Pharmacy Hat Trick

I don't know if there is an official "Hat Trick" for pharmacy, but I think tonight would be pretty close to a dictionary or Wikipedia entry. In one hour, and consequently, the last hour of my shift, I experienced a Twilight Zone episode. I checked the lunar cycle for answers, but alas, it mocked me. I've written about the off-lunar cycles in the past, and this experience is only adding to my ever-growing pile of data. I intend to fully disprove the "full moon brings out the crazies" notion.

Chapter One
"Excuse me," she started. "Do you have a copy of last week's ad?" she rudely and interruptively queried. "I want to see what I missed," she went on to postulate.
(As I write this, I'm listening to "No Shelter" by Rage Against the Machine. I think you know why.)
"They must have one up front," she rattled on. "I'll go see what going on up there," she yammered.
Now, needless to say, I'm not sure what she was angling at, but it was pure evil. I couldn't get a word in edge-wise and just let her go.
(The song just changed to "Bullet In the Head," also by Rage; how appropriate.)

Chapter Two
"What do you think?" asked the scary woman whom appeared out of absolutely nowhere. I craned my neck quickly out of shock and fright. She was holding what looked like a retainer with one tooth dangling from it. "Which of these is better?" she wondered aloud while still holding the contraption that was just in her mouth a couple of seconds ago. She was pertaining to the dental repair kits she had wrangled. "I don't know," I replied. "They both seem to have the same basic constituents," was my final answer. (People of the Sun now playing - this is scary) She took the cheaper one and put that thing back in her mouth and was on her way. She was nice enough to leave the more expensive dental repair kit on my counter for us to re-shop, thought. Thanks, toothy.

Chapter Three
At last, a phone call. Take me away from the madness, please. Wait, the phone. Shit. The phone has fucked me repeatedly for my entire career. It did not disappoint tonight:

Caller: "Can I start, well, that is, if I'm on ciplox, ciprox, ciplofloracin, cipr-"
Me: "Ciprofloxacin?" I interrupted, putting her out of her misery.
Caller: "Yeah, that's the one," she stated. Long pause........"HELLO?!?"
Me: "I'm still with ya, just waiting for your question"
Caller: "Oh, yeah, well I might have an infection and well I just got um.....ahhhh...Zypr....Zyprella....Zyp-
Me: "Zyprexa?"
Caller: Yeah. That's it. Can I start, er, well, restart, well I was on it but then I stopped and then the doctor gave it to me and I need to well can I take it with the Ciprofunacin?
Me: There are no interactions between the two, to the best of my knowledge and resources available to me.
Caller: Well, I was readin' and I saw it can cause infections or sumtin and I don't wanna die.

This was the gist of about 15 minutes and a call back with a belligerent not-so-significant other in the background.

I wonder why it takes "15 minutes" for a waiting prescription?

He shoots, He scores. A natural hat-trick.

Did you really just ask that?

Upon being witness to the pharmacy's goings-on, she was intrigued. Her mind was formulating a money saving scenario, of which, this generation has never seen. In the meantime, a busy technician rang out the veritable endless train of cars utilizing the drive-through.

The young lady noticed something.

Something of monument.

Her interpretation of what was transpiring couldn't be more accurate.

Finally, upon being rung out herself, she had to ask.

"So, if you go through the drive-through thingy, like, you don't have to pay? It's free?"



The technician looked at me, with a smile running away from her face. She looked to me, the Pharmacist, to take this one. I did what any mature, competent, and compassionate professional would do. I asked a question in return.

"Are you serious right now?"

I didn't hear the rest of the conversation, as Earth beckoned me. This exchange did, however, give me hope. If the drive-through was paying for itself, then maybe, just maybe, my phone would answer itself.

It just keeps ringing. Shit.

Cutting out the middle man?

Doctors don't like patients and patients don't like anybody. Patients think they know what's best and doctors are sure they know what's best. When it comes to prescriptions, both are completely in the dark. I have had some doozy conversations during my career, but this "on-call" "doctor" took the cake.

Long story short: Trying to clarify the old "use as directed" for Coumadin 5 mg, #60. Called the office twice during the day to no avail. They can't pull this off. It's not in the chart, written on the wall, on crib sheets in the doctor's pocket, in the bloodwork history, on the roof or anywhere. Nobody at the office can tell me this guy's dose. Meanwhile, if I try to be the "good guy," I will have not 1, but 2 insurances (medicaid secondary) fucking me in audits in years to come. What's a boy to do? I know. I'll page the "doctor on call."

Let's just say I've had better ideas. These better ideas include:

• reading a pamphlet in high school about the rewards of a pharmacy career
• riding a bike while utterly intoxicated
• punching myself in the face
• heckling grizzly bears
• taunting badgers
• kissing a possum
• answering the phone at work
• giving policemen driving the opposite way the middle finger

The "on call" "doctor" then tells me she has no idea what the dose is. First, she says to talk to the patient's Mom. I told her this was not a very good practice; letting the Mom prescribe Coumadin, that is. After bantering back and forth she then capitulates and says: "well, just give him 1 pill daily.....30 pills." Well that is some sound and thoughtful advice, "doctor." So, Mom is now the MD, is she? What. The. Fuck. You know what I did? I called Mom.

I went with Mom's dosing, it actually made more sense. I notated the prescription: 2 daily, per Mom. Come get me insurances, I don't care.

The next lady was a patient on Lipitor. She was on 40mg, a usual dose, but the "Physician's Assistant" wanted to jack her up to 60mg. This is not a usual dose. Why? Let's get schooled, shall we? There is a "rule of 6s" with statin drugs - for every doubling of the dose, there is a 6 percent response (roughly). So zippy the "PA" is going to deduct a whopping 3% from this lady's LDL. Nice work Sherlock. Oh, did I mention the patient thinks she's a doctor? According to her, the dose of 60 mg is too high. I think she said:

"Now, tell me, really, this Lipitor, this 60 mg, tell me, that's a high dose, 60 is too much?"

First, that's not a question, it's just a feeble attempt to put words in my mouth. My opinion must count for something, because people are always trying to form it for me. I can hear them now, "my pharmacist says that smoking crack is just fine when you're pregnant." Look, if 60 was too much, I'd tell you. Stop trying to trick me into saying it is. It's not. It's retarded, but not too high.

"Well, I'm going to stay on the 40mg. I can do that, can't I?"

