out everything falls
apart but once I put it back there again
here you go very clear what the shape is
now would it be possible to take people
who are highly hypnotizable sometimes we
call them highs can we take people are
highly hypnotizable and tell them that
the occluders are actually there when
they’re not just impose on them and tell
them they’re actually occluders there
and expect them to Colusa Nate the
occluders and as a result of that see
whether they can actually see the figure
in the direction turns out that the
answer is yes
this is an experimental question so you
can do an experiment we do the
experiment and we see that for people
who are highs they score very very very
highly a towering result there’s
something special about being highly
hypnotizable perhaps as special as being
a good placebo responder we’re still
trying to find the link between being a
good possible responder and being a
highly hypnotizable person but you don’t
need to be you don’t need to be highly
hypnotizable or good placebo responder
in order to experiment and in order to
see what’s going on let me give you an
example let’s say that I asked you to
participate in this study that involves
combing your hair I have a special box
and from the box I take a regular comb
and the comb looks like a men’s come
from 1940s plastic nothing special but
of course I don’t qualify for this kind
of experiment because I don’t have much
to comb but let’s say that you do and I
hand you the comb gingerly and you take
the comb and you comb your hair and you
do it for let’s say 2 minutes and the
purpose of the study is for you to tell
me how the experience was so you do it
for 2 minutes and let meet many weird
psychological experiments you say at the
end I felt good I felt that and at the
end you give the comb back and I put it
in the box and of experiment or is it
it’s not the end of the experiment
because then the experimenter turns to
you after you filled out all the
question is how you felt and everything
and he says something like this oh sorry
you’re probably wondering about the
glove you see this is no regular comb
this used to be
Hitler’s comb now these last two words
Hitler’s comb will change the experience
for most people certainly for people
with my family background a national
heritage because there’s something about
meaning that we connect with very very
strongly there is something that defines
the experience even in retrospect after
it was over just giving this information
changes the whole experience now as we
move deeper afield into the twilight
zone that is between deception and
top-down processes I want you to
understand that in real life people have
shown time and again that it’s possible
to even
use deception without deception in a way
you can take lesea bows and use them
even without tricking people into
thinking that they’re not possible you
can do this with irritable bowel
syndrome you can do this with lower back
pain you can do this with ADHD people
have done these studies you can also
demonstrate that you can use placebos
with non-human animals so the question
is what is this mysterious effect that
starts up top and then trickles down and
changes our physiology in all kinds of
weird ways can we quantify it can we
understand the mechanisms and the answer
is yes we’re beginning to and let me
tell you a little bit about that and why
you should care because all of you are
thriving on placebos and you don’t even
know it let me show you a few examples
well first of all I’d like to start
talking about antidepressants why
antidepressants because a lot of people
in our culture are taking
antidepressants in the US alone one in
10 people are on antidepressants when it
comes to middle-age women it’s one in
four
these are staggering numbers staggering
numbers and why do you take
antidepressants usually this is a major
backbone drug of modern psychiatry why
do people take antidepressants well all
kinds of reasons but mostly for
depression and usually for mild to
moderate depression but we have a lot of
evidence that shows that for mild to
moderate depression clinically
antidepressants and placebos are on par
well what does that mean well some
people take it to mean that
antidepressants don’t work when there’s
a big promotion around it and I think
there should be but in a way what I’m
here to tell you is that that’s wrong
antidepressants do work they work well
they work so well that clinically for
mild to moderate depression they work as
well as placebos do this is how good
placebos are this is how powerful they
are
now some people listen to this and say
well I’ve heard of other examples from
clinical medicines for example sham
surgery versus real surgery and this is
true
has been done for the knees and for
other parts of the body and sometimes we
can show the Chancellor jury and real
surgery are on par but this is not the
point that I want to make I want to make
a point a little bit of a point about
technology for example take
neurofeedback I think many people don’t
realize that today we have technology
that allows us to watch our brains in
action we can actually see what’s
happening inside our brain while it’s
happening in real time and some people
