CREDIT: CREATIVE COMMONS
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David had taken the same tablets for years. Why the sudden side effects?

Long-term medication keeps changing its appearance – round white tablets one month, red ovals the next, with different packaging to boot.

David had been getting bouts of faintness and dizziness for the past week. He said it was exactly like the turns he used to get before he’d had his pacemaker inserted. A malfunctioning pacemaker didn’t sound too good, so I told him I’d pop in at lunchtime.

Everything was in good order. He was recovering from a nasty cough, though, so I wondered aloud if, at the age of 82, he might just be feeling weak from having fought that off. I suggested he let me know if things didn’t settle.

I imagined he would give it a week or two, but the following day there was another visit request. Apparently he’d had a further turn that morning. The carer hadn’t liked the look of him so she’d rung the surgery.

Once again, he was back to normal by the time I got there. I quizzed him further. The symptoms came on when he got up from the sofa, or if bending down for something, suggesting his blood pressure might be falling with the change in posture. I checked the medication listed in his notes: eight different drugs, at least two of which could cause that problem. But David had been taking the same tablets for years; why would he suddenly develop side effects now?

I thought I’d better establish if his blood pressure was dropping. I got him to stand, and measured it repeatedly over a period of several minutes. Not a hint of a fall. And nor did he now feel in the slightest bit unwell. I was stumped. David’s wife had been watching proceedings from her armchair. “Mind you,” she said, “it only happens mid-morning.”

The specific timing made me pause. I asked to see his tablets. David passed me a carrier bag of boxes. I went through them methodically, cross-referencing each one to his notes.

“Well, there’s your trouble,” I said, holding out a couple of the packets. One was emblazoned with the name “Diffundox”, the other “Prosurin”. “They’re actually the same thing.”

Every medication has two names, a brand name and a generic one – both Diffundox and Prosurin are brand names of a medication known generically as tamsulosin, which improves weak urinary flow in men with enlarged prostates. Doctors are encouraged to prescribe generically in almost all circumstances – if I put “tamsulosin” on a prescription, the pharmacist can supply the best value generic available at that time, but if I specify a brand name they’re obliged to dispense that particular one irrespective of cost.

Generic prescribing is good for the NHS drug budget, but it can be horribly confusing for patients. Long-term medication keeps changing its appearance – round white tablets one month, red ovals the next, with different packaging to boot. And while the box always has the generic name on it somewhere, it’s much less prominent than the brand name. With so many patients on multiple medications, all of which are subject to chopping and changing between generics, it’s no wonder mix-ups occur. Couple that with doctors forever stopping and starting drugs and adjusting doses, and you start to get some inkling of quite how much potential there is for error.

I said to David that, at some point the previous week, two different brands of tamsulosin must have found their way into his bag. They looked for all the world like different medications to him, with the result that he was inadvertently taking a double dose every morning. The postural drops in his blood pressure were making him distinctly unwell, but were wearing off after a few hours.

Even though I tried to explain things clearly, David looked baffled that I, an apparently sane and rational being, seemed to be suggesting that two self-evidently different tablets were somehow the same. The arcane world of drug pricing and generic substitution was clearly not something he had much interest in exploring. So, I pocketed one of the aberrant packets of pills, returned the rest, and told him he would feel much better the next day. I’m glad to say he did. 

This article first appeared in the 13 March 2018 issue of the New Statesman, Putin’s spy game

Tracey Thorn. CRedit: Getty
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“Not technically beautiful, she has an engaging laugh”: 35 years of being described by men

For women in music, being described most of the time by men is just par for the course.

I am sure you all saw the Twitter challenge that took off the other day – a request to women to “describe yourself like a male author would”, started by the writer Whitney Reynolds. There were thousands of hilarious replies, with women imagining how a bad male author would describe them. I thought about posting an example, but then realised, I didn’t have to imagine this. I’ve been being described by male journalists for more than 35 years.

Katy Waldman in the New Yorker wrote about the challenge, and how it highlighted clichés in men’s writing: “…prose that takes conspicuous notice of a female character’s physical imperfections. This is done with an aura of self-satisfaction, as if the protagonist deserves credit simply for bestowing his descriptive prowess upon a person of less than conventional loveliness.”

And oh boy, that hit home. Yes, I thought, that is precisely how I’ve been described, too many times to recall, so many times that I’ve actually sort of stopped noticing. The following aren’t direct quotes, but near enough.

“Not conventionally pretty, Thorn nevertheless somehow manages to be curiously attractive.” “Her face may not be technically beautiful but she has an engaging laugh.” “Her intelligence shines through the quirky features.” Often what’s irritating isn’t the hint of an insult, but just being wide of the mark. “She isn’t wearing any make-up” (oh my god, of course she is). “She’s wearing some kind of shapeless shift” (it’s Comme des Garçons FFS).

I’m not trying to arouse sympathy. I’m much thicker-skinned than you may imagine, hence surviving in this business for so long. But the point is, for women in music, being described most of the time by men is just par for the course.

A few weeks ago, when I was in Brussels and Paris doing interviews, I was taken aback all over again by the absence of female journalists interviewing me about my album – an album that is being described everywhere as “nine feminist bangers”. As the 14th man walked through the door, my heart slightly sank. I feel like a bore banging on about this sometimes, but it astonishes me that certain aspects of this business remain so male-dominated.

Even the journalists sometimes have the good grace to notice the anomaly. One youngish man, (though not that young) told me I was only the third woman he had ever interviewed, which took my breath away. I look at my playlists of favourite tracks over the last year or so, and they are utterly dominated by SZA, Angel Olsen, Lorde, St Vincent, Mabel, Shura, Warpaint, Savages, Solange, Kate Tempest, Tove Lo, Susanne Sundfør, Janelle Monáe, Jessie Ware and Haim, so there certainly isn’t any shortage of great women. I’ve been asked to speak at a music event, and when I was sent the possible line-up I couldn’t help noticing that over three days there were 56 men and seven women speaking. The final bill might be an improvement on that, but still. Any number of music festivals still operate with this kind of mad imbalance.

Is it down to the organisers not asking? Or, in the case of this kind of discussion event, women often feeling they don’t “know” enough? It’s a vicious circle, the way that men and their music can be so intimidating. The more you’re always in the minority, the more you feel like you don’t belong. Record shops seemed that way to me when I was a teen, places where guys hung out and looked at you like you didn’t know your Pink Floyd from your Pink Flag.

I also have to watch songs of mine being described by male writers, and sometimes misinterpreted. I’ve got one called “Guitar” on my new record. There’s a boy in the lyrics, but he’s incidental – it’s a love song to my first Les Paul copy. That fact has sailed over the heads of a couple of male reviewers who’ve seen it as a song all about a boy.

That’s the trouble, isn’t it? You miss things when you leave women out, or view female characters through the prism of their attractiveness, or when you take for granted that you’re at the centre of every story, every lyric. I bet you think this piece is about you. 

Tracey Thorn is a musician and writer, best known as one half of Everything but the Girl. She writes the fortnightly “Off the Record” column for the New Statesman. Her latest book is Naked at the Albert Hall.

This article first appeared in the 18 April 2018 issue of the New Statesman, Enoch Powell’s revenge