Effectiveness and Side Effects: Medicine Is a Double-Edged Sword

Asahi Shimbun Morning Edition – February 27, 1999

When you read the Japanese word for “medicine” (kusuri) backwards, it becomes “risk.” Indeed, medicine is a double-edged sword.

In politics and economics, trial and error is often tolerated, but in the field of medicine, that is not the case. However, if we bind ourselves to the myth of infallibility, many doctors might end up ceasing to prescribe medication altogether.

In psychiatric treatment as well, medications can sometimes cause life-threatening or difficult-to-treat side effects.

The film Awakenings (1990) tells the story of a once-brilliant boy who became speechless and immobile due to encephalitis, turning into a statue-like adult. Thanks to experimental medication, he awakens.

Robin Williams plays a neurologist—originally a research doctor turned clinician—who begins administering L-DOPA, a dopamine precursor that had shown promise for treating Parkinson’s disease, to Leonard, a long-term patient at a Bronx hospital.

As a result, Leonard awakens from a 30-year sleep at the age of fifty. He reunites with his ever-supportive mother and begins to feel romantic affection for a young woman visiting other patients. Other patients also awaken in similar fashion. However, the side effects of the drug begin to appear, and the miracle comes to an end with the summer of 1969. Leonard and the others return to their slumber.

Leonard, who continues taking the medication despite knowing the side effects, for the sake of the other patients, presents a deeply moving and tragic figure. Robert De Niro’s performance as Leonard was outstanding.

In reality, dopamine-based experimental drugs for Parkinson’s disease can induce hallucinations, and antipsychotic medications can cause Parkinsonian symptoms. Forty years have passed in anguish, caught in this endless game of cat-and-mouse.

In the 1990s, the emergence of antipsychotic drugs that were less likely to cause Parkinsonian symptoms was reported by Time magazine as a new “awakening” in psychiatric treatment.

“All or nothing.” Medical treatment cannot be reduced to such a simple binary. We must not forget that medicine only realizes its true power when combined with the persistent support of the medical staff and families.