Sam had long understood that there is a link between attitude and physical health. He knew, for example, of the placebo effect, in which the power of the mind can influence physical changes in ways that remain a mystery, but he was skeptical of the power of a positive attitude with respect to overwhelming physical problems. He had always been, appropriately, wary of oversimplifying this approach into a belief that could, essentially, "blame the victim." That is, a belief which held that those who become and remain ill somehow have flawed attitudes and beliefs about themselves. Now, however, it occurred to him that while positive thinking might not hold magical curative powers, it certainly could improve his ability to live with his illness which, in turn, could indeed have health benefits. He began to realize that his negative outlook had evolved without any conscious thought.