Selected for The Best Australian Essays 2011
I TRIED NOT to jump to conclusions. I remembered Oklahoma – those few hours (or was it days?) during which people thought that the blasted government building, its child-care centre littered with tiny corpses, was a Muslim crime scene. So I said, 'Bin Laden couldn't do it.' Afterwards, I wondered whether my reaction, hearing about the planes crashing into the World Trade Center, was 'denialism'. I had not meant that bin Laden wouldn't do it, but that he had targeted the complex once before, and failed. He would have done it, but he couldn't. Maybe the hijackers crashing planes into New York and Washington were well-organised white supremacists.
Somehow, I didn't think so.
I phoned friends and colleagues, woke them up and said, 'Turn on the television.' ('Which channel?' 'All of them!') We calculated the date in America, wondering whether it was significant. September 11, 11/9. My colleague translated it into American – 9/11, the emergency number.
And so we crossed the border into the post-9/11 era, although it took a while for the phrase to come into circulation, and longer still to name the apprehensive, hyper-vigilant state of mind that has characterised the past decade: nine-eleven-itis.
SOMETIME DURING A flight to Lahore at the end of September 2001, I went from being half-Pakistani to being half-white. I felt the transition as I slid between selves, a shift in gear marked by the change in the pronunciation of my name. English-speakers tend to place the emphasis on the second syllable; Pakistanis stress the first, just slightly. Sha-kee-ra; Shah-kira. With a half-caste's flexibility, I use both versions myself.
We are not supposed to feel comfortable with such slippery identities, but I have never minded. I like the duality, the not-quite-fitting-in, no matter where I am. It helps me to see things from a different perspective, and makes me careful. It excludes me from collective plurals, and from certainty. My skin changes shade according to the onlooker. Anglo-Australian friends and family give me T-shirts and dresses in pastel shades of pale pink or apricot to suit my dark complexion; Pakistanis give me shalwar kameez in a burnt orange that looks good with fair skin. I like the range of my wardrobe and I like my skin, with its mongrel capacity to lighten or darken according to the company I keep.
But September 2001 was a bad time to be a hybrid. Bodies were still being dug from the ruins of the World Trade Center and Pakistan was bracing itself for what George W Bush called a 'crusade'. People yearned for absolutes. They were suspicious of complexity and shape-shifting crossbreeds. It seemed as though everyone was quoting Samuel Huntington and his Clash of Civilizations (Simon & Schuster, 1996), a work that angered and frightened me. I knew that I did not want to live in a Huntingtonesque dystopia, forced to choose between my twinned selves. I like to live on the rich grounds of overlap and cross-fertilisation – the mongrel's true homeland. But I was afraid that this would soon become no one's land.
There were more concrete fears, too: destruction from the coming war, authoritarian politics that find justification amid the ruins and the grief. In the days before I left Australia for Pakistan, my mind was a jumble of images. The gleaming buildings pierced by the aircraft, an image on permanent loop in the collective consciousness, but also a delicate-boned Afghan girl crying for her mother still trapped in Afghanistan, waiting for another round of bombing.
So much already lost, so much more still to lose.
JAVED PICKED ME up from the airport in Lahore. It was an awkward situation. During my previous visit, a year earlier, he had told his mother that he intended to marry a half-white single mother from Australia, leaving out the bit where I'd said no. His mother was even less enthused by the idea than I was. She told him that such a match would disgrace his family for generations. I told him that I would never marry a man who couldn't make a cup of tea for himself. Javed didn't give up immediately. He told his mother that while I was a half-white non-virgin, I was nonetheless a descendant of the Prophet. And when I got back to Australia, there was an email waiting on my computer, announcing that he had learned how to make a cup of tea.
But his mother won that battle for both of us. While Javed was practising his tea-making skills, she was out looking for suitable brides. A few months after my visit, he was abruptly informed that he was to be married in three days' time – and not to me. He begged to be released from the match, or at least to be able to meet the girl in advance, just to glimpse her face. His mother was unyielding. To cancel the wedding at such short notice would shame both the families, and especially the bride. And you couldn't go around asking respectable people to show you their daughters' faces.
Javed was a journalist on one of Pakistan's major English-language dailies, but his salary couldn't provide him with the lifestyle he felt was appropriate to his social position. So, grizzling like a spoiled toddler, he allowed himself to be scolded into matrimony.
