Health & Beauty

The family album

Barracetamol popped out of a pill packet in Exeter, in South West England on the 29th November, 2012. Known to his friends as Barry, he has been tracking down his long lost relatives ever since. Since then, he has become a phenomenon. In this interview, we catch up with him to learn more about his rise from the kind of unnoticed ‘health essentials’ pill you might find in a cupboard at home or in the bottom of your bag. We meet him in an office in the Watson Institute at Brown University in the USA, where he is on tour. Greeting us with his contagious smile, it becomes clear that Barry really is the simple, ‘no Anadin extras’ family guy we’ve heard so much about.

Interview

What caused you to pop out? How did your adventure begin?

I think it was time. Time to stop living a lie. It’s a lot of pressure you know - taking all the credit for ‘multi-symptom’ pain relief! Every pill knows full well that Parames in Malaysia, Benson in Zambia, Charlie in the USA, and the 200 men who descend 2,000m into the Ijen Volcano in Indonesia every day are responsible for making us what we are today. But none of us can say a word about it, unless someone listens to their stuff. That’s what happened to me one day at the University of Exeter, in the UK. A group of students noticed me, and took an interest in my life story.

I like social scientists. Natural scientists had failed me and my family. Years and years I waited, compressed into a faceless white tablet. I became more and more frustrated as chemists continued to hide behind a veil of scientific jargon, confusing figures and ‘controlled environments.’ If you look at the Royal Society of Chemistry Paracetamol curriculum resource [1], this is what they say about me:

Paracetamol is a relatively safe drug but toxic side effects have been observed with high doses greater than 10-15g. … Pure Paracetamol is a white crystalline solid which melts at 169-171°C. Its solubility in cold water is 1.43g/100cm3 but it is much more soluble in hot water (5g/100cm3) and in ethanol (14g/100cm3).

You’d think I’d been created solely in a laboratory. But where was my family, my social life, my personality? I’m much more than a simple thing, you know. Those scientists seemed so uninterested in pills like me. So, I was waiting – not so patiently – in my little foil compartment to be noticed, listened to, given a voice. And I was lucky! I was popped out, drawn into life, by a group of students.

What do you mean, ‘drawn into life’?

These students all had packets of us in their bags, and at home. They’d swallowed us countless times, with a swig of water, to get rid of a headache. But they hadn’t noticed us before. Then they started to, reading the writing on our packaging. What we’re made of. What we’re for. Who made us where. But our packaging didn’t say very much. They wanted to know more. One of them - Nancy - started drawing a picture of a paracetamol pill that comes to life, who looks like a doctor, and who has a winning smile and a clipboard. Another - Katie - came up with the name ‘Barry’, because it’s a good name for things, she said. That’s how I was drawn into life and got my name: Barry the paracetamol: ‘Barracetamol’.

I was finally free, and we started to work together. I had been longing to visit my family for as long as I can remember. We thought that some ‘family reunions’ would help to uncover the stories of some of the people like Parames and Benson who helped to make me and countless other things. So I went off on my little adventure and here we are today in the USA, meeting my American cousins. Nancy, Katie and their friends helped me to track down members of my extended family and posted photos us on facebook [here], tumblr [here] and twitter [here].

This drawing wasn’t their first attempt to bring you to life and tell your story, was it?

No!! Before I was drawn into life, they were going about it the completely wrong way! I do chuckle to myself. When they set up ‘my’ twitter account, they blasted any person hashtagging #paracetamol – people who were feeling sick already - with information about ‘the people affected, the ingredients you don’t know about’ by you taking this pill. They got some angry replies, like ‘who do you think you are?’, ‘what are you doing?’ ‘My’ account was suspended for spamming. None of this was really all that surprising. Before I appeared, things just hadn’t really clicked. God that sounds arrogant, doesn’t it?

No, not at all. How do you think you helped them to spread the word?

