I take medicine. A few pills. Wish I didn’t, but seeing how they make me feel better, I’m grateful. Besides, they might help me live longer than I otherwise might live without them. That’s the idea, isn’t it? But not everyone has this view about taking prescription medication. Even when they have pressing medical conditions that are sure to, sooner than later, cause harm, and can be helped with medication.
Some people view prescription medicine as an evil. Even those who are not constantly consulting Dr. Google and his many opinions. They feel meds are more (potentially) harmful than beneficial. They have an unfounded fear and almost hysterical concern that any proposed medicine might make them sick in some way.
Their fear is not necessarily of a new untried medication, but that it may cause any number of adverse events regardless of how many years it’s been on the market or how many millions of people have taken it without issue. Some concerns are: their hair might fall out, the liver might fail, their heart might stop, or, their sexual prowess might be impaired, among many others. These concerns are important no doubt. But what I’m referring to here is an irrational understanding (rather, lack of it) of the benefit-risk equation.
Recently someone came in with high cholesterol and very high blood pressure whose father died from a sudden heart attack at the age of 52. Her 48-year-old younger brother had a heart attack recently. It appears her family has the “bad heart gene.” Upon recommending a low dose statin and anti-hypertensive medication she bristled, sat up, with eyes widened, and worried what the medication might do. “What are the side effects” she asked.
“The side effect profile is very low.” I said. “Both of the medications have been out since Jimmy Carter was president. But they’ve been known in some people to cause nausea, headache, or a rash. But this is uncommon.”
“Will they make me gain weight?” she asked.
Trying to put things in perspective, I said, “Well, would you be okay with another five pounds if they kept you from having a fatal heart attack or crippling stroke?” But before she could answer, added, “but no, they don’t make you gain weight.”
“I just don’t want to feel bad in taking any medication,” she said. “I just feel it might make things worse.”
“Worse in what way? What do you think will happen to you if you take the medication?”
“I don’t know. When I was little our next door neighbor had a reaction to some medication. He almost died in our kitchen.”
“Okay, but everyone is different, you agree?”
“Okay,” I said, “listen, did you drive yourself here to the office today?”
“Yeah, and it was all I could do to get here on time.”
“Well, did you consider what the side-effects are of driving in a vehicle around here?”
“What do you mean?”
“Well, if they made Patient Information sheets for driving automobiles like they do medications the list of side-effects might include – maiming, amputation, bleeding, bruising, decapitation, paralysis, laceration, and sudden death, to name a few.”
“Oh, that’s silly,” she said.
“You didn’t consciously think it but you instinctively knew the benefit of driving to the office here today outweighed the risks that come with driving a car, didn’t you?”
She agreed to take the medication, so I called three days later to see if she had any questions and to maybe quell her anxiety about taking new medicine. She hadn’t had them filled. She thanked me for calling then asked what she should do about the headache.