Since then, Javed and I had agreed to keep our relationship friendly but professional. This agreement was not rock-solid – my email announcing my next visit had been headed 'writing as a colleague only', while his reply was titled 'U R still my little princess'. I'd bought him a wedding present at Sydney Airport, an alarm clock clutched in the arms of an angry plastic koala. I didn't think it was open to sentimental interpretation, and anyway, it was on sale.
It might have been more prudent not to contact Javed, but I'd been told that incoming passengers were having a difficult time with immigration, and like most middle-class Pakistanis Javed was adept at the threats, bribes and rank-pulling required when dealing with officials. With him to smooth the way, I was whisked straight through, a porter at my side to cart my luggage to Javed's battered little car.
I handed Javed the gift-wrapped koala clock.
'Why have you bought me a present?' he demanded, half-angrily, and tossed it into the back seat.
'It's a wedding present.'
'You give me a present, but nothing more. To tell you the truth, madam, I had a very torrid time after you left last year. Ten whole days I was in agony.'
'Ten days? You must really have cared about me.'
'Two weeks, even.'
'I'm sure Samina will make you a much better wife than I ever could. How is she?'
'Samina is well, I suppose. I have not seen her for a long time. She is still living with her family. We will not be living together until next year. I am not looking forward to it. She is a good girl, but to tell you the truth I have no feeling for her.'
'That's not her fault. You shouldn't have married her if you weren't going to care about her.'
'I told you, madam. I was in shock, absolutely. What choice did I have?'
'You could have left home. You have a job, after all.'
'I can't live on that money. I tell you, my wage pays only for my cigarettes.'
Already our relationship had fallen into its usual pattern – Javed complaining, me scolding. We might as well have been married.
'I have booked you into a very good hotel. The Amir. They have agreed to an excellent rate, half their usual price. It is in a good area, not like that stupid place you stayed in last year.'
This, too, was an old quarrel. I liked one of the cheap hotels along the cinema strip on Abbott Road. I liked the strings of coloured lights above the cinemas, the gigantic lurid film hoardings showing gore-splattered men silhouetted against the lavish bosoms of maidens in distress. I liked the stalls where street food and banter were available at all hours. I had never been game to taste the goats testicles, which were set out in neat rows, pale and plump and glistening, waiting to be fried. But I did buy samosas, freshly baked naan and slices of crisp sweet watermelon sprinkled with chilli. And a shop around the corner sold my favourite pistachio milk drink, a treat worth the airfare from Australia.
But decent girls weren't supposed to stay in hotels alone. Javed had worn out that argument last year; this year he had a new line.
'You can't stay there. The police are checking all those cheap hotels for foreigners.'
'I can't imagine why. If it's journalists they're looking for, they'll be staying in expensive hotels.'
'I am telling you, madam. Things are different here now. You must be more careful.'
I gave in. The Amir had a fancy lobby and lots of uniformed bellboys, but the room was no different to those in the cheap joint, and it smelled of insecticide. I dumped my suitcase and changed, then went with Javed to his newspaper office. It was after midnight, but Lahore is a nocturnal city. I was tired, yet I was also keen to talk to people, to hear what they were thinking.
We had all stepped through the looking glass on September 11. In Pakistan, just as in Australia, people kept saying things that sounded bizarre, out of synch. Back in the car, Javed told me, 'Of course I support Osama bin Laden. Everyone here does.'
I mistook the lurch of surrealism for jetlag. 'Scuse me?'
'Yes, why not? A strong leader, standing up to America and all.'
It wasn't what I expected from Javed, the lazy, dandified princeling who had danced the night away at the Pearl Continental's ABBA tribute a year before. 'I thought you hated the Taliban.'
'I do hate the Taliban.'
'So how does that work? Supporting bin Laden, but not the Taliban?'
'The Taliban are Afghan.'
Most of Javed's colleagues were still in the office, but few of them were actually working. I had talked to Australian journalists since September 11 who were powered by sheer adrenaline. War fever had migrated from the ruined towers in New York, through the internet and over satellites, to grip editors in Sydney and Melbourne. It acted like speed, giving their eyes a manic gleam and sharpening the air around them.
