RIP CPM

This post is to inform the readers of Conservative Propaganda Machine that Spiffy, the roguish brilliant and ruggedly handsome author of CPM was eaten by a pack of wolves late last evening near the New Jersey Turnpike. He was on a mission to deliver medications to a patient that was desperately in need.

Spiffy always hoped that his apothecary tales brought enjoyment to those who read them. He also hoped to educate the world about pharmacy etiquette. At this he failed. His idealism blinded him to the fact that most pharmacy patrons cannot read.

You may contribute to his memory by burning down your local pharmacy. If you coordinate your efforts, with a little luck, the burning buildings will be pyres visible from space for all the worlds to see.

Corrupt Copy Caper

I wrote this last night during a little down time at the ol' pill room. Of course I got about half way in and was really rolling when the shit hit the fan. The middle section is the first guy that interrupted me that turned out to be drunk/high/confused. You decide.

***

Right now it is far too quiet to be a Friday night in the pharmacy. I shouldn't even think that let alone type it. My two techs left and it's like a tomb in here. Maybe even a little spooky being this close to Halloween.

Last night, however, was a doozy. It was steady enough that I stayed busy the entire night both filling scripts and taking care of some projects. The highlight of the night, though, was definitely Faker.

Faker came in around 11:30 wanting to fill a prescription for Oxycontin. I recognized him immediately having filled a rather large prescription of oxycodone for him a few weeks prior. That one had been for 240 oxycodone 30 mg tablets. For those of you not in the biz, that's a lot of damn oxycodone.

My wind was already up. One of my fellow Corpopharmacists had called me an hour earlier warning me about Faker, saying that he had already been to another pharmacy that night and was most likely Up To No Good. Not only that, but Faker himself had called earlier in the evening on two separate occasions. The first call was to see if I had a large quantity of oxycodone in stock, the same amount that he had gotten at my pharmacy before. The second call was to see if I had the Oxycontin which he was now trying to fill. He told me he was planning on paying cash. Sixty Oxycontin 80 mg is about $900. All this adds to up to one big stinky bit of fishiness.

_____________________________________________________

Hahaha. A quick funny. Some guy out in the OTC section just started mumbling rather loudly, ending in PHARMACIST. I look up, and he's about 50 feet away from the pharmacy holding a box of some vitamins waving them around like a traffic director, apparently trying to ask me a question. I asked him if he had a question, but he just continued to stand where he was and mumble at high volume. I instructed him to come over to the pharmacy if he had a question.

Guy: I just wanted to see if you were awake.

Me: (glare) Do you have a question about those vitamins?

He stared down at the box of vitamins as if he was surprised to see them. After a few seconds he looked back up, puzzled. He looked back down at the vitamins.

Guy: No. I don't have a question.

His cell phone started to ring.

Guy: I'm not here. Nope. I'm not here at all.

He walked away.

____________________________________________________

Where were we? Ah yes! Faker. Faker was standing at the drop off window while I looked at the prescription that he has just handed me. The prescription appeared to be a copy, although close to being good. The doctor's handwriting was a pretty excellent forgery but the prescription itself was obviously a copy on plain old white printer paper. I was trying to decide what reason to give Faker for denying the fill when he opened his mouth and started to dig himself even deeper. Fakers do this quite often.

Faker: Yeah, I'm heading out of town tomorrow and I forgot all about this prescription. I know it's a little early but I need it. Unbelievable! I gotta pay cash for it, too. I hope that's OK. I've been taking this stuff for years after my surgery. When can I pick that up?

This is an abbreviated version of Faker's story. The Story is a trademark for every person who's trying to fill a fake prescription. I have no idea why, but they all have diarrhea of the mouth when it's time to try and pass off a fake. Maybe they think that if they distract the pharmacist he/she won't realize they're a big fat liar. Maybe it's just nervous babble. Whatever the case, every faker has the same story that is used every damn time, and this was no exception. Faker had given me the same spiel a few weeks earlier, even when I had no reason to suspect him and filled his prescription without argument. It's tiresome. This was just another clue that Faker's prescription was about as real as a three dollar bill.

My computers were down at the time. I told Faker to come back in about a half hour. I wanted to be sure of myself before I refused to fill the script. Faker left and I was poring over the presumed fake script when the night manager came back to the pharmacy.

Night manager: Did that guy try and fill a script?

Me: Yeah, I'm looking into it now.

Night manager: He was just up front making copies of a prescription. I saw him doing it and he said it was for tax records. Did you fill it?

Seriously? My jaw hit the floor. I probably looked like I'd just bought the Golden Gate Bridge and suddenly realized it. Picture the situation for yourself. This guy walks in a Corpopharm, proceeds to the copy machine (10 cents each) at the front of the store, slaps down his prescription template and runs off ten or so copies. He pulls out a freshly copied blank, scrawls out whatever prescription he's craving, and walks to the back of the store where the pharmacy is located. On the way he folds his newly minted fraudulent prescription back and forth a few times for good measure (he doesn't want it to look too fresh). Everybody knows most smackheads can't keep their prescriptions pristine anyway (they're usually torn, wrinkled and dirty). Arriving at the pharmacy, he presents his prescriptions with pride and the solemn knowledge that he has Done Good. Corpopharm, your one stop shop for all your fraudulent prescription needs.

I just stood there for a few seconds and let my brain process the information. Who the hell is that stupid? As it turns out, he was a whole lot dumber, but we'll get to that later.

Faker called back over the phone after about an hour and asked if his prescription was ready. I told him I would have to verify the script with his doctor because of the high dose. He mumbled part of The Story again and said he would be back in a few minutes.

Faker returned and brought out the big guns, the Guilt Trip Please Help Me Story. He stated that him and 'the wife' were leaving for a cruise the next day, and that he would miss the trip if he didn't get his medication NOW. He even told me 'the wife' was out in the car crying here eyes out. Boo hoo. He begged. He pleaded. He all but accused me of suspecting him for what he was, stating he'd never had a problem filling before and didn't understand what the big deal was. It was pretty neat to watch his emotions range from distressed to angry to hopeful. I just stood there and looked bored. After a few minutes he finally stopped orating (or maybe paused for breath). I simply reiterated that I had to verify the script this his doc before I could fill it. Faker looked like I'd just told him his dog died. Had I told Faker that if he got down on his knees and begged for it, I'm sure he would have. Don't doubt it. Opiate addiction is a terrible thing. Faker finally said he would take his prescription somewhere else to fill it. I wished him luck and he left.

When the day pharmacist arrived I explained the situation and asked her to verify Faker's script with the doctor's office and see if they wanted to try and catch him. When I arrived back to work this evening, a note was pinned up at the pharmacist's station with some paperwork attached. This was it:

That's right. Faker was so anxious to get his dope that he left the original in the copy machine. At Corpopharm. At the Corpopharm he was trying to commit fraud at.

This is the pinnacle of civilization has to offer in the year 2009. Excuse me while I go dump cyanide into the water supply.

Gonzo Drugs for Hapless Thugs

It sounds like people are enjoying the Gonzo journalism style posts. Here's one from last night.

1. yen needs help with topamax coupon card. She gets all excited when i show her how to do it.

-Yen is one of our interns who works a few hours a week when she's not doing the pharmacy school thing. Going to pharmacy school and working in a retail pharmacy concurrently is one of the surest recipes for disaster in terms of your mental health. She's a good sport, though. What is funny about this is that Yen has very exaggerated responses and giggles a lot. It's hard to be in a bad mood around her.

Yen: I can't get this to work. Can you show me?

Me: Yeah, I can work on it (Spiffy starts working).

Yen: Oh, WAIT! Shouldn't you check this first? She's waiting (indicating another prescription a patient is waiting for).

Me: OK, sure (Spiffy starts checking the script for the waiter).

Yen: Oh!!! Phone call has question for pharmacist!

Me: Don't worry, I'll get to it.

Imagine this tiny little person (she's around 5 feet tall) rushing around, flapping her hands like angry birds and giggling like a school girl every time you respond to a question. It's too comical to be aggravating.

