Rants

Medical differentiation

In Design, Rants on 4 February 2010 with Comments Off

At Christ­mas, Al’s Grandma brought two boxes of Ibupro­fen with her — 200mg and 400mg. The ques­tion was, which was which? Al’s Grandma is eld­erly, often con­fused and has prob­lems with her vis­ion. Given that she was nurs­ing a broken thumb at the time, adequate pain relief was neces­sary, so we explained which was which and how many of each to take, set­tling the mat­ter. But it niggled at me that the mat­ter wasn’t even slightly settled — as soon as she got home, she’d be straight back to square one: one of these dosages is higher than the other, and I don’t know which.

So this art­icle from Futur­ity, “Cau­tion, may cause con­fu­sion and mis­use” has me think­ing about why med­ic­a­tion dir­ec­tions, both pre­scrip­tion and over-the-counter, are so dif­fi­cult to follow.

“Half of adults mis­un­der­stand com­mon stand­ard drug warn­ings on pre­scrip­tion labels, put­ting them at risk for using the medi­cine incor­rectly or even hav­ing a life-threatening event.”

The inform­a­tion on med­ic­a­tion is overly com­plex and often dif­fi­cult to fol­low. Instruc­tions are mis­lead­ing, abstract and word­ing used just because it always has been, even when there is no evid­ence of its effectiveness:

“A lot of the cur­rent warn­ings were phrased very abstractly and were con­fus­ing. For example, we changed ‘For external use only’ to ‘Use only on your skin.’ We moved from the intan­gible to the concise.”

A sim­ilar pro­ject was under­taken by a graphic designer for Tar­get in the US in 2005, com­plete with identi­fy­ing col­our labeling for fam­ily mem­bers. As far as I’m aware, noth­ing sim­ilar has made it over to UK phar­ma­cies yet.

The photo to the right is the label from some nose drops when I had a sinus infec­tion (let’s skip over who pre­scribes med­ic­a­tion that needs you to hang upside down four times a day to someone with a bad sinus infec­tion). One drop to be “instilled” four times a day for “esven” days, later con­tra­dicted with mildly ter­ri­fy­ing warn­ing “not to be taken”. The instruc­tion is in small, blurry, badly prin­ted text, with the name of the phar­macy as, or more, prom­in­ent than any of the directions.

I take a lot of med­ic­a­tions, and there is noth­ing con­sist­ent about them. While they all come in boxes (apart from the odd ear/nose drop) almost all are gen­er­ics, so there’s often very little pack­aging dif­fer­ence between one and the other — it’s brand­ing for the gen­er­ics com­pany, not the med­ic­a­tion, so get two from the same com­pany and con­fu­sion ensues. If I hap­pen to go to a dif­fer­ent phar­macy to pick up my pre­scrip­tion, then I’ll more than likely get a dif­fer­ent brand of gen­er­ics from them than my usual phar­macy, with a dif­fer­ent box and dif­fer­ent brand­ing. As for the actual pills, they can vary so much between brands that there is no real point in try­ing to identify them by shape, size or colour.

I’m lucky. I can read without prob­lems, and I have no prob­lem remem­ber­ing what the GP has told me about my med­ic­a­tion (or ask­ing them to repeat it until I have no prob­lem remem­ber­ing). I can pull out a load of pill boxes, men­tally sort them, and remem­ber which ones to take when — when I remem­ber to take them at all, that is. I’m bolshy enough that if a medi­cine isn’t work­ing as it should I’ll go back to the doc­tor and whine until they change it. But what if I couldn’t read well? What if I couldn’t remem­ber? What if I’d had a stroke and couldn’t com­pre­hend writ­ten lan­guage well but lived alone? What if I for­got why I was tak­ing any med­ic­a­tion in the first place, let alone what it was or how many to take? What if I was too embar­rassed to ask for help? What if I didn’t know where to go for help? At least one, if not all, of these things will hap­pen to me in the course of my life. You too.

