By Debbie Gilbert and John Branston

MARCH 30, 1998: 

Prescription for Disaster: The Hidden Dangers in Your Medicine Cabinet
By Thomas J. Moore
Simon & Schuster, 261 pp., $25

Chances are at some point in your life a prescription drug has made you ill. If you were lucky, maybe it was just a little upset stomach. But for some people, the consequences are deadly. According to Thomas Moore, at least 1 million people are hospitalized and 100,000 die every year from drug reactions – and those are conservative estimates. The exact toll isn’t known, because no agency keeps track of such things.

In Prescription for Disaster, Moore argues that we are way too complacent about this problem. Government resources are spent enforcing safety regulations in industries such as air travel – which kills only a few hundred people each year – while the dangers of legal drugs receive almost no attention.

There are about 3,200 different medications on the market now, and only 4 percent of the Food and Drug Administration’s budget is devoted to monitoring their effects. Most drugs, even those often taken for years at a time, receive FDA approval without any long-term studies being done. We don’t learn the true nature of the drug until – as in the case of fen/phen and Redux – a lot of people have been injured.

Moore, a former investigative reporter and now a senior fellow in health policy at George Washington University Medical Center, already made this point in his previous book, Deadly Medicine, in which he documented that several drugs intended to treat mild irregular heartbeats were actually causing cardiac arrest in an alarming number of patients.

As his latest book reveals, other drugs have similarly backfired. The sleep medication Halcion caused episodes of violence (some patients even committed murders while taking it). Popular behavioral drugs such as Prozac and Ritalin may turn out not to be as benign as once thought. The painkiller Ultram was discovered to be addictive only after it was already on the market. The antihistamine Seldane was recently pulled from shelves due to potentially fatal heart complications. And while we all recoil in horror at memories of thalidomide babies, the acne medicine Accutane causes birth defects that are equally profound.

Who protects consumers from these hazards? Ideally, pharmacists should provide a safety net (catching dangerous drug interactions, for example), but they’re overworked and not always vigilant. Doctors can’t possibly know all the side effects of 3,200 different drugs, and in any case, they tend to downplay the likelihood of problems because they don’t want to frighten patients into not taking their medicine. And the pharmaceutical industry has a vested interest in keeping patients “compliant.” The more drugs we take – whether they’re appropriate for us or not – the more money goes into the coffers of the drug companies (who have vigorously fought against establishing a nationwide system for reporting adverse drug reactions).

Moore’s answer is that the patient must take charge. In the final section of the book, he offers suggestions on how to become a knowledgeable consumer and work in partnership with your doctor.

Prescription for Disaster is extensively researched, with almost every statement backed up by an article from a medical journal. Moore’s only flaw as a writer is that he keeps reiterating his main point, beating us over the head with it as if we didn’t comprehend the first time. But his criticisms are valid, and this nontechnical, easy-to-read book draws attention to a health issue we can no longer afford to ignore. – Debbie Gilbert

Confederates in the Attic
By Tony Horwitz
Pantheon Books, 390 pp., $27.50

If you want to really understand a man, walk a mile in his shoes.

Tony Horwitz takes that advice literally, and it’s the basis for his book about the enduring hold of the Civil War on Southerners.

A large (and, I think, the best) section of the book is about the weeks he spent tromping around Civil War battlefields with “hardcore” reenactors. Hardcores, as opposed to dilettantes or “farbs,” not only wear authentic period clothing, they may also eat rancid bacon, march barefoot, avoid bathing, sleep in the rain under moldy blankets snuggled up like spoons next to their comrades, and rub grease in their clothes and beards.

Horwitz, a reporter for The Wall Street Journal, went hardcore to keep up with Robert Lee Hodge, a legendary hardcore whose signature act is bloating when he “dies” in battle. Dressed in stinking period garb, they made a bizarre two-week tour of Civil War battlefields and shrines called the “wargasm.” Carrying a leather-bound notebook and a small tape recorder instead of a weapon, Horwitz managed to continue to function as diarist and reporter, and the results are funny, touching, and revealing.

In a more conventional mode, Horwitz writes about Shelby Foote, Shiloh (which he visited before dawn on the anniversary of the battle, only to find several others doing the same thing), blacks and Jews who keep the memory of war alive in Vicksburg, modern Atlanta, and a black-on-white murder that divided the Kentucky/Tennessee border towns of Guthrie and Clarksville.

“More than anything with this book, I wanted to have an adventure and indulge my own passions for the Civil War,” said Horwitz, who spent 18 months traveling and another year writing this book.

You may think you know some of these subjects pretty well, but Confederates in the Attic is full of surprises. Horwitz is an incredible reporter who can get people on different sides of an issue to open up to him and who will spend weeks holed up in fleabag motels to soak up local color and points of view.

A couple of years ago, Horwitz spoke at a convention of weekly alternative newspapers in Nashville. He was modest and unassuming, although he had just won a Pulitzer Prize. “Surprise your readers,” was his advice. And that is what he does, without being sentimental, condescending, or a Civil War bore.

We learn, among other things, that there have been more than 60,000 books written about the Civil War. This is one of the ones worth reading. – John Branston

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