Your Pharmacist May Hate You

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

2012-01-28T00:23:00.000-08:00

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.

2012-01-19T02:36:00.000-08:00

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.

2012-01-15T03:16:00.000-08:00

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.

2012-01-11T00:33:00.000-08:00

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.

2011-12-27T23:33:00.000-08:00

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.

2011-12-26T21:16:00.000-08:00

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.

2011-12-11T21:13:00.000-08:00

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.

2011-12-10T20:27:00.001-08:00

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?

2011-12-06T02:58:00.001-08:00

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.

2011-12-03T15:03:00.001-08:00

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

From happyplace.com. Via @DrJRod on Twitter.

Normally I'm A Thirst For Knowledge Kinda Guy, But I'm Calling This Quest Off And Remaining Blissfully Ignorant.

2011-12-01T00:35:00.000-08:00

It started the way most great intellectual pursuits do, by aimlessly wandering through the classified ads of Craigslist. Did you know the Internet can trace its origins to a government research project into ways to keep computers in the defense department safe from enemy attack? I'm sure the people who worked night and day with a vision of keeping the world safe for democracy all those years ago take great pride in the number of men who have been able to enlarge their penis thanks to special offers spammed to them through their creation.

Not that I'm looking to enlarge my penis or anything. I was actually looking through the real estate ads, I swear, I live in a tourist town you see, and the IRS says if you rent your place for 2 weeks or less, than the income from the transaction is tax-free. I was browsing around looking to see if anyone might be interested in taking a short term possession of my condo by the sea while I am away this summer.

I didn't really find any serious prospects, but I did come across an ad from a couple who said they would be in the area and wanted to know if anyone would be up for some "knotty" fun. Something wasn't right about this, it was clear. There was a secret here that I was not a party to, and not knowing things doesn't sit well with me. My Mom tells the world that she helped me learn to read because I would get mad that there were things on a piece of paper that other people could understand and I could not. That same intellectual fire started to well up in me as I stared at this ad that was coded in a way I could not understand.

If you do not want to be shocked, appalled, and disgusted, stop reading right now.

So I set out to break the code just as surely as I cracked the code of printed English almost 40 years ago. back then the result was gaining eventual access to the poetry of Shakespeare, the wisdom of the ancient Greeks and Romans, the modern insight of writers like Philip Roth and the practical life lessons to be had in the novels of Tom Wolfe.

Tonight however, I learned that "dog knotting" is another term for fucking your canine companion. I am not making this up. Evidently.......sigh.......a dog's penis swells up at the base during intercourse, forming a "knot" that acts as a plug so no semen can leak out. It stays like this, keeping the two.....in a perfect world......dogs....locked together for anywhere from 10 minutes to half an hour. There are, I am saddened to report, humans who evidently take advantage of this. And for two of them, getting their own dog and sharing this among themselves wasn't quite enough. They were advertising for strange people and/or dogs to share this, hobby(?) with.

I am going to take a handful of Ambien now in an effort to forget this ever happened.

If You Pay Attention, Most People Give You Subtle Little Clues As To How Their Mind Works....

2011-11-25T22:33:00.001-08:00

......other times, it's not so subtle.

Nation Prepares For The Annual Running Of The Tools.

2011-11-24T13:00:00.001-08:00

BETONVILLE, AR- From the small town Sears to major shopping destinations in cities around the country, excitement filled the air today as millions readied themselves for the start of the annual shopping season that begins tonight with the Running of The Tools. This years Tool Run is expected to begin as early as midnight at retailers in all 50 states, as dullards of every stripe gather to test their mettle in competition with what passes for human beings these days in an effort to score a discounted price on electronics, clothing, toys, and other miscellaneous crap that will most likely end up in a landfill within a year.

"We used to call it the running of the sheeple" said Wal-Mart Vice President Johnnie C. Dobbs. "but then we realized that sheep, unlike the crowds of barbarians that gather in front of our stores every year, very rarely get violent when crammed together in large herds."

Dobbs then climbed to the top of corporate headquarters and tossed 10 vouchers good for $100 off any laptop computer to the crowd below "just to give them a little taste of blood" One person's eyes were gouged out in the resulting melee.

While the precise origin of The Running of The Tools is unclear, archaeological research indicates it may have begun as part of a ritual of giving thanks for the sweatshop laborers whose work producing plastic disposable trinkets makes it possible for Americans to maintain a standard of living unmatched in the history of humanity.

Actually, "living" is probably the wrong word to use there.

In that spirit of thanks, Tool Run participants across the country this year will pause for a moment of silence to honor Jdimytai Damour, the Wal-Mart employee trampled to death under a frenzied crowd of Tools desperate to get rid of their money in 2008.

Not really. There will be absolutely no recognition of what happened to Mr. Damour tonight. Except possibly among the people who loved him.

"Unless you come from the dark place inhabited by these people's souls, the significance of the Tool Running can be hard to understand" said Dr. Glen Nealon, author of GET YOUR HANDS OFF THAT DVD PLAYER!! Tools And The Ascension Of Consumption As The Basis Of The Modern Economy "In the absence of meaningful relationships based on caring and consideration, worthy cultural outlets, or any other type of intellectual stimulation, the life of a Tool soon devolves into a search for meaning through competition for material symbols of status, and they are willing to risk almost anything to fill the vast void of nothingness that is their existence."

"HOOOOOOOOAAAAAAAAAA!!!!!!!!!! I'M GONNA GET ME A PLAY STATION FOR SEVENTY-FIVE BUCKS!!!!!" said local Tool Jacob Hatfield, who said he had been waiting in front of a Target store for 36 hours. He also added that if we even thought about barging in line in front of him, we could expect to be cut.

Reached in the eternal glory that is heaven, the almighty Jesus sobbed softly when asked for comment.

My Thanksgiving Gift To You. A Passive-Aggressive Way To Strike Back A Bit At One Of The Forces Destroying The Profession.

2011-11-24T10:37:00.001-08:00

Some of you followed my live blog of this as it happened the other day via my Twitter feed. For those of you that didn't, here's a fun game to play the next time you have to call a Medco mail-order facility for a prescription transfer:

The process will be excruciating, as you are probably well aware. It will start more times than not with a customer giving you a scrap of paper with an 800 number on it that will get you nowhere near a pharmacist. You will wade through voicemail hell to get to a human, who will begin the process of transferring you to a person who can actually help you. The ordeal will be like my penis, long and hard, but so worth the effort to get to. Because, when you finally reach that pharmacist practicing the profession from a cubicle 2,000 miles away, and you beat the information you need out of them, they will ask you a question:

"Can you repeat that back to me?"

It is their policy that you repeat the information they just gave you back to them. Their policy I said, not the law. Which means at this point you should hang up on them. Then the fun will begin. Because they will try like hell to get that repeated information. They will call you back almost immediately, and now my friends, all the power in this transaction shifts into your hands.

I've figured out they'll hold for about 10 minutes of silence before they give up. So what I'll do is around minute 7 or 8, pick up the phone and apologize for being so busy, but tell them if they can just hold on a little longer, I'll get to them as soon as I can.

Then I assure them their call is very important to me.

A couple of other tricks you may want to use: If you have a bilingual staff, you can help out the Medco cubicle rat by offering to help them in multiple languages. They'll appreciate your commitment to customer service as you let them know they can request Spanish by pressing numero seiete. In my case, I can also offer them Hindi. I bet they'll give me an extra dispensing fee for that.

Or, you may want to remind the cubicle rat that Medco's CEO seems to think that talking to retail pharmacists is vastly overrated, and that robots may be the way to go. Then maybe suggest that the cubicle rat go try to call a robot and hang up again.

The possibilities are endless really, and it makes your workday....I dare say...slightly pleasant. I now treasure an opportunity to transfer a prescription from Medco almost more than anything else I do.

Until the robot comes that is.

Highlights From A Half-Day Of Pill Counting Action.

2011-11-23T23:04:00.001-08:00

OK, so, I have a question for you. Let's say you're out there in the world, just kinda living your life, going about your day to day business, everything going just fine, and all the sudden you get a call from a robot who says you have a prescription ready. What would you do? Would you 1) Ignore the call because you know you're doing OK with your meds, or 2) At most, go to the medicine cabinet and check your bottles to see what you could be running low on so you could decide whether you wanted to buy another refill? Because if you would do either one of those two things, I have another question for you:

Do you really exist? Seriously. Are there people out there who would make the slightest effort to find out what the machine has told them to buy? Because I'm not seeing it. What I do see is a constant parade of people coming to the counter because they have been ordered to. They have no idea what they could be about to purchase. Not a clue as to how many prescriptions could even possibly be waiting for them. I'm not kidding you, when they get that call from the robot it's like getting some sort of surprise package for them. My already low opinion of humanity managed to sink a few more feet when I saw the other day how many more prescriptions we've been selling since the corporate mothership started their auto-fill program. The only good thing is the bonus money I'll be getting from all that extra revenue coming in.

BWWWWAAAAAHHHHAAAHHHAAHHHAAAAAA!!!!!! There's no bonus.

That does remind me of our district manager though, who I've mentioned before kinda sounds like a pirate when she talks. I know it's hard for a woman to sound like a pirate, but trust me on this, she pulls it off. An imitation of my District Manager is usually sure-fire comedy gold but my attempt this day fell flat on its face as I entered the happy pill room. I thought maybe it had something to do with the lady I saw brushing her teeth in our parking lot on the way in. How someone spitting their used toothpaste into the public sphere might put people in a bad mood. I was wrong.

The District Manager had been in earlier in the day evidently. With her boss. And her bosses boss. This was the equivalent of a visit from the Pope, or at least a high ranking Cardinal or two, thankfully without the pedophilia. Reports indicate the first thing they did was inspect the trash. There are now at our company, let me pause and make sure I'm getting them all... five different categories of trash. Each of which has it's own container. For example, a used alcohol swab, which, thanks to the characteristics of alcohol, is within a minute or two is a dry piece of cotton, is "hazardous waste," while a cotton ball used to stop someone's bleeding after an injection, which I will point out has and always will contain human blood, is just regular trash, and can be thrown out with my empty coffee cup and read newspaper. Call me a rebel, but I've always put the blood stained things in the sharps container. Fortunately no one noticed this during the trash inspection conducted by the man with a Masters in Business Administration.

The MBA man did leave word that I was unacceptably behind in my computer training modules though. So once I settled into work I stopped filling prescriptions and taking phone calls and learned that if there was a fire in the store, I should make my way to the nearest exit, and not walk up to the fire and try to make sweet love to it as I had previously thought.

Here's another question for you. Do you know if you're right handed or left handed? Because the first flu shot of the day didn't seem to. I always ask, you see, because my goal is to put it in the arm you use the least, as that arm is gonna be sore for a couple days. After a good minute of the man explaining that he did some things with his right arm but considered himself left handed, but he had an identical twin and he thought his twin was right handed, but threw a baseball with his left hand, I took a page out of the robot's playbook and just ordered him to roll up his left sleeve. While this was going on a man was insisting to my Supertech that his zero co-pay be put on his medical benefits card.

"I'm going to the bathroom" she said when the transaction was over.

"It's really gross back there." I reminded her.

"I know, but at least I'll get some peace and quiet for a few minutes."

About 10 minutes after I explained to a man that I could only print out an expense report for the year that covered his prescription drugs, and not what he paid for his extended hospital stay in another state, two fatty carts got in a wreck. Seriously. One of them just broadsided another right at an aisle intersection and neither of the fatties wanted to get up and help untangle the damage. I bet there would had been some road rage if either of the fatties had been able to muster up the effort.

The man who didn't know if he was right handed also missed his own age by 10 years when he filled out the flu shot questionnaire.

It could have been worse though. My Daddy could have toiled nights in the plastics factory, picking up overtime whenever he could in order to give me a chance to make something of myself, and I could have toiled away in one of the nation's finest universities, forgoing parties and football tailgating, in order to put into my head the knowledge both theoretical and practical that would allow me to make it in the world of commerce, and then... I could have been given the trash project, and spent my days making sure the HIPAA paper was always kept separate from the HIPAA plastic. Which is nothing like what a janitor does.

I also could have been ordered by a robot to buy the cheap scotch. Which makes me glad I didn't give them my real phone number. Cheers.

A Thanksgiving Rerun: After Roughly 400 Years, I Think The Lesson Of The Holiday Is Crystal Clear.

2011-11-23T13:24:00.001-08:00

If strange white people come wandering into your neighborhood, kill them. That is the lesson of Thanksgiving. I seriously don't think you can make a case that the Indians wouldn't have been better off if they had just killed the Pilgrims. Or let them starve.

Same way with Louis and Clark. Indians totally should have just killed those honkies.

California's Medicaid Problem Solved.

2011-11-18T23:52:00.001-08:00

The Drugmonkey settled into the soft glow of the nightlight as it filled the room and felt the warmth of scotch slide down his throat. It had been a rough week in the happy pill room, and he was letting it go. Decompressing. Forgetting. Beginning the process of regaining his strength for the workweek to come when the glow... became brighter. Steadily and surely, against the room's far wall a figure appeared. An overweight man it looked like. With wings. And a halo, a five 'o clock shadow, and a glowing white wife beater T-shirt. He had a lot of body hair. The Drugmonkey knew it wasn't good to mix alcohol with Wellbutrin, and as he sat his scotch glass down on the table he swore this would be the last time.

"Fear not, oh pill jockey" said the disturbing yet somehow comforting figure. "I am the Medicaid Fairy. And I bring good tidings!!"

"Oh happy joy!" said the Drugmonkey, "California Medicaid is in the most awful of ways. The state budget is a shambles, with revenue down and those in charge reducing Medicaid payments to providers, already among the lowest in the country, by another 10 percent!! Egads Medicaid Fairy, my friends who run independent pharmacies have told me they will actually lose money on any brand name prescription over $50! Imagine that, losing money by filling a prescription! Please make it better!"

"Make it better I shall, my friend, the Medicaid Fairy has a solution..."

"Yay! I can only assume this plan involves asking those that have benefited the most from living in our society to once again pay their fair share in order to make that society better for us all, as opposed to breaking the backs of small independent businesses. Perhaps we could restore the top income tax rate for millionaires to what it was under the Clinton administration, or better yet, the rate that prevailed during the reign of that stalwart of the GOP, Dwight Eisenhower."