use it therapeutically in order to help
people get better and change their
behavior and so on in the image that you
see here you’re basically looking at a
creme de la creme inverted toilet on top
of your head kind of you know technology
that allows us to do this kind of thing
when you go into a regular neurofeedback
clinic you’re not going to see this this
is way out of budget for most people and
very rare they will basically use EEG
neurofeedback and here they just put you
know a few electrodes on your head and
listen to the elec you know electrical
jazz that is playing under your scalp
but the point is that what you see on
this screen which is allegedly the
feedback from your brain is not so
important what do I mean by that if I
show you your own brain activity my
brain activity his brain activity her
brain activity even if I doctor up a
video from a simulated brain I showed
you people get better people get better
what does it smell like to you it smells
to me it reeks of a placebo component
there’s nothing wrong with it it just
shows you how powerful pacy bose can be
even if you pay a lot of money for them
now I mentioned hypnosis before I would
be remiss if I wouldn’t mention
meditation meditation is all the rage
these days meditation is in vogue and
when I say meditation I don’t
necessarily mean mindfulness and I don’t
necessarily mean yoga or guided imagery
or you know compassion training whatever
pick pick and choose I mean it’s
completely it’s a free world I’m talking
about the idea of a top-down process all
these contemplative practices are
basically allowing us to see what is
happening in the brain in our body and
our physiology as a result of practicing
these top-down techniques and we’re
beginning to see what’s happening we’re
beginning to understand what’s happening
and we’re beginning
then who are the people who are likely
to benefit from this more we’re
beginning to say what are the systems
that are involved more than that we are
now getting into sort of a new kind of
direction where these techniques that
were present thousands of years ago
I mean meditation Buddhism thousands of
years back we don’t have to go that far
if you go back to their recent past
1970s I got you a black-and-white
picture showing you the things drink
effect that a lot of people don’t know
that they think drink effect is
something that people don’t know about
because they’re too familiar with the
drink effect the drink effect is what
happens when you you know imbibe alcohol
in generous amounts you don’t need a
TEDTalk for that but what people don’t
realize sometimes is that you can
actually get a non-alcoholic beverage
this is my palcohol placebo alcohol and
you know if you give people a
non-alcoholic beverage you can sometimes
get some pretty good results if they are
under the impression that this is an
alcoholic beverage so much so that they
will show you impaired cognition slurred
speech inability to walk a straight line
they will vomit they will have you know
hangovers serious stuff all on palcohol
now sometimes when we do these
experiments the people who are
susceptible to this are too drunk to
understand that the experiment is over
when you tell them you know this was a
hoax this is strong stuff
this is palcohol for you now what have
we had here today I mean we had some you
know blinking we had all kinds of
parental deception we had a magician was
an honest liar
we had some hypnosis with dancing lines
we had Hitler’s comb we had some
antidepressants
we had neurofeedback now I’m beginning
to talk to you about meditation and
alcohol listen at the end of the day
although deception is a slippery slope
and it is a slippery slope we are in the
process of gaining better scientific
insights into what it is to use the
power of top-down control
and as a result we’re beginning to
ponder if it would be possible to use
placebos in a way that is both judicious
and ethical judicious and ethical and I
am here to tell you and to submit to you
that in some circumstances it is
actually unethical not to use placebos
but we can talk about that over a stiff
drink of alcohol whatever you do
whatever you do I want you to next time
you hear a person come to you and say hi
my name is dr. Raza and I am a pal
coholic please don’t laugh it’s a
serious top down matter it’s a serious
top down matter
thank you for placebo in with me today
Cheers
you
well thank you for welcoming me to this
meeting – placebos anonymous you look
like a real audience you really do you
look like a real genuine audience
unlike the cardboard cutouts basically
making the mock spectators in the
cartoon behind me so I should probably
introduce myself in the vernacular and
template that is reserved for these kind
of meetings let me do it hi my name is
dr. Roz and I am addicted to placebos
yes I kid you not I really am I
systematically study placebos I read and
write about them I experiment with them
I take them on occasion and I even think
that I know a little bit about them
there you have it in a way I’m a placebo
scientist if you’d like to think about
it that way now the crux of what I’m
about to tell you is that you – if
you’re human that is
foster a strong predilection for placebo
effects and placebo responses you need
