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Drugs and driving

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In 1972, a medical officer was transferred out of the US Food and Drug Administration’s cardio-renal-pulmonary unit because his division “had approved no new chemical entities … from 1968 to 1972, an experience that contrasted with the experience of every other medical [sic] modern nation and …  other divisions of the FDA.”

This allegedly over-vigilant assessor was John Nestor, a paediatric cardiologist. But Dr Nestor’s cautious approach may have helped save many US children from tragic birth defects. Soon after joining the FDA in 1961 he supported his colleague Frances Oldham Kelsey when she refused to authorise thalidomide for the US market, despite its prior approval in more than 20 other countries. When her safety concerns turned out to be justified, she praised Dr Nestor for reinforcing her scepticism.

Although Nestor’s cautiousness may not have pleased the FDA, it made him a hero to others. Campaigning for his reinstatement, Ralph Nader’s Health Research Group argued that Nestor had “an unassailable record of protecting the public from harmful drugs”. His transfer was eventually overturned and he received a public apology.

Sadly, it is not for Nestor’s pharmacovigilance that America remembers him. When he died in 1999, aged 86, his obituaries focused on his notoriety among road users. In 1984, the Washington Post published a letter from him describing his driving method on dual carriageways. He would stick to the offside lane with his car’s cruise control set to the speed limit, refusing to move aside when drivers behind hooted or flashed their lights. “Why,” he asked, “should I inconvenience myself for someone who wants to speed?”

Nestor’s letter enraged many motorists and led to the coinage of the word “nestoring” for his driving style and, more generally, for any strict conformity to a custom “more honour’d in the breach than the observance”.

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From: Beyond pharmacy blog

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