If the Australian journos were speed freaks, their Pakistani colleagues were morbid drunks, nursing their gloom like flat beer and swapping dark predictions. Their mood matched the office, dingy with stale cigarette and food odours, moth-eaten furniture and ancient computers without internet connections. The journalists –all male – sat drinking tea, gossiping and listening to the cricket. I was updated on the office politics: a new editor, the odd promotion or transfer. Someone asked how I had managed living in the West since September 11. They were all familiar with the stories of Muslims (and those unfortunate enough to be mistaken for Muslims) who had been beaten and abused for having the same religion as Osama bin Laden.
'We hear about these things here, you know. There is a lot of strong feeling about it. There was a mosque burned down in Australia.'
'Yes, that was in Brisbane, where my grandmother lives. Some Muslim schoolchildren had rubbish thrown at them, too. And women in hijab have been abused by people on the street, but I haven't had any problems, personally.'
'Well, I suppose you just wear your jeans and all, and nobody can tell what you are.'
'I haven't been wearing jeans. I've been making a point of wearing shalwar kameez. I don't want people to think I'm ashamed of my background.'
'Shalwar kameez? In these times? Are you crazy?'
The others agreed. 'My brother is studying in London. He told us he doesn't travel on the Underground anymore. He doesn't feel safe there. People said racist things to him.'
'And in America, there have been so many Pakistanis arrested since September 11, just students and visitors, not terrorists.'
'It's getting too dangerous for Muslims to live in the West. I think you should come and live here. You could find a job teaching in a girl's school. Not some rubbish government place. A posh school. You would be safe, living here.'
Safety now lay in the familiar, in the homeland. My friends in Australia had not wanted me to go to Pakistan, either. Terror: it ran through the fissures and ravines of identity, leaving people clinging to their own familiar rocks.
And I was a half-and-half in Pakistan, just as I had been in Australia. I was also an unaccompanied woman who wanted to not only revisit the familiar landscape of women's space ('aunties and activism', I privately called it) but also come to grips with the hyper-masculine mood of the new political era. The journalists considered my safety.
'She doesn't really look foreign.'
'Those faces she pulls are very Panjabi.'
'And always with the dupatta. No one wears a better dupatta than Shakira.'
I asked whether the Pakistani press had come under increased government pressure since September 11. Although a military government, the Musharraf regime had allowed considerably more press freedom than had its civilian predecessor.
'When this government came to power, it made the boundaries clear to us – what we could and couldn't say. We keep to those boundaries, and we have no problem with them.'
'So what are the boundaries?'
One of the younger staff laughed. 'You don't criticise the ISI!' Inter-Services Intelligence: ISI. The initials conjure a blend of mystique and menace.
'There are times when you don't even mention ISI!'
'ISI knows everything. Everything. They make the CIA, M15 and all look like babies. If – if – bin Laden planned this, ISI knows. But I would never say that to just anyone. I would never write it.'
Javed took me through to meet the new editor. It was an encounter requiring his most deferential manner. 'Sir,' he purred, 'an Australian journalist who wishes to talk with you.'
Following his lead, I twitched my dupatta into place, lowered my eyes and murmured a demure 'Assalamu alaikum.'
The editor gave a bewildered blink. 'This is an Australian journalist? She's more Pakistani than a Pakistani! Sit down, sit down. Javed, get the boy to bring more tea.'
He was an amiable man, his English smooth with the 'excellent accent' so prized in the subcontinent, his belly nestled on his lap like a pet. The television in the corner was tuned not to the constant CNN updates on 'the crisis', but to the cricket being played overseas. Between overs, he gave his reading of the political climate.
'It is impossible, really, to say what will happen. The situation changes so fast and there are so many rumours. But I do think that the foreign press is underestimating the anti-American feeling here. Musharraf can say all he likes that the people are behind him. But you know what we Pakistanis can be like. If the Islamists can convince us that Islam is in danger, the nation is in danger – oh my God. We go blind. We go mad. We won't listen to anyone. Ah, look at that. The South African side is in excellent form.'
It was like finding the eye of the storm. I let myself be soothed by the scalding sweet tea, by the mellow ripple of the cricket commentary and the editor's easy, sonorous conversation. Exhaustion began to flood through me. I returned to the hotel, and sank into bed and sleep. The flit of insect legs across my face lit one last spark of irritation at Javed. The other hotel had been bug-free.