2. Guy needs cough medication for kid. Doesn't get what i show him. Thanks.

Not a terribly uncommon occurrence (unfortunately). People come to the pharmacy and want an immediate solution for their intractable malady NOW. They leave with what I recommend to them about half the time. Why? Because many people are just one rung away from apes on the evolutionary ladder (sometimes above, sometimes below).

This pisses me off for two reasons. 1) If you aren't going to listen to my advice, why waste my time asking? 2) I'M A FUCKING PHARMACIST. There is no other person that is more knowledgeable about over the counter medications than me. ME. The person standing in front of you sticking EXACTLY WHAT YOU NEED right in your stupid, vapid face.

3. Guy and girl approach pharmacy. Recognize them as the ppl who asked me a few months ago about what to do for her vag. Apparently they just got married and started having sex and her vag hurt. I immediately cringe because i think they are back for something related to that. They're here for her mother's achy knees. Relief.

This is true. It may sound funny to you, but you're not the guy that these two newlyweds came to early on a Saturday evening because they needed something to make the brides vagina less painful.

I'm serious. I remembered them because the situation was just that ghastly. A month or two ago they came to the pharmacy early on a Saturday. I was neck deep in refill-too-soons, transfer requests and ER scripts when they showed up. I have to give it to them, they explained their situation without an ounce of embarrassment. Quite simply put, they explained that they had just gotten married. They were both virgins, and their newfound forays into sex led to one very painful vagina. Just how the hell am I supposed to handle this? Anyone who is not a virgin will know that this conversation was a bit inopportune for my time and place.

4. Guy comes to ask for something that 'you drink and it clean you out'. I start to stand up to show him the mag citrate and he says 'which aisle? I find it.' interesting. I tell him which aisle and he actually comes back with mag citrate. I wonder if he was testing me.

This situation was strange because he actually went out into the store and picked up just what I would have gotten for him. That's like winning the lottery as Corpopharm has roughly a billion shitty products you can buy.

5. everybody that comes in at night are foreigners. They're coming to me for health care. Good fucking luck. Don't know why, they all have medicaid. That's not prejudice, that's truth.

For the most part, this is true. There are multitudes of people that come to the pharmacy after hours seeking medical attention from a pharmacist that has no business giving it to them. 90 percent of them speak shit for English and end up dragging their 7 year old out of bed to interpret for them. The ones that are the most fun are the people that are looking for a suppository and pantomime inserting said suppository into their ass.

6. Just filled an rx for one of those families where every member is on like 5 psych meds. Mom, dad, kids, dog. I wonder what dinner time at that house is like? 'hey dad, can you pass the... wait, who gave dad a knife? Run!'

Yep. You know those families you see at the restaurant on Sunday where all the kids are running around in an uncontrollable frenzy and the parents are staring daggers at each other? They spend a SHITLOAD of money at the pill room. Well, the state spends it because Medicaid pays for their drugs.

There really are families that exist (nay, thrive) where every last family member takes numerous psychotropic medications just to achieve some shambling form of normality. It makes sense if you think about it. Two really fucked up people meet and get hitched, then have lots of fucked up kids. Their mental illnesses are passed on via inherited chemical imbalances and drastic behavioral abnormalities. The result is a crazed family circus where the worst occurrence is much, much worse than Jeffy mispronouncing spaghetti.

Baffling Busch Bonanza

I walked in the door this morning to find a can of Busch sitting in the counter. Seriously:

And what else? It's empty. Someone actually drank the damn thing.

My eyes immediately darted around the house surveying for damage. What kind of fiends would bring redneck beer into my home late on a Friday and leave one solitary, innocuous can sitting on the counter? If you ever come home to find empty Busch cans littering your domicile, you can also expect broken furniture, public nuisance citations and the change stolen off your dresser.

In this house, this just doesn't make sense. Don'tworryaboutit and Risk are both home this weekend, but neither of them would trade their hard earned wages for this swill. Risk is a wine man, I don't know that I've ever seen him bring beer home for his own personal enjoyment. Don'tworryaboutit would drink window cleaner if it would get him drunk, but even he has more sense than to buy skunk like this.

I'm definitely not hating on Busch. There's plenty of good ol' boys out there who pull dusty cans of Busch out of the beds of pickups after a long day in the field for a refresher. God bless 'em for it. However, if there's any beer you could classify as classic American Skunk, this is it.

I set the can down, shaking my head and opened up the keg fridge for my own after work refreshment. What I saw appalled me. The genesis of the can on the counter was made clear by the entire case of Busch occupying a shelf of the keg fridge. What compounded the mystery was the case of Pabst on the shelf above it.

What the blue fuck? Busch? Pabst? Busch and Pabst? While Busch is almost exclusively poor white trash and farmer beer, Pabst nowadays belongs to hipsters, college students, and the old timers that still recognize that blue ribbon quality. But the young professional crowd that my roommates run with? No sir.

There really should be quite a good story behind this.

Anal Alice Argument

Enough bullshit. Here are the facts:

1)Alice in Chains, after a 14 year hiatus, is releasing their new album Black Gives Way to Blue on September 29th.

2)Alice's previous lead singer, Layne Staley, was found dead in his Seattle condominium on April 19, 2002.

3)Alice will be featuring a new lead singer (William DuVall) on their new album. They have already released two singles via their website, A Looking In View and Check My Brain. Both tracks are unequivocally awesome and will melt your face the second you hear them.

Everyone is aware to the aforementioned facts. That's why they're facts, there's no arguing them. Everyone is waiting for the album and probably would murder kittens to get it early. I know I've got my flannel shirts and Doc Martens ready like it's 1995. I even had all my jeans stonewashed.

Here's where the BS starts. You generally hear this piece of BS from two camps, the metal heads and the hippies.

Metal heads: Heard the new Alice single? Bro sounds just like Layne! Aww, man you can't even tell the two apart!!

Hippies: Hey man, that new lead singer for Alice sounds just like Layne Staley, man. Yeah, it's like he was, like, reincarnated or something. It's totally trippy (cough cough cough)!

You even hear a radio DJ say it from time to time, although most of them are wise enough not to. Let me clue all you assholes in on something.

Alice in Chains uses a technique known as vocal harmony in most of their music. Vocal harmony occurs when two vocalists sing various parts of the song together in the same tune. Much of their old stuff contained vocal harmony, and both of the singles released for the upcoming album feature extensive vocal harmony.

What does this mean? It means you're all retarded and don't realize that half of this vocal harmony has always been and will continue to be the musical genius and guitar god Jerry Cantrell. What used to be Layne Staley is now William DuVall. With half of the equation being the same as it has always been, of course it's going to sound pretty similar. In the parts of the song where DuVall is singing alone, it's pretty clear to me that he sounds nothing like Layne Staley. Is he good? Yes. Are the songs good? Obviously. Is William DuVall reincarnated Layne Staley? Don't make me laugh. Maybe if I was taking constant bong rips throughout the song (hippies) or headbanging (metal heads) I wouldn't be able to discern a difference. Please, pull your heads out.

We can all agree that the new album is going to be divine. Let's settle for that.

Marauding Moneybags Motherfucker

Moneybags is a regular at my pharmacy. I've written about him before. He's the guy who came through the drivethrough one night with literally a trunk full of cash. Normally, he's pretty tame. Last night, he was in rare form. He pulled into the drivethrough in a Lexus sedan. He always has a different car. He told me one night that he hasn't owned a car long enough to have to change the oil in the last 10 years.

Moneybags: Hey, Spiffy! I need my refills. Here's one of my bottles...

He threw the empty script bottle toward the pass-through, missing by a wide margin. He always has one bottle with him for one of the refills that he's already called in. It's only one bottle, even if he has multiple refills. I can't figure out why. The bottle bounced off the passthrough and fell to the ground near his car.

Moneybags: Motherfucker.

He said it in an almost contemplating tone, as if he was trying to figure out how he'd gone wrong. He put his fancy Lex in reverse and started to back up. He suddenly stopped and stuck his head out the window.

Moneybags: Where the... motherfucker.

This time, he almost breathed the curse so I could barely hear it. He continued to back up until he had enough room to get his door open and got out. He walked toward the empty bottle and swung his foot at it with grim determination. He missed.