Thirty seconds of silence enveloped the room. Punctured by the sound of a deep belly laugh.

"Oh silly Drugmonkey, we cannot possibly risk returning the American economy to the state it was in during the 1950's or 90's. Plus, most of the drugstore owners who are about to get shafted with a barbed wire penis would not hesitate to tell you raising taxes on the affluent is not a solution to any problem."

"But.....isn't Medicaid funded by tax dollars? So if we collect more of them, then we won't have to subject doctors, hospitals, and pharmacies to these drastic cuts. Right? I mean, more money coming in means more money to spare providers these painful cuts, and maybe a pharmacy could even get paid more than a prescription costs them."

"SILENCE!!" said the Medicaid Fairy. "I have the solution to your problem, and it as follows!! No one will pay any taxes from now on!!"

"Really?"

"Yes! And as a matter of fact, everyone will get a $500 rebate from the state. And pay no more taxes. Ever!!"

"And will they get a puppy too?"

"Yes. And a blowjob from the supermodel of their choice."

"Wow. So the Medicaid Fairy just shows up, waves a magic wand, and enough money appears to keep the providers who serve the poor from getting fucked. I'm pretty sure that's what everyone was counting on happening all along. Can I ask one question though?"

"Yes."

"How does it work, this magical system where we continuously reduce the tax burden of the rich while taking a chunk out of the hide of those upper middle class people who think they belong to the elite of society?"

"It's the magic of the free market Drugmonkey. No one outside of the tea party is capable of understanding."

"Really?"

"In the world of fantasy and magic, of course. In the realm of reality though, you're doomed. I was just fucking with you."

And with those words, the Medicaid Fairy disappeared, and a retroactive invoice for 10 percent of all medicaid payments made since June was left in his place.

Wake up independent drugstore owners. Like it or not, you are most certainly part of the 99 percent.

Another Reason Your Prescription Costs So Damn Much. Medco Wants A Chunk Of Your Lipitor.

2011-11-17T23:28:00.000-08:00

The whole idea of a Pharmacy Benefit Manager is that it will save an insurance plan's sponsor money. I mean, why the hell else would you hire a company to do something for you if it ends up costing you more than it would take to do it yourself? "Let us take care of the pharmacy end of your insurance plan" the PBM's say. "We know the ins and outs of the pharmacy business and can drive a hard bargain with drugstores." It's the whole reason they exist. To create savings and pass them along to the plan sponsor. Keep that in mind as we talk about this article from Friday's New York Times:

The biggest introduction of a generic drug in pharmaceutical history is being met with tough business strategies by Pfizer and pharmacy benefit companies, according to recent letters to pharmacists.Many drugstores are being asked to block prescriptions for a generic version of Pfizer’s Lipitor starting Dec. 1, when the company loses its patent for the blockbuster cholesterol drug and generic competition begins. Medco Health Solutions, among the nation’s largest pharmacy benefit managers, is one of the companies issuing instructions, seeking to have pharmacists keep filling prescriptions with the more expensive Lipitor for six months.

What? Has Medco lost its mind? Requiring pharmacies to use a more expensive drug? "Medco must be stupid" Some of you are probably thinking.

Pfizer has agreed to large discounts for benefit managers that block the use of generic versions of Lipitor, according to a letter from Catalyst Rx, a benefit manager for 18 million people in the United States. The letters have not previously been made public.

"Oh my gosh! Medco isn't stupid, Medco is smart!" You're now saying. "After anal raping drugstores to the point where they have nothing left to give, Medco is going after the drugmakers and negotiating discounts! They really will be giving value to plan sponsors when they pass all those savings from Pfizer along!"

To which I will say..........BBBBBWWWAAAAAAHAHHHAAAHHHAAAHHAAAAAAA!!!!! You obviously don't know PBM's very well:

A pharmacy group and an independent expert say the tactic will benefit Pfizer and benefit managers at the expense of employers and taxpayers, who may end up paying more than they should for the drug. “I’m stunned,” said Geoffrey F. Joyce, an associate professor of pharmaceutical economics and a health policy expert at the University of Southern California, after reviewing the letters. “This is just an egregious case. Clearly there’s been some negotiation between Pfizer and the large P.B.M.’s saying we’re going to make this cost-beneficial to them, but the plan sponsors are going to eat it.”

"Eat it" in this case, is a polite way of saying "take it up the ass"

Objections to the deal were raised publicly on Thursday in a news release from a group called Pharmacists United for Truth and Transparency, which opposes some tactics of pharmacy benefit managers. The statement called the move “a blatant attempt” by benefit managers to keep Pfizer’s discount while employers still have to pay the full price of the brand-name drug.

Got that? Medco negotiated a discount from Pfizer alright, and evidently is planning on keeping it all to itself. Now I only had a few business electives in college, so maybe an MBA out there somewhere can explain to me how that's not a kickback.

But is Medco really planning on something so brazen? Why don't we just ask them directly:

Melissa Mackey, manager of public affairs for Medco, said its letter described “a custom plan design, which is not a new concept,” in which clients could “tailor their formulary to maximize value.”

That, my friends, is a textbook case of corporate bullshit. You ever need an example of how to talk without saying anything, you just go back to that quote. Why don't we try just asking them a simple question that requires a simple answer:

Asked in an e-mail specifically whether Medco would pocket the Pfizer discounts while employers and taxpayers paid more than the generic price for brand-name Lipitor, Ms. Mackey declined further comment.

Yup. Think we have our answer. And I'm thinking we can expect more of the same when Medco merges with Express Scripts and controls a third of the market.

Tell me again why I'm supposed to be afraid of socialized medicine?

So...Um....Yeah...Not Sure Where That Last Post Came From. Moving On....

2011-11-16T22:57:00.001-08:00

What's the deal with water towers? Seriously. Every podonk town in the Midwest had one and I don't understand. I mean, I understand why the podonk town wants to have water, but why put it up in a tower like that? You have to expend energy to get it up there, right? So I don't see the advantage here. Other than being able to paint shit on them. That can be kinda cool.

By the way, I said get it up.......huh huh.....huh huh. Beavis and Butthead are back in case you didn't know, and that makes me very happy.

So anyway, the fact I don't see water towers all over California the way I saw them all over Ohio also leads me to believe the idea of storing your water 500 feet off the ground isn't the best one. Feel free to enlighten me.

I'm glad I'm thinking about stuff like this again. I think the Wellbutrin has finally kicked in.

Side Effects May Include The Ability To Get Through One More Mediocre Day.

2011-11-15T23:54:00.001-08:00

It's nighttime, and soon I'll swallow the Ambien that will serve as a cut off switch to end this day. Hopefully I won't drink too much and I'll remember to lie down before it sinks into my brain, so I won't do things like have entire Facebook chats I don't remember, so I won't have to piece together what I did this night from clues that are available tomorrow morning. Hopefully, but don't count on it. There are new episodes of Beavis and Butthead on MTV.com, and those little guys remind me of the 90's, which were my decade of hope. I'll probably watch them and not remember.

Soon it will be daytime, and a jolt of Wellbutrin will make it possible for me to get out of bed and face you. I'll open the bedroom curtains and look for something. It's better with the Wellbutrin, honest it is. Before the Wellbutrin I didn't know if it was gonna be you or me, but someone was gonna get hurt. Probably me now that I think about it. I'm a lot easier to hurt. Anyway, we don't have to worry about that these days. The Wellbutrin has lifted some of the fog from my brain and let me be productive again and keep a smile on my face as you ask me about shampoo and demand to know what happened to BC headache powders. The only reason I'm able to type this now is because of the Wellbutrin. Otherwise I'd be outside on the deck staring into the night looking for something.

It's probably making some of you uncomfortable to read this. People don't like to hear about other people who take antidepressants. I'll put you at ease by instead writing about how I burned my hand on the stove tonight. The skin on my fingers is turning white and thick and it hurts like hell. I'll take a couple more pills for that.

I wonder if you know I have to wring every last bit of norepinephrine from my brain the way a man stranded in the desert would desperately squeeze out every last drop of water from a sponge just to be able to get through a workday. My mind probably stopped producing the norepinephrine on its own because it saw what it was getting me. Making me say it three times won't change the fact you should see a doctor for that wart on your genitals. No, there isn't an over the counter cream that will help. Even if you make me say it four times.

The little red light just went off so I ran to the phone. Maybe somebody left me a message on Facebook. The little flickers of light are the only moments of hope left in the day now. Like dying embers in the fire of the 90's. The other day Michael Moore sent me a direct message on Twitter. Seriously.

The giant martini I just poured will help me forget about this. It'll wipe the memory clean and let me jolt myself awake with the Wellbutrin tomorrow with a blank slate and the ability to pretend maybe something will be written on it. Or at least that the little red light will go off and it will be someone I'll want to text back.

There has to be more than this. I know there can be a lot less.

Republican Presidential Candidates. The Gift That Keeps On Giving.

2011-11-15T09:43:00.000-08:00

I understand a lot of you aren't following the politics that much. It's a whole friggin year before the election after all, and you have other things to do. I get it.

It's just that....the people who *are* following the politics...they're about ready to give the presidential nomination of one of the two major political parties in this country to this man. I really think you should know this.

So, um, maybe you could tune in, just a little? Because they haven't yet, which means there's still time to change things.Plus the entertainment value can be very high at times.

I promise.

Speaking Of Debates....

2011-11-10T21:51:00.001-08:00

A lot of you have no doubt seen this already, but for those of you who haven't, this is real, actual footage of last night's Republican presidential debate. The featured speaker here is Texas Governor Rick Perry:

I'm thinking my fellow uber-liberals and I could use this to our advantage:

"It was Defense"

"Wha?"

"The third agency of government you said you would eliminate Governor, it was the Defense Department"

"I said that?"

"Yes, of course, it was genius"

"Was I drunk?"

"Probably, but it doesn't matter, this is quite frankly the boldest, most decisive game changing move in the history of presidential politics. Now eliminating the entire Pentagon might be a tad extreme, but immediately ending the bailout of Iraq and Afghanistan would put you in stark contrast to President Obama, showing you have the cajones to actually do what he only dreams about."

"You mean, I'd be doing the opposite of what Obama has done?"

"Absolutely, you could be the second American president in a row to win the Nobel Peace Prize, and the first to deserve it."

"Well sign me up pardner......YEEEEEEEEEHAAAWWWWWW!!!!!"

Yup, a tough talking Governor of Texas, short on smarts, not much for details, leads with his gut and reliant on others for big picture guidance.

What could possibly go wrong?

Oh. Yeah. Um, never mind.

What Better Way To Cut Through Bullshit Than With A Good Old Fashioned Debate.

2011-11-09T01:21:00.000-08:00

The Drugmonkey settles in behind a very statesmanlike looking podium as the buzz among the crowd settles into a low whisper. A bald, clownish-looking man enters stage left while four tired and rumpled people slowly stager in from the other side. The four are offered a seat and they immediately burst out in tears of gratitude. They sheepishly ask if there are snacks or perhaps bottled water that will be provided during this event. Not one asks about restroom facilities, as if they have no expectation of nature calling. The low whisper in the auditorium drifts into silence as the Drugmonkey takes the microphone.

"Good evening, and thank you all for coming to tonight's event. As you all know, pharmacy faces tremendous challenges as we move forward into the 21st century, and views differ as to how the profession will best meet the obstacles before us. One thing is for sure, no matter what direction pharmacy ultimately takes, CVS/Caremark will play an integral part. With over 7000 stores and control of one of the nation's major Pharmacy Benefit Managers, some will already say that as CVS goes, so will go the profession. With that in mind, we present tonight's debate, "CVS, a progressive force for the future or an embarrassment to pharmacy?"

"First let me introduce Tom Menigan, CEO of The American Pharmacists Association."

"Thank you for the opportunity to be here Drugmonkey. I gotta say our new headquarters in Washington, D.C. is much nicer than this dump though."

"And now, four pharmacists currently employed by CVS"

"May we speak now?"

Let me jump in here and let you know that while this debate took place only in my imagination, every word attributed to APhA's CEO comes from this post on his blog, while the words from the CVS pharmacists come from actual messages I have received in my e-mail box.

"Mr. Menigan, would you like to make an opening statement?"

"Recently, Megan Sheahan, Michelle Fritts, Erika Trevino, Olivia Putman, and I visited a CVS Caremark pharmacy in the Dupont Circle neighborhood of Washington, DC, where I received my annual influenza vaccination. We had a chance to see their advances in patient care, including numerous systems upgrades to assist pharmacists in identifying, monitoring, assisting, and documenting patient care activities and outcomes."

"Interesting. I think what I'll do now, as opposed to the traditional role of debate moderator, is step back and just let the two sides engage in a little back and forth. CVS pharmacists, you're up next."

"This pharmacy keeps enacting brand new programs (more things to do). I refer to myself no longer as a pharmacist. I am now a prescription salesman. I do not counsel, I do not care about outcomes, All I am supposed to care about is getting another script filled."

"By improving patient engagement through enhanced interactions, pharmacists have created new ways to improve clinical care and provide counsel that can improve adherence. By using increased technology and maximizing the use of pharmacy technicians in the pharmacy, CVS pharmacists are improving the health of patients while lowering the overall cost of health care."

"I managed to stick out 4 years at CVS before the fateful night of January 2nd, the Monday after New Years and the busiest day of the year when I worked a 14 hour shift with one 10hr technician, filled 300 prescriptions, fell asleep driving home and ended up crashing my car into a median. As soon as I woke up, I gave my notice and went to a grocery store pharmacy, making the same money with much better hours and 10 times less stress."

"The CVS team of Papatya Tankut, Cherise Wilson, Scott Staso, and Rosaline (Rosy) El-Khoury showcased recent patient care initiatives the company has implemented to allow pharmacists greater opportunities to interact with patients and prescribers."

"This is not why I got into pharmacy, I am not a telemarketer, I am no salesman, but I am that person that will tell you, 'don't take tylenol while on that'. I would give anything just to be a pharmacist again."

"It’s clear to me that the organization is taking enhanced pharmacists’ services seriously."

"There are the traditional complaints about retail and then there are the extreme cases and CVS is one of those.... CVS takes the cake with pharmacist abuse."

