William Wetherall, the hospital’s Senior Physician, led his team of doctors and nurses onto the ward. It seemed that the theme for this particular round was to be the varying effects that drugs can have on different patients. The consultant had recently read reports in the Medical Journals that many well known proprietary medicines, particularly cough medicines, had been shown in scientific studies to have no useful therapeutic effect.
This advice had particularly pleased me as I had painful memories of the nauseous linctuses that my mother had forced me to swallow four times a day as a child whenever I had been ill! Not only had they been foul tasting, it now appeared that they had done absolutely nothing to speed my recovery!!
‘Doctors will now have to find other treatments for patients who have nothing seriously wrong with them,’ he remarked humorously.
We stopped beside the bed of a lady who had been admitted having vomited some blood. On investigation, this had proved to be due to the large quantities of aspirin that she had been taking for her headaches. Although the aspirin had relieved her pain, as a side effect it had eroded the lining of her stomach, causing an ulcer to form.
‘You must be aware,’ the consultant explained, ‘that any drug that you prescribe may affect different people in different ways. Take alcohol, for example. That’s a drug, after all, and it can have remarkably different effects in different people.’ He turned to Sister Rutherford, the Ward Sister.
‘How does it affect you, Sister?’
‘I’m afraid it makes me giggly, Sir’ she said.
He turned to me. ‘And you, Lambert?’
‘It seems to affect me in different ways at different times of the day,’ I replied. ‘If I take alcohol at lunch time, it makes me sleepy; if I take it in the evening, I’m afraid that it loosens my tongue and I become over-talkative and I confess somewhat uninhibited.’
‘And what about you, Simon?’ he asked of the surgical registrar, whose curt and condescending manner made him unpopular with the other junior doctors.
‘And we know that it makes other people aggressive, the results of which we see on our streets and in the Emergency Department every Saturday night. So you see…one drug, but different reactions in different people. So be aware that the drugs you prescribe for patients on the ward may not always have exactly the effect that is described in the textbook.’
Quotation of the Day
Alcohol enables parliament to do things at eleven at night that no sane person would do at eleven in the morning.
George Bernard Shaw 1856 – 1950
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