Over the counter

The French philosopher Voltaire is believed to have written:

Doctors are men who prescribe medicines of which they know little, to cure diseases of which they know less, for human beings of which they know nothing.”

I was at a party in Athens, Greece, in the early 1980s when I suddenly became aware of bilateral back pain and nausea. Luckily, there was a medical doctor amongst the guests. He diagnosed a kidney or bladder infection and wrote a prescription for bactrim. The tablets were very effective and rapid acting.

A year or so later, I was flying to Greece via Rome in Italy when I experienced a recurrence of the symptoms. As I had quite a long stopover in Rome, I took the opportunity to visit a pharmacy, but this time without a prescription. To my great surprise and relief, the pharmacist sold me some bactrim without requiring a prescription.

In the UK, it is not possible to obtain antibiotics and most other medications without a prescription. There are also rules determining how much non prescription medication can be bought at any one time.

In India, which I visit often, I have never been asked for a prescription to obtain any kind of medication. One just asks for the medicine or tablets required, and then following payment they are handed over the counter. Quite a few of the medications I have needed in India have been clearly marked as prescription only medicines, but these words are ignored by the pharmacy salespeople.

Having been trained as a dentist I have some knowledge of pharmacology. So, I feel that I am unlikely to abuse the ease of obtaining medicines in India, but I worry about others with less knowledge than me.

The freedom of being able to obtain medications without having to first get a prescription has mixed blessings. On the one hand, if you are certain that you need a particular drug or simply need a repeat of what you have been taking, not needing a prescription can save you time and money that visiting a doctor entails. On the other hand, self diagnosis and self treatment is not without risk.

What Voltaire wrote many years ago is less true today than it was then. But, still, even after so many advances have been made in medical science , a great deal of ignorance about the human body remains.

Mad cow

we don’t see ev’rything

that we consume:

might be germs with any bite

 

Bovine_500

From time to time, the United Kingdom is subject to agricultural diseases that need to be accompanied by nation-wide restrictions to limit spreading. A frequently occurring example of this is so-called foot-and-mouth disease. During such epidemics, those not involved in agricultural activities, such as hikers and tourists, are confined to roads, told to keep out of fields where traces of the disease may be lying.

During one outbreak of foot-and-mouth, we were spending a holiday in Wales. Wherever we went, we saw signs and barriers that prevented free movement across the countryside. What with the incessant rain, it made our trip rather dreary. We stopped for lunch in an ugly little town in central Wales. The most attractive looking eatery was a dowdy pub, devoid of any architectural merit. We sat down in its ageing dining room, trying to avert our eyes from the peeling wallpaper and a horrible worn carpet that badly needed to be replaced. Things looked up when the inn-keeper arrived to take our food order. We were attracted to beef steaks. There was a bewildering range of options for this on the menu.  Our host patiently explained the differences between the different types of beefsteak, explaining how the tastiness of the meat itself was related to its fat content and distribution within the cut. Fillet steak, for example, has little fat, not much taste without sauces, but wonderful texture. He recommended rib-eye as being the cut with just the right amount and distribution of fat to be tasty on its own. He was quite right, we discovered in that unattractive dining room in rainy Wales.

bovine

Some years later, Mad Cow disease (Bovine spongiform encephalopathy) became a concern in the UK. One evening, when we were going to a theatre near St Martins Lane in London, there were large headlines about the disease on the front page of the latest issue of the Evening Standard newspaper. Before the performance, we entered a branch of McDonalds for a quick snack. Almost everyone in the café was eating beef burgers, despite the headlines on the newspapers that some of the customers were reading!

Shortly after this, we went on a driving trip through France. In one small town, we walked passed a small restaurant with a sign hanging in its glass-fronted door. It read (in French): “We might be mad, but our beef is not.”

While the Mad Cow scare was at its height, we were invited to stay with some friends in Belgium. We had stayed with them often before. We asked them what they would like us to bring from London. They said they would love a home-made curry, enough for about twelve people. Although I am married to an Indian, it is I who makes the meat curries in our family. I prepared and cooked a huge lamb curry. As it is only a few hours’ drive between London and Belgium and the curry would have to be re-heated before being served, we thought it safe to transport the casserole containing it without refrigeration.

There were more security checks than usual at the English end of the Channel Tunnel. After our car had been examined, and the engine checked for hidden items including explosives, we were asked if we were carrying any meat products across the English Channel. We mentioned that we were transporting a casserole of cooked lamb curry. The security officials looked puzzled, told us not to move, and then walked away towards an office. One of them returned, and asked:

“It’s lamb, not beef is it?”

We confirmed that it was not beef.

“And thoroughly cooked?”

“Yes.”

“Well, what with all those spices, we’ll let you take it through the tunnel.”

Nobody asked us about meat when we arrived in France. We drove through a bath containing disinfected, and then headed for our destination.