"Let me just jump in here now, since the subject of pharmacist abuse has come up. Mr. Menigan, what do you have to say about published reports that CVS systemically ignores the will of the North Carolina Board of Pharmacy, which has mandated a 12 hour workday for pharmacists, by having pharmacists in North Carolina routinely work 14 hour days?"

Since APhA has never said a word about this flouting of a law it helped defend, you can insert 30 seconds of the sound of crickets chirping in the background here.

"Very well then. Well it seems that one thing is crystal clear tonight. The views of The American Pharmacists Association differ sharply from those of actual pharmacists. Mr. Menigan, you managed to get your message out even when outnumbered 4 to 1 by people in the profession you claim to represent. That's quite a feat, but to be honest, not at all unexpected. I see the corporate special interests that actually control pharmacy have come with their pocket now, which means it must be time for you to crawl back in. Thank you for being here, and thank you you to the CVS pharmacists who have to be back at work for a 14 hour day bright and early in the morning. Try not to drive into any highway medians on the way home!

And a special thanks to our audience here at the Medco auditorium and around the world on C-SPAN and online. Be sure and tune in next time when Walgreen's Chairman and CEO Greg Wasson will discuss the topic, "How tobacco sales can drive top line pharmacy revenues" Until then, goodnight, and be sure to meet that flu shot quota!!

Walgreen's POWER Outages Continue: The Emergence Of "Deep Pill 2"

2011-11-01T20:41:00.000-07:00

Get it? Walgreen's calls its initiative to redefine the future of retail pharmacy its POWER program. POWER outage....you with me? 'Cause people are outing it....bwwwaaahhhaahhaa...

I'm so damn funny it's a wonder I can be around myself all day without my head exploding.

At any rate, here's my original post featuring a source I've dubbed "Deep Pill" exposing what life is like in the real world of a Walgreens central-fill POWER pharmacy. Tonight we'll let "Deep Pill 2" give us the scoop on conditions at a POWER retail store. I am tired of body and weak of brain this night, so I'm pretty much just gonna run Deep Pill's story unedited. I'm sure you'll agree that story speaks for itself. And that we're all, pharmacists and customers alike, very fucked if Walgreen's gets its way:

I worked for the WAG in AZ for just about 10 years. I have seen many changes... but not as destructive as POWER. Your article about POWER was spot-on. I wanted to share with you some of the problems I experienced with POWER during my tenure at the WAG.

WAG, for those of you not in the know, is Walgreen's stock symbol.

I was the pharmacist at the store-level. Not sure if you were aware of this... but anyone who wanted to remain a staff pharmacist at the store-level when POWER was rolled out, had to re-apply for the job. I kid you not. After working for a solid 8 years, I had to re-apply for my job. For those pharmacists who wanted to transfer to the CPO, they did not have to re-apply-- they were automatically accepted. Then WAG spent a TON of money to hire an independent hiring company to make the determination whether or not we could remain a staff pharmacist at the store level. This whole process was absolutely stressful on all of us. Pharmacy managers who wanted to stay at store level were exempt from re-applying.

I made the cut. Great, right? Not so much. I had to deal with understaffing, angry customers who were misrouted by our "colleagues" at the call center, managing two lanes in the drive-thru, customers at the counter, and customers at the consultation window. I forgot to mention flu shots. Now POWER looks great on paper. All this "free time" to provide MTM services (which all our friends at APhA are probably orgasming to...). This simply wasn't the case. (emphasis mine) Because of the lack of staffing, we had zero time to perform MTM services. Our District Supervisors told us time and time again to call upon the store manager if we needed extra help in the pharmacy. Well, a lot of the store managers were not willing to come back to help us out. They had their own crap to do. I don't blame them... but I digress.

One of the biggest problems I had to deal with was the amount of errors that I caught from our wonderful "colleagues" at the call center (CPO). These errors were careless and made my job a lot harder. Let me give you an example. I was counseling a patient on her Prometh w/ Codeine. The sig: Take one or two TABLETS every 6 hours as needed for cough. Now I know this may not sound like a huge deal... but I have a huge problem letting a prescription leave my pharmacy that has a blatant error. In order to fix this, I had to delete the prescription, find the hard copy, re-scan it so that our wonderful CPO can retype it. Mind you, this patient is in the drive-thru wanting to get home because she's feeling lousy. So the whole verification process at the CPO starts all over again...

The District Supervisors encouraged us to fill out an error form online so they can take proper corrective measures with the people at the CPO. (Drugmonkey to malpractice lawyers; those error forms are no doubt stored somewhere, and subpoenable I bet) I have no idea if that was done or not. I'd still get error after error. Let me say this: I totally understand that technicians make mistakes while performing data entry. What makes me frustrated is when pharmacists at the CPO are under pressure to "make their numbers" and when quantity takes precedence over quality. This isn't totally the pharmacists' fault. I'm sure the corporate 'tards stress the importance of quantity quantity quantity. These verification pharmacists at the CPO did not have to worry about the drive-thru, phones, customers, etc. Their ONLY job is to verify prescriptions without any distractions. One error (which I caught) was Augmentin 500mg Take 4 tablets an hour prior to dental appointment. Of course the prescription image said Amoxicillin. And of course, we at the store-level looked like retards when the patient came in to pick up their medication. We had to take the blame from the patients for the errors that were made at CPO. What makes this so ironic is that the pharmacists at the store-level actually prevented harm to the patient. We were not allowed to talk bad or against the people at the CPO.

Arizona is a mandatory counseling state. I have seen pharmacists who do not counsel. Combine that with the errors at the CPO can lead to a disaster.

I'd be willing to bet a Benjamin that it already has.

And that we're all fucked.

Thank you APhA.

Thank you Boards of Pharmacy.

But the biggest thanks of all..... goes to the Pharmacy America Trusts.

At least they're still a decent place to buy cigarettes.

From The "I Work At Dundler Mifflin" File.

2011-10-28T23:11:00.000-07:00

Dunder Mifflin, for those of you not in the know, is the fictional paper company portrayed in the TV show "The Office" Until this year the manager of this company was a character named Michael Scott, who I'm betting was a little too uncomfortably close at times to what you go through in the real world. Once in the show Michael Scott didn't quite grasp the importance of a celebration of the Indian holiday of Diwali, telling his girlfriend it was a "costume party' The girlfriend showed up as a cheerleader, to much awkwardness

Today my real pharmacy manager told my supertech, who is of Indian origin, that she should wear a sari and a bindi to the store's Halloween party. Saris and bind's are generally not considered costumes, and would produce much awkwardness to be used as such, but that did not phase the Pharmacy Manager, who brought up the idea several times

The lesson I leaned this day, Michael Scott lives.

Walgreen's Bold Vision Of The Future As It Actually Works In The Real World, Including Tips On How Addicts Can Use The POWER Program To Get A Fix

2011-10-26T13:20:00.000-07:00

Like I said in my last post that wasn't inspired by the violent crackdown on peaceful protesters that happened in Oakland yesterday, Walgreen's, the country's largest drug store chain, has decided that big changes are in order for the profession. For the last couple years their emphasis has been on what they call the POWER program, which to recap for those of you just now tuning in, is a radical transformation of how pharmacy is practiced at the community level. POWER turns the act of filling a prescription into an exercise in industrial-type efficiency management, moving as much work as possible away from the store. Routine refills are done at a central location, phone calls are taken at a remote call center, and prescriptions themselves are scanned into a computer and verified by pharmacists working at home."The goal" a Walgreen's Vice President told Drug Topics in 2009, "is to relieve in-store pharmacists of certain tasks in order to give them more time to offer medication therapy management services"

Great. What could possibly go wrong?

"Let me start off by saying that not everything that Walgreens has done with POWER is negatively impacting our profession." says the source I've developed, who for no other reason than my love of all things Watergate I'm calling "Deep Pill." "The central fill concept is actually a good idea. Having all the next day refills filled at a separate location and then shipped to the pharmacy saves the pharmacy staff in the store a lot of time to focus on the patients who are in the store."

To do lots of Medication Therapy Management I bet, and totally not to do things like ring up potato chips and Walgreen's brand beer.

"If POWER stopped there," Deep Pill went on, "any of the few problems with central fill could be easily mitigated, and, even if not, the benefits would far exceed the liabilities"

Well there you go, can I just stop posting now?

"However, POWER, as you are well aware, does not stop there."

Oh crap. Although you knew that was coming, didn't you?

At this point I think I'm just gonna let Deep Pill take over, as his and/or her experience speaks for itself. Read on to see where the big thinkers in the biggest player in the profession are taking us, and our patients:

I worked in what is called the Pharmacy Care Center (PCC), which is a call center. The way it works is that, when someone calls a Walgreens store in Florida or Arizona, the call goes into a call bank where it first goes through a voice recognition automated system, then to a non-pharmacist staff member (called specialists) when the automated system does not suffice. Normally, that would be fine. That is what would happen in stores where technicians answer the phones. However, the people whom Walgreens hires for these jobs almost never have any pharmacy experience whatsoever. Walgreens is literally hiring people off the street. They do not understand, and, in many cases, lack the ability to understand how a pharmacy functions. The customers and doctors' offices can quickly ascertain this incompetence. The calls that the specialists could not resolve were transferred to the pharmacists at POWER (on the other side of the room from the specialists). Usually, we were able to resolve the calls fairly easily. One example of that early on in my career there was that the specialist was unable to clarify for the customer the meaning of the phrase "1 refill remaining before 6/19/09" printed on a prescription label. For the calls we were unable to handle for whatever reason, we pharmacists transferred the calls to the store pharmacy directly.

Now that you understand the workflow of the call center aspect of POWER, let me break down the problems that occur at each step. While the specialists are told that they are not to answer any questions the callers may have about their drugs, they frequently did anyway. If you click on the name of the drug, you can see its common uses; however, as is the case with several drugs (e.g. gabapentin, cholestyramine, amitriptyline), the FDA-approved use is in many cases not why the drug has been prescribed. Giving the callers misleading information results in panicked callers being transferred to the pharmacist queue where we had to calm them down and correctly educate them about their medications or panicked callers hanging up and calling their doctors. This problem is exacerbated by the fact Walgreens has these specialists answer the phone as follows: "Hello. This is the registered pharmacy technician (insert first name). How can I help you?" While that statement is true about their position, most people hear the word "registered" and think that the following word is always "pharmacist". Some people do not listen closely and miss the part about technician. Others cannot discern the words after "registered" because the specialists slur them together so much (a product of answering hundreds of calls per day). This problem is annoying and troublesome, but there is a more serious issue at this step.

Here is where all you addicts should start paying attention:

When the caller wants a refill and cannot figure out how to request it online or on the automated phone system, they will speak with one of these specialists. They also tend to speak with one of the specialists if they know there is going to be an issue with the prescription (e.g. want to change from insurance to cash, pick up at different store, change quantity). The following scenario played out quite frequently. The caller wants to pick up his Lortab or Xanax refill but wants to pick it up at a different store in the area. The specialist, without looking at the last time the prescription was filled, processes the refill at a different store. The patient is then able to refill whatever prescription he wants extra early without anyone noticing because he is paying cash price. I saw many examples where this problem happened. The worst one was a customer who filled the same prescription (for Lortab 10/500 quantity of 240) 5 times in 5 days at 5 different Walgreens stores. (Yes, you can transfer a controlled substance prescription more than once if all the pharmacies have a shared database.) What made that example so much worse was that the authorized refills on that prescription were authorized by a specialist, and the "original" prescription was a bogus verbal prescription (I called the doctor to check on it) taken by one of the pharmacists at the call center.

Got that? It's way easier to phone in a fake prescription when the pharmacist isn't familiar with the community, and way easier to get early refills when the person processing them isn't even a pharmacist.

It becomes really hard for the call center pharmacists to even investigate prescriptions we believe might be fraudulent because that means not taking incoming calls for a few minutes in order to call the doctors' offices and the local Walgreens pharmacy. Everytime we stopped taking calls for any reason, the non-pharmacist managers would start getting on our case. The senior group manager of our department publicly called such time shrinkage. Having worked in retail, I know the term "shrinkage" means stealing the company's resources, either by the customers or employees. These non-pharmacist managers just wanted us to take calls and get the callers off the phone within the target time of 1 minute and 55 seconds. Therefore, many pharmacists at the call center did not even investigate the validity of any prescription so as to avoid trouble.

Seriously, you addicts should go back and read those last couple paragraphs again. And thank the God of controlled substances a Walgreen's manager invented the concept of "time shrinkage"

The other problem at the call center pharmacist step came with taking new verbal prescriptions (legitimate ones). At first, we just wrote them up by hand. Then a specialist would walk around, pick up these paper prescriptions, and scan them into the patient's profile. Then the prescription would go through the Central Utility Department. This department types and verifies new prescriptions. Therefore, these new prescriptions that we had taken would be typed up by a specialist and then verified by a pharmacist in that department. About a year after I started working at POWER, they stopped having us write the prescriptions by hand, and instead we just inputted them ourselves directly into the computer. The next step after we inputted the prescription was clinical review, or, in some cases where clinical review did not apply to the prescription, it went directly to the store to be filled. This change most definitely saved time, but it removed that additional safeguard of having a couple of different people look at the prescription to prevent careless errors (e.g. it would be easy to acidentally pick Abilify 20 mg instead of Abilify 2 mg because they are right next to each other on the scroll down tab).

As for the store pharmacy staff, the final step in the call center chain, there are a couple of major problems. The first problem is that, due to the implementation of POWER, staffing levels in the store (pharmacy and non-pharmacy) were drastically reduced.

Wait.....I'm a little confused. Walgreens said the goal was to give store pharmacists time to do medication therapy management. How can they do this with drastically reduced staff? I don't understand. Maybe because I didn't go to business school. Or because I'm not a liar.

When a call is transferred to the pharmacy, very often there is only 1 pharmacist with 1 or 0 technicians working. That pharmacist is handling all the problems of the customers in the store and cannot pick up the phone. After a specified number of rings, the call will be terminated. If someone in the pharmacy miraculously picks up the phone, typically the pharmacy staff member will ask the caller to hold. After a specified number of minutes of holding, the call is terminated. When the call becomes disconnected by one of the previously described processes, the caller becomes irate and has to actually go to the store for service.

Sweet. So basically an integral part of POWER would seem to be hanging up on customers when you can't get to the phone.