Moneybags: Motherfucker. Mother... (cocking his leg back for a hearty kick) FUCKER!

This time he connected with the bottle, sending it spinning across the drive through lane and careening off the curb. I was absolutely speechless. He looked like a five year old throwing a tantrum. I would have been laughing if I hadn't been so taken aback.

Moneybags: Fucker.

He walked calmly over to his confrontational bottle, picked it up, and walked back to the pass-through. Calmly, he placed it in the pass-through.

Moneybags: I'm getting back in my car now.

Me: OK.

I wonder what had him so riled up. I thought about asking if someone had broken into his trunk and taken his bankroll. I decided it would be wiser not to. I didn't want to end up in there.

Sassy Signature Log Scandal

At Corpopharm you must sign a piece of paper when you pick up a prescription. This is Corpopharm's proof that the person you're interacting with has offered the patient the opportunity to speak with a pharmacist. Pharmacies must make the offer to counsel because of this boring law that nobody cares about known as OBRA 90. That's not the point.

The point is that nobody can figure out the signature log. You could hand the signature log to a MENSA member and suddenly they would transform into a knuckle-dragging, shit-chucking mouth-breathing ape. The sig log is divided up into three columns. The middle column is designated for a sticker that comes off of the label of the prescription you are picking up. On each side of the middle column is another column, this one with a blank space. You sign on the left if you wish to wave your privilege to speak to the pharmacist, and sign on the right if you do not. It doesn't even matter which side you sign on, as long as you sign somewhere. The instructions are stated at the top of the form in plain English.

Sounds easy, right? WRONG. Last night provided a good example of just how difficult this task is for your average pharmacy patron.

Idiot: Huh? Sign?

She looked at the sig log like it was a recently uneathed Hebrew script from 150 BC. I could tell it was going to take her some time to decipher it, so I took a deep breath and provided her with instruction.

Me: See the stickers in the middle column? Just sign to the left of each one in the blank space.

She trailed her hand over the form, tracing the runes and heiroglyphs that undoubtedly danced before her eyes. Her finger stopped on the middle column, where the stickers from her prescriptions resided. There is no room to write on the stickers. She looked up at me bravely and smiled.

Idiot: (pointing to the stickers) Here?

Me: Sign on the left side of the stickers.

She looked back down at the form with a puzzled look on her face. After a few seconds she looked back up.

Idiot: I need to sign? Where?

Me: (pause for effect) Sign to the LEFT of the stickers. See the blank boxes?

Her finger made another drunken course around the sig log. She finally landed on the righthand column.

Idiot: You want me to sign to the right?

Me: (audible sigh) Send the form back in, please.

She sent the form back in (she was at the drive through, of course) and I put a large X in each box she needed to sign. They don't make us pharmacists go to six years of school for nothing. I sent the form back out, deciding that if she couldn't figure it out this time I would refill her scripts with anthrax and hope for the best.

Damnable Deer Hunter Depravity

Deer Hunter was back last night. I really need to get rid of that asshole.

This time was different, however. This time, he was Deer Hunter Incognito. He approached the counter with some girl who had a few scripts from the ER. I took the scripts from her and entered them into the computer, telling her it would take just a few minutes. She walked over to the waiting area and sat down, but Deer Hunter remained. I didn't realize it was him until he handed me a script from the same ER with his name on it.

I hadn't recognized DH initially because he was wearing a baseball cap pulled down low over his brow, part of what I'll refer to as White Trash Uniform. You wear this uniform if you live in my city and fit these four categories:

1) White/Anglo/Caucasian
2) Male
3) Age 13-50
4) IQ < 100

The White Trash Uniform (WTU) has many variations and a few crucial components. They're all clASSy. The most important feature is that all articles of clothing are no less than two sizes too large. The pants must be hanging off the ass. Headwear is optional, but if not present corn rows are preferred. Bling in the form of neck chains or oversized watches is preferred, just so people can see what a balla you are. Neck tattoos are also preferred. Shirt should feature local professional sports team or weed leafs.

I'll never understand the White Trash Uniform. You might as well wear a sandwich board that says, "I live in a trailer, beat my girlfriend/dog/kids, get arrested biweekly, and generally suck at life."

DH handed me a prescription and surprisingly did not start into some long winded explanation about how he had fucked up and lost his drugs. I started to put them into the computer and remembered that the last few times he had been in he'd had no insurance cards. I kindly asked DH if he could provide me with his insurance information.

DH: Uh, yeah! I got Medicare!

I surveyed DH with my eyes for a few seconds. He returned my gaze with a look of puzzlement and dim hope. I sighed internally and asked DH if he happened to have an insurance card on his person so that I could properly bill his scripts.

DH: I go to Kmart! They got it all there.

I reminded DH that Kmart was not open in the middle of the night. I nearly reminded DH that he and I had been through this particular performance before. I decided he might read between the lines, realize I was calling him an idiot, and opted not to.

I eventually located DH's Medicaid coverage with the miracles of modern technology and filled the scripts he had from the ER. I called him up to the counter to ring him up at which time he engaged me in cordial conversation.

DH: Yeah, me an' the ol' lady havin' a rough night. Went to the ball game! I fell down the stairs at the stadium, and she got a sore mouth. Helluva deal!

Remember the last time DH came to my pharmacy? He got drunk at the river and lost his drugs. Tonight, he got drunk at the baseball game (drunk? based on the way he smelled, he was probably swimming in the beer) and stair-surfed the upper deck. He must not be able to handle his liquor.

In related news, NPR reported this morning that my state is in budget crisis for next year. One of the key areas needing more funds was Medicaid, so people like DH can get drunk and fall down not just on weekends but Tuesday too.

I quit.

Corpopharm Crisis Calamity

Sometimes life can throw you a curveball. The last month at Corpopharm has been a big old shit sandwich, and we've all gotten to take a bite. Here's the highlights:

1. One of our regular pharmacists quit. The grass was greener over at Corpopharm 2 and he hauled stakes like a donkey on a hay binge. Which leads to...

2. Floaters! I've talked about floaters before. They're temp pharmacists that Corpopharm sends in to pick up the slack when a general infantryman goes down in the heat of battle. Even if they don't suck, the pharmacy just doesn't run a smoothly with one of it's well oiled parts missing. That's not even worth considering though, because they always suck. Hard. The floater we had this week actually threw a tantrum and got in a fight with a technician, right in the middle of a busy work day. Fucking sweet.

3. My partner got fired. The asshole decided to let his license expire. This means I've been working the last month by myself. Whatever, I don't need time off.

4. New computer system! This wouldn't be much of a problem, but most of our technicians our legally retarded. I'm bringing in a bunch of monkeys to bang at the keyboards while hurling excrement. I'm sure it will be an improvement.

I'm sure there's been plenty of funny stories, but I don't remember them. It doesn't matter. Next month contains two events that will erase this month in one fell swoop:

1) Nine Inch Nails: September 5, Wiltern Theater

I've heard LA is quite an awful place. I'm willing to bear it, if only this one time. NIN is currently on their last tour ever, and I managed to score tickets for the second to last show EVER. If I survive it, you can expect some eventful pictures and video footage.

2) Great American Beer Festival Sept 25

Nestled in the heart of downtown Denver, this quaint little festival is host to the best breweries in America. With literally thousands of beer ripe for the tasting, you're a fool not to be there. I am not a fool. I will be there.

Anal Asinine Analgesia

Remember the deer hunter from last November? He was back last night! Without referring to the old post, this gentlemen arrived at the pharmacy in the middle of the night late in last November because his maintenance narcotics had been unceremoniously removed from his person by a cadre of ruffians. It grieves me just to say it.

Deer Hunter: hey i got these scripts from the 'mergeny room here in town cuz i was out to the river today an' i had my meds in my backpack an' i slid down the river bank an' my backpack came off an' i lost my meds can you fill these for me?

This time DH had brought backup in the form of Deer Hunter Mother. She was clearly in charge here.

DHM: My boy needs his med-i-ka-shun! How long will this take?

Me: Just a few minutes. If you would like to have a seat, I'll let you know just as soon as...