I told her that it was a free country and up to her doctor and her.

"I can't get through to my doctor, just this physician's assistant."

I told her the last time I got through to a doctor that she said to do what the patient's Mom thought was best. I guess getting the doctor is not always a winner.

Good luck out there. Let us RPHs handle the drugs. Please? Pretty Please?

I Wish I Was Lying.

People do say and think the darnedest things. That's a pretty blunt and bland statement to say the least. My creativity has been drained. Countless hours trying to dispel the same myths and thoughts of folks not trained in the pharmaceutical sciences has taken it's toll. I'm not trying to sound mightier than thou or as if I'm God's gift to the world. That said, I definitely am smarter than at least two people I've encountered the last two days.

It was a Friday and the masses were huddling and jockeying for their weekend controlled substances. It's as if a gumball rally had marked my pharmacy as it's destination. Mired in prescriptions and phone calls, there she appeared. She was docile this day, but her words were confusing.

"I have a bagel of prescriptions to drop off," she said.

Now, I was working with 2 techs at the time and one heard "bagel" and the other didn't want to think he heard "bagel," but ultimately did. I can only assume she meant to say gaggle, but she said "bagel." Much like the boiled then baked traditionally Jewish delight, the ribbing would be delicious. I didn't know what direction to take this one. I took the high road and made analogies of other baked goods in ratio to large amounts of things.

• I have a knish of phone calls to make
• I just rang out a pastry heart of people at the counter
• We are selling a cookie of silly-bands
• That is a danish of Lortab for one person to take
• I have to fill a donut of refills for him
• That is a muffin of money for so few tablets
• Feel free to add your own baked good analogy in the comments

The second person asked me for diabetic socks. Yep. So I asked if he was looking for support stockings? No. Socks, but for diabetics. I asked what they were made of. He said "socks." I then told him I was not aware of such a product. I did tell him to check in "SkyMall." They have everything; even the "arthritis gloves" some lunatic was looking for last month. Boy, was my face red. I am going to market a line of cotton socks (breathable) and have the word "DIABETIC" stitched across the toeline and at the top of the crew. Then, I'll be a millionaire, as the rate of diabetics is exponentially soaring and they all need socks.

I've lost my mind. Carry on, carry on.

"The Call"

I think every member of pharmacy personnel has received "the call." You know, the dreaded one. I'm going to paint a picture; you may want to put on a smock. Remember in second grade and the art teacher had you bring in your Dad's old shirt to put on backwards? Well, the following scenario is a little less comfortable, but equally as frustrating as trying to keep on an oversized backwards oxford.

The time: always 4:59 p.m.

The person: almost always the bored housewife or retired housewife (sorry ladies)

The task: obtain (insert drug that could wait until tomorrow but really can't because everything is an emergency when you stare at the wall all day or watch grass grow or wash the same dish repetitively) a refill

The problem: there is always more than one problem at that given time

If you've been to a doctor's office, then you probably realize they close at 5 p.m. (for the most part). The "nurses" or "employees" that work there obviously have no fucking idea about the posted hours on their glass doors. If they did, I wouldn't want to beat somebody with my phone receiver after I get "the call."

You know what "the call" is if you're in the profession. In fact, you're probably trembling with anticipation. You know I'm gonna light this fucker up and send it into the clouds. We'd all like to blow something up when we get "the call." With out further delay, here is "the call" :

Me: PharmacymayIhelpyou? (I'm so busy it's all one word)

Bored Housewife: Uhhhhh, yeahhhh, uhhhh I've been on hold, ugh for 10 minutes.....

I'm going to interrupt the "conversation" here. First, "bored housewife" will be shortened to B-HO for the remainder of this "conversation." Secondly, why is the universal amount of time that somebody lies about always 10 minutes. It's without fail, always, always, always 10 minutes. In the drive-thru, behind the old lady, on the phone, wandering the cough/cold section, no matter. "I've been doing such-and-such for 10 minutes!" No you haven't and stop lying. I'm putting this out as an edict to squelch the 10 minute rule. Just suck it up, life is a wait.

Me: What can I help you with, I am juggling many phone calls/questions/waiting prescriptions/drivers-thru all at the same time?

B-HO: What? Anyway, MY doctor says you HAVE to call him...
Me: You mean they'd LIKE me to call them?
B-HO: What? No. He says, well not him, but his nurse says you have to call.
Me: Well, that was quite kind of them to lend my time and services. I'd be glad to call them, but aren't they closing in a few minutes?
B-HO: Oh, yes. They said to call RIGHT AWAY, because they're going home.
Me: Well, I'll do the best I can, I have many things in front of your call on the docket right now. Hopefully they won't go home just yet.
B-HO: Oh, no. You have to call them IMMEDIATELY. They said you have to.
Me: Okay, ma'am. I don't HAVE to call anybody. I will call them, but if they are too lazy to pick up the phone, then beggars can't be choosers. I, as a chooser, however, am begging you to let me go so I may call the office and tend to the business at hand.
B-HO: When can I pick it up? It better not be too long, I've got a roast in the.....
Me: I'll call you when it's ready (click).

That's the gist of the exchange, you've all lived it. There are a few variances, but that is the basic ebb and flow to "the call." As we all know, however, "the call" has many layers of piss-me-off flavors.

Upon calling the doctor's office, you talk to "Peggy" or "Kathy." They, in turn, have no fucking clue why you are calling. Questions like: Who's the patient? What do they need? What's the date of birth again? pervade the conversation. It typically ends up with them calling you back. The irony is hauntingly reflective of the health care industry. One hand doesn't know what the other is doing and truly doesn't care.

In the meantime (meantime = within 15 minutes) B-HO calls back.

B-HO: So'd ya get it??????
Me: No, your doctors...
*Interrupting* B-HO: What do you mean?????
Me: They said they have to call me back.
B-HO: Why? They said to just have you call......

I'd like to personally thank every doctor's office that has ever pulled this shenanigan. I do hope that your giant, block-like fingers will undergo successful surgery one day that will allow you to properly dial a phone. They do make phones with enormous numbers on them, look into it. I also pray your taxing form of dyslexia will be overcome by the years of therapy, allowing you to call me. Then again, maybe you are just the laziest thing on the planet. It's not hard. Just call me when you know what you're calling in. Better yet: it's 2010. There's these things called computers, like the one I'm using now, that can assist you. I know that you are not reading this, for rotary phones don't have screens. What you could do is e-scribe, fax, or even give the patient a written rx at their appointment. You've already been put on notice, don't make me do it again.