The other larger problem comes in the prescription filling process. When there is a technician working, the technician does all the filling, and the pharmacist just stands at the cash register to sell prescriptions. Supposedly, the pharmacist is to verify prescriptions by comparing the image of the dosage form printed on the leaflet to what is actually in the prescription bottle. In many cases though, that does not happen. One reason is that the prescription is for a liquid. There is no way that can be verified because there is no image and the technicians are told to never put the stock bottle next to the bag. All the pharmacist ever receives is the plastic Ziploc bag with the labeled prescription bottle and the leaflet. Another reason is that the store pharmacy staff is so rushed due to under-staffing that they do not have time for this visual verification. The store pharmacist feels that the NDC number matched up or the label would not have been printed or however he or she rationalizes not visually verifying the prescription. I know Walgreens will state that this error is on the individual pharmacist, but the company created that environment due to its own staffing levels.

But wait.....there's more.......

My understanding of pharmacy law as it pertains to the pharmacist-technician relationship is that the technicians are to be under the supervision of a pharmacist. At the call center, there are technicians (or specialists as I call them) and pharmacists working in the room. However, the pharmacists are busy with their own calls and are not supervising the technicians. There are quality analysts listening in on the calls. However, they do not listen to all the calls, and, even if they did, these quality analysts are not pharmacists. I submit that these technicians are working without pharmacist supervision, a violation of the Florida Pharmacy Act (and probably of the pharmacy laws of any other state). Walgreens has its own representative at the Florida Board of Pharmacy. That situation seems like a conflict of interest to me and enables the company to get away with such violations. However, even still, when POWER management learns that the Board is coming to inspect, they move some of the pharmacists over to where the specialists work in order to give the illusion of supervision. Even if that enabled pharmacist supervision (which it does not because we all wear headsets and have too many of our own calls to monitor anyone else's performance), that is not how POWER typically operates. With the exception of visits from the Board or from corporate, the specialists and pharmacists do not sit together.

"Well at least Walgreen's never tried to have technicians do the type of work that the law says can only be done by a pharmacist" you may be saying.

And you would be wrong:

Another legality issue that arose during my time there was the issue of transfers. Each day, management would designate 1 or 2 pharmacists to do incoming transfers. Those pharmacists would not take incoming phone calls during their shifts. They would just call competitors for prescription transfers. Even still, there were so many transfer requests that they were always behind. To remedy this situation, management came up with the idea of having technicians call to get transfers, recording the phone call, and then having a pharmacist listen to the call and compare it to what was written up for accuracy. This program was eventually scrapped because there were not many of the call center pharmacists who were willing to participate. Also, many of the pharmacists for the competitors called the Board to complain about it. Much like the other legal issue, the reason that this issue even arose was a result of non-pharmacist management's desperate attempts to save money any way possible. They did not want to pay pharmacists to be monitoring the specialists' phone calls (because then those pharmacists would not be taking incoming phone calls themselves), and they did not want to use more pharmacists to do the prescription transfers (because then that would take too many pharmacists away from answering calls). They did not care what laws they broke in their quest to save money.

I'll repeat that last line again, in case you were just skimming that last paragraph:

"They did not care what laws they broke in their quest to save money."

Except I'm sure Deep Pill really meant "In their quest to give pharmacists more time to do medication therapy management"

And finally, this is who is deciding the future of your profession:

There are some pharmacists in upper management at POWER; however, the vast majority of management are not pharmacists, and, in fact, they have never even worked in a pharmacy. For example, the senior group manager to whom I alluded earlier was a call center manager at Sprint.

So they can't even sell out the future of pharmacy to managers of GOOD businesses. I'm sure it's not news to most of you that Sprint sucks.

Generally speaking, the non-pharmacist management there treated the business as if we were selling aluminum siding rather than drugs. I have seen other companies start to emulate Walgreens' POWER model, and I would like to see POWER have its plug pulled by the Board of Pharmacy so that this disease does not infect the entire pharmacy world.

So would I Deep Pill.....so would I.

And so should you. If you give a crap about the potential poisons you put in your body.

I am not hopeful however. God help us all.

"No Excuses" Said The Pharmacy District Manager, "Tomorrow You Will Meet Your Flu Shot Quota Or There Will Be Consequences"

2011-10-26T00:54:00.000-07:00

Walgreen's Puts One Vision Of Pharmacy's Future In The Nation's Newspaper Of Record, But Seems To Be Awful Quiet About The One It's Actually Been Working On.

2011-10-25T01:41:00.000-07:00

Here's the shiny, happy vision of pharmacy's future, courtesy of The New York Times:

As the Walgreen Company pushes its army of pharmacists into the role of medical care provider, it is bringing them out from their decades-old post behind the pharmacy counter and onto the sales floor.

The pharmacy chain, based in Deerfield, Ill., and the nation’s largest, has renovated 20 stores in the Chicago area and is converting more than 40 in Indianapolis to get the pharmacist closer to patients. Pharmacists in the revamped stores are being kept away from the telephone, where dealing with insurance coverage questions and other administrative tasks occupy 25 percent of their time, Walgreen says.

“What we are seeing now is pharmacists should be using their knowledge to help consumers manage their medications appropriately,” said Nimesh Jhaveri, executive director of pharmacy and health care experience at Walgreen. “It’s not about the product but the care we give.”

Wow, that's almost enough to get me all choked up and misty eyed. Things are going to get better. Really. Walgreen's says so.

"I am a pharmacist who is under the most stress of my career trying to keep my position under this new program. We have 11 or less seconds to review an Rx for data accuracy ... and less than 8 seconds to review it clinically for interactions and dosings. They are actually riding us now to do clinical in 4 seconds [as of] our last meeting. Do you know how hard it is to look up a drug/dosing in 4 seconds? If we do not accomplish this timing, our 'metrics' are out the door ... We are put on level 1 discipline, then level 2, then we are given a 'life line' to find another position."

Huh? What? How did that get in here? Oh for the love of God, that's only an actual letter from an actual Walgreen's pharmacist that showed up in my mailbox awhile back. The "new program" he's talking about isn't the PR stunt that the Times wrote about, but a vision of Pharmacy's future Walgreen's is much further along in implementing it calls the POWER program. The idea is to move as much work away from the store level as possible, using things like off-site central fill centers to deliver refills to the store, call centers to take calls from patients, and splitting the prescription filling process into individual, repetitive tasks to be assingned to workers off site. The pharmacist above had the job of verifying the accuracy of prescription images sent to his home computer.

"The goal of the program is to relieve in-store pharmacists of certain tasks in order to give them more time to offer medication therapy management services." Walgreens told Drug Topics when POWER rolled out. Which sounds an awful lot like the bullshit they were sending the New York Times' way. Let's see how that's working out:

I just wanted to add a comment in regards to Walgreens POWER. I received my first average (usually always above average or exceeds expectations) performance evaluation because I was going against policy and checking hardcopies (that were typed and verified by POWER) before dispensing medications to patients. I was told not to double check hard copies and to only check product.

But.......but.......the future pf pharmacy isn't about the product. That's what Walgreens said.

By double-checking hard copies, I caught several mistakes a day. These mistakes I documented. At my high volume store, my near misses went from around 20 a month, to over 100 a month. One specific prescription that I discovered was incorrect due to my double checking of hard copies was a prescription for a child for morphine sulfate written as 20mg/5ml to dispense 1 teaspoonful every 6 hours as needed. The prescription was typed and verified as 20mg/1ml to dispense 1 teaspoonful every 6 hours as needed. In a child, this could have been deadly.

Even more deadly than the cigarettes Walgreens sued the city of San Francisco for the right to sell. Nothing says it's all about the care you give more than fighting for the right to profit from poison.

That quote was from a different pharmacist than the first by the way. I got quite a few:

I am writing to you in response to the letter you received from the Walgreens pharmacist who worked at POWER

I too was one of the pharmacists working in the stressful environment that he talks about...

...My "numbers" rarely came in where they were supposed to because I actually read the prescriptions, checked for interactions, looked at refill history, etc. So on my weekly phone call from my supervisor, who was a pharmacy technician, I would be reprimanded and told to go faster. I was verifying upwards of 1000 Rx's per 8 hour shift. The "fast" employees were verifying about 5000. (emphasis mine)

I'll stop here and point out that's 625 prescriptions per hour. Or ten a minute. Every minute. All day long.

The Andersonville neighborhood store includes a 50-square-foot room behind sliding doors where a pharmacist, James Wu, can sit and counsel patients, who sit on a padded bench that has enough room for the patient and a family member or two. Mr. Wu’s desk is steps to the right of the private room.

Wait. I'm sorry. I've got all my notes and papers mixed up here and I keep getting Walgreen's versions of Pharmacy's future mixed up. I think that was the bullshit one.

They were also going to enroll me in a class that taught me "what to skip over when verifying prescriptions"

Well they did say it wasn't about the product anymore.

Mr. Wu said he could now spend more time talking to patients or out in the store aisles, and rarely is distracted now by the orders being placed for prescriptions.

POWER pharmacists are stuck at a computer terminal situated between the Consultation Window and 2-3 cash registers (plus drive-thru). There's absolutely no peace or privacy; the potential distractions are incalculable, and their mere likelihood itself soon becomes a distraction in-lieu. RPh's no longer have their own personal terminal; they share the register computer with the Technicians, Interns, cross-trainers, Store Managers- basically, anyone who wanders through the pharmacy can enter data under the pretense of the RPh's initials.

Mr. Wu didn't say that second paragraph. A Walgreen's pharmacist actually working in the Walgreens of the future said that second paragraph. I could go on, but you get the picture. The reports I'm getting from the real world are nothing like the blowjob that New York Times reporter gave the nation's largest drug chain.

But wait my friends, because as they say in the advertising world, it gets better. One Walgreen's POWER pharmacist wrote me not long ago and gave me the complete scoop on what this program is like. The ups and downs, ins and outs, and all the dirty laundry of this initiative undertaken by the Pharmacy America Trusts™ to shape the profession's future. Those of you not in pharmacy will likely be shocked. Those of you in the profession most likely will just be saddened. You'll have to wait until I get the time to get the next post up, but I'll give you a hint: it doesn't involve a 50-square-foot room behind sliding doors where a pharmacist can sit and counsel patients.

Stay tuned.

Darvocet And Dulcolax Are Interchangeable For The Right Patient.

2011-10-23T00:55:00.000-07:00

I can't claim credit for that headline. it came from an alert reader who tipped me off to this story from the website of WSB-TV:

JOHNS CREEK, Ga. — Investigators are looking for a burglar who has hit a Johns Creek pharmacy twice in the past three months.

Back in July someone broke into the business and got away with Adderall, Oxycodone and thousands of other pills. The store's surveillance cameras captured that crime...

Now police believe the same man may be responsible for both crimes.

"From the footage of the video from both of the incidents, we're pretty sure it's the same individual,"

But this time around the pharmacist outsmarted the burglar. According to a police report, the pill bottles taken were filled with candy and laxatives.

Reached in a fictional headquarters less opulent than the new building his organization can't stop bragging about, American Pharmacists Association President Marialice S. Bennett praised the "outside the box" thinking "in improving medication use and advancing patient care"

"This pharmacist obviously realized that a person ingesting a large quantity of narcotics, as this burglar or his customers were evidently doing, is at risk of severe constipation, and took measures to address the needs of his community, extending the same quality of care provided to the law abiding to those on the other side of the law. I'd like to think of this event as the culmination of a lot of effort and hard work here at APhA, as we have been advocating various medication therapy management schemes while standing idly by as pharmacists get ripped off in business transactions for almost two decades now. Bravo Health Mart Pharmacy of John's Creek Geogia, bravo!"

Pharmaceutical Benefits Manager MedcoHealth Solutions Inc., acting on the possibility that the alleged burglar was one of its cardholders, immediately imposed a $10,000 fine against the pharmacy for not having a hard copy prescription for the candy and laxatives on file.

Why Do People Call Them Teabaggers? For No Other Reason Than To Insult Them With A Sexual Innuendo, Obviously.

2011-10-22T23:46:00.000-07:00

From today's New York Times:

It's hard to ridicule people who do such a good job of it themselves.....

I Think This Might Be The Closest I Can Get To Being In Love Without Crossing The Gay Line.

2011-10-13T22:28:00.000-07:00

I Suppose It Would Be Rather Horrifying To Look At Your Baby And Discover An Ass Problem.

2011-10-12T00:29:00.000-07:00

I wouldn't know, as I don't have any. Babies that is. We'll leave any ass problems I may or may not have out of this for now.

But like I was saying, I've heard the love between a parent and infant is unlike any bond in the human experience, which totally makes sense. Evolution would have to create a pretty damn strong bond after all to withstand the noisy, smelly, mess making, mess getting into, sleep depriving experience that is parenthood. I've worked in a retail setting for close to 25 years now, which means I now see babies who could be the babies of the first little shits I saw wailing down the toy aisle long ago, and I am convinced. To put up with one of those things you would have to love them. A lot.

I bet the people at Stiefel Laboratories understand that as well. That a few of them are even parents, and that on occasion, they have experienced the unique horror that must come from seeing the child you love so much with its ass on fire. I'm talking about diaper rash, and I'm not trying to minimize the condition. I'm sure it's awful for a little guy or girl to have to go through. I'm also sure that the first reaction of most parents would be something along the lines of "I NEED TO DO SOMETHING!!!!!" That the sight of such suffering, along with a tinge of guilt that would come from thinking maybe they had had something to do with this, "Did I change the diapers enough? Was I not diligent enough with the baby powder?" Would spur a parent to do anything in their power to make things right again.

That's how most parents would think that is. The parents who work at Stiefel Laboratories evidently thought something along the lines of "We could make some money off of this. A literal shitload of money" Which would explain the creation of Vusion ointment. A product I am nominating this night as the biggest rip off piece of shit ever to grace a pharmacy shelf.

It's not that Vusion is ineffective. It never would have been approved unless there was evidence that it worked. The product's package insert lists three ingredients; miconazole, zinc oxide, and white petrolatum.

Miconazole is an anti-fungal agent used to treat secondary yeast infections that can take hold during an episode of diaper rash. It's good stuff to use in these situations, and Vusion contains it in a concentration of 0.25%

Thing is, you can buy an over the counter tube of miconazole , eight times as strong, in the athlete's foot aisle. It goes by the name of Micatin.