I HAD NOT anticipated finding pleasure on this journey. I had been too driven by the compulsion simply to be there, to observe and to write. I had forgotten how much I liked Lahore. Looking at the city from the back of a rickshaw the next morning, I remembered. It was a joy to see the Lahore streetscape, the relics of the British and Mughal empires. We passed the cannon that Kipling had made famous as 'Kim's gun' (where he sat, in defiance of municipal orders, astride the gun Zam Zammah), and a little further down the Mall the museum where Kipling's father had been curator (Wonder House, as the natives call the Lahore Museum). The lawnmower splutter of the rickshaw's engine was like a symphony to my rising spirits. I had the driver stop in a side street lined with food stands so I could cram my body with flavour. Mince and roti, freshly friedgulab jamuns in rose syrup and the special Lahori fruit salad, heavy with pomegranate seeds and walnuts, glittering like treasure.
Pakistan was awash with testosterone and conspiracy theories. It was hard to find people who were prepared to believe that bin Laden or any other Muslims were responsible for the attacks on New York and Washington. It was the CIA. Colombian drug lords. Mossad – the story of the four thousand Jews who supposedly knew better than to turn up for work at the WTC buildings on the fateful day was widely repeated. Or – my personal favourite – it was George Bush. 'The father. He wanted to test the mettle of his son.'
Many of those who were not thinking conspiracy were thinking blowback. 'Of course, I don't support terrorism. But really, the Americans were asking for it.'
I understood the seductive power of the conspiracy theories. I was prepared to believe that bin Laden was the prime suspect, but I had seized on the white-supremacist hypothesis as a more palatable explanation. And while I did not think that the Americans – and Australians, and Britons, and Arabs, and Israelis, and Pakistanis – who had died were 'asking for it', I had begun to grow angry at the way the carnage in America overshadowed routine, never-ending violence elsewhere.
Entering into a strategic pact with the Americans was always going to be a hard sell. The alliance came with financial sweeteners, as General Musharraf reiterated at his press conferences – billions of dollars worth of development packages. 'Will all the money go to a few generals, like the last time?' one of the journalists asked.
Like the last time. The last time, when the Soviet Union had occupied Afghanistan, when the United States had propped up a previous Pakistani dictator as part of an Afghan strategy, when the Pakistani military and Islamist parties were used to channel aid to the mujahedeen across the border. The last time, when the Americans had left the battlefield after the Soviet withdrawal, allowing Afghanistan to sink into an abyss of civil war while Pakistan was encumbered with the infrastructure of 'Islamisation' that successive civilian and military governments failed to dismantle. As the editor had said the night before, 'People are worried that the Americans will just use Pakistan and discard us, as they did after the Soviet occupation of Afghanistan.' He had refrained from using the simile commonly used to describe Pakistan's fate – 'discarded like a used condom' – but the sense of having been defiled remained.
Now the feckless seducer had returned for another cycle of intimacy and exploitation, bearing aid packages rather than flowers and chocolates. Pakistanis were understandably cynical.
OVER IN PESHAWAR, Osama bin Laden's image was everywhere – painted on the backs of rickshaws, photoshopped against suitable landscapes and props in the posters that were spread out along the pavements of the bazaar, and used as banners in demonstrations. Osama as a desert warrior galloping across the desert, submachine gun over his shoulder. Osama as a kind grandfatherly figure overseeing a young boy as he read the Qur'an. Osama wearing a white robe and a beatific expression as a plane slammed into the side of a gleaming silver building in the background.
The youths at the recruiting booth proudly displayed a book filled with the names of those who had signed up to join the battle. They looked so young – children. I asked whether there were any age restrictions on recruits. They said that they didn't take anyone over the age of fifty. They dismissed my suggestion that some might be too young. 'If they want to go, why not? It's a chance for them to fight for Islam.'
At seventeen, Anwar was already a seasoned fighter. His brother had already become a shaheed – a martyr– fighting Indian troops in Kashmir. At fifteen, Anwar too had joined the battle and crossed the border into Kashmir to fight with the Hizb-ul-Mujahadeen. When I met him at an Islamist demonstration, he was preparing to leave for Afghanistan. He was a good-looking boy, with gold-rimmed glasses below his Arabic-sloganed headband and strong muscles apparent beneath his appropriately modest combat fatigues. Despite the muscles and clothes, he seemed more like a student. He showed no discomfort talking with a woman and shooed away a group of youths who'd been harassing me.