DH: Yeah I need 'em cuz I take these real regular an' if I stop...

Me: Yes, I'm aware. Please take a seat. This won't take long.

Did I mention DH was shirtless? The young man had obviously been out to the river shirtless as well, as evidenced by the very nasty sunburn that was now resident on the upper half of his body. About this time, the night manager wandered by. Last nights manager was the type of woman who takes Zero Shit from anybody. I love her precisely for that reason. As soon as she spotted DH, she immediately decided to lay down the law.

Manager (addressing DH): You gotta shirt? You can't be in here without a shirt.

DH: I got second degree burns...

DHM: He's got second degree burns all over...

At this point, I managed to catch Manager's eye and telegraphed to her that I had the situation under control (so far) and that I would radio for backup if necessary. She tipped me a wink and continued about her work.

Those of you in the field will know that DH's insurance claims were promptly rejected by Medicaid because he had just filled a months supply recently. The medications he was aiming to replace would cost about $70 out of pocket. I motioned DHM to the counter. I assumed she was the one funding this little adventure. DH had also already fled the scene.

I explained how much the medication would cost and why. DHM accepted my explanation with no malice, stating that she would go to DH's regular pharmacy in the morning and take care of it. I was glad DH was not present, as he would have undoubtedly had a Class I Nuclear Meltdown in the pharmacy. When you tell junkies they have to go without their fix for any extended period of time, they tend to get a bit upset.

The best part? The Manager had her eye on DH from the second he entered the store, and caught him shoplifting a cane (of all things) on his way out. As DHM was paying for a few other very necessary purchases at the pharmacy upon concluding our business (soda and potato chips) Manager approached and informed DHM that her sticky fingered son owed the store for one (1) cane. DHM stammered out an apology and counted out some bills on the counter. I bit my lip, allowing the better half to fight the battle.

I've been on the Medicaid rant before. This is just another great example of how dumb people breed dumb(er) people who make many bad decisions that all the rest of the tax paying populace gets to pay for. DH went and got loaded at the river, sustained a second degree sunburn, and lost his medication. Good fucking deal.

DH strutted proudly away from the pharmacy with his new cane-enabled gait, and the very ground shook. Jesus wept, and all the philistines cast out their nets.

Yesterday Morning

Yesterday morning I was wandering around the house doing my normal after work routine when the doorbell rang. Normally, I never answer the door. Anyone who has to ring the doorbell at my house has no business entering. Yesterday, I was feeling feisty. I opened the door.

Old Lady: Hello! My name is Gladys, and I'm here from the church off...

Her spiel ended nearly as quickly as it started. If you've ever interacted with a door-to-door religious zealot, you know those crafty fuckers fire it up as soon as they hear the door knob turn. Once her eyes broke from mine, she lost her train of thought and just sort of gaped for a second. Trying to see it from her perspective, I wouldn't blame her. I was wearing shorts and nothing else. I had a glass of whiskey (Baker's(neat)) in my hand. I have many tattoos.

Me: Good morning! Are you recruiting?

Old Lady: I, uhhhhh...

At this point, I started to feel bad about answering the door. Picture the situation. This self satisfied retiree gets up early and dons her summer appropriate flower pattern dress. Dog eared bible in hand, she sets out upon the local neighborhood to locate prospective congregation members. What does she find? Some young, tattooed, whiskey drinking miscreant who is more inclined to curse her off his porch than he is to tithe to the lord. I decided terrorizing her would be a lowly form of entertainment.

Me: Thanks for stopping by! I already belong to the church up the street (a blatant lie, but she would have taken any excuse up to and including I was a devout muslim).

Old Lady: Of course! Have a nice day!

She scampered away. I only hope I didn't injure her ideal version of the American Dream.

Happy Honky Happenstance

So, last night I was called a honky motherfucker on the phone. I don't know how he knew I was a honky. Maybe it was my stubborn refusal to answer his question, or possibly my go-to-hell air of authority. I have to admit, though, he had me dead to rights.

The phone rings 3:45 AM CST:

Guy: Hey! I got a question... How ya doin? Uh, what is this A-L-P-R-A-Z-O-L-A-M?

People often spell out the names of drugs they don't know how to pronounce. I always have to scramble to write it quickly, because they usually read off the letters like they're some kind of crazed circus auctioneer. I missed the class in pharmacy school where we learn how to string together 10 letters in our heads to spell fancy words.

Also, a side note is in order here. Any time someone calls and asks me about one of the popular controlled substances like Vicodin or Xanax (alprazolam), I usually stonewall unless they can prove they have a script for it. The calls come in two forms: 1) they want me to identify a pill that turns out to be one of the aforementioned drugs or 2)they find a bottle of aforementioned drugs and give me the name without knowing how to say it. What does this mean? Usually that this drug is not theirs. What does that mean? That they stole it from a friend/relative or found it (stole it). In either case, they shouldn't be taking it. If I tell them what it is, they will DEFINITELY be taking it.

Me: Is this your medication?

Guy: Yeah!

Me: Did you get that filled at Corpopharm?

Guy: Uh, yeah!

Me: OK, what's your name? I'll look you up in the computer and then we can talk about it.

Guy: No, man, I just need to know what it is. It's A-L-P...

Me: I heard you the first time. If it's your medication, I'll look you up in the computer and tell you all you need to know.

Guy: It's my wifes medication.

Me: Does she have a question about it? I can talk to her.

Guy: Man, ya'll some honky motherfuckers!

Me: OK. Later.

At least he was honest. I have to say, I always frigured myself for more of a high-handed cracker than some lowly, ignorant honky. I guess beauty is always in the eye of the beholder.

Laptop Literature Lasciviousness

Here's a few more funnies from the ol' laptop archive. Once again, these were all typed out quickly while the pills were flying and the patients were screaming. I'll put in exactly what I typed at that time, followed by an explanation to help preserve that raw pharmacy experience I know you all crave.

1. why so much? medicaid patient elected not to get lancets.

-I thought this one was pretty funny. This guy was picking up about 8 scripts on Saturday night. He had Medicaid and everything went through with paid claims except for his lancets. Lancets are what diabetics use to pierce their skin in a relatively painless and sanitary manner so that they can get a blood sugar measurement. For some reason his lancets wouldn't go through Medicaid. So, when I rang them up it was for the cash price.

Guy: Why is it so expensive? (translation: why is it more than $0)

Me: Medicaid didn't pay for your lancets.

Guy: Ok, just leave those here. I'll take everything else.

I wanted to ask, but I didn't. How the hell is he going to draw blood for his blood glucose checks? Steak knives? Rusty nails? Get in a fight with the wife?

2. i don't carry a purse anymore. I work in the ghetto and we get help up about 2x monthly. (medicaid pt who didn't have here childrens cards.)

-This was from a woman who was getting some medication for her kids. Apparently she lives in a poor part of town and works at a Cricket kiosk. She said they get robbed at least twice a month. So, if you're lucky enough to be working when the robbery occurs, you get robbed as well. Fabulous. Not only does she have a shitty job, but everytime she goes in some thug steals her purse. Wonder how her 401 is. Anyway, the woman had had her purse stolen so many times that she just gave up carrying one. She did have all her kids Medicaid information in a well organized laminate folder, though. So that was nice.

3. Guys comes looking for vaporub in 'little tins'. I show him the vaporub, saying that's all we have. He stands around waiting for the little size to materialize. Opens a couple packages to make sure i'm not lying. I walk away. He comes back to the pharmacy and wants to know if blistex is ok to use. I ask what for, and he says his 3 year olds lips are dry. I say yes that should do the trick. 2 hours later: guy returns with girl, asks where the vaporub is. I blow my brains out.

-Pretty self explanitory. No shit, he did ask again where the Vaporub was on his second trip into the store. We were out in the aisle for at least 5 minutes the first time because I had to explain the difference between Vaporub and Vaporub. It's these type of interactions that once again prove that humans should be born sterile until they prove themselves intelligent.

4. A bunch of the techs here must read magazines like us and people, because they're always sitting around the pharmacy. The fact that those magazines exist is a sure sign that we as humans are doomed. Does anybody but me think that the jon and kate plus 8 (even i know what that show is now i guess) couple look like a couple of aliens? All those little fuck trophies are going to end up on abilify, adderall, prozac, and catapress. Mark my words.