Signs of the Apocalypse

Have you ever gotten that feeling you were about to have a bad day? There's no individual event that triggers this feeling, but your spidisenses indeed tingle? I think we all have. I had a day of actual irony and near sublimation and disbelief. There's not an abundance of professions that can boast a trilogy such as this.



Near sublimation...where do I begin. Well, let's start with the definition of sublimation. As I remember it, sublimation is the change of a gas to a solid while skipping the liquid phase. My near sublimation was not exactly that. Okay, it wasn't even close, but it's the only analogy that came to mind at the time. A stroke suffered Hungarian or Austrian man brought me his bottle of Digoxin that was filled when I was on vacation. Normal enough until he was garbling some words to my technician. I was on the phone, but it sounded like:



"ARRRR THUGH PROBLUHHHH RRRR!!!!!!!"



He repeated the above to me when I was off the phone. I opened his bottle of Digoxin and it was a vial of dust. I shit you not, it was dust. It looked like flour or baking soda or maybe a clever mixture of the two. At any rate, he wanted the "INSURAHHHS" to cover it again. After much "debate" he settled on saying he'd just take the powder. I think. To be sure, I told him that would not be a good idea. I think he said "why" but it sounded like WHNNNNN????!!!? I told him it may kill him to randomly ingest digoxin powder. Now, I have a few questions.



How the hell did Digoxin disintegrate in two weeks?

How the hell did he not notice this transpiring?

Why would you think anybody owes you a new refill if you let this occur?

Why bring me into this?

Can you take the stroke out of your mouth and convey a thought coherently?

Why did you drop "F" bombs on me in the drive-thru months earlier?

Is it a full moon?

Are there any hospitals hiring?

How many licks does it take to get to the center of a Tootsie Roll Pop?



I eventually sold him some for cash, reluctantly. My theory is he dropped them or did something with the original fill, filled up the bottle with a placebo powder and then expected me to fix his transgressions. Well, Strokey Mcstrokerson, it takes a little more than that pull the wool.



Just to clarify: I don't actually have a problem with stroke sufferers. This guy just has a marble mouth and a big ass scar and an accent. A stroke is the best way to describe his vocal ability.



Ironies...bitter irony. A lady who is a true pain in the ass claimed her Proctofoam was "leaking." She first calls on the phone. She complains about everything and whines how her life is so hard. She's the 50 year old virgin (going out on a limb) who still lives with mom and dad. I have no idea what she wanted on the phone other than to complain. When I tried to rectify (rectify - get it) her situation, she goes off the handle and says:



"I don't know why I always have a problem. What the hell kind of pharmacist are you, anyway?"



My retort:



"I'm the kind of pharmacist that hangs up the phone now, good bye and have a nice day."



Hard to believe she came in. Armed with her used anal medication, a belligerent attitude and a fourth grade comprehension, she started in on me. As it turns out, my pain in the ass with a pain in the ass was too stupid to clean the foam out of the applicator tip. Warm water fixed her problem and HOT water and soap fixed my hands. I guess she's the better person......



A creepy customer always gives us candy. He's nice, but the candy is always warm and looks like it's undergone some type of tampering. Well, my timing was impeccable for once. I'd just retrieved some sale candy after helping a customer find it, because that's my job, right? My trusty tech had just rung me out and the candyman came to the counter. I said:



"Today, the tables are turned, my friend!"



I promptly opened my mini peppermint patties and gave him a handful. He looked confused and a little shocked. Turns out he gave it back to my other tech, citing he didn't feel comfortable taking my candy. So, it's okay to give creepy, softened, yet warm taffy but my brand new patties are no good?



It's all good, though. We've started a 60 dram vial and have begun collecting his candy. My donation of patties were deposited. I hope to anonymously mail the whole lot to him once our collection is complete. I'll be eating the patties, though; I bought those.



As for the disbelief: My company has cut our tech hours by nearly a full timer. If I'm not dead, I'm sure I'll have lots to write about.

Finally, some recourse

Recourse is a slippery entity. It seems to be the carrot in front of our noses, dangling, never to be caught. I'd like to have some recourse when it comes to my two greatest but no so new found annoyances. It took a recent trip to the "magical" world of Disney to bring everything together. Now, at the risk of sounding miserly, I will navigate my transgressions carefully.

My two annoyances will wait until the trip is recalled. I'm going to lay it out in a game called "bright side, dark cloud."

Bright side: The weather was perfect. It did not rain a drop and the temperature was between 85 and 90 degrees all week.

Dark cloud: Scooters are now affordably rentable at Disney World. The scooters are being used by fat people (mostly), some old people and fat, old people.

Bright side: I don't require a scooter, but can swiftly manuver a double stroller around a scooter.

Dark cloud: Not all fat people use scooters.

Bright side: I can accurately clip their ankles with said double stroller and then say "so sorry, I didn't know you were going to move that direction"

side note - yes I did. You see, fat people have an uncanny way of wandering just in front of you and moving slightly to the right or left, depending on which way one is trying to jockey around them. It is insensing to say the least, but the game of ankle crashing makes it better.

Dark cloud: I endured this for a week.

Now, after coming back "refreshed" from my vacation, I was painfully reminded that work is like the fat person meandering in front of you at Disney. You can't get around them. You try to go to the left and there's someone coming the other way. You duck to the left and speed up - aimless 3 year old not paying attention.

At work, however, the fat person in the scooter is acutally a fat person in a scooter. The people coming the other direction(s) are the helpless old people in the aisles "shopping." The aimless three year old is either an aimless three year old or guy/chick on cell phone at counter. My phone ringing, on the other hand, is likened to nothing in life. It is incessant and overwhelming. It is relentless but grating to the core. I hate my ever-ringing phone. If we ever get new phones, I'm going to ask if I can take one home - I have a field behind my house. Let's just say....


Now, I would undoubtedly act as Michael Bolton in this scene. That about covers item 1.

The second annoyance is old people with time to burn. Now, I understand you have a legitimate question. I actually enjoy answering those. On the flipside, if you rush me and poke your snout over the counter as if you are on fire only to ask me the whereabouts of cotton balls....