I think the problem is, when you used to pop me out of a packet of 16 that you paid 24p for, and looked at my clean white exterior, it was easy to see me as this simple, insignificant thing! In reality I’m quite a complex guy: just ask my wife! But, jokes aside, I am. Have you seen my ‘ingredients’?

Paracetamol 500mg Tablet Formulation per tablet: Acetaminophen (Active ingredients) 500 mg; Maize Starch (Binder) 5% w/w 42.5 mg; Croscarmellose (Desintegrant) 3% w/w 25.5 mg; Nipagin / Methyl Paraben (Preservative) 0.03% w/w 0.255 mg; Nipasol / Propyl Paraben (Preservative) 0.07% w/w 0.595 mg; Microcrystalline Cellulose (Filler) 10% w/w170 mg; Purified Water; Microcrystalline Cellulose 102 (Filler) qs ad 94.15 mg; Talc (antisticking) 0.5% w/w 4.25 mg; Silicon Dioxide Colloidal (antiadherent) 1% w/w 8.5 mg; Magnesium Stearate (Lubricants) 0.5% w/w 4.25 mg. [2]

Nancy, Katie and their friends had no idea what I was made from, even though the information was on the packet. They got lost in the chemistry. But they learned that if you ask questions about ingredients, you can learn about the lives in things. So it’s a bit of a balancing act really. Some of it is a little difficult to get your head around, though. I don’t think anyone would have expected a group of undergraduate geography students to understand my complex chemistry! They got a bit stuck in the ‘scientific stuff’ and their ‘follow the thing’ research went out the window completely. That’s where I came in. I just broke it down for them. I can give you a bit of an overview, tell you what I told them about the people who made me the paracetamol I am today.

Yes that would be great…

The easiest way to get behind this chemical information is to take each ‘ingredient’, or step in the making, of paracetamol and see where it leads you. Say we take Magnesium Stearate and go from there. I’m 0.5% Magnesium Stearate and 0.5% Talc you know! Both serve a role in my formulation but they’re not ‘active pharmaceutical ingredients’. They won’t do anything for your headache. Rarely if ever can you find pills consisting entirely of their ‘active’ ingredient, nothing else. [3]

Magnesium Stearate and Talc are lubricants used in powder form in the manufacturing process to ‘avoid complications while using the Rotary Tablet Press…[as the] adhesive forces between the powder and press can lead to partially compacted tablets’. [4] They can’t sell you compacted tablets. You’d complain! When tablets stick in the presses that shape them the production line has to be halted for maintenance. That’s what these ingredients are for. They’re chemically inert. They won’t do you any harm. You don’t need these ingredients. I do! They help make sure I don’t get stuck or crushed in a machine. I’m very grateful for that.

But this is where we need some balance. I could ramble on for hours about the pros and cons of lubricants, quoting chemists, pharmacologists, engineers and plenty of other scientists! But that wouldn’t lead me to Parames in Malaysia and Benson in Zambia, would it? We need to ask more questions, like what is Magnesium Stearate? Where does it come from? What are its ingredients? How is it made? Who makes it, where? And what is that work like? My friend Dr. Ron says:

Hydrogenated oils are a common source for the magnesium stearate used in pharmaceuticals and supplements. The stearates are made by hydrogenating cottonseed or palm oil…[which have] the highest content of pesticide residues of all commercial oil; cotton crops are heavily sprayed. [5]

Now we’re getting somewhere! At last, we’re starting to follow the thing. All sorts of questions started popping into our heads, the students and I. If Magnesium Stearate is made from palm oil - the most heavily sprayed commercial oil – they who are the sprayers? This is where I can tell you about my friend Parames who lives in Malaysia.

