Story 7

Polluting the Planet

Tom has joined a community environmental group and is busy helping with a ‘rewilding’ project From Waste to Wild. The group has taken over a small patch of waste land at the edge of the village, the site of a disused garage. Tom and his mates are preparing the ground for tree planting. It’s a slow job, but they are making progress, bit by bit. They also plan a special space for plants that attract bees. Vera, Tom’s wife, always loved bees! The air is so clean he thinks, as he pauses to remember the many hours he used to spend sitting in his lorry in traffic jams, choking on fumes along the by-pass. He isn’t using his inhaler as much these days. And thanks to all this digging, he has managed to lose a bit of weight from round his middle. He feels so much better.

Tom digging in the garden

Once a week, Tom goes to the locality meeting in the village hall. He has been learning about the steps everyone can take to help save the planet. He hadn’t given the planet much thought before, but now he is a planetary enthusiast. He has even managed to persuade his grandchildren to make compost in their back yard. They love getting their hands dirty! Waste food, waste water, waste plastic. Waste thinks Tom might seem a bit boring, but it’s something we need to care much more about.

At the meeting this week, Tom noticed Dr Jones from the local GP surgery. He didn’t remember seeing her there before. Perhaps it’s her first time? Lovely doctor. Tom clearly remembers the day he cried in surgery, shortly after Vera died. He was attending one of those routine medication reviews when they go through the list of medicines one by one: blood pressure, breathing, heart...goodness knows what else. It’s hard to keep track of all these pills! Tom was feeling so down; tears were rolling down his face! He felt a little bit embarrassed in front of Dr Jones. On this occasion she didn’t bother much with the medicines. She just sat there quietly as Tom sobbed. She gave him a tissue at just the right moment and invited Tom to call her ‘Jackie’. Bless her, she is a lovely doctor. We are lucky to have her at the surgery. What kind of doctor does that? thought Tom.

Within moments, Tom’s attention turned to the heated debate that was stirring around the table. Agenda item 1: Trees. Everyone threw in their tuppence worth about which trees they wanted to introduce to The Wild. It was not the first time they had discussed this. Trees cropped up on the agenda most months. Who would have thought trees could fire everyone up like this? thought Tom, as he observed the enthusiasm around the room. As usual there were those who insisted on using the trees’ Latin names. Tom found this a bit frustrating. Why do people show off like this when all it creates is confusion and crossed wires? he thought. At the same time, Tom felt so blessed to be part of a little group that cared so much about their trees.

Just as everyone was getting hot under the collar with their tree suggestions, Martin, the chair, called them to order and gently reminded everyone that rewilding was all about letting nature take care of itself and enabling natural processes! Yes, it was all too easy to want to take control, rather than helping nature to flourish and restore its natural rhythms. Tom chuckled quietly to himself as he wondered which trees really want to become part of his neighbourhood.

The discussion turned to Agenda item 2: Waste. Lots of chatter about what steps the group could take to encourage their neighbours in the village to put their banana skins and carrot peelings in the group’s recycling buckets. Jackie, the GP, cleared her throat and leaned forward at the table: “I wonder if we can discuss one cause of waste that people often forget about?” Everyone hushed. Jackie now grew more animated, her voice becoming faster, louder and more urgent by the moment. “Did you know that the biggest portion of carbon use in health services is prescribing? By a huge chalk! Drug development, manufacturing costs, transport. And inhalers! Did you know how much damage inhalers can cause? Consumption, consumption, consumption. Polypharmacy – it’s just another symptom of a society driven by markets and mass consumption. Half of the medicines we prescribe for long term conditions are not even taken. Did you know that? And did you know that being on large numbers of medicines can sometimes put patients at risk! We have all got ourselves into a bit of a muddle with medicines, but I am sure we can do something about it if we all work together. Doctors, patients, pharmacists. Maybe there are little steps we can take to improve the situation?”

Jackie the GP telling a group of people about medicines being wasted

What a stir! Stunned silence. What kind of doctor says that? thought Tom, as he puzzled over what he had just heard. He could feel a furrow forming in his brow. How strange…doctors prescribe all these things after all he thought. A muddle with medicines…what kind of muddle? Dr Jones leaned back in her chair again, as Barbara and Brenda quietly shuffled off to make tea for everyone.

Polypharmacy. Is that what she said? What on earth is polypharmacy? thought Tom. He had heard of polymyalgia, as one of his friends had suffered from it for years, but he had never heard of polypharmacy. He didn’t want to embarrass himself in front of Dr Jones again and didn’t like to ask, but he scribbled it down in his diary before tucking into a welcome piece of cake.

Late that night Tom got out his diary and propped it next to his computer. He typed the word carefully: ‘p-o-l-y-p-h-a-r-m-a-c-y’ feeling very curious to know what all the heat was about. He found that it is a term that doctors use to describe the situation when people use five or more medicines. Well thought Tom I am one of those polypharmacy people that Jackie was talking about! Not five, but ten medicines, since they found my blood pressure was up. It’s funny Jackie has never mentioned it before. Tom had no idea how many of these medicines go to waste, nor that it can sometimes be harmful to be taking lots of different medicines. Then he remembered how he had found a large plastic bag full of Vera’s unused medicines under the bed after she died. Perhaps Vera knew something he didn’t all along? Tom’s head spun with lots of questions, and he wished he had been bold enough to ask Jackie to explain a bit more about this polypharmacy problem at the meeting. Why are Tom and all his mates on so many medicines if that isn’t always a good idea? Where are all these wasted medicines ending up? Hopefully not in the sea along with the plastic!

Tom searching 'polypharmacy' on his laptop computer

Tom returned to his computer keyboard and wrote an email to Martin, the convenor and chair of the environmental group:

Dear Martin,

Tom here. Interesting meeting this evening, eh? Please can you pop this on the agenda for one of our future meetings.


Yours, Tom.

Illustrations Satoshi Hashimoto

For Discussion


One cause of waste within the NHS is the prescription of medicines that are either not needed or not wanted by patients. How do you think doctors and patients might start to address this problem?


Have you been in a consultation when there was confusion because you and your health professional used different names for your medicines, or different ways of describing them? Taking your medicines to your consultation may be helpful. How do you think this may help?


Polypharmacy (the use of many medicines by one person) is on the rise. Why do you think this is happening?


Dr Jones suggests that doctors, patients, and pharmacists may need to work together to tackle polypharmacy. Why do you think this may be so? How do you think patients might be able to help?