One of the peculiarities of buying medicines in Pakistan is that there is little or no regulation when it comes to prescription medicines. The other is that things like birth control, contraception and tampons are sold with a commitment to clandestine concealment that you’d usually reserve for heroine or nuclear weapons, but I feel like that is separate essay.
Depending on which side of the Big Pharma debate you fall on, you could see the ease with which you can get prescription drugs here as either as a wonderful or horrifying thing. Personally, I never saw the point in what I consider the very ‘First World’ obsession with prescription drugs, but that may be because I am unimaginative or perhaps because the abuse of things like anxiety medication or sleeping pills is not widely enshrined in our pop culture. You don’t catch the beleaguered bahu from one of our TV soaps shakily locking the door to her bathroom and inhaling fistfuls of Xanax as a coping mechanism to deal with her abusive mother-in-law, though I daresay that would make for some interesting TV.
Here is just a sampling of the things that the pamphlet tells me the drug is used against: skin structure infection, intra-abdominal infections, typhoid fever, urethral gonorrhea, inhalational Anthrax (post-exposure), acute Sinusitis and the Plague
I have a friend who used to buy Xanax fairly frequently and quit easily, a fact I always found odd because they had no prescription for it and anyone knows it highly addictive. But prescription drugs can be bought and sold online too – here or abroad – and so I am not sure who to blame for this. I reserve my surprise for things that are not considered party drugs. Personally, I never knew for the longest time that antibiotics are a precious and rarely prescribed medicine. Growing up it was perfectly normal that at the slightest preview of the barest whisper of a cough I would be put on a course of antibiotics for five days – so strong that it would eviscerate all bacteria within a five foot radius of my body.
This was normal. Indeed, when I went away from home for the first time to live at college, I took several boxes of antiobiotics, anti-inflammatories, muscle relaxants and beta blockers just in case I feel too ill to navigate the alien world of healthcare.
My bag remained untouched for a few weeks, until about halfway through the term I fell seriously ill. In retrospect it was probably my body getting used to the new bacteria and viruses of a new biosystem, but at the first sign of a sore throat I began taking Ciproxin, one of my antibiotics of choice. My roommate at the time, James, came into our shared flat, saw the box on the table and freaked out.
'The Triumph of Death' - 16th century depiction of the Black Death, by Pieter Bruegel the Elder
“What are you doing with this?” he said wide-eyed, waving the blue box in his hand.
“What?” I replied incredulously. “I’m taking my medicine.”
“Do you know what this is?! I mean, do you have CLUE?!””
“Of course,” I said, snatching the box back from him. “Antiobiotics. It’s no biggie, I think I have a cold.”
“You think you have a cold,” he repeated slowly.
“Yes.”
“And you’re answer to that is to take Ciproxin. But not just any dosage, 500mg of it.”
“I mean, from your tone you seem to think that that is a bad thing, but I don’t see-”
“My dad is a pharmacist,” he interrupted, his features dark and foreboding. “And let me assure you that Ciproxin is some very, very serious medication. I mean, last resort kind of medication. I’ve only ever seen it twice in my life and even then it was behind two layers of glass. That’s how serious it is. They give it to people who have Anthrax whose bodies have rejected everything else. Anthrax, do you hear me!”
I considered this information.
“Well,” I said finally, “At least we know it works then, don’t we?”
He eventually gave up, and probably attributed my lack of shock to a cultural difference. The conversation has stayed with me over the years though, especially as I’ve seen documentary after documentary on the fact that bacteria are becoming increasingly immune to antibiotics and that one day, in the near future, we may face a “Super Bug” (ew) on which antibiotics don’t work at all.
The truth is antibiotics are fairly recent in the scale of our medicines, and are currently our last weapon because we don’t have another one after them. There is no other line of defense, and by using them indiscriminately we run the very real risk of rendering them useless.
So I try, when I can, to stay away from antibiotics unless a doctor tells me to get some. But this week, I had a bout of stomach flu so multidimensional that I’m still confused as to how one body can go so wrong in so many ways so quickly. I stood firm for about three days (or rather crouched pitifully, truth be told), withstanding the bloating, cramps, nausea and other torturous symptoms that leave you in wonder that the human body even holds that much water. Then I felt better for one day, and smug at how I had contributed to world peace by resisting drugs. But that night it felt like there was a genocide in my stomach and I couldn’t take it anymore, and I popped a Ciproxin. 500 mg.
Here are just a sampling of the things that the pamphlet tells me the drug is used against: skin structure infection, intra-abdominal infections, typhoid fever, urethral gonorrhea, inhalational Anthrax (post-exposure), acute Sinusitis and the Plague.
The Plague. It actually says that on the form. You’d think that we had some Latin derived name for it by now, but no, it’s still the Plague. Capital ‘P’. There are more warnings, labels and advisory messages on the pamphlet, but I am sitting in bed now and I haven’t felt like death for about two hours, which is a vast improvement. So, with the wisdom that a much younger me embraced without doubt, at least we know it works.