Zinc Oxide is a skin protectant that also helps to seal out moisture. Again, a great idea to use when skin is irritated and wet. You'll get it in a concentration of 15% in Vusion. Or you could get some over the counter Desitin and get it in a concentration of 40%.

The audacity to list white petrolatum as an active ingredient is my favorite. White Petrolatum is Vaseline.

So, let's recap. Vusion is a prescription product that contains a combination of ingredients in weaker strengths than you can find them over the counter. Now let's do some math:

One tube Micatin, 14grams- $6.49 (all prices from drugstore.com)

One tube Desitin, 120 grams, $4.42

Vaseline, 75 grams $3.29

Which gives us a grand total of $14.20.

So, how much do you suppose a prescription of Vusion goes for, after you go through the process of being examined by a licensed prescriber and given the right to buy something not as strong? Guess. Seriously...before you read any farther, I want you to take a stab at how much you think the good folks at Stiefel laboratories will charge you for watered down over the counter products.

Ready?

$265.99 for a 50 gram tube. I am not making that up. It's almost enough to make me slightly sympathetic towards insurance companies.

So by all means, the next time you gasp in horror when you realize your little one's ass is in an awful way, ask your doctor if Vusion is right for you, and if your doctor says yes......

Find another doctor.

I Make A Vow To You This Night. As Surely As I See This Glass Of Absinthe Before Me, I Will Dedicate The Rest Of My Life To Work Worthy Of The Nobel Peace Prize.

2011-10-08T00:49:00.000-07:00

An open letter to the people of South Africa,

Comrades,

It may seem odd that I, a common citizen of the United States who has set foot outside of my country only four times, would make an appeal to you, a nation halfway around the world and seemingly far more politically complex than anything I have ever witnessed. I ask only that you hear me out however, as my humble plea to you may just end up benefiting us all.

For you see, the demon seed of apartheid, planted so long ago and so far away from me, has sprouted into a flower of fire that threatens to burn out of control. Consuming my own house the way it has burned through so much of your country. I understand your problem with the white Afrikaners in a way that no one else who is not black can. They came uninvited, assumed all positions of power and went on to rule with an iron fist, tolerating no questions, much less actual opposition. First in South Africa, then with my employer. Because when you freed yourself , you chased many of your oppressors directly into the corporate suites above me, subjecting me to the very woes you once endured. By liberating yourselves, you set up my own enslavement. I suppose it is only karmic. I was a Republican during the time Reagan was propping up the regime that held you down. I am truly, deeply, sorry.

Did they do weird shit with the trash when they were in charge of your country? The trash system they have set up in my company is truly bizarre. Did they dismiss your ideas out of hand only to implement them months later and give you no credit? Did they tell you you did not know how to do simple arithmetic when you pointed out you did 75% of a store's prescriptions? I can only imagine what it would be like to live in a land where those people were the only ones with guns. Look into my face my African brothers, and you will see the pain of a modern Nelson Mandela.

Which is why I am writing to you this night. Because like my brother Madiba, I choose not to fight the power of injustice with force, but with the power of peace. From this moment on, I will not rest until you have settled your differences with the Boers and they can go the fuck back to where they came fr........I mean....they can return to their homeland secure in the knowledge you no longer want revenge for the fact they used to beat your head in and make you go to the shittiest beaches. I am in a unique position here my friends, as I both know what it is like to live under their heel and am pretty sure they will never call me a kaffir. Let us sit at the table of reconciliation and let me help you work together in the common interests of humanity.

As long as that table is in your country, and not mine. Before they conscript me to do off-site flu shot clinics, please, let's see if you guys can work this out.

We Have Finally Reached A Bipartisan Consensus In Washington. Now All We Need Is A Time Machine.

2011-10-04T23:37:00.000-07:00

So the words of yesterday's right wing whack job can get someone branded a flaming socialist today. I can only shudder at the thought of what tomorrow will bring:

A Question About A Question.

2011-10-03T21:12:00.000-07:00

My world could not be more unlike that of the Norteños or the Sureños and their ilk. I don't have to worry that picking out what color clothes to wear in the morning might be a life or death decision. I do have to be concerned that if my peers find out I eat non-organic bananas for lunch I will lose status in my community. I think about drive-thrus far more than drive-bys, and I'm pretty sure I'll never have to shank or be shanked. I do live close enough to the gangster world, at lease physically, that news of it often appears in my local paper. The accounts usually start off sounding something like this:

"Blue dude saw a red dude and asked him a gang related question....."

I'm not making this up, they oftentimes refer to this "gang related question"

What could it be? This question. Do they mean there's like a quiz? Really? And I thought I was under a lot of pressure what I took the pharmacy boards. At least no one was sitting there waiting to bust a cap in my ass.....

OK, seriously. What the hell is this question the gangsters ask each other. This is bugging the shit out of me.

Attention Pharmacy Students: Take A Good Look Before You Decide To Enter Retail.

2011-10-02T22:34:00.001-07:00

It Was A Shit Sucking Day At Work Yesterday. Oddly Enough, This Made Me Feel Much Better.

2011-10-02T09:00:00.000-07:00

It's good to know we're not in this alone, yes?

From lastrefills.com

Sonny Rollins And The Candy Lady

2011-09-27T01:10:00.000-07:00

There was a time in this country when Spam was mainstream. When middle class housewives across the country popped open a can and readied it for their husbands and children and the spam made them all feel like the very epitome of modernity. Before locally grown organic bought from the farmers market vine ripened tomatoes became our status symbol, we ate Campbell's tomato soup from the can, and pitied the poor slobs who had to make soup themselves. Before we had green tea organic natural nourishing shampoo we had Prell."You can be watching TV and see Coca-Cola," Andy Warhol once said, "and you know that the President drinks Coke, Liz Taylor drinks Coke, and just think, you can drink Coke, too. A Coke is a Coke and no amount of money can get you a better Coke than the one the bum on the corner is drinking."

Except Liz Taylor wouldn't be drinking Coke today. Anyone with even a little bit of status ambition would be drinking Fiji water, at the least.

I thought about this as I wandered down the main street of the quaint little Victorian-style town a little off the beaten path and into the candy store of the sad little old lady. She wasn't sad mind you, but seeing her behind the register would break your heart a little. Most of the town had been redone to create a tourist-friendly version of the past; "authentic" saloons, old style hotels that looked like they were ready for you to ride up on your horse and ask for a place to spend the night, restaurants that made you feel all 1875 while serving you up fair trade certified sweetbreads, it was a past in which we all can pretend we'd like to spend a little time, much like a Renaissance Fair.

The sad little old lady's candy store though, represented a past that actually was. Spartan, while tiled, and spare. Serving up Snickers, Three Musketeers, Jawbreakers, and Bazooka gum. A perfectly acceptable inventory for 1975, barely tolerable for a 7-11 today. The little old lady tried to talk you up as you looked over the Mars bars, but she was slightly out of touch in that unique way that the elderly become. She wouldn't be running her candy store much longer. She found her comfort zone sometime around the year I was born and never left it. I doubt though, if the sad little old lady has any regrets.

Earlier that weekend I saw Sonny Rollins headline one of the country's premier jazz festivals. For those of you who don't know, Sonny is the last echo of that golden jazz era that gave us the likes of Miles Davis and John Coltrane, which makes him of almost the same age as the candy store lady. He's lost a step or two physically, his voice is a little frail, but he still commands the stage in a way in which he won't for much longer. He sent his tunes around the arena that night like a boomerang, the notes coming back to their source so he could hurl them back around until they made us all dizzy with delight. He played like a man on fire, a man who knew he wouldn't be doing this many more times, a man who didn't want to let it go. He played and played for a good half hour longer than would have been considered giving the audience their money's worth.

I wondered, as I sat there, if the intensity of the performance might be because of the time he spent in prison when he was young and an artists creativity is at its peak flow, the months or years it took him to break his heron habit. The frequent years-long stretches he took away from music when he was of strong body. If, looking forward and not seeing many years there, he regretted what he did with some of those in his rear-view mirror.

I doubt Sonny Rollins ever found his comfort zone. I doubt he ever will.

I've thought about Sonny and the Candy Lady ever since, and I'm not sure which way is the best way to be old; comfortable and irrelevant, or on fire and searching, until the last moment.

I Must Give Big Pharma Credit Where Credit Is Due. I'm Glad They Stopped The Corruption.

2011-09-14T00:02:00.000-07:00

It's been almost three years now, and I can't tell you how much better I feel about myself. Today you see, I bought my own pack of pens. With my own money. I earned them, and I couldn't be happier. For the first time since I was in high school the marks I make will be my own, free of drug company influence. I am not proud of this, but for most of my career, I never told a drug company sales rep no. So the free pens came. Along with the T-shirts, ball caps, tape dispensers, a flash drive and a mouse pad, and probably a clock or two. With each plastic trinket I felt like a dirty whore. But I could not stop. The Vytorin tongue depressor was too important to me.

Not to mention the Actonel kitchen timer. I made cookies once using the Actonel kitchen timer and they turned out perfectly. They wouldn't have otherwise. Big Pharma corruption was improving the quality of my life, and I knew it even if I wouldn't admit it at the time.

Fortunately the pharmaceutical industry saw the tangled web they were weaving and saved me from myself. Its been almost three years now since they stopped the flow of pens, saving us both from even the appearance of impropriety.

Thank God. Now I am free to read the morning paper in peace.

Several companies, pressured by Congress or required by legal settlements, have started to reveal the names of the doctors they've paid to deliver promotional talks or serve as consultants.

What? Paid? Like money? Nooooooooooo....surely they mean things like Zantac toboggan hats .

Among the top-paid speakers from that sampling was Santa Monica pain physician Gerald Sacks. Since 2009, he has earned at least $522,113 giving promotional talks and consulting for four companies, according to the data.

Wait. That's half a million dollars.

Sacks, an anesthesiologist, isn't a leader in prominent pain medicine societies, and several top pain physicians told us they hadn't heard of him. He doesn't work in an academic medical center such as UCLA or USC. He hasn't published much research. We tried to talk to him about what he was paid for, but he didn't return numerous messages.

Sacks' slides from a 2008 educational talk and 2009 presentation before the U.S. Food and Drug Administration describe him as the director of pain management at St. John's Health Center in Santa Monica. A hospital spokesman said Sacks has never held that title and that his pain clinic is not part of the hospital. He does have the ability to admit and treat patients at St. John's.

Drug firms have a pretty fair idea of whether their investment in doctors like Sacks pays off. They pay millions to researchers who buy data from pharmacies and track the prescribing habits of doctors. Pfizer, which gave Sacks at least $318,250 for speaking in 2009 and 2010, according to its data, could find out if and how often he gave patients Lyrica and Celebrex, two of the company's pain medications. Firms can also track whether and how often the people who attended such talks prescribed the drugs that were discussed.

Yet somehow the problem was my copy of 2000 World Series highlights with a Claritin sticker on the side. Dr. Christian Erik Sandrock of Sacramento gets $156,000 from Pfizer and I'm the one that has to be stopped.

Really.

So the post that I started in such a positive way, with a realization that a boost of self esteem was in order, ends with the realization that I am not even a good whore. I feel better at least, about the Whole Foods cupcakes my Lilly rep snuck in last week.

Go Humalog.

The Perfect 9/11 Poem. That Wasn't Written About 9/11. Or By Me.

2011-09-11T00:00:00.000-07:00

It was actually written in 1984, By Depeche Mode, but it sums up 9/11 and the following Decade of Osama quite well:

I don't want to start any blasphemous rumours/
But I think that God's got a sick sense of humor/
And when I die, I expect to find Him laughing

Try to forget the 10 years that started on 9/12. And try to remember the best memorial we could build to the people that died in the twin towers and in that field in Pennsylvania is a world where neither Al-Qaeda or the United States military can find any recruits.

And maybe take a few minutes today to see if you can do a little to make it happen.

Highlights From Friday's Pill Counting Action

2011-09-07T23:52:00.000-07:00

"I really hate western medicine" the customer started. "It's not about curing anything, just about making profits for the drug companies"

Blah blah blah....you hear this type of thing all the time on my side of the counter. Especially when that counter is located in affluent California. I tuned out and started to think about that hardest of choices. Would I have a tumbler of scotch or a giant martini after work to help me forget about all this? My psychology professor told me once the hardest choice to make is one between two positive outcomes, and I was starting to see what he meant all those years ago.

I tuned back in to see if anything important had come up. I heard the words "potassium iodide" and took the exit ramp right back off this conversation. I wondered if I had any olives in the fridge should I go the martini route. Put a little olive juice in your shaker and you've got you a dirty martini. That just might hit the spot right now.

I've been in the profession about twenty years, and it took me about fifteen to hone my spidey sense to the point where I magically know when to start listening to a customer again. I felt the force and tuned back in.

"So I should have three prescriptions ready" said the scientific skeptic. "And can I get a flu shot?" The Vicodin and Soma were too soon to be filled. Meaning Ms. Western Medicine Hater would be leaving the pharmacy this day with only her Ambien and a sore arm. The incredible disconnect between the words that came from her mouth and reality almost made me ask her if she'd be interested in sending in a resume' to corporate headquarters. I think she'd really fit in.

I stuck my head back into the prescription pile and was next startled by the sound of a woman berating her child.

"I know you can read!!" She told the little one. "You shouldn't need me to tell you what kind of battery you need"

Five seconds later, the same voice......"VISINE!!!!!!!!" I'll translate that for those of you still left with a modicum of etiquette. What the lady meant was "Excuse me, do you know where I could find the Visine?" People in affluent California though, are far too advanced to actually form a question, they simply boil it down to its essence and scream the one world really loud at the person they expect to answer it, regardless of any evidence that this person is aware they are there or may be doing something that requires paying attention.

"Under the sign in front of you that says eye care" I told the woman who had just stressed the importance of reading. The great thing about the affluent assholes is that as long as their child-like need for immediate gratification is satisfied, they rarely will pick up on things like irony or the fact that you just insulted them.

I took a phone call and was immediately met with a scream. "I PUT ACID IN MY MOUTH!!!!! I PUT ACID IN MY MOUTH!!!!!" The person seemed to be forming words pretty well for someone in the process of incinerating their upper GI tract. Still, I started to give her the number for poison control.

