And Into The Deep Pool I Go. The Rhythm Of A Weekend Off.

Pharmacies are busy places, chaotic more than your average patron will ever realize. There are phone lines and fax machines, in windows and out windows and the big window in the middle that is neither but the place where anyone and everyone can walk right up and grab you. Input terminals and places where labels are spat out, paperwork to be sorted, people to be served. Lots of people. You are given enough resources to handle things if they go absolutely perfectly, and things never....go absolutely perfectly. There are prescriptions not sent and prices higher than expected. Insurance information expired and why do you need my card anyway? Isn't it in the computer?

And now the people are unhappy. And you have to manage them. Every once in awhile there is even someone with a question about medicine.

You also have a mountain of potential drug interactions, dosage errors and handwriting judgments to make. All while making sure the masses move through the pill mill at a reasonable speed.

I'll admit it, sometimes it's exhilarating. It can make you feel very important to spend 12 hours with multiple people demanding your immediate attention. It's not unusual for someone to be looking to me to solve their mini-crisis from the moment I put the key into the gate until I shut it 12 hours later. And when that gate comes down, the final preparations for closing are made, and the last person inevitably comes running up at the last minute, you walk out the door, and into.......

Nothing. For the next three days you have no reason to exist. The quiet is disorienting. The nothing is disorienting.  It's like.....breaking the surface of a water world and sinking. Not even sure you are sinking, but surely being carried away...

The rest of the night you're exhausted. Spent and thinking of sleep. But the sleep doesn't come easy. The mind has been wound up and neurons are still desperately firing, but the brain is mush, thinking impaired. Music is a good salve and you find yourself in the dark with a glass of scotch listening to Miles Davis, "Kind of Blue," which is the very sound of 3 o'clock in the morning. Exactly when will never be remembered, but the last of the day gradually slips away.

Into Saturday. Finally. You owe no obligations to the world and today it will not be your master. Clocks are turned to the wall, coffee is made and the paper is read at your leisure. Projects are worked on, writing and the prerequisite procrastinating primary among them. There are no people. You have had enough of them tormenting you during the workweek and the only time you step outside is to pick up some takeout from the dive down the street. Your mind is sharp from the rest, and you stay up writing and reading and thinking deep into the night.

And wake up Sunday with regret. The world has been having fun for two days. People doing what they actually want to do, not what they are forced to do. You understand that the "want to do" part of their lives has nothing to do with yourself. You think about the ex-lovers who were in the arms of their current lovers the night before, watch the sun set over the ocean and wish for something different. Anything different. The bars are lonely and quiet, doing you a favor by being open even.

Monday the world packs up and gets back to business without you. The hustle and bustle of workaday life is all around. People are earning their keep and making the best of it while you silently catch up on laundry and other housework. Reports come in from the radio of what's happening out there and eventually you prepare yourself to be thrown back in. Because the job that tears you down, taunts you and humiliates you, kills you slowly as surely as the cigarettes you're desperate to inhale once more, is the only thing you feel. You return because when you walk in the door and it cuts you again, it's the only reminder you're still alive.

The only reminder you're alive.

Highlights From The Week's Pill Counting Action. New Year, New Drugmonkey.

I don't know if it's Zen or apathy, but a peaceful calm overcame me when the customer asked me if it was normal that his albuterol inhaler didn't work. A few weeks ago I would have felt the need to point out to the Einstein, that no, the plan generally is for albuterol inhalers to be manufactured in such a way that they are functional, and if his was not, then that would not be normal at all. As it was I simply reprinted a label while Einstein was going into great detail about how when he pressed down on the canister nothing came out, and by the time he was ready to take it out of the box and show me I simply handed him another without a word. He looked disappointed that I had cheated him out of some of his planned bitching time.

The next customer at the register complained that there was only one of a "buy one get one free" item on the shelf and instead of following my employer's incredibly bureaucratic rain check process, I just told Supertech to ring it up as half off.  Who am I kidding. It's definitely apathy, and the irony is it allows me to provide a superior customer experience.

Not at all like the good mother who came in to pay for her son's prescription. She definitely wasn't apathetic. Her 24 year old son by the way. An age when I had a pharmacy license and would never have thought to ask Mommy to help run my life. They stood there together, mother and man-child, as Supertech asked for the patient's date of birth. The date of birth has to be put in the register so it can check that you're selling the prescription to the right person. The man-child mumbled something that no one could hear. When Supertech asked him to repeat it Mother exploded.

