Years ago, a friend gave me a tiny antique pillbox. It was silver, had a blue stone on top, and just enough space to hold a single pill. But the times, they are a-changin’. Whereas the pillbox of yore was a simple ornament to store the daily pill, the pillbox of today is a complex and necessary organizer.
In our family, my father began the practice years ago with a single-row pillbox with one square for each day of the week. He then graduated to a 7×4 pillbox, with 4 compartments for each day of the week. My mom joined him some time later and now has a single row pillbox for the morning and one for the evening.
Seeing how useful the system was for my parents, I introduced the multi-compartment pillbox to my in-laws last year. And now, having turned 50 myself and with my daily medications increasing, I think my time has come.
Pillboxes are ubiquitous and necessary these days for three reasons. Firstly, in many western countries the population is aging. Secondly, with advances in treatments, we are living longer to have chronic illnesses that require regular medication. Thirdly, the pharmaceutical industry has developed a plethora of drugs—some must-haves and some nice-to-haves. These reasons are combining to give rise to the issue of medication inadherence: people not having their medication as prescribed. The best solution is the pillbox.
The plastic single-row pillbox and matrix pillbox are probably the most common. However, today’s pillboxes also come in metal, sterling silver, china, and wood. They can be enameled, jeweled, or topped with murano glass. They may be circular, oval, heart-shaped, or molded like a carabineer. They may have English, French, or braille text. They can have a logo printed on them like Hello Kitty or Lacoste. It could have “Diamond Jubilee” engraved on it; the Queen may have one on her bedside table. And perhaps Bob Dylan, who is the same age as my mother, has a leopard-skin one, just for old time’s sake.
The more practical pillboxes come with a timer or multiple alarms to remind you to take the medicine. Some are also intelligent enough to initiate another alarm or blink if you have ignored them the first time around. To work in conjunction with the various pillboxes, iTunes now offers “MedAlert:” an app to remind you to take your medications on time.
Perhaps Steve Jobs’ successor can think up of an iPhone with a compartment for pills. Like a smart phone, a smart pillbox. Apart from proving very useful to an aging population, it could also provide some social cache. So according to the schedule you set, an alarm rings, and a drawer slides open on your phone, revealing the pill of the moment. You excuse yourself from your General Counsel meeting or lunch with your circle of close friends, with a serious “Sorry, but I must take this.” With a toss of your silver-gray curls—being careful not to throw out your back—you swallow the pill with studied carelessness. If the pill is for some deadly or rare disease, your standing in the eyes of others will rise. If it’s atenolol, which half the elderly are on, this can be a great icebreaker and lead to a conversation on shared drug experiences. If it’s merely a vitamin, say nothing at all.
Because I was occasionally forgetting to take some of my important medicines, I started a pillbox a few months ago and since then it has grown. My parents encourage me to have Omega 3 so I can escape inherited heart disease. My in-laws suggest homeopathic medicines for what they think ails me. My husband tries to slip in extra thyroid hormone and Ginkgo Biloba—hoping that I’ll have more energy to finish all my tasks and also the memory to remember what those tasks are. He doesn’t realize that there is no pill yet for laziness.
Like an Agatha Christie novel, we seem to be entering the Mysterious Affair of the Growing Pillbox. There have been news stories of seniors or even entire nations being over-medicated. My father once got a large pillbox once to fit in all the big-size vitamin supplements; we referred to it affectionately as his snack box. Sometimes, out of frustration with taking so many pills, my parents threaten to one day throw all their medication out the window. You hear stories of individuals who did just that and miraculously felt all the better for it. Of course, those that did this and died the next week were not around to regale their family with their tale.
While visiting my parents, I see them at their Sunday morning ritual. Winter sunlight streams in through the windows. Classical music plays softly in the background, while the foreground is filled with little clacks and clicks. They sit at the kitchen table with all their bottles of medicines and their prescription list, and fill up their pillboxes for the coming week. I watch them for a while, focused and hunched over their respective pillboxes. Then I go and get mine.
In the jingle jangle morning, I’ll come followin’ you.
Ranjani Iyer Mohanty is a writer, editor, and increasingly close observer of pillboxes.