So, that's about it. Vacation, all I ever wanted......blah, blah. I never did enjoy the Bangles. I was always more partial to Bananarama's "Cruel Summer."

Oh, yeah, I almost forgot. This clip would be relevant to both work and Disney. One could say it's the "background noise" in either place. Enjoy.

Let's Make a Deal.....

Remember that show? Now it's been remade with Wayne Brady or Kadeem Hardison (Dwayne Wayne) or Urkel or something. I like to play the pharmacy version, myself. I'd like to stroke my ego here and say I'm the "Monty Hall" in the pharmacy version.

Pick-up Window#1: The Oxycontin guy on crutches that smells like weed/booze/cologne all at the same time.

He presents with a "subscription," usually wrinkled, and has a long story about why he's prepared to pay cash. Except when asked for I.D. and then has a longer story about why he doesn't have it. Until, that is, you tell him no 50 cents, no Coke. Then he forgot; it's been in his front pocket all along! "How forgetful of me," he says.

Drop-off Window #2: The no-speak-a-da language guy with two names sans vowels and an insurance card that just says "Preferred Gold America Standard" or something to that extent.

S/he presents with "dis piece of da paper for the drug" and barely speaks English. Now, they may or may not have Medicare, Medicaid, some from of insurance you've never seen or just think they get it free because they have a prescription. It will take no longer that "I wait heeere" to get it ready and they undoubtedly smell like some type of food made with seaweed, curry, garlic and fish. Then, upon review of the prescription, there's no date on the (insert controlled substance here) prescription.

Drive-Thru Window #3: They simultaneously have sped into and pushed the call button while still rolling down their window while lighting a smoke and taking a call on their cell.

The call button has you now in a dimension of pissed you didn't know you were capable of. Upon waiting on the customer, they tell you they are "picking up and dropping off" and then have rolled up their window. They can't get the "drop off" under the metal bar and have flung the "subscription" angrily into the drawer. Luckily, it didn't blow away (this time). You ask for an address and they have no idea what that is. Then you look at the drop off and it is written for something that doesn't exist. Let's say......"Serax 10 mg." You explain this scenario and they ask if another pharmacy will have it in stock. Hmmm. "Can't you just fill it?," they ask. You assure them you'll have to call the "prescriber" (seriously, Serax 10, c'mon dude) and verify what the fuck they were thinking/smoking. And around and around.

So, which door do you pick? Honestly, I'd have to take whatever door has the donkey. I'd much rather deal with a donkey than these three mutants. Must go drink beer now, losing power.

Next time: Pharmacywood Squares. It'll take a while - Jm J. Bullock does not easily translate to the pharmacy world.

A Happy Medium

That's all I crave, heck that's all anybody craves. The exception would be manic depressives, that is; they crave divalproex sodium. Throughout the day, my staff and I are challenged by a plethora of left field-type questions. Here are the top three products that I can't make up that were actually asked for within the last week:

1. "Melatonin PM"
2. Arthritis Gloves
3. Mint capsules

Now, without explanation, these seem to be on the harmless side. Let's pause for just a second and think: Who would request these items and what would they look like? Let's just let that simmer for a moment.

Still cooking.....

Almost......

Did you come up with a mental image?

1. "Melatonin PM" may or may not exist. I don't have it and it's not in my computer system. According to the somewhat sleep deprived and strung out fifty-something, it DOES exist and has melatonin, PINEAPPLE, and some other exotic fruit that I can't remember. I think it was papaya, mango, or guava; something to that extent. Now, I do understand buying melatonin, it's a good choice, but the fruits? Really?
2. A smoke-smelling man who just lit up in his car or other confined non-ventilated space smokily asked me where the "arthritis gloves" his aged mother had seen "on the TV" would be. I honestly had no response. I just looked aimlessly at the incontinence products (which is the aisle I happened to be in) and waited for him to smokily speak again. "Yeah, she said she saw 'em on the TV." I think he smokily covered that in the first "query," but this didn't seem to be going anywhere. They didn't magically appear next to the Depends, so I said: "aaaaaaaaahhhhh, what were they now?" He took the hint and smokily walked away.
3. Mint capsules. Capsules, but filled with mint. She "usedta get 'em," but could not provide a location. I'm assuming they are sold in the world of make believe, next to the gumdrop q-tips and the gummy worm oxycodone. Mint capsules. Someone actually asked me for mint capsules. Emphatically. I told her we had mint gum. "Ya chew it," was my advice.

The topper to the week was a very old man tappa tappa tapping on the counter. He apparently bathed in moth balls earlier in the day. Maybe this was part of his weekly ritual, I don't know. Anyhow, he wanted dental products from sometime between 1940 and 1984. Astring-o-sol is apparently made famous by Joey Eastwood, who must be long dead. Google didn't bring up anything other than a bunch of Joey Eastwoods not related to this crap at all. The second thing he wanted was Topol. Now, if anyone smoked in the 80s (like my dad) then you'll remember "Topol, the smoker's toothpaste." I had no idea this was still made. Maybe the arthritis gloves guy might find it useful. Why father time needed these specific items is beyond me. The advances in these products are stocked neatly in the dental aisle. I made no mention of it to him, I had a hunch he was somewhat set in his ways. People who smell like a cedar closet tend to be a little on the finicky side of the equation. I wouldn't want to be around when the "cabana wear" comes out. That's gotta be slightly pungent. I freaking hate moth balls. Just live and let live, man. I've been around long enough to have moth-ridden clothes, but have never had them. Let's just say my closet is probably not as well thought out as this guy's closet. I really see no need to bring moth balls into a house. Moths gotta eat too.

You see, the "happy medium" I'm looking for is an ounce of common sense. I don't know all the ins and outs of an automobile, but I don't go to a repair shop and ask if they have "muffler trim" or "radio knob glitter" or something ridiculous like that. I've learned that most things have a replacement and move on with life just a little tiny bit less satisfied. It's not necessary to hold on to dental relics - just look in the dental aisle. There is an oasis of products. There's actually a product called "Oasis," as a matter of fact. I'm sure if he doesn't use these products that the ladies will say: "wait, moth balls, minty, yet smoky toothpaste, and......mint? You usually smell like moth balls, minty, yet smoky toothpaste and myrrh! No kisses for you!"

Yeah, that's what I thought. A happy medium. Just try to be nice and ask sensible questions in a time sensitive manner. A happy medium. The highs and lows of (allegedly) fictitious products has me craving......

