Damien Hirst spent a good part of the nineties arguing that the pharmacy and the gallery run on the same faith. You walk into either one and accept, on the evidence of clean surfaces and confident labels, that the thing in front of you will act on you. His medicine cabinets made the argument with real packaging. The spot paintings made it more quietly: each grid of colored dots carries the name of a compound taken from a chemical supplier's catalog, so a canvas with no subject acquires the authority of a molecule.
"Proproxasant; Indicated for Brugada Syndrome" borrows that authority and then declines to cash it. The drug does not exist. Its name is built the way therapeutic brands are now built by the agencies paid to invent them (i.e. Brand Acumen), with hard consonants up front, a doubled syllable for weight, and an X planted in the middle because an X reads as science and sells as confidence. On the page the word has not yet settled into a logo. The P appears in several typefaces at once, one of them overlaid with a wire grid, and the X has swollen into a yellow field large enough to sit behind both staves. It looks like a naming committee's whiteboard at the point where nobody has agreed on anything.
That unsettled word matters because pharmaceutical neologisms are odd among invented words. They are coined to be spoken by strangers, often exactly once, at a pharmacy counter, and to be trusted on that single hearing. Below the title the score shows what happens to language held to that standard. "Andedase Trohotre" and its smaller companions look like names that failed trademark screening and were photocopied until the letters filled in. The bass staff carries text where notes should be, most of it too degraded to read, which is roughly how a package insert reads to anyone outside the profession.
The subtitle is where the joke stops being general. "Indicated for" is label language, the phrase that fixes what a compound is legally for. Brugada syndrome is a rare inherited disorder of the heart's sodium channels, most often linked to mutations in SCN5A, and it can cause fatal arrhythmia in otherwise healthy adults, frequently during sleep. No drug is approved for it. Patients receive an implanted defibrillator, and some are given quinidine, an old cinchona alkaloid, off label. It is exactly the kind of condition the orphan drug framework was written to address: few patients, real mortality, too small a market to attract development without incentives. Attaching a fictional compound to it points at a gap that is not fictional at all.
A disorder of rhythm is also a strange thing to prescribe for a pianist. The first half of the system is nearly empty. Staves run under the title with almost nothing on them, and whatever the performer does there is governed by fragments of lettering rather than pitch. Toward the right edge the notation packs itself tight: beamed clusters, nested rhythms, ties arcing over one another, accidentals stacked like structural formulas. Read against the subtitle, the layout resembles the course of the disease more than any treatment for it. Long stretches of apparent normality, then an event the page can barely hold.
I am less certain what to make of the rendered apparatus at the bottom center, with its chrome pipework, a red manifold running down past the staff, and a copper figure somewhere between a reactor and a reliquary. It could be the plant that would manufacture Proproxasant if anyone were willing to pay for it. It could as easily be the body drawn as plumbing, which is how cardiology diagrams tend to draw it anyway. The score doesn't choose, and I would rather it didn't.
Hirst's cabinets were full of real boxes. Here the box is empty and the indication is real, which is the more uncomfortable arrangement.


























