Tuesday, January 14, 2025

Science in Cormoran Strike: Narrative misdirection or plain old error? Part 2: Pharmacology.

 Originally published: January 8, 2019 by  Leave a Comment

Strike was familiar with the behavior of heroin addicts; he had met plenty at the last squat his mother had lived in. The drug rendered its slaves passive and docile; the absolute antithesis of shouting, violent alcoholics, or twitchy, paranoid coke-users. Strike had known every kind of substance-abuser, both inside the army and out. The Cuckoo’s Calling, p. 165

The principal lesson that Strike had learned during his two months of home-based education was that cannabis, even if administered spiritually, could render the taker both dull and paranoid.The Cuckoo’s Calling, p. 64

We have known from the beginning that Cormoran Strike is familiar with substance abuse, having lived it with Leda and policed it in the SIB. Thus, it is not too surprising he immediately recognizes Lady Bristow as addicted to sleeping pills (specifically, Valium) when he visits her deathbed.

“Could you please look in that drawer,” she whispered, pointing a withered finger at the bedside table, “and get me out my pills?” Strike slid it open and saw many white boxes inside, of varying types and with various labels upon them. “Which…?” “It doesn’t matter. They’re all the same,” she said. He took one out; it was clearly labeled Valium. She had enough in there to overdose ten times.

Later, he speaks to her nurse:

“Her Valium addiction’s as bad as ever, then?” he said. Unsuspicious, trusting, the nurse smiled a tolerant smile. “Yes, it is, but it can’t hurt her now. Mind you,” she said, “I’d give those doctors a piece of my mind. She’s had three of them giving her prescriptions for years, from the labels on the boxes.” “Very unprofessional,” said Strike.

It surprised me, therefore,  to see the Doom Bar Detective make a rookie error in his lengthy exposition of the crime to John Bristow. He tells the the client/perpetrator,  “Your mother hardly knows what day it is, the amount of opiates she’s got in her system.” The trouble is, Valium is not an opiate. Why is this important?  I’ll tell you after the jump.

This may seem a nit-picking point. But opiates are an entirely different class of drugs. They are powerful painkillers, far more dangerous and with much more abuse potential than Valium. Opiates include drugs like morphine, codeine, oxycontin and fentanyl, and, of particular interest to Strike, heroin, the one drug that Leda Strike apparently avoided taking, up until the day it killed her.

I have written in a previous post about Strike’s apparent carelessness with some scientific facts. But I find it hard to believe, with all of his knowledge of substance abuse, he would mistakenly call Valium an opiate. He would certainly know, as an ex-SIB man who worked on innumerable drug cases, that being caught dealing Valium is a less serious matter than being caught dealing morphine, fentanyl or heroin. Once again, we are faced with a question–  is this a mistake by the author and editors, or one of Strike’s?

We might not expect Strike to be as knowledgeable about prescription drug abuse, given he has likely seen more of illicit street drugs. That turns up in his visit to Lady Bristow. It is very unlikely, for instance, that her drawer contained enough to overdose even once, let alone 10 times. While dependency on Valium is easy to develop, overdose is rare, unless the drug is combined with alcohol or other sedative medication. With Valium alone, most people would have to take 100-200 times the recommended dosage in order to kill themselves.

This is why Valium and other benzodiazepine drugs, when they became available in the 1960’s replaced barbiturates –on which one can overdose with only 10-20 times the recommended dosage-as the sleeping pill and anti-anxiety medication of choice. Valium became so popular among housewives that the Rolling Stones immortalized it as “Mother’s Little Helper” in 1966. Fifty years later, concern about over-prescription continues, which resulted a recent series of lawsuits in the United Kingdom.  Lady Bristow, spoiled, anxious and with the wealth to pay multiple private physicians, certainly fits the profile of a pill-popping housewife. It is not a stretch to imagine she has been using Valium since Charlie’s death, three decades earlier.

As an end-stage cancer patient, Lady Bristow would likely have also been on a morphine drip for the pain; Strike even reports seeing a “drip on its metal stand” in the sickroom. But morphine is a drug with high overdose potential, so its administration would likely have been by IV, not pill, and carefully regulated by the nurse. A drawer full of morphine tablets, left for the patient to take at will, would likely have had the good Lady overdosing the first day.

It is entirely possible that early drafts of the book had morphine as the drug that addled Lady Bristow’s perception of time; it would certainly do that as well or better than Valium. Later, perhaps in response to news reports about the lawsuits, RG/JKR could have decided to make Lady Bristow a long-term Valium addict, in addition to her other misfortunes, but forgot to edit Cormoran’s final conversation with John Bristow accordingly. That is the simplest explanation.

But could there be another? Could RG/JKR have intentionally written Strike as making this very atypical error? Surely we can forgive the good detective for a momentary lapse under the circumstances. He was, after all, sitting in the dark with an injured knee, an unattached prosthesis and and “batshit insane” killer who he strongly expected (correctly, as it turns out) would attack him with a knife at any moment. Even a psychology professor such as myself can understand if the specifics of psychopharmacology were not his top priority.

But, there might be an even more meaningful reason for the mistake. Strike is thinking of Bristow’s dying mother, which may have stirred up memories of his own. In which case, the “opiate” error might have been a Freudian slip, showing that, even in the worst of times, Leda’s death by heroin overdose is never far from our hero’s mind. All of which, of course, serves as yet another clue that solving the mystery of Leda’s death, and bringing her killer to justice is the ultimate goal of the series.

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