-I know some of you read those magazines, but I'm not going to make any attempt to hide that I believe they are pure trash. As a side note, I would fire every tech in that pharmacy save for a few of the interns if I were in charge. What a pack of animals. One of the few good ones bailed 5 months ago without a word to anybody. Zero. Fast forward to late May and I'm taking a piss at a Nine Inch Nails concert. From behind me I hear someone call my name. I turned around (don't worry, I finished pissing first) and BAM, the tech that eloped. Go figure. I guess he got sick of the city and moved out to California to hang out with his girlfriend. Too bad he left me with a bunch of morons.

5. Some guy gave me shit for telling him to back off to provide private consultation. He said, 'i heard that, and you didn't talk about drugs at all.' great. Don't think he realizes he just proved my point.

-Corpopharm doesn't do much to provide a private consultation area so that people can talk to the pharmacist without others hearing. That's important, because I have to be able to explain why their copay is so high. This particular incidence involved a guy coming up to the counter and standing directly beside the person that was picking up a script. Seriously, they could have held hands. So, I told him to take a few steps back and he looked at me like I'd just offered to rape his mother. Who does that? I don't even get in people's personal space in line at the grocery store, let alone in a place where they're talking about their boner pill or psoriasas cream. Freak.

Sunday Fun Day

So I decided to try something new at work. The last few nights, as soon as I arrived I opened a doc on my laptop and made notes of every 'incidence' that occured, be it amusing, interesting, infuriating, etc. I just realized lately that all the things I used to write about started to seem so normal that by the time I get home I don't even feel like writing about them. So while you're reading these, picture some obese woman screaming at me about her Vi-Co-Dans while I'm snickering and pecking away at my laptop. That should make them funnier.

-----------------------------------------------------------------------------

Weekends are a magical time in the pharmacy. Saturday and Sunday nights, I have to be to work at 7 PM instead of 10 PM. This means I get to interact with lots of interesting people that I miss out on during the night time. The first phone call I received was from one such interesting person.

Person: Yeah, uh, I fill my, uh, seizure medication at the Corpopharm at, uh, _____ and they is closed! It's for my seizures!! What am I supposed to do?

You know it's going to be a fun conversation when your conversant says uh five times per sentence. She stressed the what, as if it was somehow my fault that she decided to run out of her pills. I almost told her that forgetting your seizure medication is a common side effect of Idiopathic Stupidity, an untreatable terminal condition, and that she might as well drive her minivan off a cliff and save the system millions of dollars in Medicaid payments. Instead, I told her to come to my pharmacy to pick up a few pills. I'm such a nice guy.

My very second call came from a young woman proclaiming that another Corpopharm had made a 'crucial error' in her medication, and she demanded to know what I planned to do about it. I asked her for her name and punched her up in the computer. The very handy corpopharm database presented me with her medication history from another pharmacy. I decided to get right to the heart of the issue.

Me: Ok, what's the problem.

Idiot: Corpopharm was supposed to call me when my prescription came in. They didn't, and now I'm out!

Me: Corpopharm typically doesn't call everyone when they get a script faxed or called from a doctor. Did you ask them to call you?

Idiot: No, but they gave me a few tablets when I was out a few days earlier, so I assumed they would know!

Me: (sigh) What medication is it?

Idiot: My Synthroid. I'm all the way out and I have to take it at exactly 5 am. My pharmacy doesn't open until 10 am. Something needs to be done about this!

The whole conversation was pretty unnecessary, but I had decided to let the chick slip the noose around her neck on her own because it amuses me. The computer record stated her rx had been filled 7-30. Yestday was 8-1, meaning she had let it sit there for 2 days. Oh boy.

Me: It says in the computer that your script was filled 2 days ago. Its ready to pick up at your pharmacy. They open at 10 AM tomorow. You can pick it up then.

Idiot: I said I have to take it at 5 AM!

Me: I said that a few hours on one day won't make a difference. You waited until you were out of your medication and your pharmacy was closed to address this issue. Pick it up tomorow.

She was at my pharmacy an hour later, saying she had called her doctor and that she HAD to take her dose at 5 AM. I almost went in back, grabbed a hammer, and pounded on my balls for a few hours. It would have been as painful as talking to all those assholes, minus the stupid. Instead, I gave her a pill and sent her on her way. Hopefully she made it to her vehicle without jumping out into traffic.

----------------------------------------------------------------------------------

The next thing I saw was a cabby praying in the parking lot. It was sun down, and apparently this guy was Muslim. He got out of the cab, put his little rug down on the concrete facing Mecca, and started praying away. I understood completely, as I usually feel pretty spiritual whenever I'm at Corpopharm. Most of the other parking spots were currently in use by people at the bar next door, so I guess he was sort of balancing out all those sinners.

----------------------------------------------------------------------------------

Beautiful Booze Boon

Just so you know, Corpopharm is still open and the pills are flowing like amber waves o' grain. Although there's been plenty to write about (swine flu, the FDA wanting to take away Tylenol and Vic-O-Dans, the Obama Health Care Masacre), I haven't felt like writing about any of it. Sometimes, well, it just doesn't seem that funny (tear, sniff).

Of course my patients have been up to the same old antics. Just the other day a guy told me I gave him 50 Vicodin instead of 100. I have to admire that he really went for the gold on that one. Even my fellow health care professionals are going crazy. A fellow pharmacist stopped in the other night to tell me how much better things were going for him. He stated that he was getting some of his health problems under control and that he had a date lined up for Friday night after a long dry spell. Then, he proceeded to visit another 24 hour Corpopharm and tell the pharmacist there (who called me afterward) that he was planning to kill himself soon. So it goes.

This, however, is just Too Fucking Rich. On my way up to the front of the store last night for my daily dose of Diet Mountain Dew (one of my few vices, besides amputee porn and skinning hookers) I spied with my little eyes this monument to alcohol abuse in the photo above. Just another representation of Corpopharm's concern for your health and well being. The first thought in your brain bucket upon entering the apothecary should be Jager bombs and drinking until you black out. What? Do you know anyone using Jager for anything else?

An elderly couple enter Corpopharm. The woman is supporting herself with a walker. There are tennis balls attached the feet that are that perfect bright yellow-green in the July sun. It's morning sun, not that hot, angry afternoon sun that bakes the parking lot asphault and makes dogs want to bite. The man has on a straw hat with a little feather poking out of the hatband at a jaunty angle. They are here for their monthly medications, and that's all right.

Woman: My, my! It's certainly fixin' to be a cooker! 90 degrees by noon, mark my words!

Man: Yuh, I reckon you're right. Why, it's a good thing this pharmacy is open so early. I do declare that venturin' out into the heat for us old folks is a per-i-lous pursuit!

Woman: While we're here, don't let me forget to pick up... Saaaaayyyyy, is that a cooler full of that Jager-whats-it over yonder?

Man: Where? I don't... Ah! By gum, I think it is! Isn't that the concoction that all the kids are drinking these days?

Woman: Yes, it is! They drink it by the quart, then they go out on the town and get up to dickens! Why, I do believe junior had a headful of that stuff when he burned down the ol' McCibben place.

Man: Golly! It's even in the cooler already. What do you say, Maud, don't you think a cold snootful' would be powerful refreshin' on a hot day like this?

Woman: Oh, to be young again!

The old couple forgets all about the pharmacy and their medication. The leave Corpopharm with an ice cold bottle of Jagermeister and a little extra spring in their step. They never return.

Happy Independence Day, everyone. Remember what it's all about.

Silent, Salient Sanity Solution

Ever since I became a night pharmacist I’ve contended that there isn’t a better pharmacy job out there.  Sure, there may be jobs that are more fulfilling.  There may be jobs that would allow me to put more of my high powered education to use, to be the big-brained professional that the health care system needs.  Just not for me.  I wouldn’t trade all the engagement in the world for the freedom that my current job affords me, not only for my time spent at work but for the time I’m away from work.  Ask any other pharmacist when the next time is they’ll have 7 days off in a row and they’ll laugh in your face.  I get it every other week.

