Preface and disclaimer:
- If you haven’t seen the movie and plan to, DO NOT read this blog post.
- If you haven’t seen the movie and weren’t sure if you should, let’s just say it’s a 3 out of 5 stars, in my opinion
- I am not a movie critic.
With that out of the way, “Love and Other Drugs,” starring Jake Gyllenhaal and the always endearing Anne Hathaway, is a love story set in the heydays of the pharmaceutical industry. Jamie (Gyllenhaal) loses his job selling electronics and becomes a hot-shot pharmaceutical representative. He runs into and falls in love with Maggie, an very medically knowledgeable young woman with early onset Parkinson’s and a medication list that suggestive of polypharmacy. Sounds like a perfect couple, except that Jamie specifically represents Zoloft, Azithromycin, and – later in the movie – the king of all prescriptions in terms of demand and no-questions-asked prescribing – Viagra. There are poignant observations and classic stereotypes. A comment made by Jamie’s struck-by-dumb-luck-but-emotionally-immature-internet-entrepreneurial brother suggests that being a doctor is certainly not the road to riches it once was. The main physician character in the movie finds that the solution to dealing with the demands of practicing medicine is to say “Sure. Why not?” and write out needless prescriptions to appease patients and get through a packed schedule. Casual and reckless sexual interactions throughout the film serve as apt metaphors for the role of Big Pharma in the practice of medicine. Reap rewards now, pay for the consequences later.
The film portrays how perfect as bedmates they were in the 1990s. MDs were seduced – figuratively, but also literally in the movie – by former cheerleaders and athletes turned drug reps (“Because it’s the only entry-level position that pays $100000 per year”) who were supplying them with free food, trips, and even pens (!). Of course, all of these items are now considered contraband in most clinics. But it was a great arrangement at the time. Even the third party (patients) were unknowingly complicit. After all, free brand-name samples were better than paying a small copay for generics, right? And why wouldn’t one keep going back to the generous doctor who gave them to you? Unfortunately, as the saying goes, you don’t get something for nothing, and free samples were no exception. Why? If it works well for a patient, it is much easier to continue to prescribe it than to change it to a more affordable, equally effective, generic option when the free samples run out. Patients, who also prefer not to change medications that are working well for them, are then essentially “hooked” on an expensive treatment. To quote yet another age-old adage, if it sounds too good to be true, it is.
This says almost nothing about the love story between Jamie and Maggie. The former is driven to be successful, and the latter has a chronic and incurable illness. The most intriguing aspect of the movie for me was Maggie’s perspective of day-to-day life (not just in the doctor’s office waxing poetically about her delayed diagnosis and multiple treatments). How she felt about herself and what she felt she deserved. Why she was willing to forego the possibility of true love because of a fear that it was not unconditional and that her illness would get in the way. The unpredictability of her symptoms. The cover-ups. The witty, sarcastic words that she thought hid her pain. How she hid her diagnosis and, at other times, hid behind it.
Now that is great subject matter that gets a little lost in the drama and ease of exciting new drugs, like Viagra. But isn’t it also lost in real life, when doctors look at a medication list and presume to know their diagnoses or find themselves using their pens more than their ears? How many of the meds we prescribe are actually treating the results of a patient’s self-perception of their illness? Benzodiazepenes for anxiety, muscle relaxants for the tension that comes from the anxiety, the sleep medication for the insomnia that is caused by ruminations and perseverations, etc.
How much is our self-worth tied into our health? It is fascinating, integral, but little understood by the very people who prescribe treatment just how a disease and prognosis affects the psyche of a patient suffering from chronic disease. Once that diagnosis is made, reality is altered and with it, the definition of oneself.