Polypharmacy and Deprescribing

The Overwhelmed Kitchen Brigade

Imagine a restaurant kitchen where the head chef (your liver) breaks down ingredients and the dishwasher (your kidneys) clears the mess. When five meals arrive, the brigade handles it fine—each cook knows their job, timing is smooth, no chaos. But when fifty orders flood in at once, the head chef can't chop fast enough, the dishwasher drowns in dirty pans, and cooks start grabbing each other's ingredients by mistake. One cook needs salt but grabs the sugar jar (drug interaction), another cook's station floods because drainage is blocked (kidney backup), and someone faints from the heat and confusion (fall from toxicity). The real problem isn't any single meal—it's the system receiving more orders than it was designed to handle, and nobody at the front door is asking 'Do we really need all fifty meals right now?' That's polypharmacy: too many 'orders' (medicines) for the body's processing capacity, compounded by no one reviewing whether each order is still necessary.