A happy medium.

Something in the air?

There must be, or else the Mayans were right. I haven't had as many quirky phone calls, drivers-thru, Sudafed wranglers or superfluous questions as the last couple days. Some of these include, but are not limited to:

• A MAN asking: Do you have yernary track?

Now, I was pretty much frozen at this point. I do have a urinary tract, as far as I know, but I wasn't convinced that's what was on his mind. "Do I have......" was my response. "Yernary track," was his retort. So, basically, right back to the beginning; as per usual. "Are you looking for a product or a body part?" was my question to his retort. "I'm not sure," was his answer.

I like where this exchange is headed. I'd like to have a shovel handy, just to scare away the riff-raff. I doubt corporate policy will allow this act. Shucks.

"I'm lookin' for it for my lady, y'know, fer down there," was his next utterance. "So you're looking for pain relief from a urinary tract infection?" was my question. "Well, no, um, well, fer, um, down, there, y'know, fer my lady....." "Sir, I really don't know what you're looking for and there is not a product called yernary track as far as I know," was my final answer. "Well, um, I guess, ahhh......" was his way of saying goodbye.

A hearty pat on the back to the first soul who knows what the fuck this guy wanted.

• Designer pill cases are now available as an impulse item. Even at $2.99, they are going like hotcakes. Back-scratchers (bamboo ones at that) are $0.99, nobody has bitten.

A fool and their money are easily parted. These pill cases are available in zebra, flower, elephant, other flower, fish, bug and some other ugly design I can't remember. I'm astonished we don't have them in leopard for our "cougar" population, who would most definitely keep their Lor-a-tab(s) in them. I think these things hold about 2 pills (Lor-a-tab sized, of course) and are exceedingly ugly. Now keep in mind we already give you a FREE light and child resistant container for your "pills" upon dispensing. Instead of keeping them in that silly thing, you'll instead put them in a 3 dollar piece-of-shit metal container. It is morally wrong for a sucker to keep his money. I'm going to move the back-scratchers front and center and see what shakes out. Now that is a good use of 99 cents if you ask me.

• Am I interrupting your conversation in the Drive-thru? I'm so sorry.

Yeah, not so much. We at the pharmacy have a few dos and don'ts for the DT. I'm kindly going to share them with you now so there won't be an incident:

1. DON'T push the call button. There is a loud doorbell inside signalling your arrival. You will wait an additional amount of time (varying by employee and district manager presence) if the button is pressed. Thank you.
2. DO tell us your name in a cohesive manner. I don't want backstory (ever) but particularly when there is a choo-choo line of anger behind you.
3. DON'T light up a smoke mid-transaction. I can understand smoking, really I can. I can also understand you can wait for 30 seconds so your discount menthols don't waft in and make me yak in the DT drawer. On second thought, light up. This could get interesting.
4. DO either speak loudly or shut off your radio/engine/both. I thought K-cars were from the late 80s. I thought it was publicly embarrassing to still listen to Whitesnake. I, of course, was/am wrong.
5. DON'T have a conversation/textversation while we're trying to help you. A woman today asked if I could hold on. I tried to think of a shorter word than NO, but that was the best I could do. This was in the midst of trying to obtain her worker's comp info, mind you. Where's that shovel?
6. DO bring us lots and lots of goodies. We never get anything. We're expected to shove sunshine and rainbows through that fucking drawer all day and get nothing but grief and attitude in return.
7. DON'T even expect to sit there while your script is being filled. Enough said already. Shouldn't have to be said, already. Maybe we can come out and squeegee the windshield for you? How's your oil level? Air in your tires? Drive the fuck around.

• I silently pray (hourly) for the death of the sole person responsible for putting Sudafed behind the counter. Keeping a federal registry on this is just another reason government should take some advise from regular joes like me and any Pharmacist in the world.

They're (tweakers) going to buy/steal the combo products? Really? They're (methheads) making meth with acetone and a coat hanger and vinegar and a cooler in their basement. You really think the have the technology or know-how or resources ($) to extract Sudafed out of an extended release preparation of Claritin-D? Do you George W? Oh, that's right, you were a "C" student on your Daddy's word at Yale. What'd you major in again? Not meth making, I'd bet. Now, that being said, I've never made meth either, but I know it's not going to be with Zyrtec-D. The pollen is out and the masses are flocking to get "dried up" by the wrong drug. I'm gonna put this out there: C-E-T-I-R-I-Z-N-E. In most cases, 95/100 I'd say, that's your winner. Stop getting the pseudoephedrine products unless I deem you need them.

• A lady I was counseling about her anxiety meds kept saying "that's what she said."

She was talking about her female doctors comments matching mine, of course. What'd you think I meant? Get your dirty mind out of the gutter.

• An abundance of the moon howlers lately.

The crazy eyes type. The kind of crazy that looks through you like they're dancing in "Thriller." I'm a little skittish of these types; they may want to eat you, they may want to be a friend. I'm not a fan of either option, frankly.

• It's my fault your prescriber doesn't know how to use a fucking computer or know what day it is.

You're yelling at the wrong cowboy, kimosabe. Look, when the script is DENIED in my system for "Already responded by other means" by your prescriber, who went to college for at least 6 years; then I'm assuming they know how to "respond by other means." Needless to say, I've made an ass of you and me several times in the last couple days. I'm not sure where these "other means responses" have ended up, but it ain't with me. Also, if your prescriber post-dates the prescription because of retardedness, let it be known my name is not Marty nor do I have access to a flux capacitor nor do i know what a jiagwatt is. It'll have to wait until tomorrow, Chachie.

I've aired some grievances and feel a little better. I think I'm going to buy a back scratcher now.

Everybody was flattered!

This commercial could not make less sense to me. All I know, is that I wish that I perpetually worked for CVS in the mid 80's. I think you'll see why.




Okay, if that wasn't the most senseless, piece of shit you've ever seen....

So, 1985 CVS, what you're telling me is that in 1985 an "empty gelatin capsule" DOES NOT get destroyed the second it meets stomach acid? I'm not sure if gelatin and stomach acid were different in 1985, but pharmacy sure was. If that's all I had to do to "flatter" people then life would be grand. So, flattered little fat girl, is your tummy better now? Yes, the magic of a paper-thin gelatin capsule will cure all.

