Imagine a pint of Guinness filled with sand. The most unpleasant drug used in A&E is activated charcoal, and it looks just like that: black, thick and textured.
It is given to patients who have attempted suicide with an overdose of something particularly toxic, but who have come into hospital quickly enough for it still to be in their stomachs. It absorbs the poison and carries it out the other end, which is more effective than pumping out the stomach.
One 52-year-old builder arrived after taking an overdose of aminophylline, his medication for bronchitis. His new girlfriend had been helping him with his gambling addiction. She had given her savings of £500 to him to book a holiday, but he had lost it by betting on horse racing. Many prescription drugs are not actually that dangerous, but aminophylline is an exception. It can
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easily result in fits, coma and cardiac arrest.
So now he lay in the resuscitation room, attached to a cardiac monitor, with me standing over him making him gulp down charcoal. He was in a sorry state, but he agreed that it was better to consume this than die. Sip by sip he slowly struggled through two large cupfuls, ending up with black lips and smudges all over his face.
When working in A&E it is easy to become cynical about overdose patients, but an additional benefit of charcoal is that sympathy floods back as they force it down.
After 36 hours of observation on a ward he did have a fit and was taken to intensive care. Then at last his luck improved, and eventually he made a full recovery. By minimising the amount of aminophylline that entered his system, the charcoal had probably saved his life. 
FIRST POSTED NOVEMBER 15, 2006
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