The patient has a fast-spreading cellulitis of the face, which stemmed from a pimple near the nasal opening which the patient squeezed a few days before consultation. The area of the nose occupies the central part of the dangerous triangle, so called because any infection in this area can lead to fatal consequences if bacteria or other pathogens are able to penetrate the cavernous sinus and consequently the brain itself. The astute physician makes the correct diagnosis and hurries to write his prescription, backed by long years of medical schooling and thousands of patients later. In a country where the market is cluttered with both efficacious and substandard drugs, the physician, who fears the possibility of a fatal complication, writes the generic name of the drug but sadly enough, stops short of writing the brand that has given him the most number of successfully treated furuncles, boils, and other staphylococcal skin infections, because the law has deprived these faithful disciples of Hippocrates of the right to choose the best drug for their patients. The unwary patient heads for the nearest drugstore and is met by a well-meaning but ignorant saleslady who dutifully helps the patient select from ten available drugs bearing the same generic name. The wrong choice is made, and the patient dies from a fulminating septicemia three days later, all because of one unintelligent law. Physicians, whose noble calling is guided by the dictum primum non nocere (first, do no harm), are powerless in a silly and tragic event such as this. Who suffers most? Who is to blame?
© 2008 Raul E Ramos, MD
