In this paper I argue that the "placebo effect" doesn't exist; placebos do, but they are inert so they have no effects (that's what "inert" means). Yet we know that often enough, things do happen after placebo administration. Among various causes for such change, I attribute some effects to the meanings the placebos convey to the participants in the medical event — the doctors, nurses, patients, family, community, etc., of the patient. I call these "meaning responses," and survey here some of the ways they occur (with or without the presence of placebos). Then, I describe some recent studies which dramatically complicate the interpretation of RCTs, and our perhaps overly simplistic understandings of the nature of medical efficacy
