Is There Anything We Can Stop Today?

Alfie left the GP surgery and stepped out into the grey, drizzly air. He set off home via the pharmacy to pick up his dosette box for the following week. Another futile appointment with the doctor thought Alfie, as he walked his well-trodden route across the marketplace. He had gone in with high hopes that he might be able to drop at least one of his many pills. As usual, Dr Begum had spent a long time gazing at the computer screen, scrolling up and down, pausing here and there. The look on her face assured Alfie that she was thinking very hard about something. Finally, she slumped back in her chair, looking quite defeated, and said, “I’m sorry Alfie, but I don’t think there is anything we can stop today.”

How strange. What was Dr Begum sorry for? wondered Alfie. Does she feel bad that I’m on all these medicines? Most of Alfie’s medicines were started years ago at the hospital. Dr Begum had been providing them month on month ever since. A realisation dawned on Alfie. Maybe that’s why Dr Begum can’t stop them... because she wasn’t the one who started them in the first place? This continued to puzzle Alfie.

Alfie thought that if all Dr Begum’s older patients had accumulated as many medicines as he had then Dr Begum must spend hours signing prescriptions. No wonder she looks so tired all the time! Perhaps he should be bold? Maybe he should come out and say it at his next appointment: “Dr Begum, I just don’t want to be on all these tablets anymore.” Then Alfie remembered the hospital doctors telling him the pills were “for life”. Did they really mean that? Did they realise how long his life might be? Surely it can’t be good for you taking all these pills for all these years? It had now been twenty years or more! Perhaps he had squeezed all the goodness out of these pills that he could expect?

The pharmacy was busier than usual, but the friendly pharmacy technician spotted him and gave him a wave in between stuffing paper bags with medicines. Alfie joined the back of the queue but soon realised the person at the counter was taking a very long time. Alfie took a seat, propped his stick up against the wall, and waited. He wasn’t in a hurry. Besides, he hoped to have a good chat with Armeen, the pharmacist.

A delivery man charged through the main door, pushing a trolley piled high with large boxes. “Mind your backs. Mind your backs” he called, as he squeezed past. The delivery man was dressed in a blue and green uniform that matched the MedzSupplies van which was often parked outside the pharmacy. Alfie wondered how many of those large boxes arrived at the pharmacy each day. The NHS must be spending a fortune on all these medicines thought Alfie. He hoped that those leaving the pharmacy, clutching their bulging bags were going to take their medicines, as he was. Alfie’s friend Bill was a bit hit-and-miss with sticking to his tablet routine. Bill had admitted to Alfie on a few occasions that he didn’t always take his tablets – particularly the one that made him need to pee. The last time Alfie was at Bill’s house, he’d seen lots of packets of unopened medicines in the bathroom. He didn’t like to say anything to Bill, who was a dear friend. Pills are really quite a personal thing, especially pills that make you pee. Why was the doctor still prescribing them if Bill wasn’t using them? Maybe Bill didn’t need some of his pills after all? Bill seemed to be doing OK without the green tablet that he said he often skipped. Alfie suspected that most of his friends were just like Bill. It is a very tall order expecting people to take all these pills.

Thinking about all those medicines coming into the pharmacy in large boxes, only to go out again in small paper bags, was making Alfie’s head spin. Or was that a side effect of one of his medicines? He had been having more dizzy spells lately but completely forgot to mention them to Dr Begum while she was studying that computer screen. Drat!

A ray of sunshine shone through the pharmacy shop-front window, drawing Alfie’s attention to a large poster on the wall. The poster seemed to be speaking directly to him: Would you like to reduce the number of medicines you take? Alfie was intrigued and edged closer to the poster, adjusting his glasses and squinting to read the smaller print. It was an invitation to take part in some new research to test what happens when people take fewer medicines. Alfie read on, intrigued. The poster said that if he chose to take part, half of his regular medicines would be replaced with inactive pills called placebos. These placebo pills would look just like the ones he normally takes but would have no medicine inside them at all. But Alfie would not know which pills had been replaced with placebo pills. The pharmacy would prepare his medicines as usual and put all the pills – active ones and inactive ones – into his dosette box as usual. It would look exactly the same as it usually does.

Alfie pondered. In one way he wasn’t bothered about some of his pills being replaced with ‘pretend’ pills. Since he had started using the dosette box he had rather lost track of which pill was which. It was much harder to recognise them now that they were no longer in their distinctive packets. At the same time, Alfie was a bit worried about how the researchers would decide which pills to replace with pretend pills. The poster was silent on that important matter. If Dr Begum – who had known Alfie for so many years – couldn’t work out which pills to stop, how would the researchers know what was best for him?

Alfie startled as he heard Armeen, the pharmacist, clearing her throat and beckoning him to the counter with her hand outstretched, clutching his dosette box as usual. “How are you today Alfie?” asked Armeen, “and how are you getting on with your medicines these days? Any problems?” Alfie bit his tongue and stopped himself from replying with his usual I can’t complain refrain. Instead, pointing to the poster he replied, “Now you mention it Armeen, I do have a few questions about my medicines.”