"WHAT!!!!!!! IT'S FOR HER??? YOU LIED TO ME! HOW MANY TIMES HAVE YOU LIED TO ME???? PUT THAT BACK ON THE SHELF!!!!!

"But.........."

"SHE CAN DIE!!!!!!!! DO YOU HEAR ME???? SHE CAN DIE!!!!!!!"

There really aren't any size capital letters than can properly convey the volume of Mother's yelling. She left the store with man-child three steps behind. I wanted to see how heartless this woman was and went over to see the prescription. It was for Ambien. No biggie. I went back to being apathetic.

We have a pharmacist who comes in periodically who is a stickler about having instructions on prescription labels read exactly as the doctor wrote them. She worked the other day, as evidenced by this phone call I took:

"Is this the pharmacist?"

"Yes"

"I got my Viagra prescription filled the other day and it says to take as needed for ED. Who's Ed?"

I was hoping that maybe the man thought we had given him someone else's prescription and not that we were questioning his commitment to his partner or Ed's attractiveness. Being apathetic makes these situations easier because all you have to do is explain to the nice customer that ED stands for erectile dysfunction. I should have become more apathetic long ago.

A man asked me the best thing for the pulled muscle in his back and I said Aleve. I always go with Aleve for muscle pain because I know that it has actually been shown to work better for menstrual pain than other NSAID's, and since woman pain has to do with muscle cramping, you might as well go for it when other muscles are involved as well. I'm not sure if there's any evidence to back that up, but it's a plausible enough theory, and probably more clinical thought than you're gonna get from the average "doctor" of pharmacy working a retail assembly line.

"Cause I'm here working up on the roof and I kinda felt this twinge while I was going up the ladder"

"I'd try the Aleve"

"Yeah? Cause by the time I got up there I could feel this knot"

"I think the Aleve should do the job for you"

I decided to make a game out of how many ways I could suggest he try Aleve. After awhile I boiled it down to just one word.

"Aleve"

A final confirmation was still required.

"Yeah?"

That would have really bothered me at one time, but apathy is freedom.

Later on I came up with an idea that might just be a game changer for retail pharmacy. What if insurance companies started gathering the information required to file a claim, and printing it on some sort of card, like a driver's license, that a person could carry around with them and have ready to show when they needed health care services? Imagine it, I mean who would want to just spout off whatever bits and pieces of random information that pops into their head or write a few numbers on a postage size piece of paper to carry around if they had this "card" option? Customers would overwhelmingly make the choice to make their life easier if only they had a way.......

BWWWWWWAAAAAAAAHHHHAAAAHHHAAAHHHAAAHHAAAAA!!!!!!!!

OK, I'm going back to being apathetic now. Because thinking about stuff like that is a sure ticket back to depression.

Goodnight.

The Republicans Finally Prove Me Wrong.

SACRAMENTO- In a stunning indictment of California tax policy, experts admitted today that the state stands to collect hundreds of millions of dollars from the widely anticipated initial public stock offering of internet giant Facebook, illustrating the link between the state's higher than average tax rates and the effect on the behavior of the innovative, technology driven companies that are the key to sustaining the middle class.

"It's just common sense that high tax rates will drive out the entrepreneurial leaders who are the foundation of a modern economy" said California Republican Sate Senate leader Bob Huff  while speaking from the Capitol of a state where Apple Computer, Adobe, Hewlett Packard , Sun Microsystems, and Amgen have somehow managed to eek out a living. If you have some Enbrel in your pharmacy refrigerator, you're storing the results of innovation in a state where millionaires pay a 1 percent income surtax to fund mental health programs.

Experts fear a repeat of the 2006 Google IPO, in which 16 Google executives paid the state almost $380 million dollars, enough at the time to fund the salaries of more than 3,000 state workers, who did such things as guard the state's violent prisoners, teach its children, and man the pharmacy board that many panty-waisted ninny pharmacists in the state expect will act as a counter balance to the giant national corporations that have already largely destroyed the profession. Those 16 executives are now largely destitute. Four of them starved to death in the winter of 2010.

