Late Night Litany

The phone rings. I check the time. It's ten minutes until my relief arrives. I say a little prayer (only in foxholes) and pick up the receiver.

Me: Corpopharm, this is Spiffy.
Manic: Hey Spiffy, it's Jamie!

She paused for a minute. My mind started searching for any Jamie that I knew until I realized that this was one of those people who expected me to know them solely by their first name.

Me: What can I do for you?
Manic: Oh, hey babe! I just need some refills. I live down here in (town) but get all my medications there. These small town pharmacies, full of nosy people. I don't care what they think, you know? I really think...
Me: Ma'am, what's your last name?
Manic: Oh, gosh hon! I just need my normal refills. Last time it was like $120, now how do those things get so gosh darn expensive? I tell you what...

I could imagine her wildly gesticulating on the other end of the line, probably holding a cigarette and leaving tendrils of smoke in deranged patterns in the air. She would also be drinking coffee. At the rate she was speaking, she could have been banging down a few rails as well. At 6:45 am, most people aren't that stimulated. It took me a few minutes to get the information from her that I needed to refill her medication. By the time I did, she was so wound up again that she took off.

Manic: Say, sweetie, are you taking any vitamin D? You know that you people that work nights don't get enough sun right? Do they teach you kids that in pharmacy school these days? I'm real into vitamins and herbal supplements. I think we should take a more holistic approach to medication, sort of a east-meets-west mentality, you know? I think...
Spiffy: Ma'am? I have another phone call coming in.
Manic: Oh, jeez! Listen to me. Have a good holiday hon!

__________________________________

The work force crisis continues at Corpopharm. For the last week and a half, I've been working overnight at a Corpopharm that just lost one of their night people. The conversation with TheBoss went something like this:

TheBoss: Spiffy, we need some coverage over night at the 72nd store for 2 weeks. Can you help us?
Spiffy: I'm not comfortable being away from my pharmacy for that long. Who else can you get?
TheBoss: There's no one else.
Spiffy: Well, that sounds about right.

You can all feel comfortable knowing that one of the largest, most wealthy corporations in the United States has such poor staffing policy that they wait until 1 week before the shit hits the fan to find a solution. You don't need your medication anyway, right?

Working overnight does have it's benefits.

1. The drunks. If you see a drunk during the daytime, it's a little depressing because they've probably got a drinking problem. If you see them at night, well, it's a party!

2. Workload: nonexistent. I've watched a few movies. Usually at least one every night.

3. Reduced stress level. This is directly related to workload.

4. Doctors, insurance companies, and most other pharmacies are closed. Want me to call your doctor for a refill? Tough shit, do it yourself.

5. The crazies. It's true that they come out at night. Whether it's street corner gospel or paranoid delusional, you can be sure you'll be entertained.

6. The music. Corpopharm plays the same loop of shitty music day in, day out. With no people to talk to, I just listen to my ipod all night.

Bar Triathalon

So here's what you do:

1. 1 shot Jägermeister
2. 1 Irish Car Bomb
3. 1 Pint Miller Lite

You and your dumbest friends each receive the above list. You all start drinking at the same time in the above mentioned order. The last person to finish the series buys the round. Just think of it as a get retarded-o-thon.

This event is known as the Bar Triathlon. It is not for the faint at heart.

This weekend myself, Don'tworryaboutit and Dr. Warner tackled the Bar Triathlon with gusto. It might not have been so bad if we hadn't just been to a 4 beer happy hour and it was only about 7:30 PM. Needless to say, by midnight the memories began to grow dim.

Amnesia aside, I have to say I found the Bar Triathlon very enjoyable. I was able to show off my chugging prowess while getting 3 free drinks. That's a win-win in my book. If anyone out there ever wants to challenge me, feel free. Just know this: you will lose.

Sexy Offender

So the posts have dried up lately. Working at Corpopharm for 60 hours per week saps my creative energy and makes it hard to see the humor in it. My district has gone to shit lately (again) do to my fellow pharmacists getting fired or quitting. That much fun can make you numb.