Joel is truly a hero. He went to such lengths - take it with food and milk. Nope. Finally, (wait, finally? Isn't there supposed to be a few more steps in there? Not if you work for 1985 CVS.) put the icky medicine in a gelatin capsule and fool Donna Anton possibly more that the little fat girl. Her stomach was probably upset from all the fucking candy and bacon and sausage and pork shoulders and various stews she'd consumed earlier. Who's fat in 1985? Really. Look in the family album from 1985ish. Everyone is slender. What the fuck was Donna Anton doing? Someone should put her in a gelatin capsule.

I'm off topic now, I'm too angry. Until next time.


Gelatin. Really? Jesus H. Christmas. I quit.

Nothing to do with Pharmacy

Do me a favor, try not to laugh at this. Can't be done.



Go shorty, it's your birthday.

The Ten Pharmacy Commandments

These Commandments shall hereby be anointed Pharmacy Law. Breaking of any rules shall be punishable by revocation of Drive-thru privileges. Any backlash and I will smite the to ye end of the pick-up line for eternity.


I. Thou shalt not lie. About reasons for needing a controlled substance earlier than dictated by correct days' supply of a prescription. Vacations, funerals, funerals while vacationing, loss due to toilet-hovering while attempting to pour medication in the hand, or loss due to uncontrolled children/pets will be prosecuted to the fullest extent of Pharmacy Law (and Jesus).



B. Thou shalt not press the Drive-Thru call button. This offense is punishable by death. Your Hell will include a person using your nipples as the call buttons of a drive-thru.

3. If thou can't find it, ye can't have it. I'm a pharmacist not a directory in a shopping mall. I don't know where the Herbal Essentials Green tea Lite is. I'm sorry. Nor do I know where the strange and/or fictitious supplement is that you MUST have. Lastly, you know my stance on shoelaces.

IV. Thou shall recognize the clock as an essential part of a functional society. When asked a pick up time for an order, a concrete and fair time must be given. Unacceptable times include, but are not limited to:

• later
• after dinner
• after lunch
• today or tomorrow
• I don't know
• I'm not sure
• after I work out
• after work
• after I do some "running around"
• when I'm done with my errands
• after the grocery store
• after we go out to eat
• after the movies
• sometime later on
• 10 minutes
• I'm on my way now
• when it's ready
• when I get around to it
• whenever I can get a ride

The words out of your mouth better be in this format:

• XX:XX a.m.
• XX:XX p.m.
• XX:XX (military); who says I'm not flexible?

Five. Thou shalt not covet thy neighbor's insurance. Your copay is what it is. I have no magic, black or otherwise, to lower it. Twenty dollars to extend your miserable life is really not to much to ask. How much do you spend for beer? for restaurant food? for entertainment? Without the medication that extends your life, none of that would be possible. This is America, the greatest show on Earth. Would you rather be in Bangladesh dodging a tidal wave? Would you like to be eating in a fine Hatian restaurant? I hear the special there is great. If you like cannibalism, that is. Perhaps you'd like to be eating rice out of your own shoe in Chile? What's that? Yes twenty fucking dollars is right.

F. Thou shalt not partake in the use of technological devices. Put the phone down. You are not important. You may think you are important, but trust me, you're not. So put your phone on mute and listen to me so you don't end up with someone else's meds or pay an exorbitant amount without even realizing it. Example:

Pharmacy Staff: That'll be $4,237.96.

Dickhead on cell: Yeah, no, that was awesome. Dude, no, you didn't. What'd she say? Seriously? What did you...hold on, hold on. (to other dickhead) What? (to PS)

PS: $4,237.96. Did you have a new ins-

DOC: HERE! (agitatedly tosses credit card in drive-thru drawer) Okay, I'm back. (to other DH) Yeah, that was the shiiiit. Dude, I was so fucked up. I know right? Yeah she was.

PS: Okay Mr. Head, you're all set. Any ques-

DOC: Nope, I'm good. (pulls out hastily --- if only his father had done that in the first place)

Of course you know what comes next. They realize they just mortgaged a prescription and the calamity ensues.

7. Thou shalt not argue with the advisor. If you asketh me, I will telleth you. Don't try to barter or make me somehow implicated in the notion you have a clue about treating the common cold. You don't. If you did, you'd need not asketh about whatever flashy green, yellow and purple box is in your hand. Stay away from the dressy boxes. They are shiny, like fishing lures; they're intended to catch your intention. Holy Mackerel.

VIII. Thou shalt not kill (the messenger). Being the insurance company's go between, life is always a touchy situation. I'm forced to tell you that IF prior authorization is obtained (laughing break), you're still going to be out 75 bucks. That dog most certainly won't hunt. I tell you there is a generic alternative. You tell me that you read online that generics aren't as good. You failed to realize your were on the Merck/AstraZeneca/ScheringPlough/Glaxo/SmithKline/Lilly website (seriously, isn't there just one big brand company now?). I am then forced to tell you there is no other way out. Luckily, the DT glass is bulletproof.

9. Thou shalt not ring out more than three items at the pharmacy register. I'm not lazy, I just had hoped the years of college had afforded me a higher place in life. Leave your water in the cart and push it to the front. Don't even think of putting that Snuggie on my counter. No, I don't know the sign said that those cookies were a dollar off. You probably got them in the wrong spot, because we don't keep E.L. Fudge next to the K.Y. Jelly. They both sound delicious, but only one of them is. Probably, some little snot rocket left them there with the lubes when mommy said: "Aiden, where'd you get those? Put them down this instant!" Aiden obliged and there you go. K.Y. cookies. Not a delight.

TEN. Thou shalt not ring out any items unless pursuant to a prescription transaction. No, you may not ring out here "real quick." I don't care if the line up front is filled with animals two by two. I don't care if I'm staring longingly at the clock while the line is filled with Noah's passengers. I can't help you are ashamed of your cooter medicine or that you don't want anyone seeing you buy rubbers. I refuse simply by principle. My employer, however, does not. So I guess this last commandment is in vain. Here endeth the lesson.

Wax on, Wane off

I thought briefly there was a full moon today; and the last day I worked. Come to think of it, most days seem like a full moon. Now, we all know the "crazies" come out for the full moon. I seem to think the waxing and waning phases are dramatically overlooked. It's not science at all, it's just when people are most likely to be out and about. Limiting odd behavior to one day in every thirty or so is just not fair to the masses. I have proof.