Estimates are that Facebook's IPO could be four times as large as Google's, which means California could conceivably see over a billion dollars in tax revenue, while CEO Mark Zuckerberg's emaciated, lifeless body will be found on a San Francisco street corner in about a year after he becomes penniless.

"We simply cannot afford fall behind low tax states such as Alabama, Oklahoma, and Alaska when it comes to competing for the companies that will innovate the way to the economy of tomorrow." Huff continued while tapping on his iPhone. "The free market system has clearly shown what happens when you try to tax the people creating the jobs that are the key to growth."

You are reading this very post on blogger.com, a part of Google, which like I said, generated $380 million dollars for California and none for Alabama with its IPO.

Asked about the fact that California sends 22% more in taxes to the federal government than it receives, effectively subsidizing the rest of the country with the products of its economy, Huff plugged a set of earbuds into his iPod and pretended not to hear the question.

I Hope There Will Be Oompa Loompas Involved. The Oompa Loompas Were My Favorite Part.

LINCOLN, NEBRASKA- In a move many industry watchers are calling "completely outside the box" Global pharmaceutical giant Novartis announced today a nationwide promotion to honor the 41st anniversary of the release of the classic film "Willy Wonka and The Chocolate Factory."

"We all remember Willy from our childhood, and no doubt have wondered what it would be like to win a magical golden ticket that would allow us to enter a place of pure imagination." said Norvartis CEO Joseph Jimenez. "Well today Novartis is happy to announce our very own golden ticket. Starting immediately, select packages of Excedrin, Bufferin, NoDoz and Gas-X may contain a way to a world of absolute drug-induced euphoria! That's right, we may have substituted the most popular narcotic in the country, oxycodone, for any of these products! How's that for powerful headache relief!!

"Of course, it would be ironic if you found one in a bottle of NoDoz, but we're betting you won't mind."

Mr. Jimenez went on to say that in addition to the wildly popular oxycodone, the promotion also features the classic narcotic morphine. Second place prizes include oxymorphone and hydrocodone.

I'm not making this up about oxycodone showing up on your Gas-X. Seriously, check your Gas-X if you have some. 

When asked why Norvartis would choose to honor the 41st anniversary of the film instead of last year's 40th, Jimenez said "well it's also the 7th anniversary of the remake. There's no need to overthink this really. The important thing is to realize that with every purchase of one of these selected over the counter products, you could be opening up a dream world of bliss. And possibly constipation."

"This is bettern' a lottery ticket" said Pikeville, Kentucky resident Buford Radley while emptying the shelves of a local Rite Aid of all forms of Excedrin. "It's kinda like a scratcher the way it builds anticipation, but the prize is better, especially now that Skeeter raised the prices on his Oxy's and I'm going through withdraw."

Industry analysts expressed surprise that a major recall of over the counter medicines did not involve Johnson and Johnson Corp in any way.

"I read the press release and Tylenol, Benadryl and Children's Motrin don't seem to be mentioned at all." said Merryl Lynch's Andrew Sigmond. "Go figure. Now, if you'll excuse me, I feel a killer headache coming on. I'm betting that some Bufferin will really hit the spot."

Full disclosure- The Willy Wonka idea came to me via an alert reader. It takes a village. 

Zogenix Pharmaceuticals Meets The Country's Need For More Hydrocodone.

SAN DIEGO- In a story I am totally not making up, Zogenix Incorporated is working hard to get more hydrocodone to your customers.

The company soon hopes to market a 50 milligram tablet with no acetaminophen. I swear. That's the equivalent of 10 Vicodin in one pill without any of that pesky Tylenol to slow someone down. Early indications are that the drug, which Zogenix plans to sell under the brand name Zohydro, has the potential to be quite popular.

"If one thing has been consistent in our market research, it's that pharmacy customers are almost universally saying one thing, and that is 'we want more Vicodin'!!" said Zogenix CEO and scumbag Roger Hawley in a fictitious interview. "The demand is almost universal, reaching across all regions, social classes, ethnic groups, and even the occasional pain sufferer. So we have developed an innovative new way to get consumers what they are craving. With the dose limiting effects of acetaminophen gone, there is literally no limit to the potential use of this profit....I mean, product!!"

Early contenders for the street name of Zohydro include Supervics, Turbonorcs, Zoes, Hydros, and Yellow Death, pending final determination of the tablet color.

