I recently listened to a segment of Radiolab, titled, ‘You Are The Judge.” It featured the story of Sydney and Lelsy Piddington. Apparently, they were a big deal on British radio 60 years ago.
The Piddingtons purported to be mentalists: he would be on stage somewhere in front of a live audience while she was somewhere else altogther. A call would be placed to Lesley by an operator and she would read Syndey’s mind. You will need to listen to the podcast to appreciate the drama and mystery of their trick.
It was produced incredibly well and there are 2 episodes of their show that have survived. In one episode, Sydney was able silently convey to his wife the full line of text of a book randomly selected by an audience member from a pile of random books on stage – while she was in a building miles away. In another instance, she was able to recite a poem written by a randomly selected audience member despite flying overhead onboard an airplane. Their explanation was simple: Sydney was able to telepathically communicate with Lesley. How else could she know?
After he discovered the Piddington’s history 40+ years later, Jesse Cox, their grandson, desperately wanted to know how it was that his grandparents were able to pull off their trick. There had to be a code, he thought. Perhaps it was the stuttering of his grandfather. Maybe it was the pauses in his brief communications with his wife. For years, people have been offering creatively elaborate ways to explain the Piddington’s successful silent communication, but no one knows exactly how they did it.
A few years ago, Jesse audio-recorded Lesley, who has since declined into dementia:
Jesse: Alot of magic secrets, they get passed down to generations and they get reperformed over and over again, and they very much become a part of that family. Now as a performer myself, if I wanted to bring back the tradition, would you feel like you could have down this magic trick to your grandson to carry it on?
Lesley: Of course, if I had a grandson who wanted to carry it on, I would have enormous difficulty telling him how to. I don’t think it would be possible, because there is an awful lot that I wouldn’t be able to tell you…it’s hard to explain why I wouldn’t be able to. It’s just that I wouldn’t be able to.
Jesse thought that she wanted to keep her secret, and its mystery alive. And he was okay with that. Not Radiolab. They wanted the truth and if Lesley wouldn’t share the family secret, maybe someone else would.
So Radiolab’s producers sought Penn Gillette and asked him for his take on the trick. He informed the producers that he knows 3 or 4 ways that the Piddingtons could have pulled off the trick, but he warns, “The only secret in magic…is that the secret must be ugly. You cannot have a beautiful secret. In magic, what you want is an idea that is not beautiful. You don’t get an ‘A-Ha!…one of the strongest feelings in life – rewarding feelings – is the feeling of ‘A-Ha, I finally understand.’…I can tell you easily how they did that trick, but you will not get an’A-Ha.’ It is ugly.” Penn Gillette calls it a book trick.
Listening to this podcast, I was reminded of the practice of manual therapy. It works. There is a slew of empirical data to support the use of manual therapy for painful conditions. Much like those trying to guess how a magic trick is designed, clincians and experts spent decades looking at bones, ligaments, fascia, muscles, tendon and other connective tissues and developed a great number of theories as to how and why their techniques were successful. One by one, such explanations have been proven invalid or indefensible, but (much like the magic trick) the treatment persists. In the end, therapists have played the role of Lesley Piddington.
Penn Gillette argues – quite convincingly, I must say – that Lesley was indeed a part of the trick, but had only a role to play and was likely being honest with her grandson when she told him that she wouldn’t be able to tell him how the details of how the trick was done, only that it could be done. Sound familiar?
Radiolab elected not to air how the Piddingtons were able to ‘do’ their trick. Instead, they steered those who wanted to hear the ugly truth to their website with the url: radiolab.org/theuglytruthyouwerewarned/. This way, if a listener wanted to hear a tidy, 6-minute explanation, it was available to them. If they wanted to relish in the mystery of the Piddingtons, they could do that as well.
When it comes to understanding the effects of manual therapy, however, there is not a 6-minute mp3 file to explain how or why ‘it’ happens. But, if you feel compelled to read, watch and think…here are a few places that might be a good place to start.
- Introduction to Neuroscience with Robert Sapolsky
- The Modernisation of Manipulative Therapy – Maz Zusman
- Max Zusman’s Therapeutic Mechanisms of Movement-Based Treatments
- How Placebos Change the Patient’s Brain – Fabrizio Benedetti, Elisa Carlino and Antonella Pollo
When done right, the therapeutic encounter can be beautiful thing and manual therapy can yield wonderful – sometimes specacular results. The explanation, however, ain’t pretty. It’s muddy, noisy and full of doubt and uncertainty. Penn Gillette would say that it’s ugly.
I’ll just say that you’ve been warned.