Notable quotable

Posted by David Roberts at 11:29 AM on 10 Apr 2008

Read more about: quotables | health | insanity | air travel

"I wouldn't want anyone taking those medicines and having to make decisions in a safety-sensitive position."

-- Dr. Robert Bourgeois on the pills, "including lorazepam, an antianxiety medicine; Imitrex for migraines; Provigil to increase wakefulness; and Darvon Compound-65 for pain" being taken by Capt. John Cota, pilot of the container ship that plowed into the San Francisco-Oakland Bay Bridge last fall, for his illnesses, "including glaucoma, depression, kidney stones, migraines, pancreatitis and, most recently, sleep apnea"

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For that matter,

I would not want anyone who uses "safety-sensitive" as an adjective, unironically, within thirty feet of me.

As for Captain John Cota: At what point are we allowed to say that proliferating diagnoses are equivalent to hypochondria?

OK, that is unfair. But nevertheless, it seems fair to ask, How did someone with so many potentially incapacitating maladies get put into a position that allowed him to imperil a large number of ecosystems, i.e. the lives of many animals and plants?

Chickens deserve our true friendship! So do fish! So do other sentient beings! Let us learn to be kind.

by caniscandida at 12:18 AM on 11 Apr 2008

I'm surprised

that the man could walk upright, let alone drive a ship, given that he was taking no less than four CNS-acting drugs at the same time.

Lorazepam is similar to Valium, and while mainly prescribed for anxiety, is a CNS depressant, and is also prescribed for insomnia.

Provigil is similar to amphetamine and is a CNS stimulant that, in addition to "wakefulness," produces "psychoactive and euphoric effects,
alterations in mood, perception, thinking, and feelings typical of other CNS stimulants in humans."

Darvon is an old-school centrally-acting narcotic analgesic, similar to methadone and slightly less potent than codeine. It is a CNS depressant.

Imitrex (sumatriptan) acts on the serotonin system in a manner not unlike many anti-depressant drugs (Prozac, etc.).

Each of these drugs act on the central nervous system. Each of them carries warnings in their drug labeling about combining with other drugs which act on the CNS. Lorazepam, Provigil and Darvon all carry warnings about the potential for drug addiction, mood alteration & psychosis, and suicide. With this many CNS-acting drugs in his system, he was also at high risk of serotonin syndrome, a potentially fatal systemic toxicity resulting from high levels of serotonin in the brain.

The man's brain was floating in a veritable stew of conflicting pharmacological agents. This is classic pink-elephant land; hallucinations, paranoia, ideation, excessive sleepiness, agression, amnesia, hostility, sedation... all of these and more.

Shame on his doctor(s) and his pharmacist(s) for allowing this. Shame on his employers for not better monitoring their employees in key positions of responsibility. And shame on Capt. Cota, either for not informing himself of the risks associated with such a regimen, or for not caring.

by kmp at 9:27 AM on 11 Apr 2008

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