"I particularly like that it's a prescription product" said 63 year old Winthrop Van Drusen from his summer home in Greenwich, Connecticut. "It makes it quite convenient to obtain a safe, pure supply of narcotic to meet my needs by simply browbeating a doctor, my social inferior, into writing a prescription."

Asked about concerns Zohydro will end up simply feeding the nation's large and growing demand for narcotics, Hawley, who will never spend a goddamn day in jail, didn't say "I think the key is to build on the lessons learned with the marketing of Oxycontin, and expand on the innovative ways they have addressed these type of problems while still meeting the needs of those in chronic pain."

Deaths from narcotic overdose have more than tripled since Oxycontin came to the market in 1995, and more people now die from prescription drug misuse than in traffic accidents. A fact Hawley doesn't seem to give a fuck about.

"I wish they's hurry up and get this shit out" said drug dealer and occasional user Juan Ventimillia outside a Philadelphia housing project. "My muthafuckin customers keep riding my ass for more and more Vics, and I thought I had the problem solved when I started scoring Norco instead, but shit, it's to the point now where I gots to carry so many goddamn pills around I sound like a goddamn shorty rattle every time I move. I'm hoping the new shit will save me some space. You know what I'm sayin?"

Street level dealers such as Juan face a mandatory 5 year federal prison sentence in the United States if they sell crack, while CEO's who peddle bullshit like Zohydro generally get to retire quite wealthy. That is why most guidance counselors recommend obtaining a degree in business before embarking on a career of getting people hooked.

Asked for comment outside his Florida radio studio, Rush Limbaugh didn't seem to hear the question. Probably because he's gone deaf again.   

Think Of This As An NPR Pledge Drive. That Won't Cost You Anything.

So a friend of mine sends me a link the other day. It was from the folks at slate.com, and it was a good one. It seems they have a regular column called "The Explainer" Which takes on such topics as "How did dinosaurs have sex?" I figured this pal of mine just knew I was the type to ponder things like this for no reason. But there was more.

The explainer is having a year end poll you see. Thirty one questions have been nominated and the one that garners the most votes will be designated "question of the year" and an answer will be provided. Hang with me here.

Question 23 is "Why does it take 45 minutes for the pharmacy to get your prescription ready—even when no one else is waiting?"  You know what this means. You know this is a golden opportunity.

Because the more exposure this question gets, the more people will be searching Mr. Google and come across the real answer. We have in our hands tonight my friends, a chance to achieve an age of universal understanding, tolerance, and dare I say it,  love for our profession.

I knew when I wrote those words it was part of destiny.

So for the beleaguered technician dealing with a foaming at the mouth lunatic at the cash register, for the pharmacist at the end of his 12 hour day (14 hours at CVS. Illegal in North Carolina but not stopping them in the least) dealing with a DUR message that says "oral contraceptives should be used with caution in women of child bearing age," for the future of the profession, for all that is decent and just and good in this world. I beseech, I beg, I humbly ask, that you go here and vote for question number 23.    

Because it might help me sell some books too.

A Practical Question At This Point.

How did it work? Back in the day, when the Mormons had finally settled down in Utah after being run out of most of the rest of the country, hanging out far enough away from everyone else that they could finally just do their thing. How did they not run out of wives?

I know, I know, I know...jokes about Mormons and their wives were all run into the ground long ago. But seriously, a little math will soon show a big problem. There are slightly more baby boys born than girls, something like 51 to 49 percent, so do the numbers, and if one guy has like 10 wives, and another guy has like 8 wives, it doesn't take long before you run out of wives.

What happened? Isn't this kinda greedy? I'm pretty sure Jesus wasn't into greed. As a matter of fact, greed is one of the seven deadly sins.

It seems like there would have been a lot of fights and possibly crime among the dudes who weren't getting any wives. After all, any kind of gross inequity, whether it be economic or of access to vagina, breeds an unstable social order.

Could Donny Osmond have the DNA of a badass?

Intriguing possibility,  but back to the point.

What did they do when they ran out of wives?

A Little Knowledge Can Be Dangerous. An Illustration.

I looked up and the affluent asshole was there. This happens a lot these days. I made my move from the ghetto about five years ago and now I'm in a place where millionaires can walk right up to me as I work. One thing I've learned here is that millionaires are quiet. People in the ghetto had ways of letting you know they were coming but quite often you can be concentrating on your work in a millionaire zone, look up, and one will have appeared like a ghost. Millionaires are sneaky.