not be feeble-minded gullible uneducated
not at all you need not be a fan of Star
Trek you don’t need to be deeply in love
by virtue of being a member of our
species
if you imbue them with meaning placebos
will move you even better than that for
some of you in certain situations
placebos will actually rock you they
will and what better place than Montreal
to talk about these mind-body
interactions because here unlike many
other places you can walk up to many
a pharmacy and for a very reasonable
price you guessed it get your own
personal stash of pharmaceutical e
engineered kosher placebo tablets and
Montreal placebos are crazy in the sense
that they work equally well in English
and in French but we’re not going to be
talking here about sugar pills or about
saline injections not at all we’re much
more high-minded than that as a matter
of fact we’re so high minded we’re going
to be talking about top-down processing
we’re going to be talking about top-down
phenomena we’re going to be talking
about top-down control top-down
regulation what does it mean it starts
with what bruise between your ears your
thoughts your expectations your ideas
your reflections it all marinates into
this complex soup that then trickles
cascades downstream to influence mold
and shape physiological systems at a
lower tier confused yet
don’t be let me give you an example of
what a top-down process is if I asked
you to pay attention to the way that you
blink will I continue to talk okay even
if I asked you to continue blinking in
the same way that you had blinked before
neither more nor less then you had
blinked usually weird things are gonna
start happening can you feel it
frankly you would draw a blank blink as
though I get a Blanc before I made this
request but an automatic process that
effortlessly keeps your eye moist and
clean and ready to see turns into a
toilet full semi voluntary experience
why because of my request I think you’re
beginning to understand what I mean when
I say top-down and placebos are but one
example of a top-down process now
sometimes we infuse a healthy bit of
parenting deception
in cue our top-down innuendo let me give
you an example when I taught my oldest
son how to ride his bicycle I would do
what a lot of parents do I I would grab
the backseat and I would sort of you
know run with him making sure that he’s
all right as he got better I would
sometimes let go just to see how he’s
doing and I would grab it again and I
would do it and at the end it was my
running presence not my dropping hand
that was actually doing the trick he was
riding on his own unbeknownst to him I
was not holding now this kind of
parental deception or educational
deception I think most of us would agree
is okay if not downright justifiable
it’s certainly very acceptable
how about parental deception when it
comes to medical issues we’ll see that’s
where things become a little bit more
objectionable don’t they well the other
night for example my elementary school
daughter complained about a tummy ache
and without thinking about it too much I
reached for one of those in different
moisturizer I have around the house and
I started rubbing it around her belly
saying you know all kinds of things in
theory here listen sweetie this stuff is
very strong it comes straight from
Switzerland it’s going to make you feel
better before you know it it worked like
magic it really did but I felt a little
bit uncomfortable why because we have
very strong feelings about lying not
just to our children and certainly
certainly we have some reservations
about mixing deception with medicine
right now deception is very tricky and I
think we agree that deception is a
general currency is probably a bad form
but I am a former magician I’m a former
conjurer a trickster an actor who is
playing the role of a wizard an artist
and in time I’m going to show you some
interesting things about deception
particularly I’m here to tell you that
not all deception is bad for you as a
matter of fact sometimes a little bit of
dishonesty is good for you
let me talk to you a little bit about
hypnosis hypnosis is something that I’ve
been using in my lab for several decades
now and in hypnosis we refer to a
process that is called a non deceptive
placebo why is it non deceptive because
in most typical hypnosis experiences
people come into the lab you tell them
that there’s a helium balloon attached
to their wrist of course there isn’t but
you tell them that there is and as the
result their hand begins to levitate and
elevate and do all kinds of things and
they’re under the impression that this
elevation is happening because of the
human balloon that isn’t there but they
know that it isn’t there there’s
something weird about this situation but
it’s not deceptive because in hypnosis
there is suspension of disbelief pretty
soon I’m going to show you how I study
these kind of experiments this kind of
top-down control in my lab I’m going to
show you in a minute
a visual paradigm that is going to
involve lines that are going to be
dancing around in this case we’re going
to use four lines only these lines are
going to be dancing around and it’s
going to be difficult for you to tell
what geometric shape they make it’s
