A mixture of medication
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* Marc Gutenstein

A delightful couple came to the emergency department recently. Married for many years, they had become mutually dependent courtesy of atherosclerosis. Her diabetes and stroke and his angina and heart failure had slowed them up somewhat, but still they managed with a little help. Every morning and evening they would each tip seven or eight pills from white pill boxes into an eggcup and take them with a little food.

They were quick to mention that they wouldn't have bothered us that evening. We reassured them that we didn't mind. It was just that over dinner that night, their eggcups must have got mixed up, and he had gone rather pale and sweaty after taking her tablets. His blood sugar was low when the ambulance arrived, a little better on arrival in the emergency department after some glucose, and better still after some sandwiches. Her blood sugar was fine the whole time, but she came too as she couldn't manage alone.

I talked with them about why the mix up had happened. We all agreed that such a mistake could really happen at any time. After all, the pills did all look the same. And there were so many of them. And indeed the eggcups were the same colour. We agreed that different coloured eggcups might be a good idea.

The next morning their pill boxes were handed back, and they made preparations for going home. Unfortunately it wasn't long before another mix up caused her, this time, to mistakenly take his tablets. Thankfully, after a morning of visiting the toilet rather a lot and a period of monitoring for bradycardia, all was well again.

Again we talked, and we agreed that it was remarkable how similar the pill boxes looked, and the names written on the boxes were actually very small, indeed probably too small to read without her glasses. And, after all, there were so many tablets; it could really have happened to anyone at any time.

In fact, we all agreed that it probably does.