On the sofa next to me, Michael was feeling the strain. His back ached from too much time in bed, his eyes stung from all the television he had watched, and there were at least two hours until dinner. He resorted to mental calculations of his earnings. 'Ten days done, pounds 1,000 in the bank; six days to go in the easiest job in London,' he droned. I gave him an uninterested nod and changed channels.
Michael and I were among a thousand 'patients' who passed through the drug research unit (GDRU) at Guy's Hospital in London last year. At pounds 100 a day, it is possible to earn pounds 1,400 for a fortnight's work. Work? I use the word loosely. A typical day in hospital consists of three meals, maternal nursing attention, limitless sleep and enough television to learn weather forecast theme tunes.
Established a decade ago, GDRU has surprisingly few British volunteers. More than 90 per cent of Guy's recruits are backpacking travellers and young tourists.
One such was Garvey, a self-styled traveller-cum-layabout South African with an MA. 'I've done trials for five years,' he said. 'I've never had a proper job and have no interest in a career. What's the point when this is the easiest money around?'
Garvey spent six months a year doing two trials in England and six months travelling on the takings. 'I'll do them for another ten years if they want me,' he said. The age limit for a volunteer is 40. At 28, Garvey had several years' slacking ahead of him.
Guy's does not advertise trials. Information travels the word-of- mouth highway across continents. 'More people know about London drug trials in South Africa and Australia than in Britain,' says Dr Jayson Dallas, a junior research physician. Of all the clinics travellers visit, Guy's is probably the most well-known and highly regarded. 'They're the most professional unit I've been to,' said Garvey. 'They explain everything clearly. I've never been sick. If the place didn't look safe I wouldn't do it.'
Five hundred recruits are turned away each year for failing rigid screening procedures designed to ensure recruits are of 'normal' health and will not react adversely to the drugs being tested.
Screening includes a comprehensive medical and physical examination with an HIV test that would normally cost more than pounds 200.
All drug courses have to be approved by an independent ethics committee and volunteers are informed of the risks they take. Doctors explain side-effects - in the worst cases dizziness, nausea or headaches - and answer any questions. Each recruit is given an instruction document which details the method and purpose of the study. If they are still uncertain, they can pull out.
On trial days the unit is less hospital ward than boys' boarding school dormitory: sweaty men slopping around in shorts or tracksuits, dozing off on sofas, talking sport in the common room.
The actual time giving blood and testing a drug is minimal. Each day is a losing battle against boredom, spent watching television and waiting for the next meal. The highlight of my internment was a curry followed by EastEnders.
Alcohol is prohibited throughout the course, though by some cruel quirk a pub is situated just across the street. I tried not to look at it. Various entertainment is provided to help tame the tedium: videos, video games, a bar billiards table. There are public telephones and visitors can come in the afternoons. I read every daily newspaper page to page, but by day three in the afternoons I was going mad.
Mercifully, my course was split up over three stays. Another group of volunteers, half-way through a continuous 16-day trial, had the glazed look of zombies. They might have earned twice as much, but they looked as if the extra would have to be spent on psychiatric treatment afterwards.
One avenue of entertainment was overlooked. Where were all the women? GDRU seldom do female studies because they require homoge5neous 'guinea pigs'. Although most drugs tested are ultimately used by women, research requires volunteers with a regular metabolism. Hormonal changes during a woman's menstrual cycle can alter results.
So we made do and joked with the nurses when they had time. They knew all our names, joined in games of Trivial Pursuit and did everything to make us feel comfortable. When we had to stay in bed they brought us our meals and set up a television set.
I was in a group of 12 testing a drug intended for treatment of multiple sclerosis. Despite the elaborate information we were given, taking the substance still scared me. Guy's commonly test anti-depressants and antibiotics. A multiple sclerosis trial was rare and somehow had frightening connotations.
I was given the dose three times - once for each visit to the unit. The dosage was a small percentage of that which an MS patient would normally receive. The pill was swallowed in the morning and blood and urine samples were taken at controlled times throughout the day. A cannula - a plastic tap-like valve - was inserted in my arm to make blood samples easier to take.
The effects of my drug were unspectacular: a slight headache that could have been caused by caffeine withdrawal or too much television. (Caffeine and exercise are also forbidden throughout a programme.) A week after my final visit, suffering no noticeable side-effects, I collected my cheque. It was that simple.
Not surprising then that some volunteers are turning professional. One Australian, completing his third trial at Guy's, has planned a visit to Berlin for a trial and will return to Guy's again in three months.
'I used to temp in a bank but that didn't pay,' he told me. 'This is the only way I've been able to make a decent living.'
The biggest danger 'professionals' face is ignoring recovery time. Guy's limit volunteers to three trials a year with a compulsory three-month break after each trial. Their reasoning is medically sound: blood taken during a trial is roughly equal to the volume taken in a standard blood donor session and a person can take up to three months to replenish those blood cells.
'Volunteers who don't follow the guidelines run a risk,' warns Dr Tim Mant, the unit's managing director. 'Those who don't wait the three months could become anaemic.'
There is also the danger that in overlapping courses new drugs will interact with chemicals not yet flushed out of the system. But, with clinics all over Britain and mainland Europe, there is no check on recruits running the gauntlet.
'There should be accredited units,' says Dr Mant. 'It's an odd situation in English law that you need to have a licence to give a drug to an animal but not so to a human being. There's nothing to stop someone setting up a unit on his own.'
In more than 10 years of research, Guy's has had what Dr Mant describes as 'two potentially life-threatening incidents'. One volunteer developed an allergic reaction to a drug resulting in severe neck swelling and blocking of the air passage. The patient received emergency medical treatment to reverse the process. The other involved a volunteer who passed out and required cardiac massage. In each case the patients survived without any after-effects.
Not so other clinics. A unit in Manchester closed down three years ago after a volunteer contracted hepatitis through infected needles. In Dublin, a volunteer had not told the unit he was having long-term treatment for schizophrenia. The trial drug reacted with the treatment drug and the volunteer died.
Dr Mant advises volunteers to ensure that any clinic they go to 'looks like a hospital' and has an ethics committee to control its courses.
Looking back, I could suggest a third proviso. To avoid death by boredom, book in during the next major televised sports event, say the European Football Championships. Dino, an Italy supporter from Cape Town, timed his trial for the World Cup and found it took his mind off worrying about the drugs. 'The only side-effect I had,' he said, 'was the stress of watching Italy lose.'
In an article 'This isn't going to hurt at all' (17 August) it was said that a drug research unit in Manchester closed down three years ago after a volunteer contracted hepatitis through infected needles. A subsequent official investigation found it likely that the virus, affecting five volunteers, was transmitted by blood to blood contact from an exceptionally infectious carrier but there was no evidence of the use of infected needles.
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