• I called a pediatrician's office and was put on hold. The song playing? Supercalifragilisticexpyaladocious. No shit. I told the nurse I preferred "A spoonful of sugar." I know, I know.
• A man asked me if candy counted as food. I told him to take his amoxicillin/clavulanate with food. I didn't want the argument. I hope he enjoyed his candy.
• A young woman inquired to which caffeine "supplement" was the best. I told her none of them were any- "My friend's a stripper," she interrupted. I think we all know that by "her friend" she meant "her." I hope her shift went well. Can you really nod off during a table dance? Just sayin'
• Justin Timberlake's "Cry Me a River" played 3 times in 2½ hours. Someone at the muzak company needs to take alertness lessons from motivated strippers. That way, I won't have to listen to the same horrible fucking song over and over. And over.
• That same someone seems to think playing Avril Lavigne is a good fucking idea. Well, someone, it's not. So play me some Mary Poppins like the kid's office.
• "You should try Zyrtec," I told a customer. "Oh. So, Sudafed then?" was the reply.
• "You should try Zyrtec," I told a customer. "Oh. So, wait, what?" was the reply.
• "You should try Zyrtec," I told a customer. "Oh. So, Mucinex then? was the reply.
• I'm trying to think of a more direct way to advise the use of Zyrtec. I'll think of something.
• I have a deaf man who calls and apparently stutters while signing. Didn't know that was possible. Every interpreter says: ooh, okay, um, ooh, well, okay between phrases/questions that make less sense than that.

All of these things happened when not a full moon. I'm scared. Really scared. I'm suggesting Mucinex only on March 30. If you have anything other than chest congestion that day and you come to my store, you're screwed. Maybe the full moon reverse psychology will result in people saying: "Oh. So, Zyrtec then?"

Congratulations Old White Man

You've made my list. I've had a bone to pick for quite a while now, been stowing this angst for far too long. Lately, the old white man has been a real annoyance. Look, I respect the fact that you fought for our country in WWII, Korea, Vietnam or whatever war appears on your mesh baseball hat. Really, I do; both my grandpas were vets. That does not give you, however, the free reign to ask where the hydrogen peroxide is whenever you want. Peeking over some unsuspecting young lady's shoulder and smellily asking where the whereabouts of hydrogen peroxide is just downright creepy. Also, I'm guessing it's not your first foray into the hydrogen peroxide experiments. I don't want to know what you are using it for, nor do I care. The hydrogen peroxide is probably where it's been for the last 50 years since you've been buying it - the first aid section. See my previous article about shopping and your son with the shiny jacket.

Why do you need new shoelaces all the time? Why do you think they are kept in the pharmacy? I don't know what passed for medication in the service, but I don't think it had anything to do with shoelaces. Usually, when I need new shoelaces, my shoes have far surpassed their use. Usually, a snapped lace is a signal for me to get new kicks. Not you. You'll hang on to those scrappy loafers until the soles have worn through. They're in aisle 5 I think. Maybe aisle 7. I'm not sure, you'd think I'd know by now. I'm gonna learn that the next time I traverse to the bathroom at work.

Your copay has nothing to do with Obama. Really. He does happen to be half not the color of your skin. He has nothing to do with your copay. He may have some radical ideas. I may not agree with them, but it's not because of his skin color. I don't agree with some of his policies, which have nothing to do with his heritage. Look, I know every drug in the world should cost no more than $1.75 in your eyes, but it's just not so. This has nothing to do with our president. I understand he looks different from you and me, but he hasn't had any influence on your copay. If you want to blame someone, it's GW, not Obama.

To conclude, old man, you don't get to be crotchety just because. The world is not out to get you. I have no agenda, and I don't know how to make your medicine cost less. If I did, I would do it so I wouldn't have to have the same pointless conversation. This is not a negotiation, it is a copay; know the difference. At least you get a discount at Denny's.

I don't. I have to pay fully price for the "Moons over my Hammy." You think about that, old man.

Nurse, turn down the a.c.

It's not what you're thinking. Air conditioning is not needed in the northeast when the "storm of the century" is brewing. No, a.c. pertains to the Latin abbreviation, or "sig" code (in the pharmacy world) meaning "before a meal." Let me elaborate. You see, some drugs need to be taken with regard to a meal in order for them to be efficacious. There is an omeprazole drug, for example, that rhymes with Shmegerid, in which this is sometimes the case. There is much debate whether it does or does not have to be taken with regard to meals. Now, omeprazole is used primarily for stomach acid reflux (GERD). Some people will have more problems with acid at night instead of during the day. This is because laying down will allow gravity to seep the stomach acid past your weak little gastroesophageal sphincter and into your esophagus. Sound uncomfortable? It is.

Now, let's say, let's just say, a nurse sends an electronic prescription to me shortly before it's time for me to slide down the old dinosaur. If you don't know the Flintstones, shame on you. Anyways, so the rx comes over as such:

Schmegerid 40 shmilligrams
#30
sig: 1 capsule po qd hs ac

Now, if you can read Latin abbreviations, you know this doctor/nurse is a rehtard. The sig reads as written: Take 1 capsule every day at bedtime before a meal. So I read this and mouth "what the fuck?" and proceed to call the MD office. I think we'll all have a good chuckle, I'll change the sig to just at bedtime or some shit and I'll go home and wallow in my own runny-nosed misery. No such luck. The call went a little something like this:

"Registered Nurse": Hello, Dr. Soandso's office....

"Me, not a retard": Hi, MNR from Blahblah Pharmacy, how are you?

"RN": Good (or something, I don't really listen, it's just an empathy trick to make them think I'm not a dick)

MNR: Calling on the rx with the sig 1 qd hs ac

"RN": AND........(agitatedly)

MNR: Uhhh, those directions don't make sense.

"RN": (huffily) Wellll, we write it like that alllll the time.

MNR: That may be so, but it doesn't make the directions coherent. Increasing the repetition of an action does not necessarily have a directly proportional result in regard to accuracy or understandability on a patient's behalf.

Now, I think this statement might have been the back-breaker.

"RN":...........

MNR: Hello?

"RN": So, what is your point? What are you calling for?

MNR: To clarify the directions on the Schmegerid.

"RN": 1 PO QD HS AC!!!!!

MNR: Yes, I'd agree that's what the rx says. To accomplish this, however, the patient would have to take the drug at bedtime and then consume a meal while she was asleep. That doesn't seem like doctorly advise to me.

