My brother is the one cracking up me and my sister.
My brother is the one cracking up me and my sister.

Once every five or so years, my stomach enters a period of storm and stress. One such period occurred in the spring of 2018. The trigger for the disturbance, which lasted for two weeks, was raw oysters gathered on some Puget Sound island and served by a friend during a dinner party. When I informed my brother, Kudzai, about my unhappy situation (Mudedes have notoriously sensitive stomachs), he strongly recommended that I try Zantac, a popular over-the-counter drug for heartburn.

Kudzai could not stop praising Zantac. He used it all of the time. It hit the spot. A day later, I found this product in the shelf of a Walgreens near my house. I read the information on the package (it claimed to be an effective acid reducer), and looked at its price: nearly $40. I returned the product to the shelf because I live by the rule that expensive drugs should only be prescribed by a doctor.

My own doctor, after a brief examination, determined that I was fine and just needed to give my system a break—don't eat red meat, stay away from red wine. I did as he said, and a few days after committing to a two-week diet of just chicken soup and green tea, my stomach was once again normal. My brother, however, never stopped consuming Zantac. Even as he was dying from a cancer that originated in his stomach or in his pancreas (the doctors never figured out which it was, even after the autopsy), he wanted the drug.

"But it doesn't cure cancer," I said to him, a week after he was admitted to Harborview Medical Center. There were empty Zantac packets near his bag.

"Just get it for me, please. It's the only thing that will work," he said.

I never bought the drug. He died two weeks later.

A month after his death, I read about a study by Valisure, an online pharmacy, which found that ranitidine (the drug branded as Zantac) contained the cancer-causing toxic chemical N-nitrosodimethylamine (NDMA) at over 10 times the level the FDA deemed to be safe. A month after this study made the news, the retail giant Walmart pulled Zantac from its shelves. Three months after that, the FDA ordered that all drug stores do the same as Walmart.

The press release from the FDA:

The U.S. Food and Drug Administration today announced it is requesting manufacturers withdraw all prescription and over-the-counter (OTC) ranitidine drugs from the market immediately. This is the latest step in an ongoing investigation of a contaminant known as N-Nitrosodimethylamine (NDMA) in ranitidine medications (commonly known by the brand name Zantac). The agency has determined that the impurity in some ranitidine products increases over time and when stored at higher than room temperatures and may result in consumer exposure to unacceptable levels of this impurity. As a result of this immediate market withdrawal request, ranitidine products will not be available for new or existing prescriptions or OTC use in the U.S.

I'm almost certain that the toxin is what did my brother in for two reasons. One, he had been taking Zantac daily for two years (judging from the packets and the receipts I found in his remains). And, two, because of his age, 37, I authorized the examination of his genes to determine if there was a some flaw that made him and the members of the family susceptible to either stomach or pancreatic cancer, both of which are relatively rare in young people (the average age for stomach cancer is, for example, 68). The lab results found no genetic defects, much to the relief of my children. This evidence provided a clue to the source of the cancer that killed Kudzai: more likely extrinsic than intrinsic.

None of this will bring my brother back, which is why I have no interest in all of the lawsuits pursuing the makers of the drug. What is of far greater importance is to warn readers who may have regularly, or, as in the case of my brother, excessively relied on Zantac for relief from backed up acid. It's something you may want to tell your doctor about, if, that is, you have a doctor. Why is the American health system so sucky?