"POTASSIUM PERMANGANATE!!!!!!!" said the millionaire. Which those of you familiar with the land of affluence know was a request to purchase some.

"I don't think we carry that here sir, you might try......"

"IT'S FOR ATHLETE'S FOOT!!!!!"

"I'm pretty sure we don't have it" At this point an assistant manager offered to help the man find out for sure if the stuff was in the store.

"YOU CAN'T HELP ME!!!! Snapped the South African accented millionaire to the African-American assistant manager, in a tone that was, historically, exactly what you would expect.

Back to me now. "ARE YOU SAYING YOU DON'T HAVE IT????" and for the third time I said I was pretty sure we didn't.

"IT WAS ON GOOGLE!!!!" he said. Obviously I needed to be reminded of the strict fact checking that takes place before something is allowed on the internet.

Now, its not that I'm mean or unprofessional, but I know better than to let this man know there were several clinically proven athlete's foot remedies in the aisle right behind him. It would have been improper for me to speak out of place to the millionaire, and believe me, I've been dealing with these people for awhile now, and I know they will let their foot rot off before they will admit that their effort to consult Dr. Google might not have given them the best result. I kept to my place in the social order and the man left with fungus living high on the hog between his toes with no end in sight. I was never asked what might work besides potassium permanganate, which, by the way, Google can also tell you where to buy.

Meanwhile, in the ghetto someone just said something to the effect of "YO!! DO YOU KNOW WHAT THIS SHIT ON MY FOOT IS?" Whereupon the nice pharmacist led the man to the Lamisil, or Lotrimin, or Micatin, which cleared up the problem in a week or so.

I'd like to think of foot fungus as a fellow member of the 99 percent.

A Rerun And Shameless Book Plug All In One. What's Not To Love About This Post?

You know, I think the ideal Christmas gift would have something like this to say about the holiday:

For someone who professes to love us all, you'd think that maybe the thought our time could be worth a little something might enter Jesus' skull once or twice. That maybe Jesus could tell us, "You know, there's no need to go all out for my birthday. Really. Me and my Dad, the all knowing, omnipotent creator of universes known and unknown, the Deity that can part seas with his breath, move mountains with his pinky and knows the exact number of hairs on your head, I'm sure we'll come up with something. Don't put yourself out just on my account." 

"And there is really no need to invent The Clapper to sell in the season of my special day. You work too hard for your money." 

That's what my Uncle Harold would say. Uncle Harold always insisted we never make a big deal about his birthday, because that was just the kind of guy Harold was. Unlike this prick Jesus who pretty much ruined my whole week with this Christmas shit. 

And by whole week I mean entire month of December. And part of November as well. Traffic gets backed up because of a goddamn parade. People everywhere I want to shop. A big pile of pine trees right where I normally park my car at work. All because this savior of mankind lets it go straight to his head. 

I got news for you Jesus. I once saved the life of a mouse we found in the backroom of the store. That's right. Instead of killing it, I captured the little guy and let him loose in the woods in back of the mall. And I don't expect the mouse to buy shit every year for my birthday either. I think maybe I could teach you a thing or two about humility Mr. Son of God. 

The sad thing is it's not just me that gets screwed. The entire goddamn planet has to put their lives on hold just for Jesus every year. Fuck it makes me so mad. I got over birthdays when I was like 9, and Jesus still gets all giddy like a girl after 2000 of them? Give me a break. Buddhism looks better every day. No wonder there are so many Buddhists.

Which is why I think my book is the ideal Christmas present. Because that was an excerpt from my book.You should totally show Jesus Christmas is just about the stuff by buying a copy. And now, finally, you can put it on your Kindle which is a bit of stuff I still don't quite understand, other than to know I get a bigger royalty when someone buys a Kindle version. So um, yeah, I'm all about the Kindle. In your face Jesus. I'm gonna make some money off your birthday.

Go here to get a copy of the greatest pharmacy book ever written for your Kindle.

Or here to get me in your Nook. Which sounds kinda fun depending on your attractiveness. 

And if you're a fan of the paper, you can order a copy here. 

From the "Someone Doesn't Quite Get The Point, And That Someone Is CVS" File.

Also from the "I'm nor surprised at all" file.

 From happyplace.com. Via @DrJRod on Twitter.