I’m definitely not trying to brag.  There’s a reason why night positions aren’t hard to get.  Most pharmacists don’t want them.  It boggles my mind, but there are a variety of reasons (that I suppose are sound enough for those who have them) more people don’t want the graveyard.  I’m getting away from my point, however.  The point here is that although I thought my job couldn’t get much better, tonight it has.

I’ve written before about the music that plays all day long at Corpopharm.  We’ve all experienced it before, the standard soft rock/pop that can be heard in any chain store across America.  Unoffensive, unassuming and most importantly, upbeat.  I imagine there’s some study out there that shows listening to the music in a Corpopharm makes people want to buy shitty merchandise, and I wouldn’t doubt it for a second.  It’s the type of fair that might make someone think, on an unconscious level, “Saaayyyyy, maybe I will buy one of those back scratchers.” Or “That 3XL tshirt is such a delightful shade of fuschia, I’d better pick up a few more.”  To some, spending 15 minutes in the ‘As Seen On TV’ aisle might seem like a sane thing to do when you’ve got ‘Lyin Eyes’ rolling in the background.  The only problem is that it makes me a bit edgy.  Here’s a few examples.

Manic Monday: Madonna

As soon as this song starts up, I get the urge to run at the first living thing I see and kill it.

Believe: Cher

In the tender words of David Cross, I’d rather hear the death rattle of my only child than listen to that piece of shit one more time.

What’s Love Got To Do With It: Tina Turner

Hearing this song makes me wish that Ike had been a little heavier with the hands.

Hearing the awful music at Corpopharm might not seem so bad to the casual visitor.  However, imagine the mild discomfort you experience after being subjected to that noise for 10 minutes, then imagine hearing it for 40 hours every week.  This mix doesn’t change, either.  It’s the same thing, every… single… day.  It’s a recipe for disaster, and I honestly can’t believe that more Corpopharm employees don’t go postal.

I asked the manager at the first Corpopharm I worked at if something could be done about the auditory assault that we were all encountering every day at work.  He calmly explained to me that the music, along with every other aspect of the store, was controlled at a Corporate level.  Nothing to be done, he said.  I accepted the answer because 1) why would he lie, and 2) I acted under the false assumption that everyone was as abused by the music as I was.  If the store manager was undergoing the same mental molestation I was, why wouldn’t he want to do something about it?

The old saying, all good things to those who wait, is bullshit.  After a careful inspection of the office at my store, I found this.  I can’t believe I didn’t see it before. 

On this simple little box was the knob of my dreams, the knob of my destiny.  Once I saw it, I felt such simple and clear content that I smiled and said, ‘Ah!  Yes.’  The knob that’s marked ‘Aux’ is the very knob that controls the volume of the ‘music’ that has been torturing my psyche all this time.  After feeling the rough, cool plastic serrations on the side, I knew it was real.  I smiled again, closed my eyes, and turned it all the way to the left.

Immediately, the Corpopharm soundtrack was gone.  Absolutely, perfectly, irrefutably gone.  It may have never been there.  In it’s place, I could hear the angels singing.

Monday Morning Mania

Okay, so not much, but this morning Don'tworryaboutit walked into the house at 7:30 and stated,

Jesus, what an awful day for a hangover.

Happy Easter.

Lonely Island Laugh Riot

If you haven't seen it yet, you need to:

It's a little sad that so many people are trapped in Cubeland that something like this is so horribly relevant.  One of these days, if a coworker of yours goes rambling around the office with a shotgun (not to mention the best of intentions), I wouldn't take the time to act surprised.  You can either hit the deck or pick up a weapon and join them.  Ah, freedom.

Scary Surgical Scandal

I'm very, very tired right now.  I'm sure I'll be asleep as soon as my head hits the pillow, but I had to get this on record first.  The quality of this stupid is quite staggering.

The career of pharmacy exposes the pharmacist to such a constant barrage of idiocy that I fear we begin to get desensitized.  I know that I don't write about many of the types of things I used to simply because I'm so used to them.  It's a sad day when all the stupid starts to seem normal, but it's the plain truth.

The phone rang at about 2 AM.  That's usually when I'm sitting down to lunch, and last night was no exception.  The woman on the line stated that needed a recommendation on pain medication.

Woman: I just had surgery and am experiencing some pain.  Ummm, can you tell me what I can take?

Me: Your doctor didn't send you home with a prescription for pain medication?

Woman: I'm not at home, I'm in the hospital.

Me: Sorry?

Admittedly, I was a bit nonplussed.  In fact, I was quite sure I was completely misunderstanding the entire situation.

Me: I'm sorry, I think I misunderstood.  Did you say you're still in the hospital?

Woman: Yes, I'm still here but I'm in pain.  I need to know what medication I can take.

I was completely speechless.  I've been at a loss for words at work before, but this time it was as though I'd been lobotomized.  I just sat there like an idiot until she started talking again, at which point I managed to formulate some questions.

Me: So you're still at the hospital?

Woman: Yes.

Me: You're admitted?  You're not sitting in a waiting room or something?

Woman: Yes.

Me: (long pause) So, why aren't you asking your nurse or a doctor about this?

Woman: Well, I'm allergic to some pain medications, and I just need to know what to ask for.

Me: Are your doctors aware of your medication allergies?

Woman: Yes.

Me: Ma'am, if you're admitted to the care of a hospital staff, they are the ones in charge of your medication therapy.  They decide what is appropriate for you to take.  I am not part of that team, and I can't make recommendations on a situation to which I am uninformed.

Woman: Well, what pain medications has my husband gotten lately?  Can I take those?

Just picture this situation.  This woman went to a hospital, had surgery, and then started making calls to Corpopharm in the middle of the night while she was still in the hospital trying to get me to tell her what pain medication she needed.  I would put that on par with the last time I saw a dog eat it's own vomit, with a few extra points to the dog for trying to recycle.

Me: Ma'am, you can't take your husbands medications, or anything that has been prescribed to someone else for that matter.

Woman: Well, I just don't know what to do.

I guess it must be a bitch to have to decide what medication you're going to take on a whim.  I mean, it's not like she was in a place surrounded by health care professionals that could make immediate interventions armed with with complete knowledge of her current medical situation.  Why not call the night pharmacist down the street who's totally ignorant of her recent surgery and any other medical interventions?

I think I'll go visit her today and bring a handful of the biggest, most colorful pills in the pharmacy that I can find.  I'm going to make her promise not to tell her doctors, though, because they clearly don't know what they're doing.  I'm done.

Haitian Hashish How-To

A quick note on Dominicans and Haitians: if you stroll along their beaches and have numerous visible tattoos, they think you love drugs.  Love them.

Here's the deal.  The Domincan Republic is pretty poor compared to American standards.  If what I'm told is correct, Haiti is even worse.  These people will naturally take any opportunity to make a buck, and American tourists look like big, fat, white piggy banks to them.  Unless it's day 2 of the vacation, in which case they look like a red piggy banks.

So, when you're down there on your expensive all inclusive vacation, they take the opportunity to squeeze even more green out of you.  The most common form of this is solicitors that hang out on the beach and try to get you to sign up for parasailing, boating excursions and in my case, illicit drugs.

So, if you're down in the Dominican and looking to score, here's a few tips:

1.  See the guys carying around the folders with parasailing/banana boat/snorkeling trip information?  They sell drugs.  All of them.  Even if you don't see them, they see you, and will be harassing you every hour you're on the beach.  Just listen for the guy yelling, "Looky looky!  Cheapy Cheapy!"

2.  Don't speak in code.  Most of these guys don't know English very well, and if you ask them for an ounce of their stickiest kind you may get something you're not bargaining for.  Weed is weed and cocaine is cocaine, you old degenerate.

3.  When negotiating price, pay no more than $75 USD for 7 grams of weed or 1 gram of coke.  Just because these guys live in huts doesn't mean you can come right out and lowball them.  Have some respect, white boy!

