Corpopharm: It Gets Ya Drunk!!!!

All other hypocrycies aside, I've got to hand it to

 Corpopharm on this one.  They're certainly not trying to hide that they're out to make a buck off of booze sales.  I saw this sign on the door as I walked in last night:

And what's this as soon as you walk in the door?

Why, it's huge fucking pile of basement bathtub vodka!  Cheery good time!  Not only can you come to Corpopharm to get your heart medication, you can also come to get retarded!  I wouldn't have it any other way.

Little boy: Mommy, why do we have to go to the pharmacy?  It's boring and that mean old pharmacist...

Mom: Quiet honey, Mommy needs her Zoloft.  If you're good maybe we can get you a...

Little Boy: Mommy?  Get what? Mom-...

Mommy: Well, hello (picks up a bottle of ghetto swill vodka). 

Little Boy: Mommy, what about your medicine?

Mommy: Quiet honey, Mommy needs to get her swerve on.  Do you have a friend you can stay with tonight?

Compound Calamity

This is an open letter to any pharmacist or physician who reads this site.  I know nobody reads it, but I'm writing anyway in hopes of saving the world from tyrany and Paris Hilton.  Forever and ever amen.

Last night I got a script for bum balm.  Bum balm is a preparation used for diaper rash.  Bum balm is not a legend drug, i.e., it is not produced by any drug company and must be mixed up by the pharmacist at the pharmacy.  This is no problem.  I love compounding medication.  It does not involve talking to insurance companies, doctors, or patients.  It involves me rolling up my sleeves and putting my education to good use.  Sometimes, it even involves me using a mortar and pestle (!).  During long nights with nothing else to do, it provides a welcome distraction and makes me feel useful.

The problem arises any time I get a script like the above mentioned.  As bum balm is not a patented drug owned and produced according to one recipe, it can be made many different ways.  In my short career as a pill pusher, I've seen at least 4 different recipes for it.  The prescription merely read, 'Bum Balm, 1 tube, apply to affected area TID'.  The doctor may as well have written, 'give them sum kewl a$$ cream LOL'.  The distressed dad that gave me the script needed it NOW, TONIGHT but I wasn't able to give it to him.  

My question is, do some pharmacists fill this type of script on a regular basis, taking it for granted that they know what formulation the doctor wants?  I can only assume that some do, because I get this type of bullshit often enough to believe that some of these docs aren't getting called on it the majority of the time.  Do some pharmacists just not give a shit and make it for whichever formulation they use most often?  My problem with this is that I'm not willing to assume any liability on the doctor's behalf.  I'm not compounding a special medication unless I have explicit directions on what ingredients to use.

So, I faxed the script back to the doc this morning with a real smart-ass note attached.  In so many words it read, 'hey asshole, how about doing your job instead of being a slothful quack.'  Seeing as it's the weekend, I'm sure they will respond promptly.  The patient is failed once again.  I don't know if that gives me grim satisfaction or just bores my tits off.

Hip Hop Translated

For all you hip-hoppers out there...

...and this video is the untranslated version, if you speak jive.

Somebody Understands Spiffy

I hate to say it, but I usually judge the pharmacy patron before I speak with them. Even worse, I'm usually correct in my assumptions. I'm not saying I endorse stereotyping. After interacting with people often enough, you get to know the type. The person the hands you the script that smells like they tried to smoke it is typically a member of a lower economic echelon. The lady with the perm that just a bit too fresh probably has a million coupons, and she's waiting for you to make a mistake. The person that see's the pharmacy and stares blankly from pick up, to drop off, to consultation may not have ever filled a script before. The disheveled guy with the glassy eyes coming toward the pharmacy with an exaggerated limp and elaborate story is probably bringing in a fake script or maybe one obtained dishonestly. The person who brings in the ER script so fresh it's still warm from the printer just wants to get the magic pill that will make them well again.

Last night, I was puzzled. The guy that approached the counter was mid 30s, bald, and wearing overalls. He was roughly 6'4", 250 lbs by my estimate. His name was in woven cursive script over his heart underneath a Ford emblem. As big as he was it took me a bit to notice him because I was engrossed in Ayn Rand's Atlas Shrugged (heavy reading for me). He didn't shuffle his papers, rap on the counter or cough to get my attention. He just waited patiently until I noticed him standing there. This automatically got him up to the B+ region of the patient grading scale.

I approached the counter and checked out the script, asking him if he wanted to wait for it. He said he would. He proceeded to ask where the condoms were. This bumped him up to an A-. Most people are too embarrassed to ask about the rubbers.

I got the script ready and paged him over the intercom. He returned to the pharmacy shortly with the condoms (magnums) to get his script. He looked around, seeming to take in the surroundings and said,

Guy: Man, I bet this shift is the shit.
Me: Yeah, I love it. As you saw earlier, I spend a lot of time reading. No stress.
Guy: Yeah. No people at night, don't have to put up with a lot of bullshit from all the crowds.
Me (pause): Yeah! That's just it. How did you know?
Guy: Aw, man, I been here during the day. All types a shit goin' on. Seems like a lot of hassle. Fuck that. Here at night, you can do your own thing.
Me: Exactly. I couldn't have put it better myself.
Guy: Truth. Keep it real, man.

He walked away and I just stood there mystified. Talking to the pharmacist like a real person instead of a register jockey almost always gets you an A+. I hope he comes back sometime.