One thing from tonight definitely broke the monotony for a few minutes. About a half hour before close some guy brought in a new script for his poison ivy. Poison ivy is a gold mine for pharmacies during the summer. I live in the middle of the city, but people still manage to find it.

As I was entering his Rx into the computer, he started a conversation with me that went a little something like this. Background: English is his second language, and he doesn't yet have a full grasp of it.

Guy: So, have you heard about the sexy offender in neighborhood?
Me: (pause) What?
Guy: Yes! There is man in neighborhood that out late at night and he take out his...
Me (interupting): Oh!! You mean a sex offender.
Guy: There difference?
Me: YES! Yes, there is a very big difference. Just make sure you say sex offender from now on, not sexy offender. OK?
Guy: I still learning (laughs).

I'm hoping that he was able to take something away from our conversation.

Fortune

I ordered some Chinese for dinner at work last night. Awesome. Some good Chinese can make the stinking 'I don't believe in grooming' patient you just had to deal with seem like last year. Plus it covers up any lingering smell. Everybody wins!

After I finished eating I fished the fortune cookie out of the condiments-forks-fortune cookie bag. It contained probably the most accurate fortune in the history of the world:

'Rarely do great beauty and virtue dwell together as they do in you.'

I know just how it happened at the fortune cookie factory in China...

Many men are sitting at a long table. The factory is dark and murky save for the overly bright spot lamps that hang over the work space. The lights all emit much heat, the workers are covered in sweat and grime. They have all been at work many hours.

Every worker has a large roll of paper. Each roll is covered in identical fortunes. The workers hurriedly cut fortunes from the rolls and stuff them into cookies. A foreman surveys the workers, shrewdly eying the mob for thievery. Suddenly, he stops and points one of them out. He screams urgently:

"Halt!"

3 ninjas fly from dark corners of the factory. They set upon the worker just as he's stuffing a cookie with a fortune like all the rest. One of the ninjas holds a tanto dagger to his throat. He freezes with the fortune cookie in his hands.

The foreman approaches the terrified worker. He bends down to be at eye level says,

"This fortune cookie going to great man. Great man require... great fortune."

YouTube: A Paragon of Drug Information

The phone rang. I expect the worst every time the phone rings. Sassy answered the call and spoke for a seconds.

Sassy: Spiffy, this lady on the phone says that she wants to know of something else her kid can take for allergies. She says he's taking Singulair and that she's afraid it will make him want to kill himself.

You may have heard in the news lately that the FDA is initiating studies investigating Singulair and suicide risk in children. I got on the phone.

Mom: Yeah, I want to know if there's anything else that my kid can take for his allergies.

Having just got on the phone, I played dumb.

Me: Anything else? Other than what?
Mom: Right now he's taking Singulair.
Me: Is he having any problems with it?
Mom: No.
Me: So why do you want to switch?
Mom: I heard something about kids taking it and then comiting suicide.
Me: Where did you hear that?
Mom: Ummm... I saw something about it on Youtube.

I thought back to my first semester of pharmacy school. I was attempting to search Pubmed for some primary literature when an instructor saw me and gave me a little talk. 'Spiffy, Spiffy' she said. 'Why waste time searching for unbiased, randomized, controlled trials when you can just use Youtube?' she asked. 'Why, just type in your keywords and you'll have hundreds of thousands of videos to choose from. Look, kitties!'

I'm sure you can find drug information on Youtube. Do you know what else you can find? Dramatic Prairie Dog Vs. Machine Gun Cat. You can also watch people getting hit in genitals. How informative.

This is the problem with the general public. They read the newspaper or watch the news and suddenly think they can make informed decisions about their medications, not to mention a myriad of other subjects they don't know shit about. The same thing happened a few months ago when the Enhance trial showed that taking Zetia in combination with Zocor didn't decrease a certain cardiovascular health risk. Another phone call:

Old guy: I just saw on the TV that Zetia is banned!!!
Me: Uh, nope. It's still here.
Old guy: No it isn't! The TV says it's illegal now!
Me: I have a bottle in my hand. I'm a pharmacist. Don't you think I would know about this?

Please, please, please don't make decisions about your health care based on the evening news.