"I SHOULD HAVE KNOWN BETTER....THE TABLETS WERE DIFFERENT. I SHOULD HAVE ASKED YOU BEFORE I TOOK ONE"

Hmmmmm....now I was thinking LSD. But why would someone ask their pharmacist about that?

Turned out the woman had gotten a different brand of Ambien CR, and she thought they had a bit of an acidic taste. She was worked up enough about it I couldn't imagine her getting much sleep that night. Which means she'll be in soon to tell me this new brand doesn't work.

The day closed with a kid in the waiting room whose attention we couldn't get because he was listening to his iPhone. He sat there, looking down, texting away while Alice In Chains poured through his headphones, as my supertech, my keystone tech, and finally myself took turns trying to let him know his zit med was ready. I finally went out and waved my hand in front of his face. Not because of any type of commitment to customer service, but mostly to see if I could scare him. I failed. He just kinda wandered up to the counter like a zombie.

"Your prescription is $25" said Supertech. And there was nothing.

No protest that $25 was too much.

No questioning of how much the insurance covered.

Not even the dreaded "I have a coupon from my dermatologist." Which was what my spidey sense was telling me to expect.

Just a blank stare. For about 30 seconds I'd say. Followed by a little shuffle that kinda carried the kid out of the store like a piece of sea kelp drifting out into the world of the big blue ocean.

It was a martini. And it didn't work. Despite the fact I guzzled it all down with a dash of olive juice I can still remember the whole day. And after twenty years of this I'm starting to become not all that fond of western medicine myself.

Like the Vicodin/Soma/Ambien/Potassium Iodide lady though. I'll be back for more of it tomorrow

If You Listen Closely, You May Detect The Sound Of A State Board Growing A Pair.

2011-08-27T21:46:00.000-07:00

"I thought I was too jaded to get excited by something like this, but I've got to admit it lights a fire under my balls to think a state board might have the cajones to step into the ring with any of the big retail chains." So says the alert reader who forwarded this copy of a survey sent out by the Iowa Board of Pharmacy. We shall see.........

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

Please take a few minutes to fill out this opinion survey on pharmacy closing rules. The Iowa Board of Pharmacywelcomes your feedback and your answers will be kept confidential. Thank you for your participation.

All responses will remain anonymous and will only be reported in the aggregate.

Do certain pharmacy business practices (such as 15-minute prescription guarantees, incentive coupons totransfer prescriptions, quotas on # of prescriptions dispensed and time to complete DUR, and pharmacist/technician staff cuts) interfere with the pharmacist's ability to serve as the safety net in the medication useprocess?

Should boards of pharmacy set a rate for maximum average number of prescriptions dispensed perpharmacist per hour?

Should boards of pharmacy require that individual pharmacies/pharmacists-in-charge determine anddocument, in policy, a pharmacy-specific maximum average number of prescriptions dispensed perpharmacist per hour?

If yes, should the pharmacy/PIC be required to regularly monitor that rate and make staffing adjustments asneeded to comply with their own policy?

Should pharmacy companies be allowed to offer incentives (such as coupons and other promotions) toencourage customers to transfer prescriptions?

Should pharmacy companies be allowed to advertise guarantees on the amount of time in whichprescriptions will be dispensed?

Should pharmacy companies be allowed to set quotas or time limits on the amount of time it takes apharmacist to perform patient care responsibilities, such as DUR and patient counseling?

Agree/Disagree

Advertising or soliciting for patronage is not in the public interest and is a grounds for discipline if it offersbonuses or inducements in any form other than a discount or reduction in an established fee or price for aprofessional service or product.

Agree/Disagree

A pharmacy shall not guarantee, promise, advertise, or in any way promote the dispensing of a prescriptionwithin a specified time limit or period that would jeopardize the health, safety, and welfare of the patient orthe ability of the pharmacist to complete the pharmacist's professional responsibilities including, but notlimited to, drug use review, patient counseling, and verification of the accuracy of the prescription.

Describe your typical workload in the pharmacy:

Do working conditions adversely impact your ability to practice pharmacy safely?

How long is your typical work shift?Indicate time period in hours:

Do you receive a break during your shift?If yes, indicate length of break in minutes:

Should pharmacies have a required meal break for pharmacy staff?

Should pharmacies have policies regarding workload?

Should pharmacies have policies regarding working conditions?

Should pharmacies have policies regarding maximum work shifts?If yes, should pharmacies have a specified maximum shift for pharmacists?

What type of practice setting do you work in?

Mail (or fax) completed surveys to:Iowa Board of Pharmacy400 SW Eighth Street, Suite EDes Moines, IA 50309-4688FAX: 515-281-4609http://www.iowa.gov/ibpe/index.htm

Today's Flu Shot Follies

2011-08-25T22:36:00.000-07:00

The conference call. I don't have to explain to a good chunk of you the futility of the pharmacy conference call. A unique opportunity to touch base with the corporate mothership and cover important business issues of the day. A chance to listen and share with colleagues. To communicate and learn.

While filling your normal amount of prescriptions of course.

And fielding customer questions.

And taking phone calls. On the other line. While the conference call is going on. You get the picture now if you didn't before. Under the best of circumstances, you'll get about half of what is said on a conference call.

Now is the point where I would play you a sample of my District Manager's voice if I could. She has a very strong and unique accent the like of which I have never heard before. I have wondered at times if it isn't actually a speech impediment, but it would probably be rude to ask your boss if she's had a stroke or something. Anyway, under ideal conditions, I can understand about 70% of what this woman says, put her on a conference call, and that'll easily go to under half.

Which means, at best, I'll get about 25% of the information that goes out on a conference call. I'm just very lucky to work for a company that never says anything important.

Today's conference call started with something to do about trash I think. Sorting the right trash into the right containers or something. We've had to make sure any trash with anyone's name on it is separated from the regular trash for over 5 years now, so I'm not sure what might have changed. Good thing I don't care very much or I probably would have been upset I missed out on the whole trash conversation while trying to explain to a moron how they were to take their prednisone. The moron's doctor was really asking a lot of the moron with the instructions he came up with, but I think I got the moron straightened out. When I got back to within speakerphone range the subject had changed to flu shots.

And the flu shot quota, which I've noticed has changed three times since originally imposed.

"So when you're asking your customers if they'd like a flu shot, what kind of reasons to they give when they say no?" Asked my district manager.

I decided that she kinda sounds like a pirate.

"Some people are saying they're worried it's too early in the season." Piped up a pharmacist somewhere who was taking this way too seriously.

"A lot of people are telling me they've already got it at their doctor's office." said another.

"OK then" said the pirate. "Pharmacist Nerd, you've given out the most shots in the district so far, so you must have a lot of experience dealing with people's concerns. What do you say to your customers that say it's too early in the season?"

"I just tell them that we've checked with corporate and they say it's fine" said Pharmacist Nerd, giving us all some goddamn valuable insight.

I noticed now that my Supertech was starting the paperwork so we could actually give a flu shot to a customer while these numbnuts sat around and talked about it.

"Very well" goes the pirate. "And Pharmacist Nerd, what do you say to your customers who tell you they already got it at their doctors?"

Which was the point where I hung up. Which I regret. Because I would have loved to have heard Pharmacist Nerd's answer as to how we can sell a flu shot to someone who's already had one.

Only seven months of flu season to go.......

Of Puppies And Rainbows And Consequences And Reality

2011-08-23T23:33:00.000-07:00

I remember the moment like it was only yesterday. It's not often you get the feeling that you're living in a world where things are breaking your way, especially if you're me, especially when I'm dealing in things work related. But there I was in a momentary place where every child has a puppy and rides around on a unicorn that shits out rainbows. Representatives of my employer were actually giving positive encouragement to rank and file employees. They had given them both a challenge and the tools to meet it, and most disorienting of all, had acted pleased when the challenge had been met. I had just graduated with the absolute last class of immunizing pharmacists in my company, and while there were smiles and back slaps all around, I knew what would be coming next.

I remember that moment like it was yesterday because it almost was. In less than three months the positive encouragement has morphed into business as usual. THE FLU SHOT NUMBERS SENT OUT IN LAST MEMO WERE NOT A GOAL, THEY WERE A MINIMUM!! ALL STORES ARE REQUIRED TO MEET THESE NUMBERS AND THERE WILL BE CONSEQUENCES FOR THOSE THAT DO NOT!!! I was genuinely shocked....that it took them this long to return to normal. I rolled my eyes, deleted the message, then walked over to the shelf and broke the seal on a bottle of Jalyn that had been gathering dust and was ready to be sent back to our wholesaler. A little harmless Lordstown syndrome is good for the soul when you work in retail pharmacy.

Thing is, it takes awhile to realize that being a retail pharmacy manager in turn of 21st century America is a setup for failure. That taking your corporate office seriously is a recipe for insanity. The game of unreasonable expectations is one that is played in every major chain, but it takes a few years of browbeating before it usually sinks in. My pharmacy manager isn't there yet, and I can see the stress on her face, aggravated by the fact she's here on a work visa. She's fired and she's also deported. So she's desperately toeing the company line, practically begging everyone who sets foot in the store to get a flu shot. I'm passive about the whole thing, if you want a flu shot, I'll make sure you don't leave without one, but I'm not about to bug your life to talk you into it. I've got plenty of other shit to do.

So far this week I have given 10 more shots than my stressed out, desperate pharmacy manager.

Because she also doesn't realize that the bullies from above, like most bullies, aren't very smart. That their suggested way of doing things rarely matches with what works in the real world. That if you really do want to give more flu shots, their MANDATORY PROCEDURE probably isn't the most effective way to do it.

So the pressure will build and the stress will rise, not only for my manager, but for like minded de-professionalized professionals throughout the company. We've had pharmacists crack under their pressure before, committing fraud regarding some sort of customer service survey and having to write a letter of apology in the company newsletter. Others that got fired over bending the rules when the frequent shopper card came out. If the bullies from above were able to break people over unimportant crap such as that, you know what's going to happen when the type of dollars to be made giving flu shots is on the line.

Someone, somewhere, is going to start making up false flu shot prescriptions to get the bullies from above off their back. I'm calling it right now. And if those false flu shots involve Medicare, which would be the easiest to do since Medicare flu shots have a zero co-pay, whoever does it will be aqua-fucked. Because that person will have just defrauded the federal government. That person will face fines and banishment from the Medicare program, making them unhirable, while the corporation that broke them with prescriptions on a time clock, lists of phone calls that MUST be made, staff cuts and sheets of unobtainable goals will at most, get a slap on the wrist.

It's not worth it. Learn to ignore them my friends, or at the very least, accidentally knock a few Lipitor tablets into the trash with every memo.

One More Reason I Am An Al Franken Groupie.

2011-08-17T02:30:00.000-07:00

I think it's around a minute 30 I start to swoon. Oh to have an entire Democratic party of Al Frankens.....

A Random Speed Dating Story From Long Ago.

2011-08-10T23:35:00.000-07:00

Those of you on the market know what it's like out there, and those of you who aren't probably aren't anxious to be reminded. The hard work, the constant pressure to perform, the degradation and humiliation, not to mention the expense. Trying to get laid my friends, is the hardest job you'll ever love. Kinda like being in sales with occasional orgasms.

The humiliation part was well in evidence as I walked into the kiddie club. The speed dating event was being held in a place that normally attracted a crowd that needed to be well versed in ways to trick a bartender into miscalculating the number 21, so it was incredibly obvious when one of us approached. "Upstairs and to the left" the bouncer said without looking up or so much as a word from myself. I shuffled up to the geriatric corner and hoped it wouldn't be as bad as I feared.

It was. Fat, old, weird, ugly and stupid filled the room. Everyone in this place had an obvious defect and I started to wonder to which category I belonged until I looked into the far corner and saw the exception. Long blond hair and the most elegant air about her you could imagine. Older, yes, but in a way that made you think classy. Worldly. Wise. And experienced in ways that would surely rock my world. The long sleek evening dress cried out to the world that she was the prize this night, and as I looked around at my male competition, a good portion of which was huddled in the opposite corner talking among themselves like this was a junior high dance, I was confident the prize was mine for the taking. I walked over and made a little small talk before the event officially started. It went well.

For those of you not familiar with how these speed dating things work, I'll give you a quick primer. Every lady sits at a table and every guy is assigned a number, guy number one goes to table number one, two to two, and so on. A bell is rung, and for five minutes each couple makes a little small talk until the bell is rung again, at which point the guys move along to the next table in line. It soon acquires the feel of a boxing match. My prize was to be the last lady I would talk to that evening, which would be perfect. I would look positively stunning after she sat through the other 12 numbnuts in the room, and the setup would be perfect for me to suggest we round out the evening by going to the grown up bar down the street. I don't have to tell the single among you what the dry spells are like, but when they break like a welcome drenching thunderstorm in the heat of July, I also don't have to tell you the feeling is among the most ego-gratifying in the universe.

I worked my way through the lesser women with the required subtle politeness. No use burning my bridges, even with the 280 pound redneck with eight... yes eight, children. Hope springs eternal, and she could lose custody of them and have a gastric bypass one day. The anticipation built as the night went on though, to the point where I admit it was hard to concentrate on the woman before the prize. I think she said she raced cars in her spare time, which under normal circumstances would have been pretty interesting. Tonight though, I was meant for more. The bell rang and my heart quickened.

I swear she looked even better than a mere hour ago. I hadn't noticed her smile and her perfect teeth. I realized that smile might be a sign she was glad to see me as I sat down. I was starting to feel something I hadn't in a long time. Happy.

The conversation started with the usual stuff. "So, where do you work?" naturally came up, and I told her about my exciting career in the happy pill room.

"Oh, I was in there once, I asked the pharmacist where the Q-Tips were and he was kinda rude"

"What were you doing asking the pharmacist about Q-Tips?" I instinctively shot back. I will mention here that I am the only man that works behind the pharmacy counter in my store.

The rest of the five minutes passed by in silence, and I went home alone and content.

An Ode To Darvocet, We Knew You Far Too Long.

2011-08-10T00:12:00.000-07:00

I've never filled your space on my shelf, dear Darvocet. For so many years I knew that I could reach behind me, to my left and slightly above my head, and you would be there, ready to step into the battle against mild to moderate pain.