So why is labeling so bad here in the UK? Why is there so much vari­ation, odd Eng­lish and so little help? What would help? If I could, I’d go back to Christ­mas and make some large colour-coded stick­ers to label the ibupro­fen with. Even if she struggled to read the digit some days, Al’s Grandma would soon learn to asso­ci­ate the pink with the pills she takes two of. Why can’t she walk into a phar­macy and say, “I’m not sure how many of these to take as a stand­ard dose” and have them sticker the packs for her?  Why can’t she get large-print, colour-coded labels on her pills, and why can’t the doc­tor print out a timetable for her detail­ing which of her pre­scrip­tions to take when?* I can Pho­toshop up a giant pink 2 icon in less than a minute (and poten­tially print it out and stick it on a box. I’m a grafter, me.), but ima­gine what could be done for labeling with a bit of research, some user test­ing and, most import­antly, some consistency?

*When think­ing about this, I planned a web­site which luck­ily already exists: MyMed­Sched­ule. It is US-based, so most UK drugs will have to be labor­i­ously typed in, but I can’t find a UK equivalent.

Not for resale as a single unit

In Rants on 17 January 2010 with Comments Off

The poverty of stim­u­lus the­ory argues (some­thing along the lines) that lan­guage must be innate, not learned, because a child could not develop know­ledge of com­plex gram­mar and lan­guage based on the lim­ited input they receive from adults. It’s also some­thing that keeps pop­ping into my head as I get frus­trated by myself and my inab­il­ity to write.

I read A Year of Magical Think­ing by Joan Didion, and came out think­ing that if I could write like that I could really write. And I think of incid­ents I could write about, how I would write about it. And then I get to the com­puter and instantly turn to Google Reader to catch up with the latest Lolcats before switch­ing my atten­tion to Twit­ter to see what know­ledge I can glean in 140 characters.

And then I beat myself up because I order a copy of Didion’s non-fiction from Amazon since the lib­rary doesn’t have it and it seems to be hard to get. Because tech­nic­ally, I can’t really afford it.

And I beat myself up because I sign up for two courses I really want to do. Because tech­nic­ally, I can’t really afford it.

Lolcats? Lolcats are free.

But in this case, is free neces­sar­ily good? Is free healthy? It’s the cheap but bad for you food versus the expens­ive but good for you food argu­ment, but in know­ledge form.

Is inform­a­tion worth pay­ing for? Can the stim­u­lus be made richer simply by invest­ing in it? How to tell the dif­fer­ence between what’s worth pay­ing for, and what you wouldn’t (shouldn’t) use, even if it were free?

You can be an expert on any­thing on the inter­net. Pick a topic, make some lists, wait to be inter­viewed on other blogs — cha-ching, pop-up Expert. This is not neces­sar­ily expert­ise worth listen­ing to. This is unlikely to be expert­ise worth listen­ing to. That may be an unjus­ti­fi­able com­ment, to assume that someone who blogs their know­ledge knows less that someone who write journal articles.

What really mat­ters is the proven­ance of the inform­a­tion. I trust Didion on grief because she has been there. Do I trust her more because she can write well about it? Because she has been pub­lished on the sub­ject? If I wrote about grief, would I trust myself as a source? I have a degree in lin­guist­ics, but there are so many more places I would send you for inform­a­tion on lin­guist­ics than my brain, which can barely recount the poverty of the stim­u­lus argu­ment. I would send you to books. I would refer you to other people’s brains. Does that mean they’re experts? Or just that I trust in the proven­ance of the inform­a­tion? I trust them to tell you what they don’t know as well as what they do know.

I don’t know.

Dear Scottish Power

In Rants on 23 October 2009 with 2 comments

Just found on my hard drive: I wrote this let­ter on Janu­ary 22nd 2009, so you can lodge it firmly in the “pro­cras­tin­at­ing” and “bit­ter” cat­egor­ies. I put it in an envel­ope, but I am almost entirely sure I didn’t post it but instead left it by the door, unstamped, and then threw it out when we moved. The issue at hand is the logo below (which, to be fair on myself, I still don’t like) which was unveiled to me atop a huge elec­tri­city bill:

Dear Scot­tish Power,

Thank you very much for my latest bill that arrived this morn­ing. I look for­ward to pay­ing you an extor­tion­ate amount for the pleas­ure of being really quite cold all the time; indeed, I believe I am now in what they call “fuel poverty” and I will take great pride in adding that detail to my CV. Admit­tedly, the cost of heat isn’t entirely all of your fault; my extremely cheap land­lord must also absorb some of the blame for his refusal to have any­thing effect­ive in the flat, like cent­ral heat­ing, gas or a sofa that doesn’t cripple you. But he lives in Aus­tralia, so I sus­pect he has simply for­got­ten what it is to be cold.

