Nursing Book Club
Taking the Medicine; A Short History of Medicines Beautiful Idea, and Our Difficulty Swallowing it
Prescribing “off-label” enables physicians to use medication for whatever they want — in effect not a big change from the past
Reviewed By Christine Contillo, RN, BSN
I think that I became a nurse because I was curious. My dad was an insulin-dependent diabetic who suffered frequent and ill-timed hypoglycemic shock. He and his sister both developed hyperthyroidism around their 40th birthdays and lost amazing amounts of weight. It was all so mysterious to me. If so many things could go wrong with your health, how does anyone reach old age?
Druin Burch is the author of Taking the Medicine: A Short History of Medicine’s Beautiful Idea, and Our Difficulty Swallowing It. He must share my curious spirit; he spends 305 pages examining the concoctions we take to improve our health and explaining, with his dry British wit, how they work or why they don’t.
In most cases he also describes how these potions were discovered, which I must admit, I found fascinating.
I’d learned along the way that aspirin came from willow bark, but who can imagine what kind of fever-induced state would lead someone to chew on tree covering! To understand, the author leads you down a pathway involving the search for a treatment for the fevers of malaria, once endemic in the marshes of Europe. It seems that curative discoveries were often totally incidental — like noticing in the 19th century that bedrooms with wallpaper had fewer bedbugs. Based on the bedbug infestations now rampant, I’d bet that less toxic glue must have eventually been found.
The search for medical cures involved a philosophy of medicine that evolved slowly. Aristotle in 500 B.C. believed all knowledge was based on observations made in nature. It wasn’t until the 1800s that physicians began to realize that their own personal experience wasn’t sufficient, and that to safely rely on the experience of others might require extensive and time-consuming research. They needed to repeat experiments in great numbers with control groups (something the pharmaceutical companies still struggle with) and ethics committees to decide who would benefit. Myths needed to be tested and replaced with facts. This might be the beginning of the “evidence-based practice” that we see today.
According to the author, it wasn’t until about 50 years ago that a patient could see a doctor and have a reasonable expectation that whatever was done would improve their health; before that time it was largely hit or miss. Initially scientists took a product, took a guess at what it might do, and then tested it on their patients without regulation.
Now, thanks to the obvious risks of that earlier method, we have government oversight but it seems that drugs are still developed and then tested to see what they are good for or what they are bad for — the adverse effects we so dread. However, prescribing “off-label” enables physicians to use an approved medication for whatever they want — in effect, not a big change from the past.
I’ve seen diagnostic testing advance by leaps and bounds during my career. Medical cures for many diseases have been found. Cures for other conditions continue to elude us, although genetic testing may make it easier to pinpoint exactly which pharmaceuticals will work for an individual patient. For pennies a day malaria can be prevented with the use of bednets impregnated with permethrin, yet several million children still die of the disease every year. Some medications are so inexpensive as to be readily available, others unaffordable for any but the very wealthy.
Taking the Medicine gives you a well-researched history of what we take and why it works. We have a millennia of scientists, both good and bad, to thank, as well as author Burch for making it all understandable.
Christine Contillo, RN, BSN is a public health nurse who suggests joining a book club as a reason to put down trashy magazines and look smart on the subway.
This article is from workingnurse.com.