Views & Reviews The Best Medicine

Conversation with a pill

BMJ 2013; 346 doi: (Published 02 January 2013) Cite this as: BMJ 2013;346:e8664
  1. Liam Farrell, general practitioner, Crossmaglen, County Armagh

“You don’t appreciate us,” he lamented, sitting on the edge of the desk, little legs dangling in the air. “No thanks, just complaints about dependence, cost, side effects. ‘For when the noble Caesar saw him stab, Ingratitude, more strong than traitor’s arm, Quite vanquished him; then burst his mighty heart.’

“Think about it,” he continued. “We are convenient, easily transported, eminently suitable for use in the home. Our quality can be monitored, standardised, and regulated; our dosages are reliable and flexible. And we are uniquely suited to testing in double blind, randomised controlled trials. We’re hardcore science, the Messi of evidence based medicine.”

“Providing the trial results are released, even if the results are negative,” I said.

“Of course,” he said.

“And made available to peer reviewed journals,” I said.

“Goes without saying,” he said, and then, more sharply, “Been following Richard Smith and Ben Goldacre on Twitter, have we?”

“You have to admit,” I said, “your record is a bit dodgy.”

“Can’t argue with that,” he shrugged. “Statistics are sluts; for the right money, they’ll prove anything you want them to, and drug companies are greedy, blood sucking, capitalist pigs who will be first against the wall when the revolution comes. But that’s what makes the world go round, man.

“Greed is good, alas,” he said. “Profit is the motivator, the innovator; if the pope or Mother Teresa ran a drug company, would any new products be developed? I’m small, not cheap.”

“And vitamin pills and homeopathic pills and flower remedies?” I asked.

“Yeah, yeah, a load of shite, I know,” he said. “But everyone has relatives they ain’t proud of.”

He drew himself up.

“We are of ancient provenance,” he said, and for a moment his voice sounded far away, heavy with longing and loss. “And across the ages we have wedded ourselves to humanity. We hitched our wagon to a star, but when the last human breathes his final breath under the indifferent skies, we will die too.

“Why do you need us so much? To paraphrase Tolstoy, the strongest of all cures are these two, time and patience; but humans have no patience.”

“I’m going to eat you now,” I said.

Et tu, Bruté?” he said sadly. “Then fall, Cialis.”


Cite this as: BMJ 2012;345:e8664


  • Follow Dr Liam Farrell on twitter @drlfarrell