She hasn’t had the easiest life: getting a job as a pesticide sprayer after having three kids. Palm oil is Malaysia’s fastest growing industry, and this growth has been accompanied by a dramatic rise in the consumption of agrochemical products and herbicides. She has spoken about this before. I think I’ve got a quote from her here. I like to keep it on me you see. I’m pretty set on not letting any of ‘my’ success go to my head. This is how she describes her work, what she does to help make me the pill I am today:

I started applying pesticides to grass, ‘lallang’ (weeds), on the oil palm trees, and onto creepers on the ground. I sprayed strong chemicals to unwanted trees. I never knew the names of these chemicals nor their impact on me. … I was a very good worker. I sprayed 22-24 tanks of pesticides each day. … The management constantly praised me for my high ability. I was proud that I could protect the trees from pests, and keep the estate clean of weeds. At the beginning, when I started handling the pesticides, I experienced headaches. During the hot season, when I used gramaxone in particular, my nose bled. I used to get severe pains on the left side of my stomach. When I raised these medical problems with the estate paramedic, called the ‘hospital assistant’ or ‘HA’, he gave some tablets, which I took. I believe they were painkillers. I did not take medical leave as I prided myself in being a good worker and did not want to lose out on the incentive benefits. … However after 8 years of spraying and being a hardworking woman, I began to have stomach pains regularly. One day the pain became very severe, and I could not bear it. I went to a private clinic where the doctor gave me an injection. He told me I had ulcers in my stomach. A fulltime worker with an environment group, Friends of the Earth, contacted me. He took me to see another doctor who did an X-ray and a kind of scan. He told me I had ulcers in my throat and my stomach. He advised me not to spray pesticides and not to carry the heavy bunches of oil palm fruits. But the supervisor of the estate insisted that I continue spraying pesticides. With an irresponsible husband, and my children depended solely on me. I had no choice except to continue spraying. [6]

I have a bit of a soft spot for Parames. She is such a lovely woman. But this isn’t a pretty story. Helping to make me this way, to help you feel better, is not good for her health. And she’s only one of the people who work to make only part of one of my many ingredients. None of this is really about me and my ability to cure multi-symptom pain.

So, what other hidden relations did you find? Who else works where to make you who you are today?

Well, there’s Benson the talc miner, who lives in Zambia, and Charlie the retired talc miner who lives in the USA. You know talc, that fine white powder? Have you ever wondered what it was, where it came from, how it was made, or by whom? I think I might have another quote for you. I keep this one on me too. This is how Benson describes his job:

It is very hard work. We use picks, hammers and chisels to mine the stone. We are self-employed, so it is up to us how long we work. Usually when I wake up, I come here and just start working, normally around 6am. It depends how tired I am. We go for lunch when we like and then finish around 5pm or 6pm. I work almost every day. When we have mined the stone, it is taken in trucks to the weighing bridge nearby and then crushed into powder for transportation to South Africa. Working in the mine can be dangerous but we are not given safety equipment by the contractors. When it rains we have to wait until the rain stops, then we come and check the mine. If it is too dangerous to work, we leave it for a few hours to dry out. It is difficult to work in the rainy season because it is so slippery. [7]

I haven’t got the photographs from this news report, but you can look at them here. They’re amazing. Not what you’d imagine a ‘mine’ to be, perhaps. Charlie’s story is different. He’s retired from this work. Many of his friends and colleagues died in their late 40s and 50s from inhaling that talc dust, day in, day out. You can easily tell if a talc miner’a lungs are clogged or tumerous, he told me, ‘Hell, just look at our fingers. They’re clubbed. Everyone’s are like that. It’s a sign the lungs aren’t working.’ [8]

So, that’s three people in our extended family, who have helped make us all who we are today. Parames, Benson and Charlie. They’re part of my family tree. Passing on, sharing, substance between bodies. Medicine and its many ingredients [9] But this is a huge tree. Swallowing a paracetamol tablet like me with a sip of water draws you into quite intimate relations with hundreds, thousands, maybe millions of other people, places, things, animals, plants, um … all across the world!

But that’s not all! I said this was complex. It’s not just the ingredients listed on the box that make our lives interdependent. The chemical processes through which I am formed connect us with many more. I should tell you now about the 200 men whose job it is to go down into the Ijen volcano in Indonesia every day to mine its sulphur. This is where we’ll get into some tricky science again, but let’s not be intimidated by that!