Wrong

I get told I'm wrong or that I've made a horrible mistake almost every day. That is not an exaggeration.

I overheard the argument start at my drive through today between one of my technicians and a pharmacy patron. After a while, Sassy invited the man to speak with the PIC (pharmacist in charge). From listening in, I got the picture that they didn't share the same world view.

Sassy: Spiffy, this guy says that he came by on Saturday after the pharmacy closed and that they were supposed to be holding his Rx at the front of the store.
Me: Oh dear.

I took the phone from her (at our drive through, there is no opening in the window and you have to communicate through handsets). The patron told me the same thing that Sassy just told me.

Me: I think there was a communication error. Once the pharmacy closes and the pharmacist leaves, no medications can be dispensed. That's the law. We never keep scripts anywhere but the pharmacy.
Patron: You're wrong.

I have to admire him, he cut right through the bullshit and told me exactly what he thought. This didn't make him any less crazy in my book. I had absolutely nothing to say for a few seconds.

Me: Uhhh... Like I said, we don't keep any scripts up front. I don't know who told you that, but we've never done that and never will.
Patron: You're wrong. I went up there and asked them for my script on Saturday, and the girl up there checked through a whole pile of 'em that were sitting there waiting to be picked up!

This guy was taking it ever further now, suggesting that not only his script had been taken from the pharmacy after closing, but many other scripts had also left the pharmacy. I performed a cursory visual examination of his car, looking for empty liquor bottles, crack pipes, anything that would explain his hallucination. There was nothing. The thing he was suggesting was ludicrous. Pharmacy law strictly states that no medication may be dispensed when the pharmacist is not present. Any pharmacist allowing such a thing would lose their license faster than Brittany Spears' credibility.

Me: I don't know what to tell you.
Patron: Do I need to talk to the Bob about this?

Bob is the front store manager of the corpopharm where I work. He has about as much jurisdiction over the pharmacy as the Pope does over Yankee Stadium. This guy apparently knows him. Some of the regulars at my corpopharm think that since they know Bob that their treatment in the pharmacy will somehow be upgraded. I have no idea why. I love it when people threaten me with talking to manager. One reason is the manager is not even my boss. The other is that no one governs the action of a pharmacist other than the state board of pharmacy and laws created thereby. God himself can come down from heaven and tell me to fill a script, but that doesn't mean it will happen.

Me: You're more than welcome to talk to Bob, but he's going to tell you the same thing I just did.

The guy just threw his hand up and drove away. Another satisfied customer. I think I deserve a raise.

Grandma's Strep Throat Prevention Happy Fun Time

A grandma approached me at work the other day. One of her grandchildren had strep throat. She was 5000 percent sure the other grandchild was going to get it and came to me for a recommendation.

Grandma: Hey! Hey! My gran-baby has strep and I can't have the other gettin' it. I can give 'em some Tylenol and that'll keep 'em from gettin' it, right?
Me: No, ma'am, Tylenol will not stop your grandchild from getting strep throat. Also, just because one of them has it doesn't mean the other will get it. The Tylenol will help for the throat soreness, though.

She said nothing for a few seconds. Her eyes narrowed skeptically.

Grandma: So, Tylenol, right?
Me: No, ma'am. There is nothing made to prevent strep throat. Just make sure the sick child isn't getting in direct contact with the other child, keep them from getting mucus on each other...
Grandma (cutting me off): Well, I got the kids this weekend and if I take 'em back to Mom sick she's goan' be all pissed at me. What am I supposed to do?

It's at this point of the conversation with brick walls like Grandma that you have to make a judgment call. You tell them what they want to hear, or repeat your last statement and walk away. I'm willing to let most people talk themselves into anything. When a minor's health who is under the supervision of a guardian is at risk, I usually try harder.

Me: Listen: if your sick grandchild has strep, she needs antibiotics. Go the the doctor and get an Rx. If your other grandchild is not yet sick, keep them apart as much as possible and you should be fine. Excuse me, I have a call from a doctor I need to take.

Using the old doctor call excuse is a great way to get out of conversations. She wandered away. About 10 minutes later I saw her in the child care section looking at the liquid Tylenol products.