It was Friday and the crowd swelled as the worshippers emerged from the mosques after midday prayers, bearing Jamaat-e-Islami (JI) flags, bin Laden posters, and banners in Urdu and English. BASTARD. UNGODLY. SATAN. HUMBUG. AMERICA IS TRYING TO ERESS PUSHTUN PIPPLES. ('I do feel like helping them out with their spelling,' a British journo commented later.) OSAMA IS THE HERO OF THE MUSLIMS; TONY BUSH WANTED ALIVE OR DEAD.
The crowd was warming up with chants of Allahu Akbar, Osama bin Laden zindabad! (Long live Osama bin Laden) and Amrika murdabad! (Death to America). Anwar started a new chant in my honour – Australia murdabad! – and smiled at me. 'Only joking.' He directed me up onto the stage, out of the crowd, where I would be safe. The bearded mullah alongside me did not look impressed. I was not happy either. Appearing on a public platform alongside leading Islamists as the crowd bellowed for jihad was a scenario that could easily be misunderstood. Misunderstood by ASIO, for example.
The boys in combat gear went into a frenzy when Qazi Hussein arrived, surrounding him protectively and clearing his path to the platform. He spoke in fiery language and at Castroesque length about God and His enemies and how the Afghan people would defeat the Americans just as they had defeated the Soviet Union, amen. JI never polled more a tenth of the national vote, but watching the party's leader address the packed crowd, the sense of intoxication, the certainty that this was the future, was palpable. It felt like a scene from Samuel Huntington's worst nightmare.
PESHAWAR'S GOD HOTELS were booked solid by international journalists, but the Rose Hotel was not a good hotel, and a bewildered-looking American was an attention-grabbing sight there. Kevin looked out of place at the check-in desk – he clearly wasn't a journalist, aid worker or thrill-seeker. He was a yoga teacher from New York who had been hired by Wall Street companies for their executives, including those based in the World Trade Center. Kevin had watched the towers crumble through the window of his apartment. 'I didn't want to see, but I couldn't look away.'
'Did you lose someone?' My question felt tactless as it came out of my mouth, and Kevin's silence and welling tears were answer enough.
He couldn't bring himself to stay in New York after the attacks, and his apartment had been deemed unliveable during the initial clean-up. So he had come to Peshawar, as near as possible to Afghanistan. George W Bush had answered the question 'Why do they hate us?' but Kevin found that answer – they hate our freedoms – unsatisfactory. He had come in search of his own explanation, without telling anyone where he was going.
Peshawar was packed with traumatised refugees who lacked basic essentials. Kevin had a hotel room, an American passport, a ticket out. In Peshawar, these were privileges. And yet I couldn't dismiss Kevin's need as irrelevant simply because it was less acute. His desire to understand and be understood was honourable, but he was too fragile to be turned loose in the wilds of Peshawar. The sight of a Pakistani-looking woman in the company of a western male tends to attract hostile scrutiny at the best of times, and these were not the best of times. So I told Kevin to keep me in view, but at a distance, as we made our way through the streets to meet people who I hoped would give a sympathetic reception to an emissary from New York.
After years of treating Afghan refugees, Dr Rahim was used to talking with traumatised patients. 'They fall into two categories. The middle-class patients suffer from psychiatric illnesses – depression, suicidal tendencies. Then there are the poor people, the majority. People whose level of existence is hardly human. They are so occupied with sheer survival that they don't suffer from mental illness.'
Dr Rahim accepted our invitation to dinner, listened to Kevin's account of his journey and talked about his most recent patients – the casualties of Operation Enduring Freedom. He did not see the latest conflict as different to that which had preceded it. 'The refugees are still coming, aren't they? We are on the main road to Jalalabad here – it is only two and half hours away. So long as there is war, they will come here. We are prepared for them.'
Kevin's bridge-building efforts were mostly sympathetically received. He told a fire crew he saw on the street about the heroism of their New York colleagues; he listened as refugees told him of lost families and homes. Occasionally his attempts to draw parallels between his own life and theirs were politely corrected.
'My neighbourhood looks like Kabul now.'
'No – no. New York is not like Kabul. What happened was terrible, but it was only one day. In Kabul this has happened over and over again. For years.'
