The Drugs Don’t Work
BMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d3335 (Published 01 June 2011) Cite this as: BMJ 2011;342:d3335- Laura Gleeson, intern, Centre for Ageing, Neuroscience, and the Humanities, Dublin, Ireland
- gleesole{at}tcd.ie
Death is a terrifying part of medicine, particularly for the junior trainee. Despite armfuls of medical terminology and the greater emphasis on emotional intelligence in modern training, nothing is more difficult to say to a patient than that the treatment isn’t working.
The indie rock band The Verve had been coasting along nicely in the alternative charts since the early 1990s. But in 1997 their single The Drugs Don’t Work crashed into the top position in the mainstream UK pop charts, bringing the band to the forefront.
The lead singer, Richard Ashcroft, may have been speaking to his dying father in the song’s lyrics: “Now the drugs don’t work / They just make you worse.” This simple sentiment resonated with millions of people around the globe in the late 1990s, a generation so overexposed to sentimentality that it was sinking slowly into indifference. And the message came through the vessel of an English rock band, the closest thing to poets of the people in our society.
Ashcroft has referred to the “rows of grown men crying” when the band performed the song, “almost like these guys couldn’t cry when they needed to cry.” His bare solo vocal, famously recorded in one take, brings together the complex ebb and flow of guitar, strings, and percussion, evocative of clamouring emotions, into a single statement. He watches his father’s inevitable fate unfold: “Like a cat in a bag / Waiting to drown.”
To listen to the repetitive lyrics alone, however, is to ignore the tumultuous activity in the instrumental. A lonely acoustic guitar and a wistful string arrangement perfectly capture the dying patient’s vulnerability. Ashcroft’s dismal tone in the opening line crescendoes as the song progresses, with swelling strings, backing vocals, and rising percussion, bringing us with him to the hopeful refrain, “I know I’ll see your face again.”
This evolution reflects the journey of the dying patient and their family that the physician must recognise and understand. When our drugs have failed, are patients to be left to make this journey alone? Ashcroft’s lyrical journey takes him to a place sometimes more challenging to the medical mind than death—that is, faith. Perhaps the junior trainee standing in front of a dying patient could use the comfort of faith as well.
Notes
Cite this as: BMJ 2011;342:d3335
Footnotes
The Drugs Don’t Work
A song by The Verve from the album Urban Hymns
Released 1997
Competing interests: None declared.
Provenance and peer review: Not commissioned; not externally peer reviewed.
Listen to The Drugs Don’t Work at www.theverve.co.uk/index.php?/media/audio/P0/