"These little essays were written during a short period at Roche when the medical department did NOT have a final say in copy for mailings to doctors. In another one I managed to get in my view that these tranqullisers should not be used for more than a fortnight!"
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It is axiomatic that the more potent a drug is, the more likely it is to have side-effects. The corollary is that if a drug has no side-effects, it is probably ineffective! The general practitioner’s problem is to balance the advantages of a particular drug against its disadvantages. Is the patient ill enough for the expected side-effect of a potent drug to be negligible against alleviation of his symptoms? Or is he well enough to be given a less potent compound without side-effects? For many drugs the therapeutic usefulness is limited to a narrow dosage range: above this range side-effects predominate, below it the drug doesn’t work. This can happen when barbiturates are used in the treatment of anxiety states. Either the patient is still too anxious to work properly, or he’s fast asleep at his desk.

Mrs. Johnson has just failed to get custody of her children: this is the final tragedy of her second marriage. The first marriage was brief and pointless, except for her nine-year-old boy little remains of it.
Mrs. Johnson, now 33, was an ambitious and talented artist, but she had little emotional contact with her second husband — a forceful and intellectual fellow who runs a management consultancy She’s a good and loving mother: but an appalling manager, and produces the classic middle-class slum that is somehow so much worse than the despair of poverty. An anxious girl, with a tendency to depression, she becomes more anxious as she tries to paint in spite of her difficult husband She is actually fairly successful — but not quite successful enough to satisfy her.
Eventually her husband leaves her to live with his girl friend and the marriage ends up in court. Mr. Johnson wants custody of his three children — ages 2 to 6— to add to the three his girl friend already has. Mrs. Johnson’s doctor feels that in spite of her inefficiency she would be a better mother for the children than the efficient but unloving girl friend. And he is prepared to say so in court. But the court doesn’t agree: the children are split up, leaving only the eldest boy with Mrs. Johnson.
Within a month of the verdict she presents at the surgery: she can’t sleep, she gets headaches, she’s always tired, she doesn’t eat. She is visibly agitated, and confesses to an increasing tension that has overwhelmed her creativity. She needs LIMBITROL