IT WAS TIME to return to Australia, to be reunited with my daughter, to work out how to live a hybrid life across barricades that I believed to be imaginary, but that others maintained were absolute and immutable. I was still unsure whether we mongrels were about to be crushed between colliding civilisations, or ripped in two as they drifted further apart.
People continued to come up with suggestions about how I might be able to return to Pakistan with my daughter and establish a life there, despite the difficulties for unattached women. Move to Abbottabad, a Pashtun journalist in Peshawar suggested. It was his childhood home, a popular holiday destination, withexcellent schools, a beautiful location, far easier to navigate than the major cities. And a military town, so very safe. In a world that was descending into chaos, Abbottabad would provide shelter from the storm. He hoped to bring his wife and daughter to visit us there one day.
My time in Pakistan was a way of grappling with nine-eleven-itis, but it was not a cure. The war in Afghanistan, then Iraq, the imprisonment of 'mainly Muslim asylum seekers' in detention centres, headlines about Muslim gang-rapists, the Cronulla riots: the weight sank deep into my body. I ran through a list of synonyms for 'tired', searching for the one that described how I felt. Exhausted. Weary. Drained. Tired to the bone. Crushed. All applied, yet none seemed adequate. 'Not normal tiredness,' I dubbed it; these were not normal times. This did not feel like tiredness – more like failure.
The sense of defeat pressed more and more heavily until the day when I reached for a pen to mark the attendance sheet for the class I was tutoring and could manage only a clumsy fumble. I did a quick audit. There was no pain or visible injury, and yet somehow the transmission signals between my brain and hand had broken down. My leg was not connecting properly either – but I could still speak and read. Nothing to prevent me from chairing a class on Confucius, so we talked about collectivist values for an hour before I was swept into the maelstrom of hospital waiting rooms, hammer-taps against kneecaps, blood tests, CAT scans, and then the appointment with the neurologist who told me that my problem was psychiatric.
'A psychiatric condition that stops you from walking?' my friends asked incredulously. But I remembered Dr Rahim's words: 'The middle-class patients suffer from psychiatric illnesses – depression, suicidal tendencies.'I was safely in Canberra – if anyone could afford the luxury of a psychiatric illness, I could.
By the time another neurologist referred me for a MRI scan, I had long since self-diagnosed. I had allowed my post-9/11 anxiety to cross the barrier between mind and brain, to cripple me. What could be more attention-seeking, more pointless, more self-indulgent, than to appropriate the symptoms of other people's trauma to manifest my own stress? And how humiliatingly visible – an unsteady gait for which the explanation was uttered only in the most secret corner of my heart: I think I've just been letting this whole 9/11 business get to me.
I struggled to express this to the neurologist when I returned for my MRI results, and concluded: 'I'm working out some complicated issues.'
The neurologist paused before responding. 'The scan was abnormal.'
Oh. Not nine-eleven-itis. Multiple sclerosis.
Although no medical doctor would tell me this, mine was a case of 'co-morbidity', assailed by both nine-eleven-itis and multiple sclerosis. The multiple sclerosis is remitting-relapsing, flaring once a year or so to blur my vision, drive red-hot nails into my face or disconnect limbs from my central nervous system, before subsiding.
There has been no remission from nine-eleven-itis for any of us. I write this essay during a flare of both my diseases, and amid hopeful talk of treatment breakthroughs. In the days after bin Laden was killed in Abbottabad, the safe military town that I had considered as a bolthole, the numbness that had been creeping into my left side jammed my fingers as I frantically attempted to write, write, write to hold back the clash of civilisations. My much-scanned brain went into overdrive as it tried to process the reports of the al-Qaeda leader's final years, the allegations of ISI involvement ('ISI knows everything'), the surreal ritual of his consignment to the ocean.
The consensus that seems to be emerging is that while it is too soon to declare victory, the post-9/11 era has drawn to a close, a decade after it began.
The neurologist is upbeat when I return for my review one month into the new treatment. The latest drugs are very effective. The long-term effect is not yet clear, and since the medication may suppress my immune system, I should have regular pap smears and breast checks. But if all goes well, I should have fewer flares, and I should be able to hold off the 'serious disability' she has warned me is otherwise likely. Inshallah, I add silently to myself.
As for nine-eleven-itis, I suspect that this improvement in symptoms may turn out to be a placebo effect.