Alexander Mccall Smith - Isabel Dalhousie 05 by The Comforts of a Muddy Saturday

me an answer which worried me, as it was not all that much in terms of an overdose. Ten times the therapeutic dose, in fact, but that was well within the limits of tolerance of that particular drug. Those limits are pretty large.”
    He looked back at Isabel. “I don’t know if you’ve had any dealings with addicts. Have you? Do you know what they’re like?”
    Isabel thought. There had been a student in her college at Cambridge who stayed in bed all day and made no sense most of the time. There had been a person in the apartment next to hers when she had been on that fellowship in Georgetown. He was an addict, she had been told, but he appeared perfectly inoffensive. A bit thin, perhaps, but inoffensive. I have had a sheltered life, she thought.
    â€œNo. I can’t claim vast experience.”
    â€œWell, I’ll tell you something about them,” said Marcus. “Everything they say has to be distrusted. Everything. And so although I was worried, I thought that the chances were that he was lying. So I got hold of the blood that had been taken from him when he was admitted and sent it off to the lab for reanalysis. And when it came back, the result showed an overdose of about one hundred and fifty times the therapeutic dose. So this patient had swallowed a whole carton of the drug. But then that’s what they do. When they’re desperate, they pump the stuff in with reckless abandon.”
    Isabel wondered what happened to the patient. She could not see him in her mind’s eye, for some reason. He was just a story.
    â€œHe recovered,” said Marcus. “He was discharged and went back to wherever he came from. Fife, I think. He’s probably overdosed on something else since then. Poor man. He won’t be long for this world, I suspect. But no sooner had we sorted him out than another one turned up. In this case the patient had been given a dose of the drug by a nurse here in Edinburgh. The nurse swore blind that the dose had been the normal one, but again the blood showed a massive overdose. Not as big as in the addict’s case, but pretty massive. Nobody could work out how on earth it happened, as the patient sided with the nurse and confirmed her story.”
    â€œSo somebody was lying?”
    He thought for a moment. “Not necessarily. Errors can be made in how things are written down. Inadvertently move a decimal point one place in either direction and you get very different results, don’t you? But something had gone spectacularly wrong. Again, we were able to sort things out and the patient recovered reasonably well. She was a nice young woman, actually. A student at one of the universities, as I recall.”
    â€œSo you wrote up these results?”
    â€œYes. I made a report to the chief medical officer. I effectively gave the drug a clean bill of health. Then I wrote the two cases up as a case note for one of the medical journals. They published it. It was just a couple of paragraphs describing what had happened.”
    â€œThen?”
    Marcus was silent for a while. Isabel noticed that his hands, clasped together in his lap, were white at the knuckles. His voice, when he spoke again, sounded strained.
    â€œA month later a man in Glasgow was admitted to hospital. He had been treated with the antibiotic. He…I’m sorry to say that he died from heart complications. He had not received an overdose—that was established. The press got hold of the case and they asked how somebody could die from taking a licensed medicine. Well, I could have given them an answer to that, but they were not in the slightest bit interested in a rational explanation about inevitable risk. They put pressure on the minister and they took another look at my report. They discovered that the doses I had described did not match a new set of lab reports on the blood. The figures were way off. And they also discovered that I had not declared a conflict of interest