Not that you would do particularly well in that battle, but if they gave out grades for effort my darling Darvocet, we all know you'd get an A+

Maybe that's why people liked you so much. Kinda like Pete Rose, you took the limited talent you were given and mixed it with an oversized work ethic, jumping into the fray day after day to improve your skills and gain a competitive edge. Except Pete Rose was successful, eventually becoming baseball's all time hit leader, and you worked just a little better than Tylenol alone. Now that I think of it, your addictive properties probably had more to do with why you were so popular.

Habit forming as you were though, I always loved your sense of humor. The way you would change from white to pink periodically. I'm pretty sure you did that just to fuck with the amateur drug dealers, more than one of which I witnessed trying to scrape off your pink coating in an effort to convince their customers nothing had changed. With every change of color we would get a spike of phone calls on Friday night from people who "found some pills" and wanted to know if we could verify what they were. You mischievous little narcotic you. You'll be happy to know Norco picked up on that trick of yours and continues to pull it off to this very day.

I'll also admit the adverse safety profile that eventually did you in was like a security blanket to me. For the better part of two decades, I knew that if things got too tough, that if the absurdity of the general public or the pressures of life in general became too much to bear, I could always just reach behind me, to my left and slightly above my head, take a couple handfuls of you, and be at hell's front door in about 40 minutes. I always make a note of where the phenobarbital is these days for just that reason, but it's not the same. I don't know why. Maybe because the phenobarbital isn't pink.

I hope you're doing well wherever you are these days dear Darvocet, and that retirement is as good to you as you were to my profit margins. Who knows, maybe if the teabaggers continue their rise to power it may be decided that the right to have a slightly effective, cardiotoxic pain reliever on the market is a matter of personal freedom, and that banning you from my shelves is akin to pissing on the grave of John Adams himself. Maybe that's why I've kept your spot open, because I wouldn't piss on the grave of John Adams.

I would recommend that people just use the Tylenol #3 though, or maybe some tramadol.

Highlights From Friday's Pill Counting Action.

2011-08-03T01:29:00.000-07:00

Asking me where the reading glasses are at work is the stupidest goddamn thing you can do. I don't say that because I don't think you should read. After all, the more people who make a commitment to getting some of their entertainment through the written word, the more copies of my book I will possibly sell. And it's not that I don't applaud you for making a positive change in your life in order to improve your vision. It's just that.....when I'm at work, I'm about 5 feet away from a reading glass display that is taller than I am, and I'm a taller than average kinda guy, and since you're probably between me and the reading glasses while you're asking....well....you get my point here?

"WHERE ARE THE READING GLASSES?" Said the first customer of the day. This happens about three or four times a week.

I also noticed we were starting off the workday at a relatively toasty 73 degrees. I've written before about our store's air conditioning troubles. They've been going on for well over five years now, but things had seemed stable of late, and I was almost ready to declare the long running situation resolved. Half an hour later it was 73.5 and I realized five years of air conditioning repair has gotten my employer nothing. I also noticed that our wholesaler's order had not shown up yet. We're very lucky in that we are one of the first stops on our wholesaler's delivery route, which means when we tell people something will be in tomorrow, we'll usually have it taken care of by 10 AM. It was now 10:30. You know what came next.

YOU GUYS SAID MY SUGAR MED WOULD BE HERE TODAY!!!

It was gonna be a long hot day. 74 degrees and rising.

At lunchtime I walked by the soon to be vacant Border's Express and thought about my last purchase there. I had been horrified to see the latest book by Philip Roth on the 50% off rack, and bought it mostly to save the poor book the embarrassment of being featured next to the latest work by Marie Osmond. I wanted to say something to the clerk about how we are lucky that Philip Roth consents to allow us to read his words at any price, but as I watched her struggle to count back my correct change and pop her gum at the same time I knew what that would get me. I remembered lamenting the state of literature in our culture back then, and I realized soon even bookstores manned by bubble headed bleach blondes will be gone. I resolved to be kinder to people seeking reading glasses.

I came back from lunch and found a man who had been waiting for me the entire time I had been gone. He asked for an emergency filling of his Cialis. This was the second time this week. A request for an emergency filling of a med for erectile dysfunction. I thought back to my recent CPR training and tried to remember if there was a part where I was supposed to have a boner.

We were now past the 75 degree mark and I got a warning from the computer that a prescription for temazepam, a habit-forming sleep aid, was being filled 15 days late. Makes me happy to know that Drug Utilization Review software is in there keeping my license safe.

I DON'T UNDERSTAND WHERE MY SUGAR MED IS!!!!!! This was the third time the lady waiting for our wholesalers order had called. She would call twice more, and when I phoned her to tell her it was finally here she said "Oh I'll just get it tomorrow." The temperature went from 75 to 78 very quickly, and it was now evening. The only possible explanation was that the goddamn HEATER was now on. I saw the assistant manager walk by wearing a jacket and realized I was on my own on this one. I called the air conditioner contractor and explained the definition of "controlled room temperature" that is on each and every pill bottle on my shelf. I explained it to their voicemail. I hung up and felt all hope melting away. Just like the polar icecaps.

"Where are the reading.....oh, never mind, they're right behind me!"

"At the end of every hard earned day", Bruce Springsteen once sang, "people find some reason to believe." I closed the gate and retained some small spark of hope for humanity.

A Special Message For The Profession From George Paz, President, Chairman, And Chief Executive Officer Of Express Scripts Incorporated.

2011-07-26T23:33:00.000-07:00

Fellow patient advocates,

As you are probably aware, my company, currently the third largest prescription benefit manager in the country, recently made a bid to acquire MedcoHealth Solutions, the largest company in the field. While we are confident this deal will be in the best interests of each company, plan sponsors, and the people they cover, you may be concerned about what this means to you, our valued retail pharmacy partners. Let me put your mind at ease. You are about to be fucked over. Completely, absolutely and thoroughly fucked like a two dollar whore dropped into a roomfull of prisoners doing life without parole.

Wait. I shouldn't have used the phrase "two dollar whore." That was wrong. I forgot we only pay you guys a dollar fifty per prescription. Still, I hope you get the idea. What you are in for will be in no way pleasant.

Some of you may be saying to yourselves, "For the love of God, after 30 years of shrinking reimbursements, pointless prior auths, endless waits on hold to contact a "help" desk, and slower and slower payments, short of actually bouncing checks, what more could they do to us?" Well, trust me, we'll find something. Unlocking the synergistic potential of our two companies is the very core of this deal, and while that certainly means things like eliminating duplicate functions and streamlining operations to take advantage of increased economies of scale, rest assured, we will also be working on new and innovative ways for you to take it up the ass with a barbed-wire covered penis of fire. For example, one idea we're batting around is actually charging you a "convenience fee" for the time and trouble it takes for us to send in an auditor to go through your records. After all, I'm sure you'll agree it is far more convenient to have them come to you than it would be for you to gather up all your files and bring them to our headquarters in St. Louis.

And if you don't? Too fucking bad, because we're soon going to control almost 40% of your third party business.

Before you completely panic though, let me assure you we have no intention of actually ending the entire business of retail pharmacy. We have learned over the years that while the process of filling a prescription is a simple one, essentially involving bringing a piece of paper to a store, and refilling a prescription is even easier, there is no small number of people who manage to fuck it up. Sadly, we are required by most plan sponsors to serve not only people with enough brain cells to be able to punch in a refill number, but those unaware of and completely incapable of handling the prescription filling process as well. The person who dumps all their pills into one vial and expects a refill on the one to cleanse their liver? That one's yours. The idiot who's been taking a blood pressure med for years and realizes at 10 o'clock on a Saturday night that they haven't had one for 3 days? Yup. You're on that one. The 86 year old lady who mailed her prescription to Oprah? Time for you to shine.

Not to mention you'll be covering for our fuckups as well. People whose enrollment information we lost, packages that get lost in the mail, prescriptions we just fill wrong. We'll leave you plenty of scraps to fight over, assuring a few of you will continue to be our valued colleagues as we assume leadership of the pharmacy benefits universe.

Just not valued very much. We're thinking 75 cents a prescription starting January 1st. If you beg for it hard enough.

Sincerely,
George Paz.

PS- I said beg for it, bitch.

Disclaimer- While this letter is completely fictional, the future it represents is very real.

Highlights From My Vacation.

2011-07-25T22:53:00.000-07:00

It was 90 degrees in Ohio as I left the delightfully cool San Francisco bay, yet I voluntarily hurled towards the inferno in a metal tube at 600 miles an hour. Like I was in a hurry. Like I really wanted to be there. This makes me question my sanity, as well as the sanity of the first covered-wagon driving pioneer who reached Ohio and decided this would be a good place to stop.

"Well, let's see, it's so hot here that not only have I sweated through my shirt, I'm actually a little dizzy and disoriented. One of my horses looks like it's about ready to die and the Indians tell me that in six months it will be so cold that the snot in my nose will freeze. On the other hand, it makes me feel good that I can be a food source for so many mosquitoes. Yup, this is the place! I'm home!!"

Shortly thereafter I imagine that pioneer started talking about football and making babies, and the people of Ohio have excelled at doing both ever since. I was 16 years old the first time someone in Ohio asked me if I had a kid, and if I know my Ohioans, Jim Tressel's troubles will lead every resident of the state to have major self-esteem issues this fall.

I escaped all this, and I was now headed back.

But not before going through Denver International Airport, which from what I could tell, is nowhere near the actual city of Denver. As we started our descent, I looked out the window and saw absolutely no sign of civilization. This continued all the way to touchdown. I was kinda glad I was just passing through, because I'm pretty sure if I lived in Denver, I would have had to catch another plane from the Denver airport to get home.

By the way, there are splotches on the carpet of the Denver airport that are totally the color of poo. I actually saw one out of the corner of my eye and instinctively avoided stepping in it.

I boarded the plane to Ohio and halfway there I had to pee. There was a lady in the bathroom changing a baby and it honest to God took her more than 10 minutes. The captain of the plane was in line behind me and got very, very, angry. Obviously he didn't realize in Ohio the babies are in charge. We landed and I saw lots of fat people wearing Ohio State t-shirts. I was home. The use of the word "epidemic" to describe the fattening of the country is not an exaggeration. At one point during my vacation I found myself in a gift shop in Ohio's Amish country. The place had two stories and an elevator. I looked around and realized that that elevator was a business necessity, as there was a significant portion of that store's customers that would not have been able to climb one set of stairs. I am not kidding you.

I didn't buy anything.

Gotta hand it to those Amish people though. Balls. Of. Steel. No way in hell you'd ever catch me trying to drive a horse and buggy along a friggin highway. And not one of them is fat, which is probably good news for their horses.

So yeah, I spent the week hot, bored, lonely and miserable. I made fun of the locals in my head and wrote a column for Drug Topics to keep me from going insane. And when I left my Mom cried. Flat out cried. Her tears were disorienting. A reminder that at one time I was one of those babies that run this state, and in her eyes I still am. I boarded another metal tube and headed back to a land of miserable, self-centered, lonely, narcissistic, truly awful people. I went back to California, where I fit in just fine.

I Don't Do This Often, But You Should Check This Blog Out.

2011-07-25T00:24:00.000-07:00

Especially if you're in the profession. Most pharmacists write like they expect that people will be forced to read their work. This guy isn't one of them. Go look:

http://lastrefills.com/

It's Not So Much About Sex As It Is Power, They Told The Sheep Later During Counselling.

2011-07-22T22:30:00.000-07:00

Do you really think this would be the best choice for a photograph to run on the front page of a newspaper?

Above the fold?

Really?

Actually, I think "Above The Fold" might not be a bad caption for the thing.

Anyway, evidently someone did indeed think this was the kind of thing that should be plastered all over town and delivered to every doorstep in the community.

The other big news story was that in large parts of the country, it is hot during the month of July.

God help us all.

Remember Minnesota, The Only Reason You Have Al Franken As Your US Senator Is Because I Decided You Could Have Him.

2011-07-20T23:16:00.000-07:00

It wasn't easy. A part of me still longs for Al Franken's radio show. For the hate mail of the day. All I ever get are emails from some guy who thinks I should be impressed he's figured out my middle name and where I work. He calls me the Drug Commie. Wow. That's great. I wonder if he thought of that all by himself.

Sigh.

Sometimes though, I get a reminder of why I let Al Franken go. That my personal loss was a gain for greater society. Like a message in a bottle that washed up on my own personal beach far from Washington, D.C., a video link showed up in my mailbox today from The Center For American Progress. It shows why anyone who enjoys watching Jesus-freak bigots get bitch slapped, and in particular those on the front lines of the last great civil rights struggle in this country, owes me a bit of gratitude:

Part of me feels like a proud parent who's little boy has all grown up. Part of me still longs for a decent hate mail.

Sigh.

Mary Sammons Given Award For Some Reason.

2011-07-20T00:26:00.000-07:00

SCOTTSDALE, Ariz.- The National Association of Chain Drug Stores today presented its Sheldon W. Fantle Lifetime Achievement Award to former Rite Aid CEO Mary Sammons, provoking awkward, polite applause among people with so little to do that they attend chain drug store awards dinners.

Seriously. I know a lot of the quotes and stuff in this post are made up, but they really did give her a lifetime achievement award. I swear.

"Throughout her career, Sammons has never been one to follow conventional wisdom. Her groundbreaking innovations in the world of retail should be a lesson to us all in outside the box thinking, and we at the NACDS are proud to honor tonight her lifetime of dedication, hard work, commitment, and near total lack of real achievement" said president Steve Anderson. "Conventional wisdom says we should be honoring conventional success, but we're proud tonight to break that mold."

During her tenure, Rite Aid's stock price declined almost 80%, wiping out millions of dollars in shareholder equity. Dozens of stores were also closed, and the company was saddled with an almost unmanageable debt burden which drove it to the brink of bankruptcy, all of which evidently is something to be very proud of.

"What the fuck?" said Tom Ryan, former CEO and chairman of CVS, a company that has gone from a regional drugstore player to the nation's largest pharmacy chain, upon hearing that Sammons would be sharing this year's award with him.

"Maybe it's just some sort of trick they're playing on Walgreen's." said a confused audience member, referring to the only one of the three major drug chains not honored with this award. Others theorized that the honor was more for Sammon's previous work with the grocery chain Fred Meyer, which ceased independent operations in 1999 and is now part of the Kroger Corporation.

Wait, no, that can't be it.