Xanax Terror

Human behavior is clearly conditioned by experience. You wake up some days thinking boy, I've got problems. These problems may consume you for days, weeks, months. They cloud your thoughts and pervade every waking hour. Sometimes dreams as well. Then, by chance, you experience first hand the problem of someone else, and yours pales in comparison. Experience lends perspective.
-Anonymous

There's a hole in the bucket, dear Liza, dear Liza.
-Harry Belafonte

It was my weekend to work. Quite clearly I survived. Saturday was a day beyond comprehension. I'm not quite sure where to start, so the knee-slapper is probably most appropriate.

She approached the pharmacy in a gait that could be most aptly described as 'drug-induced stagger'. Her arm was supported by a sling and her moo-moo was fluorescent pink and orange...tie dyed. She bore a large scar on her left eyelid that read domestic dispute to me but could just as easily have come from anywhere. She was disheveled in that a just-so way that would have been cute had she not been a dope-fiend.

Lady: Hi! Hey! I need this filled and I gotta pay cash cause my dad well he dint think I needed my Xanax and well he just poured it down the drain.

The lady was clearly intoxicated. She spoke in the runaway train method that facilitated making her thoughts known before she forgot what she was trying to say. I couldn't smell what she had been drinking across the counter and didn't want to get close enough to detect it. I told her that I would have her medication ready as soon as possible. This situation was a difficult one and I performed a risk-benefit analysis in my head before I realized I was doing it:

1. This bitch is trashed. If I give her more Xanax, I'll be sponsoring a drug binge and inflicting unknown damage upon herself/family/innocent bystanders.

2. This bitch is trashed. I need to get her out of the pharmacy as quickly as possible. My technicians aren't paid well enough to deal with junkies, and none of the other pharmacy patrons deserve to experience this lady.

Working in the trenches long enough conditions you to default to damage control nine times out of ten. The decision came quickly and with little consideration.

Me (briskly): OK! Give me 10 minutes and I'll get you fixed up.
Lady: Ok but hey it's only 2 pills and I need it my dad's got cancer you know...
Me (interrupting): Sit down. This won't take long.

The script was a laugh in itself. It was written by and ER doc for two pills. Two. I imagined the scene in an instant: this moo-moo clad banshee shambling around the ER, screaming about cancer and toilets and the doctor thinking: just a few pills. Get her out of here. Damage control.

I got the script ready very quickly and proceeded to the register. The lady did not have any insurance, so she was subjected to Corpopharm's minimum dispensing fee. If you don't have insurance at Corpopharm, you must always pay at least the dispensing fee, whether you get 1 pill or 100. Some people don't see any value in this, becuase they fail to understand that they're not merely paying for their precious pills, but for my salary, the bottle, the light bill, blah blah blah. I knew as I approached the register that my new friend would fail to see the value in my service.

Lady: $10.99 for 2 pills?!? What the fuck is this!?!

I may as well have slapped her as told her the price. The way she came alive was pretty remarkable considering how much Xanax and ethanol she had in her system. I don't remember exactly how I responded, but she wasn't listening anyway.

Lady: Jesus Christ, I tell ya, they fuck ya no matter which way you turn. They fuck me at the hospital and only give me two god damn pills, you fuck me at the pharmacy and...
Me (interupting): Hey, listen. I understand you're upset. You can't throw a fit here like this. The price is what it is. Take it or leave it.

At that moment I noticed a few other pharmacy patrons were waiting to pick up their scripts and were privy to the current conversation by virtue of it's volume. One lady, who had a thick shief of coupons in one hand and cell phone in the other quickly turned around and trundled her cart to the front of the store. I guess she didn't want to wait. The other person stared at my new Xanax friend like she was some kind of bug.

Lady: Aw, fuck it. Whatever.

She angrily extracted a battered check book from her hand bag and attempted to write a check. The result looked like a preschool experiment, but I've never really cared about whether or not someone gives me a bad check. My pay is never affected.

I took the wrinkled check and fed it into the register. The register attemped to read the check and print the authorization on the back, but it was just too wrinkled to feed through correctly. It got bound up, and the shredded ends of the printer ribbon appeared out of the top of the printer like the frayed ends of sanity. I made a game time decision and handed her the pills.

Me: Sorry about everything. Hope you get to feeling better.
Lady: Still fucking bullshit! God dammit!!!

She vacated the pharmacy and made her way to the front of the store. I breathed a sigh of relief and said something to my tech about dodging a bullet. About five minutes later a mother, daughter, and grandchild (presumably) came back to the pharmacy.

Daughter: Excuse me, there's some lady in a robe out in the parking lot asking people for rides. We just thought you should know.

Asking for rides? The ER she came from was more than 2 miles from my pharmacy. How the hell did she get here? How had she planned to leave? I wondered if she even remembered.

Postscript:

This happened a few months ago, and was not the last time I dealt with the 'Xanax Terror', as I came to think of her. She got a few more scripts from various doctors and was always trying to get early refills, taking a LOT more of her medication that she was supposed to. She offered the same story every time about her father having cancer and pouring them down the drain. Alcoholics, like chronic cannabis smokers, experience reduced short term memory. She usually tried to buy beer at the pharmacy, and we always had to remind her that we didn't have a liquor license. One time she brought back a few tall boys to get with her Xanax, and a shift manager who was working at the time remarked, 'Yeah, party.' After a month or so I took her discharge meds over the phone from a local psychiatric hospital. I'm curious how they found her.