Why would that be intimidating?

Well, Nancy and I were talking about step one of Paracetamol manufacture - ‘the nitration of phenol’ – which involves dilute sulphuric acid and sodium nitrate. I was trying to explain this industrial chemistry and how this meant that she and I were related to the miners working in that volcano. But I could tell all the 'science stuff' just went whoosh, over her head. You know that blank expression someone gives you and then they sort of just start smiling and nodding. I remember her writing something down: ‘Google the nitration of phenol’, she told me later. She hadn’t got a clue!

So what is the ‘nitration of phenol’?

Well, dilute sulphuric acid (H2SO4) is used in the initial stages of paracetamol manufacture to prepare the 4-nitrophenol and 2-nitrophenol that helps to make me me. But I understand why that might not mean much to you. Reading about chemical compounds and reactions tends to give the impression that I have been cooked up by some genius perating some elaborate equipment in a laboratory. The working conditions for the Ijen volcano's miners don’t come into this! Take a look at the photos here!!! And watch this video!!!

What are they like?

Awful. I decided to visit the minersbefore I came to the USA. My God. It was horrific. You can barely breathe, there! I tested the air. It was 40 times the UK’s safe breathing level. The corrosive airborne particles ate into my camera which completely broke down. I could feel it in my eyes and throat for days! It was shocking! How they work with just damp scarves around their mouths to protect their lungs, I do not know. They have to climb out of the 200m crater carrying 90kg loads. I’ve never seen such massively scarred human bodies in my life. [10]

A man called Sulaiman gave me a tour. He’d worked there for thirteen years. I couldn’t believe it! This is what he said:

There are many big mountains but only one gives us the sulphur we need … In the past 40 years, 74 miners have died after being overpowered by fumes that can suddenly swirl from fissures in the rock. The poisonous clouds are not steam, but hydrogen sulphide and sulphur dioxide gases so concentrated they burn the eyes and throat, and can eventually dissolve a miners' teeth … Our families worry when we come here. They say working here can shorten your life … I do it to feed my wife and kid. No other job pays this well. [11]

This, for me, is why all this ‘stuff’ is so important. I may be a success, a constant companion to millions of people, a 'household name., But we have to research and tell the stories of the people who help to make us who we are, the people to whom we are so intimately through our lives and things!

Do you have any photos of your travels that you can share with us?

Yeah sure!!! I’ve made a slideshow. You might have looked it earlier, at the top of this page. Go back and click me if you didn't! I went to the shops to visit my cousin ‘multi-vitamin’. We’re related on my magnesium stearate and talc side. We share those ingredients. And then, of course, there was my 1/20th brother neon face paint. We’re related on my talc side. I visited a lot of relations. There were so many of them, once I learned how to find them. That’s only a few. My family is enormous, I discovered, and they live all over the world. There’s also a photo of me after I tried boycotting products with talc in them, like toothpaste. I don’t look great in those! I couldn't do that for long.

So how do these family snaps ‘work’? What do they tell us?

Well … this is where the students started to lose me with their Geography jargon! So I will have to tell you how they said these snaps worked for them. I was a bit sceptical at first. I couldn’t really see how photos of my extended family would be able to convey vivid senses of the lives in things, things like me, but they did! They posted the photos on facebook and told their friends about them. They were quite popular. I think we’re up to 113 likes now! I have ‘friends’ in Portugal, New Zealand, Finland, The Netherlands and of course the UK. We have had some interesting responses. One of the students’ relatives sent us this message:

Oh Lordy … plz tell me there’s no paracetamol in Tramadol coz after reading the article on those young people mining I’d just feel SICK…???? XXXXX.

She suffers from Ankylosing Spondylitis and has no choice but to take ‘Tramadol’ to numb her crippling back pain. But it’s pretty clear from this that my facebook page allowed her to connect herself – or ‘inner self’ as the geographers might say – to other people, objects and places outside of her normal experiences of painkillers. I am no longer a faceless white pill to her! The insight into my personal life and extended family allowed her to draw an alliance between her ‘normal life,’ myself and all ‘those young people mining.’

