Cover Your Head and Cry: Crazy Comes to Town

The phone call came around 6:00. Rush hour is starting it's daily wane, but I'm still up to my ears in work. My tech tells me it's a doctor, and they want to speak to the pharmacist. This is exceptional for 2 reasons. One is that doctors themselves rarely make pharmacy calls, usually leaving this task to their office staff. The other is that it's 6 PM. Customarily, doctors are not working until 6. I brace myself and pick up the phone.

Doctor: OK, I've got this lady. She needs antifungal therapy, and I've already... *sigh*. We've already done a course of Diflucan, and... OK, this lady is crazy.


I deal with crazy people at the pharmacy every day, and one of my Crazy Classifications divides them into 2 distinct tribes:

1. Crazy Crazy

You might say you can see them a mile away, but oftentimes sight is not the first of your senses that alerts you to their presence. You may hear them shout obscenities, you may smell the reek of their poor hygiene, you may feel the crazy baking off of them like radiant energy. Sometimes, you can just feel it. These are the crazies that are blatantly obvious. They may show up dressed in winter clothes in 90 degree weather, they may decide to do some snow angels on the carpet in front of the pharmacy. They may make inappropriate sexual advances. They may bite. The Crazy Crazy will sermonize you concerning the Apocalypse while exploring their belly button for treasure. Most times they're perfectly benign, but crazy nonetheless.

2. Covert Crazy

The Covert Crazy appears normal. To look at them you would not suspect that beneath the apparently normal exterior, craziness on the scale of Gary Busey is present. At first they confer small talk chit-chat upon you. Then, suddenly they mention that the government is reading their thoughts because they forgot their tin foil helmet this morning because they were up all night covering the walls with peanut butter. The Covert Crazy has far more potential to be damaging to your work flow because you rarely see them coming. They come out of left field and spray crazy all over the place.

The warning the doctor gave me was a double edged sword. On one hand, I would know this person was mentally unstable and adjust my interaction with them accordingly. On the other, I now felt the fear of the potential interaction with a Crazy. They could show up any time. The devil is in the waiting.

My lead tech could sense my apprehension as I hung up the phone. It may have been the way I tried to pulverize the cradle with the handset. Sometimes I handle stress inappropriately.

Giggles: What's up?

Me: Batten down the hatches. I want everybody at battle stations.

My conversation with the doctor had not given me hope. The doctor explained that he had treated Crazy's thrush (oral fungus, looks like white stuff on your tongue) with standard antifungal therapy, dosed every 1 tab every 3 days for 6 days. This had not satisfied Crazy, and she demanded the same medication daily for 2 weeks. This is absurd in many ways, first and foremost because it's normally the doctor who decides the treatment plan, not the patient. Not that it mattered, because her insurance would not pay for her cockamamie dosing schedule. Of course, she would do back flips all the way from the doctor office to the pharmacy before she would pay for it out of her own pocket. Although, I'm sure she could have. Crazy people have lots of energy.

The doctor knew that insurance wouldn't cover Crazies bastardized therapy plan because he had called it in to the pharmacy earlier that day, at which time my techs informed him that insurance would not cover it and that it would be rather costly. This was even more evidence of what a pain this particular crazy was. Even though the doctor knew that it was inappropriate usage of that medication, he wrote her a script for it anyway just to get her out of his hair. Crazies are persuasive, and this one apparently had used a Jedi Mind Trick.

Doctor: What do you suggest? Her insurance won't cover the Diflucan. Big surprise.

Me: Right. How about nystatin suspension? It's cheap, and the duration of therapy should satisfy her. It seems like that's what she's most worried about. Say nystatin three times a day for a week?

Doctor: Fine. She doesn't know the prescription is being switched, though, so you'll have to explain it to her when she gets there. She's probably going to balk, so be sure to let her know that what we just talked about is what I want.

Me: Don't worry. I have experience with these kind of people.

Crazy ended up coming to the drive through about an hour later. She found out he prescription was switched and freaked. I spent probably 20 minutes with her. Not only was she crazy, she was dense. I'm talking George Bush foreign policy stupid. I explained the situation to her about ten different ways. I finally settled for something she would understand.

Me: Your doctor did a special analysis of the infection. This is the only thing that will work.

Crazy got her medication, and I defused a bomb in the pharmacy. Everybody wins.