Pills
You Didn’t Get Sick. You Got Enrolled.
Pills to wake, pills to sleep
Pills, pills, pills every day of the week
Pills to walk, pills to think
Pills, pills, pills for the family
– St. Vincent
Is the world losing its mind, or is everyone just on something? I look around and I sincerely can’t tell anymore.
Your kid can’t sit still, so the doctor writes a script before asking what he eats or how many hours he stares at a screen. He’s not broken. He’s a seven-year-old boy.
Your buddy can’t get it up, so he reaches for the blue pill instead of putting down the beer and chips. Your sister-in-law wants the influencer body, so she injects herself into a thinner version of being sick. A different disease, dressed up as discipline.
Can’t sleep? Ambien. Anxious? Xanax. Sad for more than a week? Antidepressant. It’s easy: a fifteen-minute appointment, prescription in hand before you’ve finished saying what’s wrong with you.
And the commercials. Twenty seconds of a couple holding hands in a field, followed by forty seconds of a voice listing the ways the drug might hurt or kill them. Stroke. Suicidal thoughts. Sudden death. Ask your doctor. And people do.
•••
I was twenty-nine when I visited my family doctor on the Upper East Side of Manhattan. The kind of reputable MD with a month-long wait. I went for a routine checkup and some bloodwork. He told me my cholesterol was “borderline high.” This was years before I learned that most of the discourse around cholesterol is a pharma marketing campaign doing cosplay in a lab coat. At the time I simply trusted the man.
I asked what to do.
He said, take this pill.
I asked for how long.
He said, the rest of your life. Given your family history, we can’t be too safe.
My father had picked up smoking in his thirties to cope with the stress of a pre-existing condition. Four packs of Marlboro Reds a day. Several heart attacks later, it eventually killed him. That was the family history my doctor was referring to.
I asked the name of the drug. He said Lipitor. Then I looked down at his prescription pad. It said Lipitor. I looked at the pen in his hand. It also said Lipitor.
I slowly walked out of the room backwards and never saw him again. In fact, I pretty much stopped seeing doctors after that. Not out of principle (not yet anyway). Just out of the feeling that something in the room hadn’t been on my side.
•••
Generalizations can be hard. For what it’s worth, I happen to know some great doctors who are absolutely trustworthy. And, of course, lots of people walk into a doctor’s office because they’re actually sick and the right medicine might benefit them.
It’s the rest I’m talking about. Someone walks in tired. Or a little distracted. A bit sad in February. A kid who fidgets or a wife who’s quieter than she used to be. There’s no disease, there’s a life. And the system that used to help tell the difference now turns life into a subscription.
And it compounds. The SSRI flattens you, so they add the stimulant to wake you up. The stimulant winds you up, so they add the benzo to take the edge off. The benzo wrecks your sleep, so they add the Ambien. Every new prescription is treating the last prescription’s side effect. At some point you stop being the patient and become the side effect.
Many of these drugs were studied for mere weeks and then prescribed for decades. There’s no off-ramp because the on-ramp was never built for the duration. Try to stop the antidepressant and you find out your brain has rewired around it. Try to stop the benzo and you can have seizures. The script renews itself. You churn or you stay.
Your wife agrees. Your mother agrees. Your brother agrees. The doctor went to school for this. You should listen to him. What, you think you know better? The credential isn’t on the wall anymore. It’s in every conversation you have with the people who love you.
“I won’t talk to him unless he’s on his meds.”
I look around at the people I love and I’m not always sure who I’m talking to anymore. Half of them seem to be on something. More docile than they used to be. Further away, especially in their eyes. I miss them and they’re standing right there.
Your body had a signal and they diagnosed it away. That seven-year-old kid never even got the chance to develop one in the first place.
Getting back to yourself doesn’t start with stopping the pill. It starts with trusting the signal again.