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I have a question about why placebo surgery is done for tissue transplants. I think there is something odd about the reasoning that is supposed to justify it. In the 20/20 TV program on PD transplant surgery, Dr. Timothy Johnson noted that "drug studies have already proved that patients with Parkinson's are very responsive to the placebo effect", apparently implying that the placebo effect is less in most other diseases. It would be useful to determine precisely why this is so. Perhaps having a progressively deteriorating condition for which there is no cure is itself the source of a nocebo (negative placebo) effect. If the baseline is negative to begin with, then of course the placebo effect would be greater. However, this is not my main point. In his next sentence, Dr. Johnson indicates that the great responsiveness of PWPs to the placebo effect is the reason for the placebo surgery. "So to avoid the possibility that the experimental surgery was simply causing a placebo effect, the doctors insisted that their new study compare real surgery with implants against fake surgery with no implants." I do not see how Dr. Johnson's statements justify placebo surgery for tissue transplants. The purpose of the tissue transplants is to replace those cells which are missing due to the disease, so as to re-introduce the function which the missing cells had. The success of the surgery ought to be measured by whether or not this purpose was achieved. Hugh Downs noted, "new cell growth has been seen only in patients who got the actual cells." How could it be otherwise? How could one expect tissue growth from tissue which has not been implanted? How, then, can placebo "non-transplant" surgery indicate whether or not the real transplants were successful? Phil Tompkins Hoboken NJ age 61/dx 1990