"RN": Sighhhhhhhh. Well....what do you write when you want them to take it not with food?

MNR: On an empty stomach. Before a meal means before a meal, not an empty stomach.

"RN": Fine, 1 po qhs, okay? Are you happy? Geez, I dunno what your problem is...

MNR: No, I'm not happy. Not it the least. So, 1 po qhs? Great. Your name plea-

"RN": CLICK

Oh no she didn't. Oh my gooooodnessss. Now it was on:

• til the break of dawn
• like donkey kong
• I just realized, there's not may other ways to end "it's on"

I called back and a different person answered the phone.

MNR: Hi, I was just speaking with someone about directions on a prescription, may I please just have her name so I can document the change on the rx for legal purposes?

Other Lady: Ohh. Sure it's Retarda.

MNR: Thanks much, may I ask, is she a nurse?

OL: No, she's an R.N.

MNR: You mean R.N. as in a Registered Nurse?

OL: Yeah, that's right.

MNR: You have quite a tight ship over there.

It appears that nobody in this office understand basic communication. I'll spare the rest, but it ends with the doctor calling back and the nurse chewing on a big shit-filled burrito of shame. Recognize, biznatch, R to the Ph.

It's Called Shopping.

Yes, you. You're the middle-aged man sent to a strange and scary place. You've been sent on a witch hunt for a crazy concoction (by your over-stressed wife or other legal guardian living in your residence). You've paced an aisle not really looking, but you do look flabbergasted. I've looked up to keep tabs on things, make sure nobody is at the counter and our eyes meet for a nanosecond. You've mistaken this as an invitation. I've realized you're going to ask me. For what seems like an eternity and a brief moment at the same time I try to get in a sip of coffee, but....there you are. You're in front of me. You have on a shimmering sports team jacket. You don't smell bad, but you certainly don't smell good in any way. Is that a musty smell? You're out of breath and slightly panicked. I think you have some important news. Actually, I know you don't, but it'd be a refreshing change. Instead, your "c'mon hurry up" nature is prevalent. It's palpable how anxious you are to get back home and watch some sporting event on television; perhaps one that features your shimmering jacket team. I pretend nobody is there. You drop your keys on the counter. I pretend I can't hear metal meeting Formica. You cough not because you have to or you are ill, but to grab my attention. I don't hear attention coughing. You sigh loudly and tap your fingertips on the counter. My technician is on the phone. My other technician is at the drive-through. Shit. It's down to me. Finally, after all this transpires (in a span of 5 seconds, what horrible customer service) I turn to you and say: "Can I help y.... You interrupt rudely: "Is children's Benadryl the same as adult Benadryl?"

Now I get it. You're Benadryl guy. You've been sent to procure one item and one item alone. You have no intentions on perusing our sunglasses, shoelaces (only 'old guy' asks us for those - another entry for another day) shaving creams, cotton balls, candy bars or even our sweatpants. No, you've been sent on a one item mission. You've failed before you've tried. You see, sir, "shopping" is not pacing around for ten seconds pretending to look and then asking the pharmacy staff. Try reading the fucking signs. Those are the words, giant words, plastered above the cough and cold section. They may indeed hold the key to your journey. I definitely hold the key to your journey, but that's like President for a hall pass (overkill). Just take a deep breath and look at the signs and you'll be home in no time not hanging up your shimmering team sports jacket and lounging not gracefully whilst balancing a beer on your stomach.

Or, maybe I'll just do what I always do. I'll point to the back wall, in true Sherpa fashion, and squint a little so it looks like I care. Then I'll tell you the "adult liquid Benadryl" is within that subsector, but cleverly hidden in the "children's" section. You'll come back and say it doesn't say anything about adults on the bottle. I'll laugh on the inside. It's a dirty little dance, but something has to entertain me throughout the day. Look, just make it seem like you tried, alright? Just act a little and I'll even come out and hand it to you. Just don't be that guy.

A Quick Refresher.

Class, today's word is only. It seems an easy, simple word; there are only four letters. Hell, if you look at it long enough and say it enough times, it almost seems like it's not a word at all. I'm convinced that is what my customers have done. Lately, any sentence or explanation with the word "only" seems to be a tad bit misconstrued. If by misconstrued I mean they just don't fucking get it.

Knucklehead: Can you get Armour Thyroid?

Me: No. There is a nation-wide manufacturing shortage and we can ONLY get limited supplies of it when we least expect it.

KH: Sooo, you're saying that you won't order it? (snidely)

Now, you see where the fundamental understanding broke down there? I stated a fact, and they were a reh-tard. Again:

Crotchnugget: How much is my flu shot under my insurance (I'm on your system)?

Me: Well, Shim, your insurance does not provide payment for a flu shot at a pharmacy benefit level. The ONLY plans currently participating are Medicare and Medicaid. The charge will be the cash price of 20 dollars.

CN: Oh, what about Blue Cross?

Sigh. You see, once again with the listening. I understand you pay "good money" for your insurance, we all do. Unfortunately the "bad money" plans are the only participants. Next time, just listen to the apparently useless propaganda flowing from my mouth and you'll have your answer. Now, a caveat to this (that means an exception or disclaimer or something you might not want to hear because of extenuating circumstances) idea is that you may not like my answer. You may disagree with my answer. You'd be wrong, and that's o.k. Also, you're not on my system, dickhole. If you were "on my system" it would collapse. You can't sit on a flatscreen monitor, dumbass.

Okey dokey, let's try again.

Heavymouthbreather: How can I stop my cough, it won't stop.

Now, I've been 'properly' trained to ask a series of questions which acts as an algorithm to ascertain which "cough" medication is best for you. I've done my due diligence and have selected cetirizine (Zyrtec).

Me: Cetirizine is the best option for your annoying post-nasal drip. Antihistamines are the ONLY medication that will truly impact your current situation.

HMB: What about Mucinex? (that s/he is holding which was his first inclination)

Strike three. If you don't want the advice, don't ask for it. No, an algorithm is not a mathematical equation. Yes, antihistamines will work best.

Now, can't we all, as a society listen closely when another person says "only?" The word denotes some type of exclusivity, not inclusivity, got it? I really don't have the time or energy or resources to be teaching third grade. Now, go back into the sewer with the rest of the Goonies so I can tell people what an International Unit is.