Dear Pulse readers,
An elderly patient walks into an appointment with her new doctor and empties a bag of medications on the doctor’s desk.
The doctor looks at the heap of bottles and says, “I have some good news for you! I’m going to take you off of all these pills except for three.”
“Doctor, that’s wonderful!” the patient exclaims. “Which three should I keep taking?”
“Any three,” the doctor says. “It doesn’t matter.”
As a resident, I heard this story, no doubt invented, from the grand old man of an internal-medicine department.
He told it with a twinkle in his eye, and we residents realized that the story captured a couple of truths about our practice of medicine: First, that we doctors prescribe a lot of pills; and second, that we’re often not sure which pills, if any, will do any good.
I do know that this pill will lower your blood pressure and reduce your risk of a stroke–but will it actually keep you from having a stroke? Can’t say for sure. You might still have that stroke. Or maybe your high blood pressure wasn’t ever going to cause you a stroke in the first place.
As someone who believes in the importance of human connection and in the healing power of the doctor-patient relationship, I’m humbled by the amount of time I spend prescribing pills and by the knowledge that lots of patients come to see me to get a prescription.
I don’t like to think of myself as a pill pusher. In fact, I don’t like taking pills myself.
It’s not uncommon for a patient to be on three or four pills to control blood pressure, four pills to control blood sugar, another pill for cholesterol and then another couple for pain. Do they have allergies? Add another. A thyroid deficiency? One more. And so it goes.
I once had a patient ask me, “How do the pills know where to go?” She wondered how the medication she took for her headache knew to go to her head, but the pill she took for her blood pressure knew to go to her blood vessels.
People feel very differently about taking pills. Some of my patients hate taking them. “I’m on too many pills already!” someone will protest when I recommend a second blood-pressure medication.
Some refuse to take pills at all. Others take comfort in their pills, firmly believing in their magical powers.
I often marvel at how loyally my patients take pills that have no immediate impact on how they feel–taking it on faith that these pills will keep them out of the hospital, protect their vital organs and help them live longer.
And I share that faith as well. Because that’s what our best evidence tells us–that on the whole these pills are actually working.
Which is kind of magical.
What about you? What’s been your experience been taking or prescribing Pills, July’s More Voices theme? Tell us your lived experience.
Share your story with us using this More Voices Submission Form. For more details, visit More Voices FAQs. And have a look at last month’s theme, Alone.
Remember, your health-related story should be 40-400 words. And no poetry, please.
We look forward to hearing from you!
With warm regards,
Paul Gross
Editor