Wow! Telling your story is having an impact then?

Yes, I think so. And much to my surprise! Allowing my student friends to post photos of me meeting members of my extended family has enabled other people see everyday hidden relations between my ingredients and so many other people and things. They told me that, together, we’d produced what’s called a ‘transitional space’ - more Geography jargon - a space that allowed everyone who visited my facebook page or saw these photos on twitter to reflect on some of the things they own that contain these ingredients. So, in many ways, I am the connector!

My role now is to allow you to make that transition, to see my relations, the people who made me me ... you, the people whose lives you’re taking with me to relieve your headache. Medicines like me are in your blood, occasionally, regularly, perhaps most of the time. [12] So, you, me, Parames, Benson, Charlie, the Ijen miners, and SO many more are kin! That’s what their lecturer Ian liked so much about my story. The students and I were, according to him, mobilising ‘naturalised idioms of kinship … outside their familiar domain’ [13] to offer a new, compelling approach to cultural activism in trade justice campaigning. [14] They were leading with a sympathetic character. [15] Harnessing the activist capacities of cartoon characters. [16] That's how they all talk.

These kinds of relations aren’t all bad, though. They’re bitter sweet. Considering how awful some of the stories I'm telling are - full of illness, poverty and suffering, - I also seem to make people laugh! And that’s also important to me. I have a hard enough time telling my kids off let alone giving a stranger a long sermon about Benson’s working conditions, you know!? It just wouldn’t work. That’s what the students found out quickly on Twitter! People hated being engaged in series issues in such a relentless, negative, depressing, and disempowering way. Elaine summed up nicely how I helped to engage people differently:

‘I think [he] just made people laugh a bit and get involved. It would have been boring if you went round the shops and just took photos of things and said this is something that is also in paracetamol, but because [he] has a funny face and character it was more interesting having a little quote from Barry.’

They had a lot of fun with me, but this was very uncomfortable humour. It almost got a couple of them in trouble in the University library when they were emailing my family snaps to each other, changing the captions. They couldn’t control their laughter. They were told off for being too loud and annoying everyone around them trying to work. This is not the kind of learning that’s supposed to take place in a library!

Do you often get that reaction?

Quite a lot! The weirdest thing I’ve had happen was when a Masters student called Eeva visited Exeter from Helsinki to do her thesis research on trade justice education. She recognised me from the photos, came up to me and hugged me! She had ‘liked’ me on facebook months before. This was an odd reaction. Nobody used to even notice me! But something was missing from this family reunion. My kids! They’ve been tucked up, asleep, all this time. Would you like to see a picture of them? I’ve got a couple of photos here.

Yeah sure!

Aaaah! It must be hard being away from them all. When are you planning to head home? When does the journey end?

I don’t know if it will ever end. There are always more family members to visit when you are a descendant of eleven ingredients. But for now I think I am going to go home for a few weeks, rejuvenate and then get back out on the road. We could squueze back into that box and travel together, maybe. It wouldn't be the first time! So I guess you’ll just have to wait and see. I’ll leave it as a surprise for you. You can take me on the road, too, if you like. Print me out and take me on your journey, help me to find some more relatives, take some more photos and add them to the family album, or tweet them to @followthethings. Oh, and don’t forget to print out my pill box. We all need somewhere to sleep.

Everything we need is downloadable here in my Family Reunion Action Pack.

Health and happiness for all!

