legends · 4 min read ·
Dispensing Record
A pharmacy record dispenses an unlicensed syrup that keeps a singer company at night.
**Corner Street Pharmacy · Dispensing Record · Patient: Amos Reyes, 73**
**Prescriber:** Dr. J. Hallam · **Dispensed by:** P. Wilde (pharmacist) · **Date:** 6 Oct
- **Item · Strength · Quantity · Directions · Notes**
- Amlodipine · 5 mg · 28 · One daily · Routine
- Sleep tablets (temazepam) · 10 mg · 14 · One at night · Patient reports sleeps badly
- Night syrup (compound) · 5 ml · 1 bottle · Three times daily, as needed · *Not a licensed product. Prescribed by hand.*
· · ·
**Pharmacist's note (P. Wilde, 6 Oct)**
The prescription came in written in the prescriber's own hand, on plain paper, with no patient number and no registration reference. The third item is not in the British National Formulary. I rang the surgery. They said Dr. Hallam had written it for the patient, and that the patient had asked for it specifically, by name, and that the name was not a drug.
I dispensed the first two items. I didn't dispense the third. I put it in the drawer, and I wrote the reason on the label.
· · ·
**Patient's note (Amos Reyes, 7 Oct, handwritten, left at counter)**
*I've been taking the tablets for a week and they don't help me sleep. I wake up at two in the morning and lie there listening to the house. The pipes. The clock. Somewhere under the floor, a sound like someone humming under their breath.*
*I asked the doctor about the syrup. She said it's not for sleep. She said it's for the one who comes in when I've gone off. She said it's the only thing that gets her to stop asking when the pain is going to start.*
· · ·
**Dispensing record (addendum, 9 Oct)**
Patient returned. He asked for the syrup to be dispensed. Pharmacist explained that the product is not licensed. Patient said he understood, and that he had already been given it, years ago, and had kept the empty bottle on his bedside table. He showed the pharmacist the bottle. The label reads, in his own handwriting: *Take this when you're ready to sleep through the night.*
Pharmacist dispensed the syrup against the prescriber's instruction, with a note on the label: *For use under supervision only.*
· · ·
**Prescriber's letter (Dr. Hallam to Corner Street Pharmacy, 12 Oct)**
Dear Mr. Wilde,
I'm writing to apologise for the prescription. I wrote it on my own initiative, and I shouldn't have. The patient has been coming to me for thirty years. His wife died in 1988. Since then he has been waking every night at two o'clock, and every night he has heard someone singing in the next room, very softly, a song that doesn't belong to any of our hymnbooks.
I'm the one who wrote the song down for him, in 1989, at his request. I don't know who taught it to me. I think I learned it from his wife, who learned it from her mother, who learned it from someone in the village who had been asked to sing it to the dead.
Please don't let him take the syrup. It isn't for sleeping. It's to keep the singer company.
· · ·
**Pharmacist's note (P. Wilde, 15 Oct)**
Patient collected his tablets. He did not collect the syrup. He asked if the pharmacy had the bottle, the one with the handwriting on it, which he said he'd left in the drawer.
I opened the drawer. The bottle was there, full, the cap screwed down, and the label had been changed. The new label, in a neat, careful hand, reads: *Dose: one spoonful. Let her sing.*
· · ·
**Dispensing record (Corner Street, 20 Oct)**
Patient Amos Reyes found dead in his bed at 02:30, by the district nurse. Death was peaceful. Medication found: temazepam, 14 tablets, all taken. Bottle of syrup: empty, on the bedside table, cap off. No spoon found.
*Nurse's note: the house was quiet, but the clock on the landing had been stopped at two. A woman's voice could be heard humming in the room next door, very faintly, and it stopped when the nurse opened the door. The bed in the next room had been made up with a clean sheet, the corners tucked, and an empty spoon lying on the pillow.*
· · ·
**Final pharmacy entry (27 Oct)**
Prescription for Amos Reyes: re-issued by Dr. Hallam, in her own hand, for the next patient on the list. Item: Night syrup (compound), 5 ml. Patient: *unassigned.* Directions: take at two in the morning, if you can't sleep.
The pharmacist has been asked to dispense it. He has not yet agreed. The bottle in the drawer is full again.