Side Effect

My pharmacist recently told me even a placebo has side effects. A placebo. Nausea, vomiting, diarrhea, constipation. A grimacing index of potty-mouth Latin, and all of it caused by a pill made from table sugar and enteric-coated deception.

My pharmacist snapped her gum while punching in my total at the register and said, “Yeah, amazing huh? What the mind can do? It’s like you can take a complete nothing and make it harmful. Kind of makes you wonder.”

I had to agree. But unlike her, my fascination lacked that placid, externalizing element so critical to mental health. What I felt was more like panic. “Let me get this straight,” I said. “Are you telling me even nothing causes harm?”

“Yeah. I mean no. Wait, what?”

“I’m just stating what you said. You said, nothing can be harmful. I just want to know if that means no thing can harm me, or everything can.” Because this was important, you see, in the world such as mine, where every fact was potential fuel for hysteria.

It was perfect. If properly interpreted, I could now curl into a fetal ball on a whim with the knowledge that double-blind trials and scientific rigour had both confirmed that nothing is actually hazardous to my health.

I looked at my pharmacist, feeling vaguely sad for a person who endured years of grueling advanced chem studies, earning her one or more degrees in what’s considered one of the most technically challenging fields of medicine, so she could work a cash register at Costco. “Listen,” she says. “Don’t worry about all that. It’s the worrying that causes it.”

She handed me a little brown bag, stapled shut for privacy, containing my Seroquel, by Celexa, my jumbo-sized refill of lorazepam. Though my psychiatrist promised otherwise, Risperidone had done nothing for me. The tricyclics made me ill. Divalproex pills were the size of IKEA pegs and about as fun to swallow, and lithium made my tongue taste like metal. Prozac I refused to sample on the grounds that its name derived from the word prozaic, as in listless, boring, lacking in imagination. I concluded the drug was either very poorly named or filled a niche in a market I’d already cornered.

“What’s this one?” I said, pulling an unidentified bottle from the bag, mangling the name out loud. “Noxa…flopa…spitalaloxicin? Exacin? What is this stuff? I never take —”

“Noxaflopaspitalexocin,” she says. “It’s your mood stabilizer. I had to make what’s called a ‘therapeutic substitution.’ Basically, the same stuff, does roughly the same thing, just doesn’t have the trade name.”

“But I want the Trade Name.”

“Nope. Discontinued.”

“Discontinued?” I protested. “For what?”

“Side effects.”

“Side effects! But I need my side effects! It’s part of the bargain. You can’t just offer something and then take half away.” I leaned forward over the register, could feel my pupils dilate and burn under the megawatt fluorescence. “Listen to me! I need my Trade Name mood stabilizer! Do you understand? You can’t mess around with this stuff. I’m a tax-paying North American in a free-market society with constitutional rights to branding! Now tell me, what happened to my Trade Name?”

“Already told you. Side effects.”

“Death is a side effect of Clozapine. It’s still on the market. What kind of side effect are we talking about here? What’s worse than death?”

And I’m not ashamed to say, at that moment, what I wanted most was to hear her say, “Nothing is,” because nothing is would close the circle of our day in a way that was haunting and seamless and poetic. Or even better, I’d like to tell you that upon hearing those words, I was struck with sonorous realization, cast my pills into the trash with the burst of sky-shattering laughter and set out on a new vector of life.

But as she handed me my receipt and turned away without a word, I knew nothing more would happen. There was nothing more to get. And for a moment, just a moment, it seemed nothing just might be okay.