Footnotes

[1] Ellis, F. (2002) Paracetamol: a curriculum resource. Royal Society of Chemistry, London, p.3

[2] Anon (nd) Paracetamol / Acetaminophen tablet formulation using cheap and simpleiIngredients with wet granulation method. vinesia.com (http://formulation.vinensia.com/2010/08/paracetamolacetaminophen-tablet.html last accessed 21 July 2013)

[3] Carter, J. (2009) The role of lubricants in solid oral dosage manufacturing. carterpharmaceuticalconsulting.com (http://www.carterpharmaceuticalconsulting.com/articles/role-of-lubricants-in-solid-oral-dosage-manufacturing.html last accessed 21 July 2013)

[4] Nelson, D., Wu, R., & Wymbs, K., (2012) Effects of Magnesium Stearate on tablet properties. Rutgers University, 12 September (http://soe.rutgers.edu/sites/default/files/gset/PharmaDC.pdf last accessed 21 July 2013)

[5] Schmid, R. (2012) Magnesium Stearate: What is it doing in your supplements? www.drrons.com (http://www.drrons.com/beware-of-additives-in-supplements.htm last accessed 21 July 2013)

[6] Fernandez, I., Thomas, E., Jeyamary, M. & Rengam, S. V, (2002) Poisoned and silenced: a study of pesticide poisoning in the plantations. Tenaganita & Pesticide Action Network, Asia and the Pacific (http://www.evb.ch/cm_data/public/incover_1.pdf last accessed 21 July 2013)

[7] Anon (2008) Photo Journal: Talc Miner. bbc.co.uk (http://news.bbc.co.uk/1/shared/spl/hi/picture_gallery/06/africa_talc_miner/html/1.stm last accessed 21 July 2013)

[8] Schneider, A. (2000) Generations of talc miners were fiber’s victims. Seattle Post-Intelligencer 22 June (http://www.highbeam.com/doc/1G1-63050231.html last accessed 21 July 2013)

[9] see Nash, C. (2005) Geographies of relatedness. Transactions of the Institute of British Geographers 30, p.449-462

[10] Lane, M. (2011) Sulphur mining in an active volcano. BBC News 9 February (http://www.bbc.co.uk/news/world-asia-pacific-12301421 last accessed 21 July 2013)

[11] ibid.

[12] see Freeman, S., Critchley, D. & Lee, L. (2009) ‘Cradle to grave’, in Sickness & in Health. pharmacopoeia-art.net (http://www.pharmacopoeia-art.net/articles/in-sickness-and-in-health/ last accessed 21 July 2013);

[13] see Nash ‘Geographies of relatedness’, p.459. Leading up to this argument, she asks, ‘what are the effects of considering kinship vis-a-vis understandings of relationality that extend the meaning of the social to include objects, entities, institutions and technologies of all kinds in complex networks and in continuous processes of co-emergence?'

[14] see Cook, I. & Woodyer, T. (2012) Lives of things. In Sheppard E, Barnes T & Peck J (eds.) Wiley-Blackwell Companion to Economic Geography. Oxford: Wiley-Blackwell. These ideas are being developed for Cook et al, I. (2013) Barracetamol and the political poetics of trade justice pedagogy. paper to be presented at the Royal Geographical Society (with Institute of British Geographers) Annual Conference, London, August (http://conference.rgs.org/conference/sessions/View.aspx?heading=Y&session=22c7d0a7-a057-4d33-9269-50e1bbd9040f last accessed 21 July 2013)

[15] Caning, D. & Reinsborough, P. (2012) Lead with sympathetic characters. in Boyd, A. (assembler) Beatutiful trouble: a handbook for revolution: New York/O/R Books (http://beautifultrouble.org/principle/lead-with-sympathetic-characters/ last accessed 21 July 2013)

[16] the most notable example of cartoon-based art / activism on this website is perhaps Mr Nut who stars in the film 'The Luckiest Nut in the World'.

 

 

This page was written by Nancy Scotford as part of a followthethings.com internship, and edited by Ian Cook (last updated July 2013). It was based on written work by, and interview transcripts involving, many people in Barracetamol’s support team. Barracetamol was created as part of the ‘Geographies of material culture’ module at the University of Exeter. He was drawn by Nancy Scotford, who also designed the pill packaging and made his babies. All materials have been reproduced here with permission.