Any­way, my real ques­tion is about your lovely new logo. Although the typeface you have chosen makes me a squirm a little, I appre­ci­ate how you have man­aged to use the graph­ics to com­mu­nic­ate your con­cern for the envir­on­ment with the leaf. And I’m tak­ing a leap and assum­ing that the yel­low icon is to rep­res­ent the heat you are sup­posed to sup­ply. How­ever, I’m some­what con­fused about the blue. Is it meant to some­how sym­bol­ise my freez­ing cold fin­gers? Or, as it has some­thing of a teardrop shape, does it rep­res­ent the cry­ing your cus­tom­ers do when they get their bills? I’m being facetious here, but I’m sure you can under­stand my con­fu­sion. Per­haps you now sup­ply water, and it rep­res­ents that? And if you do sup­ply water, didn’t your brand­ing people sug­gest maybe chan­ging your name from Scot­tish Power? Scot­tish Powa­ter has some­thing of a ring about it.

Yours sin­cerely,

Miss Sarah Barrie

Och, ye cannae come in the noo, hen

In Rants, Websites on 27 September 2009 with 3 comments

I’ll be hon­est: I secretly love the Daily Mail. Not in a ser­i­ous way, or even in the same — admit­tedly slightly evil — way that I love watch­ing people get park­ing tick­ets, but in the way that some­thing goes so far bey­ond the bound­ar­ies of bad that it begins to tran­scend real­ity and become breath­tak­ing awe­some, in the true ‘worthy-of-amazement’ way.

If you’re from the UK, you won’t need a primer in Daily Mail Hate, and the quite wor­ry­ing trend of people read­ing a Daily Mail head­line or story and using that as an allegedly fac­tual basis for some form of pre­ju­dice. In fair­ness, the DM also does a good line in cute animal pho­tos and in quirky stor­ies that BBC News will steal the next day, although they tend to be some­what less con­ten­tious. But they have now pub­lished a head­line that goes wildly, enter­tain­ingly, bey­ond even the DM’s usual stand­ards: “Eng­lish pas­sen­gers forced to show pass­ports when arriv­ing in Scot­land”.

In short, we Scot­tish people hate you Eng­lish people so much, even though you pay for everything for us and we steal all of your money and give it to stu­dents and ill people that we now make you show us your pass­ports at the air­port. We think you are such a major ter­ror risk that you might do an incen­di­ary Mor­ris dance or foot­ball hoo­ligan­ise us all to death that we have decided to to incon­veni­ence you slightly in order to make our point.

So let me do all of middle Eng­land a favour and trans­late the head­line into actual fact: some pas­sen­gers, regard­less of where they’re from, are being asked to show their pass­ports at some air­ports for secur­ity reas­ons. This, strangely, will prob­ably also include some Scot­tish people, return­ing home to Scot­land in order to deep fry a Mars Bar and toss a caber or two before nip­ping back down to Engli­and to steal your votes. And so hor­rific is the abuse of our Scot­tish powers that the Mail end the piece with the news that “Met­ro­pol­itan Police, which cov­ers Heath­row and City air­ports in Lon­don, also use the powers on domestic pas­sen­gers. A Met spokes­wo­man said: ‘From time to time we to stop people and look at their travel doc­u­ments. It’s not that unusual.’” This would con­sid­er­ably under­mine the entir­ity of the Mail’s argu­ment but, erm, you know, that prob­ably doesn’t count as kilt-screening because, erm, ooh, look what Sienna Miller’s wear­ing today! And is that a baby duck without a mother?

