When we checked his BP, it was alarmingly high—210/130 mm Hg. On examining for complications from prolonged high blood pressure, I found significant damage to the retina, the central part of vision, which explained his blurred sight.
I explained the seriousness of his condition and the future complications if he did not consistently take his medication. Once he understood that his blurred vision was due to uncontrolled BP, he realized that this wasn’t a trivial illness. I advised him to continue the medication and come back in two weeks.
When he returned, his BP had dropped significantly to 130/100 mm Hg, though it still had room for improvement. His vision had slightly improved, and he was delighted with the progress. But then came the inevitable question:
“Doctor, does this medicine have any side effects?”
I replied, “What you’re experiencing now are the side effects of prolonged high blood pressure. No medication could cause anything worse than this. If you had taken the medicine without unnecessary fear of side effects, this condition wouldn’t have occurred.”
He responded with a faint smile and silence.
Recently, a relative of a patient with interstitial lung disease (a severe condition) asked the same question: “Does this medicine have side effects?”
When treating such illnesses, a doctor’s primary concern is how much the medication will help, how long it can manage the disease without causing significant discomfort to the patient. But patients and their relatives often focus on one thing: “Will this medicine cause any harm?”
I told them, “Let’s first consider the effects of the medicine; we can think about side effects later.”
For patients with anxiety, depression, or related illnesses, there’s a common question when prescribing medication:
“Is this for a mental illness?”
When I explain that it’s for a condition of the mind, the next question is inevitably about side effects.
I sometimes jokingly reply, “The only side effect is that you’ll live with a little more happiness and peace than you have now.” Occasionally, this evokes laughter.
People have somehow come to believe that modern medicines are designed to cause side effects. Where does this misconception come from?
One primary reason is a lack of practical knowledge. Haven’t you seen the absurd antics of people like Jacob Vadakkanchery, quoting lines from Davidson’s Principles and Practice of Medicine and misinterpreting them?
Every medicine mentioned in medical texts has a section on side effects, categorized into severe and minor ones. Some side effects occur in as few as one in a million people, yet they’re documented in detail. Why? For two reasons:
1. These medicines undergo extensive study before being prescribed, showing the meticulousness of modern medicine. Doctors are fully aware of what could potentially happen with any medication.
2. Unfortunately, rare side effects, however unlikely, must be documented to help doctors identify and prevent issues if they arise.
This doesn’t mean everyone taking a medicine will experience all listed side effects. Most routine medications cause no significant problems. For drugs with notable risks, doctors provide appropriate warnings and precautions.
For instance, cancer chemotherapy drugs often have considerable side effects. Yet, they’re used because they offer the chance to save a life—a trade-off that’s deemed worthwhile. Continuous research in modern medicine aims to eliminate existing side effects in newer drugs.
Another reason for this exaggerated fear of side effects is the exploitation by opportunists. They highlight the side effects of modern medicine to promote their alternatives. I once treated a patient with severe diabetes who returned to a critical state after trying acupuncture therapy, influenced by unfounded fears about modern medicine.
Social media also fuels these fears with half-truths and misinterpretations. Medical knowledge combines scientific information with practical wisdom, something Google cannot replicate.
For example, steroids are vital for patients with adrenal gland disorders. When I discharge such patients, I explicitly warn them never to skip their medication. Yet, one such patient returned in a critical state after stopping steroids based on advice from a pharmacist who said, “Steroids have serious side effects.”
Steroid medications do have side effects, but doctors prescribe them only when absolutely necessary. Without them, life itself may not be possible for some patients.
Lesson:
We take medicines because we’re unwell. The primary focus should be on curing or managing the illness, not on rare or unlikely side effects. Avoid the unrealistic expectation of treatments with no side effects and no benefits. Always gather information from credible sources. Letting go of unnecessary fear about side effects will undoubtedly improve healthcare outcomes.
NB: Posting this may have its own side effects. Let’s meet in the comments section! ??