going to be difficult for you to tell
until I introduce these occluders these
kind of masks that are going to cover
the corners once I introduce the corners
it’s going to be very easy for you to
see the shape and whether it’s going
counterclockwise or clockwise I mean
depending on the shape now I’m going to
play it for you so you can actually see
it and as you can see with the lines
moving about you’ll see the two lines
are moving together and the other two
lines are moving together it’s very
difficult to see what’s going on here
exactly but as soon as I’m going to
introduce these occluders you’re gonna
see that this is actually a what that’s
right a diamond that is moving you know
in a particular direction it’s very
important that you understand that once
I take the kut’rs out everything falls
apart but once I put it back there again
here you go very clear what the shape is
now would it be possible to take people
who are highly hypnotizable sometimes we
call them highs can we take people are
highly hypnotizable and tell them that
the occluders are actually there when
they’re not just impose on them and tell
them they’re actually occluders there
and expect them to Colusa Nate the
occluders and as a result of that see
whether they can actually see the figure
in the direction turns out that the
answer is yes
this is an experimental question so you
can do an experiment we do the
experiment and we see that for people
who are highs they score very very very
highly a towering result there’s
something special about being highly
hypnotizable perhaps as special as being
a good placebo responder we’re still
trying to find the link between being a
good possible responder and being a
highly hypnotizable person but you don’t
need to be you don’t need to be highly
hypnotizable or good placebo responder
in order to experiment and in order to
see what’s going on let me give you an
example let’s say that I asked you to
participate in this study that involves
combing your hair I have a special box
and from the box I take a regular comb
and the comb looks like a men’s come
from 1940s plastic nothing special but
of course I don’t qualify for this kind
of experiment because I don’t have much
to comb but let’s say that you do and I
hand you the comb gingerly and you take
the comb and you comb your hair and you
do it for let’s say 2 minutes and the
purpose of the study is for you to tell
me how the experience was so you do it
for 2 minutes and let meet many weird
psychological experiments you say at the
end I felt good I felt that and at the
end you give the comb back and I put it
in the box and of experiment or is it
it’s not the end of the experiment
because then the experimenter turns to
you after you filled out all the
question is how you felt and everything
and he says something like this oh sorry
you’re probably wondering about the
glove you see this is no regular comb
this used to be
Hitler’s comb now these last two words
Hitler’s comb will change the experience
for most people certainly for people
with my family background a national
heritage because there’s something about
meaning that we connect with very very
strongly there is something that defines
the experience even in retrospect after
it was over just giving this information
changes the whole experience now as we
move deeper afield into the twilight
zone that is between deception and
top-down processes I want you to
understand that in real life people have
shown time and again that it’s possible
to even
use deception without deception in a way
you can take lesea bows and use them
even without tricking people into
thinking that they’re not possible you
can do this with irritable bowel
syndrome you can do this with lower back
pain you can do this with ADHD people
have done these studies you can also
demonstrate that you can use placebos
with non-human animals so the question
is what is this mysterious effect that
starts up top and then trickles down and
changes our physiology in all kinds of
weird ways can we quantify it can we
understand the mechanisms and the answer
is yes we’re beginning to and let me
tell you a little bit about that and why
you should care because all of you are
thriving on placebos and you don’t even
know it let me show you a few examples
well first of all I’d like to start
talking about antidepressants why
antidepressants because a lot of people
in our culture are taking
antidepressants in the US alone one in
10 people are on antidepressants when it
comes to middle-age women it’s one in
four
these are staggering numbers staggering
numbers and why do you take
antidepressants usually this is a major
backbone drug of modern psychiatry why
do people take antidepressants well all
kinds of reasons but mostly for
depression and usually for mild to
moderate depression but we have a lot of
evidence that shows that for mild to
moderate depression clinically
antidepressants and placebos are on par
well what does that mean well some
people take it to mean that
antidepressants don’t work when there’s
a big promotion around it and I think
there should be but in a way what I’m
here to tell you is that that’s wrong
antidepressants do work they work well
they work so well that clinically for