I admit it: I’m a bit­ter Scot who some­times gets annoyed when Dorothy Per­kins in Sus­sex won’t take my 100% genu­ine Scot­tish £20 notes without first treat­ing me like a money laun­derer who’s put on a dodgy accent. I’ve had whole argu­ments with my Eng­lish boy­friend when he won’t accept that the word “juice” cov­ers all forms of drink­able flu­ids apart from water and alco­hol. The words “answer” and “dan­cer” do not — and can not — rhyme. But regard­less of that, even we money-grabbing, bagpipe-playing, mean­ies, who have sent our entire pop­u­la­tion to work in the Cab­inet, really couldn’t care less about look­ing at your pass­port unless we have to, apart from to laugh at  your photo.

After all, our time is pre­cious: we have chips we could be eat­ing instead.

Dear Landlords

In Rants on 22 May 2009 tagged flathunting, landlord with 1 comment

Dear land­lords,

I know that Homes Under the Ham­mer prom­ised you the world. Just buy the house, they said. It’s easy, they said. Buy on Monday and by Thursday you’ll be rolling in end­less piles of cash! What could be bet­ter? Noth­ing, you thought, as you applied for the mort­gage and waited for the money to roll in.

But what they didn’t tell you was that the trouble starts when the ten­ants move in; the end­less unreas­on­able requests. Can they have a cooker with all of the knobs on? Can they have a hoover that sucks up dust? Can they have a ward­robe that can hold a few hangers without col­lapsing? It’s really quite unreas­on­able — If you bought all of that it would cost 3% of your annual profit!*

But I’m here to ask if you would, for a minute, think of the ten­ants. You don’t need to think of them nicely – I mean, they’re mostly money machines to you, but they are people-shaped money machines. They call the flat home, and they look after it for you – they have almost as much to lose if the place goes to rack and ruin as you do, home­less­ness not being an awe­some option. So I was just won­der­ing if you could take a minute out of your account­ing to think about whether or not you would live in your own buy-to-let prop­erty. Really?

You see, fire alarms are not, and will never be, “fea­tures”. Double glaz­ing is a fea­ture, that I admit, but only if it’s actual double glaz­ing and you haven’t just fit­ted per­man­ent pan­els of Plexi­glass over the win­dows so that if that fire­al­arm has to do any work it’ll take us four hours and a set of screw­drivers just to be able to jump out of the win­dow (and you’ll notice a wee flaw with that plan, too, a flaw that sounds a lot like “burn­ing to death”).

And you should prob­ably know that freez­ers ceased to be lux­ury items in the sev­en­ties, and if you were just to pop down to Tesco you can pick up a microwave that wasn’t carved out of stone for less than £40. Ser­i­ously, look around your flat: the 80s didn’t die, they just moved to Bruntsfield.

And this isn’t all your fault, I know. You pay for a let­ting agency to sort out things like fur­niture that has deas­sembled itself and car­pets that look like Jack­son Pollock’s inspir­a­tion. And they’re miser­able, those let­ting agents; it’s not like you want to make friends with them. But I do have to spend fif­teen minutes trapped in a small flat with them, and some­times get in a car with them. And it would be nice if, for those fif­teen minutes, we could all put on our happy masks and pre­tend that this isn’t the worst. Job. Ever. Because in what other job do you just turn up fif­teen minutes late, let some people into a flat, wait until they’re in the liv­ing room and then phone a friend for a chat?

Still, thanks for hav­ing some money to pay for a flat that I can rent from you for an extor­tion­ate amount – no, really, I’m genu­inely grate­ful, because home­less­ness doesn’t look very fun (although don’t think I haven’t noticed that if I would home­less I would be allowed a dog). I appre­ci­ate that. It’s just that I’m not a huge fan of spend­ing hun­dreds of pounds a month to live in ram­shackle pig sheds.

Love,
Sarah

*Sid­e­note: our cur­rent land­lord genu­inely does cal­cu­late this stuff and quote it at the let­ting agency when we do selfish things like point out we have a couch that the let­ting agent “wouldn’t give to his cat”. And then he says no. I will sorely miss him.