4.  Even better than buying from a beach vendor is buying from hotel staff.  Hotel staff need to protect their reputation, not to mention their turf.  Buying from the hotel staff will ensure you not only get quality swag, but protection from police should you be caught in the act.  As one staff member of a neighboring resort informed me, the local police could be bought for as little as $2 USD, or maybe $5 if he was having a bad day.  Not bad, gringo!

5.  Hablas Espanol!  Even if you're not fluent, a few Spanish phrases will help break the ice with your new amigo and show him you mean business.  Just don't get carried away and accidentally tell him he's got a funny face, or he'll slit your throat and drag you into the surf. Que lastima!

6.  Make sure you get all your partying done before you head back to the airport.  Those drug dogs are only sleepy if they don't smell that half ounce you decided to save.  Down boy.

There you have it.  Just because you have to pass a customs inspection doesn't mean your tropical vacation has to be lame (sober).

Please Read Carefully

I know nobody ever reads this, but there are times when I wish I could shove my prerogative up the ass of every man, woman, and Donkey in America.  This is one of those times.

To every nurse, doctor, and receptionist in clinics and hospitals across America: stop telling your patients how much their prescription will cost.  Stop immediately.  The second you open your mouth to say, "That's a four dollar prescription.  It will cost four dollars." you become a complete moron.  It doesn't matter how smart you were before you made that erroneous statement.  The second that oral diarrhea exits your orifice, you immediately transgress to the equivalent of a trisomy 21.  You're a monkey throwing feces, you're a post op lobotomy patient.  You're a dark ages trepanning victim, minus the spiritual enlightenment.  

I'm stating the obvious here, but all of these supposedly bright people don't seem to understand that they have no idea what will happen when their patient wanders into an apothecary to fill their script.  None.  How could they?  Unless they've got a crystal ball that shows them my workstation screen, they're making a blind assumption about something that they are woefully ignorant about.  It would be like me telling a patient at the pharmacy that a prostate exam will cost him $50 at Dr. X's office and that includes a happy (!) ending.  

Here's the bottom line.  You can't know what a prescription will cost until you take it to a pharmacy, enter it into the computer, and wait for the computer to spit out a price.  Period.  Cash prices are always changing,  insurance formularies are always changing, and trying to predict either of which is like trying to predict Gary Busey after an eight ball.  You just can't do it.

Then again, I'm the guy that made a lady cry this morning right before I left work.  It's a wonderful world.

Delinquent Drug Deniziens

Being a night pharmacist means you get to take care of a lot of custodial duties that the day staff may not have time for (or just don’t do because they’re lazy pigs).  Grunt work, in other words.  Some pharmacists feel above doing this kind of work (I don’t know why) and choose not to do it.  For the most part, I like it.  I’ll file scripts and count CIIs all night before I would work days again.  Most patients that come to me think that I have an undesirable job, or got demoted, or just drew the short straw.  Instead of telling them that I’d rather masturbate with sandpaper than interact with 99% of the public, I just fill their prescription.

One of the duties of the night pharmacist is returning unclaimed prescriptions to the shelves.  This is known as return to stock.  Every night around 1 AM the system prints off a list of filled prescriptions that have been waiting to be picked up for 2 weeks.  If you have not come to pick up your prescription for 14 days since it was filled, it is taken out of the waiting bin and returned to the shelf.  This means you have wasted a lot of the pharmacy’s time and should be shot.

Here’s the actual list of last nights return to stock.

Apri

This is birth control.  You know, that pill that keeps you from shitting out more hungry mouths.  If you’re a Medicaid patient, I don’t return this to stock.  I drive to your house and shove it down your throat so you don’t procreate.  Hey, I think that’s what Jesus would do.

Travatan Z

Glaucoma medication.  Do you like being able to see?  The next time you call me and harass me about not being able to read the pharmacy label, I’m going to make fun of you for not getting your eye drops, Gramma.

Humalog

Insulin!  This is for diabetes.  When your toes start falling off and you go blind, you may remember that insulin prevents your blood sugar from skyrocketing.  Guess in the mean time you’ll have to lay off the Twinkies, fatty

Blood Glucose Test strips

Allows you to see what your blood sugar level is.  Very handy for diabetics.  The same asshole that didn’t pick up their insulin also didn’t pick up their test strips.  Go figure.  I guess if you don’t know when your blood sugar is too high, then you don’t need insulin.  Right?  WRONG.

Cartia

Blood pressure medication.  You must like being a candidate for heart disease.  When your doctor asks you why your blood pressure is so high, just explain to them that you’re a worthless delinquent.  They will understand.

Cymbalta

Crazy pills.  You know, the ones that keep you from screamin’. 

Metformin

More diabetes medication.  See all the fat people walking around?

Fluconazole

For yeast infections (AKA nasty vag).  One time, a lady told me that she wouldn’t take fluconazole because she read it could damage your liver.  You only have one liver, she explained to me, and she didn’t feel it was worth the risk.  I almost asked her if she had more than one vagina.  I didn’t want a sexual harassment suit on my hands that badly.

Biaxin XL (name brand)

Antibiotic, used to treat your runny nose and bitchy demeanor.  This medication has a generic available.  This means that we had to special order this for the ungrateful asshole that decided to not even pick it up.  Moreover, it was a REFILL.  Antibiotics should NEVER have refills.  Allowing a layperson to decide if their cold requires an antibiotic is like allowing a hop-head free access to the narcotics safe.  BAD IDEA.  When our antibiotics no longer work because you’ve been overusing them, I’m going to come burn your house down.

Propecia

Prevents hair loss.  Guess you’re not getting laid tonight.

Viagra

We all know what this does.  Insert (ha!) your own joke here, there are a million shitty ones out there for this one.

Fluocinonide/coal tar compound

This one may be the worst offense.  Most medications at the pharmacy come made by the manufacturer.  A few (like this one) we have to mix up using eye of newt, hell’s bane, and a big black cauldron.  You also have to cackle really loud while you stir it or it doesn’t work.

In all seriousness, the pharmacist has to make this kind of medication from raw components, and it takes some time and effort.  They always tell people it takes 24 hours for a refill, so yours truly always makes the compounds overnight.  When I put in the time and effort to make this for you and you don’t come to get it, it pisses me off.  Although, I guess it does keep me from staring longingly at the booze aisle.

A side note on coal tar.  This stuff is the most foul smelling substance in the pharmacy, and there are some nasty ones.  Have you ever smelled fresh asphalt?  That’s what coal tar smells like.  One of the more common things it’s used in is dandruff shampoos like T/gel.  The shit is used topically, which I cannot imagine.  Smelling it while I’m working with it makes me want to run to the shower and scrub myself like a rape victim.  Gross.

----------------------------------------------------------------------------------------------------

Last night of work for a week.  I'll be heading to Chicago for the weekend for a symposium being held by Dr. Warner on ethanol kinetics.  All reports indicate that it will be educational.

Don't Mess With Corpopharm

Every day, people walk into pharmacies across America and try to fill fake prescriptions.  What's a fake prescription?  It's a medication order that was written in the name of a physician by someone who is not that physician.  They're almost never a physician at all.  I'm sure you're asking yourself, 'Spiffy, why would someone do this?'  99 times out of 100, it's because they want a controlled substance (usually alprazolam or hydrocodone) and can't get a doctor to write them a prescription.  IE, a junkie trying to get their fix.  This is one of their stories.

As soon as I reported for duty last night my partner informed me that some fake scripts had been called in during the day. I asked him if he’d confirmed them with the doctor, and he said he had. I was a bit surprised. It’s pretty tough to get ahold of a doctor on any day, and most of them don’t work weekends. This particular doctor was at an urgent care facility that never closes. Rule number one for trying to call in fake scripts to the pharmacy: don’t imitate a doctor that I can contact with one phone call.

The doctor indeed verified that he had not called in the prescriptions, and no one at the facility had written them. This means that someone else entirely had called the scripts in to the pharmacy under the guise of being a physician. This is very illegal, and one of the best ways to piss off 1) the doctor and 2) the pharmacist. It’s illegal, it’s fraudulent, and it’s a HUGE waste of time for everyone involved. Plus, pharmacists hate junkies. Well, this pharmacist does.

The doctor agreed to help prosecute if we had the people arrested. As one of my technicians (Friendly) put it,

Friendly: Awww, Spiffy, it is ON!