mild to moderate depression they work as
well as placebos do this is how good
placebos are this is how powerful they
are
now some people listen to this and say
well I’ve heard of other examples from
clinical medicines for example sham
surgery versus real surgery and this is
true
has been done for the knees and for
other parts of the body and sometimes we
can show the Chancellor jury and real
surgery are on par but this is not the
point that I want to make I want to make
a point a little bit of a point about
technology for example take
neurofeedback I think many people don’t
realize that today we have technology
that allows us to watch our brains in
action we can actually see what’s
happening inside our brain while it’s
happening in real time and some people
use it therapeutically in order to help
people get better and change their
behavior and so on in the image that you
see here you’re basically looking at a
creme de la creme inverted toilet on top
of your head kind of you know technology
that allows us to do this kind of thing
when you go into a regular neurofeedback
clinic you’re not going to see this this
is way out of budget for most people and
very rare they will basically use EEG
neurofeedback and here they just put you
know a few electrodes on your head and
listen to the elec you know electrical
jazz that is playing under your scalp
but the point is that what you see on
this screen which is allegedly the
feedback from your brain is not so
important what do I mean by that if I
show you your own brain activity my
brain activity his brain activity her
brain activity even if I doctor up a
video from a simulated brain I showed
you people get better people get better
what does it smell like to you it smells
to me it reeks of a placebo component
there’s nothing wrong with it it just
shows you how powerful pacy bose can be
even if you pay a lot of money for them
now I mentioned hypnosis before I would
be remiss if I wouldn’t mention
meditation meditation is all the rage
these days meditation is in vogue and
when I say meditation I don’t
necessarily mean mindfulness and I don’t
necessarily mean yoga or guided imagery
or you know compassion training whatever
pick pick and choose I mean it’s
completely it’s a free world I’m talking
about the idea of a top-down process all
these contemplative practices are
basically allowing us to see what is
happening in the brain in our body and
our physiology as a result of practicing
these top-down techniques and we’re
beginning to see what’s happening we’re
beginning to understand what’s happening
and we’re beginning
then who are the people who are likely
to benefit from this more we’re
beginning to say what are the systems
that are involved more than that we are
now getting into sort of a new kind of
direction where these techniques that
were present thousands of years ago
I mean meditation Buddhism thousands of
years back we don’t have to go that far
if you go back to their recent past
1970s I got you a black-and-white
picture showing you the things drink
effect that a lot of people don’t know
that they think drink effect is
something that people don’t know about
because they’re too familiar with the
drink effect the drink effect is what
happens when you you know imbibe alcohol
in generous amounts you don’t need a
TEDTalk for that but what people don’t
realize sometimes is that you can
actually get a non-alcoholic beverage
this is my palcohol placebo alcohol and
you know if you give people a
non-alcoholic beverage you can sometimes
get some pretty good results if they are
under the impression that this is an
alcoholic beverage so much so that they
will show you impaired cognition slurred
speech inability to walk a straight line
they will vomit they will have you know
hangovers serious stuff all on palcohol
now sometimes when we do these
experiments the people who are
susceptible to this are too drunk to
understand that the experiment is over
when you tell them you know this was a
hoax this is strong stuff
this is palcohol for you now what have
we had here today I mean we had some you
know blinking we had all kinds of
parental deception we had a magician was
an honest liar
we had some hypnosis with dancing lines
we had Hitler’s comb we had some
antidepressants
we had neurofeedback now I’m beginning
to talk to you about meditation and
alcohol listen at the end of the day
although deception is a slippery slope
and it is a slippery slope we are in the
process of gaining better scientific
insights into what it is to use the
power of top-down control
and as a result we’re beginning to
ponder if it would be possible to use
placebos in a way that is both judicious
and ethical judicious and ethical and I
am here to tell you and to submit to you
that in some circumstances it is
actually unethical not to use placebos
but we can talk about that over a stiff
drink of alcohol whatever you do
whatever you do I want you to next time
you hear a person come to you and say hi
my name is dr. Raza and I am a pal
coholic please don’t laugh it’s a
serious top down matter it’s a serious
top down matter
thank you for placebo in with me today
Cheers
you
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