Map of life expectancy at birth from Global Education Project.

Sunday, December 19, 2004

The Pill Era

We had the hunter-gather era, the agricultural era, the industrial era, the post-industrial era, and now we are entering the pill era.

I had the opportunity to spend some time with an elderly couple who don't know the Internet from a volleyball net and don't know Cervantes from Little Green Footballs. This gives me the freedom to use them as an example. Let's call them Betty and Ernie.

It is astonishing how much their lives revolve around pills. They each take about 8 to 10 different ones, a number which fluctuates a bit. Some pills come and go from their lives, others are always there. Ernie has some dementia, and one of Betty's greatest burdens in life is getting him to take all his pills. Although he has been officially told that he does not have Alzheimer's Disease, but rather vascular dementia, he has been prescibed two pills for Alzheimer's, called Nimenda and Aricept. He also takes Prazosin for high blood pressure, coumadin (which was originally rat poison), a statin, and an antidepressant. Betty took Dilantin all her life, as a result of which she has osteoporosis for which she takes pills, plus more pills for glaucoma and of course the requisite statin. Lately she's had an ear infection which made her dizzy. The doctors gave her valium for that, which she took for weeks until another doctor told her it was just making things worse. Recently Ernie woke up with an exacerbation of his osteoarthritis so the doctor called in codeine/tylenol and a muscle relaxer. Betty gets sinus infections and she frequently takes antibiotics for those, plus pain killers for bursitis and ..

Well, you get the idea. These folks spend half their lives trying to figure out which of their symptoms are side effects. In fact Betty's sister almost died from drug side effects because the doctor refused to believe her complaints and dismissed her as "hysterical," until she passed out in a restaurant. Sometimes the doctors decide they're suffering side effects and cancel or change a pill, sometimes they add one, either because they diagnose something new or they just figure the way to fight the side effects is with another pill.

Instead of doing crossword puzzles, crocheting, painting, going to the theater, building model boats, or going on a cruise, they sit around worrying and talking about pills, arguing about whether Ernie has taken his, whether he should use a pill boz, or whether Betty should stop taking something or start taking something, and much of the rest of the time trying to reach one of 8 different doctors on the telephone to get an explanation or an answer. Half of this stuff, they don't even know what it's for. They certainly don't know what side effects might happen from what pills, which is why they're always trying to guess. It's not their fault. Doctors usually don't tell patients about side effects because they're afraid if they do, the people won't take them.

Then of course there is the question of paying for this chemical soup. Fortunately Betty is a retired teacher and the union gives them Medigap insurance, which pays for most of the cost after a substantial annual deductible. As we know, many elderly people aren't so lucky, and it's don't take the pills or don't pay the heating pill.

So is this all worth it? Is it making their lives better? Is it making society healthier and happier? And why or why not?


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