If you want to make an arrest at the pharmacy for this sort of offense, here’s how it works. The alleged criminal usually calls in to the pharmacy before they come to pick up their fake scripts to make sure they are ready.  This is a pretty stupid mistake, because it prepares the pharmacy for their arrival. Once they call us, we call the to cops to let them know we would be needing their services within the next hour or so. Once the perpetrators arrive, the technician running the register stalls them out while another technician calls the police. The cops arrive, arrest the druggies, and the world is safe.

Last night worked out even more beautifully than we could have hoped. About a half hour before our fakers got the pharmacy, one of the front store employees witnessed a robbery and called the cops. A unit came down, and the officer was in back watching the security tape when the fakers arrived. That’s how dumb they were. There was a police cruiser in the parking lot, and they came inside anyway.

I actually happened to be the one to greet them at the register as my two techs were busy with people dropping off new prescriptions. I have to say, I wasn’t impressed. It was two older people of about 60 (I say older because they both looked about 80), both regular patients at the pharmacy. The guy even had an oxygen mask on. Picture that. Real hardcore criminals, these two. Just, uh, don’t forget to bring a spare oxygen tank on those extra long crime sprees. Christ.

I was pretty surprised because the guy had a bunch of scripts that were actually legitimate to pick up that we’d been working on the last few days. I pretended to go look for the scripts and winked at Friendly. These two criminal masterminds had picked about the worst time to show up. Friendly walked 50 feet to the back room where the policeman was watching our security tapes. It certainly was ON.

The actual arrest was pretty uneventful. The look on the couples face was fucking priceless, though. When the cops took them out of the pharmacy, it as about the saddest arrest in the history of arrests, I’m sure. The officers didn’t even bother to cuff them becase it was obvious they weren’t going to make a break for it. The old guy on his oxygen supply probably couldn’t break 2 MPH without wheezing and the old lady looked like she’d break a hip if she tried to juke left to avoid a tackle.

To me, the funniest part about the whole thing was that only one of them needed to come in to pick up the scripts. They had been called in in the old lady’s name, but that doesn’t mean that she had to be the one to pick them up. It did mean that she was already involved in the crime, so she should have been the obvious choice. Instead of just one going downtown they both got to spend the night in the clink. As far as I know, they’re still there. That’s rule number two. When attempting to fill fake prescriptions, bring as few accomplices as possible. Fewer people will get pinched that way.

Now, rule number three. As I stated above, the old lady was involved implicitly because they used her real name when calling in the scripts. It’s pretty tough to convince the district attorney that you weren’t involved when the scripts are in your name, Einstein.

Rule number four may be the most important. If you’re going to fill fake scripts, be sure to pay out of pocket for them instead of having them run through your insurance. Billing your insurance company for fraudulent prescriptions is, uh, fraud. Do you know anybody with larger litigation resources than insurance companies? I don’t. For whatever charges the doctor’s lawyer doesn’t level against you, the insurance company’s lawyers will. After they’re both through with you, the DEA gets a crack at you as well. You’re basically setting yourself up for a vicious gang rape by a gaggle of lawyers with no lube (not to mention no prayer).

So, there you have it. A perfect guide of what not to do when trying to illegally fill prescriptions. I wouldn’t recommend it, though. All the people that do try it are very stupid simply by virtue of the fact that they are attempting it (considering the legal ramifications involved). Stupid people are prone to make mistakes, especially concerning things they don’t know shit about. Like writing prescriptions. Feel free to give it a shot, but you’ll get caught. Just remember to lube up first.

Hot Pharmacy Phone Action

Case 1:

The phone rings.  The gentleman on the other end explains that he just picked up his prescription for zol-pi-dem  (generic for Ambien).

Gentleman: This pill looks different from the last time I got it.  Did I get the right medication?

Me: Yes, we just changed what brand we carry.  Generic medications are available from lots of manufacterers, and Corpopharm changes which ones they carry from time to time.  That's what the new one looks like.  

Gentleman: Oh.  Well, the new one looks an awful lot like the atenolol I already take.  Can you get the old one back in stock?

Me: We try to only carry one manufacterer of a medication at a time. It reduces medication errors, confusion, and inventory issues.

Gentleman:  Well, how am I supposed to tell these two pills apart?!?

He sounded a bit indignant.  And ignorant, now that I think about it.  Anyone who's gotten a script filled before knows that when you get a medicication, you get it in a bottle with a typewritten label on it.  This label has lots of helpful information, up to and including the name of the drug that's in the bottle.

Me: Are you having a hard time reading the label on the bottle?

Guy: No.

I let that sink in for a few seconds.

Me: So what's the problem?

Guy: Well, they just look so similar that I can't tell them apart.

Me: You can't tell them apart after you take them out of the bottle?

Guy: Right!

Me: (pause) What about before you take them out of the bottle?

Guy: (pause) I can read.

Me: Then perhaps you should do so.

Case 2:

Next phone call.  The very next one.

Do you ever get on the phone with an unfamiliar person and just know that the conversation is going to go nowhere?

Guy: Hey umm I uh need this medication (mumble mumble incoherent mumble trailing off into nothing).

Me: I need you to speak up.  I'm having a very difficult time understanding you.

Guy: Yeah um uhhhhh Risperdal uh uhhhhhhhh...

Me: Sir, what's your name?

Guy: James Jakj;a$%!@...

Me: (searching computer) I can't find you in the computer.  Do you get your medication at this pharmacy?  We're the Corpopharm at (location).

Guy: I get my medication at the pharmacy, the pharmacy, ahhh....

Me: (sigh) Touché.

We repeated the above conversation a few times before I asked him to find his prescription bottle.  All the medications he was asking me about were antipsychotics.  He either hadn't been taking them, or was very drunk. Or high.  Or, some happy-go-lucky combination of the three.  I didn't want to deny him the opportunity mental health just because he was having some communication problems.  The mentally ill are one of the very few populations that I am exceedingly patient with.  As long as they don't piss me off.

After sitting on hold for five minutes (literally) he got back on the phone and stated that he's found a 'subscription bottle'.  I told him where the Rx number was located and told him to read it to me.  He read me a 4 digit number, not the amount of digits in a Corpopharm Rx number.  

At this point, we'd been on the phone for about ten minutes.  I can be patient, but most Corpopharm patients are not.  While he had me on hold looking for the bottle, I heard some muffled conversation.  Although I was glad this guy was trying to help himself, I didn't have all night for him to do it. I decided that it may be a good idea to try and get some information from who he'd been talking to.

Me: Sir, I is there anyone else there I can speak to?  I want to help you, but I just can't understand what you need.

Guy: My girl is here she's sleepin'...

Me: Put her on the phone.  It won't take long, I promise.

I hear him waking up his girl and soon enough a groggy female voice comes on the line.

Me: Do you know this man?

Girl: Yeah watchoo want?

Me: I think he needs some medication, but I can't understand him.  Do you know where he gets his prescriptions?

Girl: He goes to Corpopharm 2.

Corpopharm 2... not my pharmacy chain.  This little revelation came 12 minutes into the call.

Me: OK, this is Corpopharm 1.  Do you see his pill bottles there?

Girl: Yeah.

Me: OK, the number to his pharmacy is on the bottle.  He needs to call them if he needs more medication.  Can

you help him?

Girl: It's the middle of the damn night, and I'm tired.

Now that pissed me off.  Her boyfriend had tried for 10 minutes to get his refill himself, and this chick wasn't willing to call some numbers into another pharmacy that would take all of 10 seconds.  I don't know why I cared.  I guess I've got a soft spot for crazy people.  Whatever the reason, I decided the only way that my new crazy friend was going to get un-crazy was if his lazy girlfriend got off her ass.  It was time to pass the buck.

Me: I know, but your boyfriend is sick.  If he doesn't get his medication, he's going to be very sick.  He just had me on the phone for ten minutes and couldn't even give me his name.  He really needs his medication to be able to take care of himself.  Otherwise, you're going to have to take care of him like this all the time.  I don't know how long it's been since he took his last dose, but he's not well.  

Girl: Fine, I call'em.