A member of NACDS who wished to remain anonymous speculated the award was probably for personal, as opposed to corporate, achievement, as Sammons was able to earn almost 3 million dollars in 2010 for running a company that hasn't turned a profit since 2006. She's also entitled to a base salary of at least $750,000 through 2012, and as much as $9 million if the company is sold. "You gotta admit, cashing in like that by creating a turd and then selling it would be a hell of an achievement" the source said.

At press time, that seems to be the only theory that makes sense. That or she blew someone.

A Groundbreaking Accomplishment By The Hardworking Professionals At Pfizer.

2011-07-06T12:47:00.000-07:00

CORPUS CHRISTI, TX- Surprise was the order of the day at this year's conference of the American Secular Society for the Promotion and Advancement of Disease, as drug manufacturer Pfizer came away with the organization's annual award for excellence in the promotion of ill health in the American populace.

"I understand the award going to an organization that ostensibly dedicates itself to the cure and prevention of disease may at first appear to be quite shocking" said ASSPAD's President Carlos Hickman after the award ceremony, which is held every year in America's fattest city. "But with the publication of a new scientific study indicating that the company's smoking cessation drug, Chantix, may actually increase the risk of heart disease by 72 percent, the true genius of Pfizer becomes clear. Don't you see? People try to quit smoking to lower their risk of disease, and Pfizer has developed a strategy in which these wellness seekers can still end up dropping dead! It's brilliant!"

Hickman added that ASSPAD was particularly impressed by Pfizer's efforts to defend and continue to market Chantix in light of increasing evidence of the medication's link to "loss of consciousness, visual disturbances, suicides, violence, depression and worsening of diabetes."

"They're taking the groundbreaking work done by GSK with Avandia and really building on it" said Hickman, whose organization broke from the North American Disease Society in 1998 in a dispute over NADS' decision to recognize Jehovah Witnesses for their refusal to accept blood transfusions. "So far there is no indication that Chantix will end up in any kind of risk management program the way Avandia did. As a matter of fact, as far as we can tell, Pfizer is going ahead full bore with promotional efforts to sell as much of this med as possible. It's pure genius!!"

"Ask your doctor if Chantix is right for you!" he concluded "You could save up to $30 on your first prescription."

Past recipients of ASSPAD's excellence in disease promotion award have included trans fats, alcohol, Blue Cross and Blue Shield of New Mexico, and Keith Richards. When reached for comment, a spokesman for Pfizer said the award was reflective of the corporation's overall goal of "MONEY!!!!!! GIMMIE GIMMIE GIMMIE MONEY!!!!!!"

Disclaimer- Everything in this post is made up, except for the newly published study linking Chantix to heart disease, even in people with no previous history of cardiovasular problems. And the previous links to loss of consciousness, visual disturbances, suicides, violence, depression and worsening of diabetes. Those weren't made up either.

A Little Thing That Bugs The Hell Out Of Me

2011-06-23T11:24:00.000-07:00

You learn to make your way through the small talk when you work behind the pharmacy counter. Tiny talk. Microscopic talk. Talk you will look up and down and over and under with a magnifying glass and still, despite the best of your efforts, find it utterly empty of any meaning. The weather. Christ on a cracker there IS no weather where I live and I still spend at least an hour a day listening to people drone on about it. Sports. Yeah. The quickest way to get me to tune you out is to start talking about the team of large men who don't realize they're gay and their efforts to hit, carry, kick, or throw a ball of some sort over an imaginary line.

For some reason though, I heard the lady say her favorite baseball team was the Brooklyn Dodgers, and I wanted to punch her.

The Brooklyn Dodgers, you see, don't exist. They haven't since 1957. This means they cannot be your favorite team. They might have been your favorite team. Maybe you like the fact that they broke the color barrier when they signed Jackie Robinson ten years earlier, which would be very admirable, but the fact is, if you can remember the day the Brooklyn Dodgers last took the field, you qualify for Social Security. Why the fuck don't you tell me now how your favorite pet is a passenger pigeon, or better yet, buy yourself a goddamn clue with the dollar and twenty five cents you just saved using coupons form the paper and enter the world of reality? The Dodgers are in fucking Los Angeles and have been since long before your pharmacist whose hair is turning grey was even born. Exactly how long will this take to sink in? The fact you still don't know what to do to operate the credit card reader you've been using at least once a week for five years doesn't give me a lot of hope.

The fact I get so bent out of shape about this makes me even madder at myself. Sports are stupid, and I shouldn't even care. The fact I do pisses me off. This is usually where I go have a drink to break the hate cycle but it's not even noon. Goddamn it.

Stupid bitch.

A Uniquely American Story.

2011-06-22T22:36:00.000-07:00

Who says good old-fashioned Yankee ingenuity is dead? This guy's a goddamn problem solver, that's what he is. To the website of Democracy Now!, which I've told you before you should be reading every day:

A North Carolina man who had no health insurance has admitted to recently robbing a bank of one dollar in order to be sent to jail to get free medical coverage. James Verone, a laid-off employee of Coca Cola, recently noticed a protrusion in his chest and had developed arthritis and carpal tunnel syndrome. Without health insurance or money for private care, Verone concluded his best option would be to go to prison. Verone told a local newspaper, "The pain was beyond the tolerance that I could accept. I kind of hit a brick wall with everything." Since being held in jail he has seen several nurses and has an appointment with a doctor Friday.

I'll also point out that the amount stolen in this case is about $999,999,999 less than the amount looted from the health care system by Florida Governor Rick Scott in his previous gig as CEO of hospital chain Columbia/HCA. Holding down expenses is important in the business world. I bet Coca-Cola wishes they could have this guy back.

Anyway, enjoy your upcoming holiday. That sound you hear in the background will be the Canadians laughing their ass off at us.

I'm Pretty Sure I Used To Date This One.

2011-06-22T21:31:00.000-07:00

I Feel I May Have Been Unfair To Big Pharma Pud Suckers.

2011-06-21T22:46:00.000-07:00

I mean, for over six years now I've written periodically about pharmaceutical rip offs, scientific shenanigans, and overall shady dealings. But pud sucking in health care is far from limited to the drug industry my friends. Today I'll even the score a little bit. To an item in last month's California Watch, a website you should have bookmarked long ago if you are the least bit interested in the affairs of The Golden State:

California Department of Public Health inspectors examined records at four hospitals owned by Prime Healthcare Services and found that 22 of 120 patients diagnosed with septicemia showed few symptoms of the disease.

At one San Bernardino County hospital, a patient was diagnosed with septicemia even though records showed “no sign of infection,” inspectors found. At a Los Angeles County hospital, inspectors said seven patients diagnosed with septicemia showed signs of having urinary tract infections, a far less serious condition.

I've long said that incompetence, laziness, stupidity and greed are the four forces that rule the universe. Almost anything that happens can be explained with one of these four words, and this case is no exception.

Medicare pays bonuses of several thousand dollars per case for treating elderly patients with septicemia, federal records show. Prime Healthcare’s chairman, Dr. Prem Reddy, testified in a 2005 trial that his hospitals were reimbursed about $9,000 for treating a septicemia case – $6,000 more than a urinary tract infection.

What? You were thinking incompetence? No, no, no grasshopper. Greed is by far the most powerful of the four forces. Always assume greed is the driving force until you can prove otherwise.

I gotta say though, $3000 for treating a urinary tract infection? Really? I could diagnose and cure a UTI for $50 and still be making a fat-ass margin, and this fucker cooks the books for an extra $6K per case. Part of me admires that. The part that doesn't pay Medicare taxes.

To get some perspective, In my imagination I called Florida governor Rick Scott, elected last year after ripping off Medicare and Medicaid for over a billion dollars as head of the hospital chain Columbia/HCA.

"It's not a bad start" Scott didn't say. "But to assure he doesn't end up in jail, he should probably run for political office, and the amounts involved here are way too small to further one's political career. Stealing $18 million like this guy appears to have done is probably barely enough to get you elected to a city council seat, although the adamant denials he's done anything wrong are a good start. His next move should be an attack on the very programs he's profiting from if he ever wants to gain any traction with the voters."

"Or, considering he's in California, make a bad action movie or two, pretend he's fighting off aliens or something. Either way he needs to appeal to people's stupidity. because while greed is the most powerful force in the universe, stupidity is far more common."

I couldn't have said it better myself. I'm calling it today my friends. Get ready for Reddy for Governor in 2014, and be sure to think of him every time it hurts to pee.

Highlights From Friday's Pill Counting Action.

2011-06-09T00:52:00.000-07:00

"Yes.....I'm calling about the pills I got from the pharmacy.....it's really serious. They made my penis like 10 inches long and 6 inches wide and I just had sex with my wife and she's crying and it gets in my way when I'm working out and...

Uuuuuuhhhhhhhh!!!!....sorry...masturbating....

....anyway my friends like to pet it all the time and .....

Uuuuuuhhhhhhhhh....masturbating again.....

....anyway I just wanted to thank you ....and tomorrow I'll be in to get some more. I'll be the one winking at you."

I wish I had a way of recording the voicemail. I know you'd appreciate it. The timing and delivery of the message actually took a little effort and talent, unlike so many other prank callers who get nervous and end up just rushing through it. I hung up thinking now that the slightly entertaining prank call barrier has been broken, perhaps someday I will get a halfway decent hate mail.

A clerk walked by on her way to the back and I overheeard her saying to a customer "Did you ever try to eat animal food when you were little? I used to all the time."

Yeah, it was definitely gonna be a highlights kinda day.

The morning was pretty much quiet except for the lady with the Cymbalta coupon card who raised holy hell when she was told it had expired. She whined and cried and bitched and moaned as if we were asking her to sacrifice her first born child. The situation was unjust, unfair, uncalled for and maybe even dangerous to her mental health. Despite this insult to her dignity, she would have her prescription filled, under protest mind you, and have it billed to her regular insurance.

Her copay was $0. That did nothing to change her perception of things.

On my way back from lunch I saw a man back into a woman's car and both of them get out to inspect the damage. The man declared to the lady whose car he just hit that "you're not worth my time" and just drove off. It made me a little glad to know I'm not the only one who has to deal with assholes. It made me more glad to hand the lady the assholes license plate number. One of the nice things about pretending like I'm a real writer is that I always have a scratch pad and paper handy.

By the way, you read that correctly all you non-California retail pharmacists. I witnessed the accident on my way back from lunch. California pharmacists are required to have a lunch break thanks to a battle fought by the United Food and Commercial Workers union years ago. If you're not in California maybe you should give the UFCW a call. Unless you're on some starvation weight loss diet or something.

I was washing up before going back into the fray and noticed the "site" memo had been replaced again. It hangs in the breakroom and stresses the importance of keeping a clear "line of site" to deter shoplifters. Three times I have taken my ever handy pen, scratched out the error, replaced it with the correct "sight," and three times someone has made the effort to replace the defaced memo without changing the typo. That says it all about my employer really.

I was dealing with a woman who asked me to "go through my profile and delete the ones I'm not taking anymore, I think there are three or four of them" when I saw the little old man shuffle around the corner. He stopped at the endcap, started a little shuffle again, and slowly......slowly.....ever so slowly....leaned over a bit....then a bit more...then a little more...until he just kinda ended up on the floor. I ran out thinking I might have to wing some CPR or something and when I got to him he asked me where the garbage bags were. The little old guy literally shopped till he dropped and when he got there he was still thinking about how to spend his money. That is all American my friend.

The store manager asked me what a Brazilian wax was and the look on the Assistant's face told me the manager was being pranked. I told the manager it was the gold standard in exterior car care.

My one professional function was to stop a Cipro prescription from being dispensed to a patient stable on warfarin. While I was waiting on hold to clear things up the customer comes to the counter with a bottle of Excedrin. I wanted to shove the Excedrin up this idiot's ass, but that probably would have led to catastrophic rectal bleeding. I remained calm and learned that saving someone's life can be extremely irritating.

I closed out the day by playing the prank voicemail for my supertech, who thought it was a call from a real customer. She started looking through patient's profiles to try to address the emergency. Now I love my supertech, but she obviously has a lot to learn about the ways of America. I went home, and she stayed after work to do some shopping, probably stopping long before she hit the floor.

Someone Goes To Bat For The Profession. Not Surprisingly, It Is Not One Of Our Professional Organizations.

2011-06-07T02:51:00.000-07:00

June 6, 2011

Malcolm J. Broussard, RPh
President
National Association of Boards of Pharmacy
1600 Feehanville Drive
Mount Prospect, IL 60056

Dear Mr. Broussard:

As the only national nonprofit organization focused entirely on efforts to prevent medication errors, we are writing on behalf of the Institute for Safe Medication Practices (ISMP) Board of Trustees to voice our concern about a safety issue that has been illustrated by a wave of recent national advertising—promoting and rewarding the speed at which community pharmacies dispense prescriptions for patients. The National Association of Boards of Pharmacy (NABP) and its members should play a key role in discouraging speed as a primary marketing tool for pharmacy services.

One of the largest pharmacy chains, Rite Aid Corporation, now advertises a “15‐Minute Prescription Guarantee,” where up to three new prescriptions will be dispensed within 15 minutes (average of about 5 minutes) or less. If a pharmacy fails to meet the mark, the customer receives a $5 gift card. Although there are some caveats mentioned in the fine print, the message is clear that speed should be a primary motivator in choosing a pharmacy. This trend is not limited to just one pharmacy corporation; other chains as well as independent community pharmacies have, from time to time, initiated advertising campaigns that insinuate or offer similar prescription time guarantees to their customers.

We have heard from pharmacists who claim that their pharmacy’s management actually tracks pharmacist productivity based on the number of prescriptions they dispense and whether or not they meet time promises. A 15‐minute dispensing claim for up to three prescriptions can jeopardize public health by putting pressure on pharmacists to work as quickly as possible and discouraging them from checking the patient’s history and drug profile; looking for possible drug interactions or duplications and other drug use evaluation concerns; calling physicians’ offices for clarification; and educating patients about the proper use of prescriptions (e.g., meeting patient counseling regulations).

It is unacceptable to hold pharmacists to specific timeframes for preparing and dispensing medications, since any mistakes that occur can have devastating effects on patients. Time limits also help promote the idea that the dispensing of medications is a ‘quick in and out process’ that only involves counting tablets.

ISMP frequently receives reports from consumers about medication errors resulting in harm to them or a family member. All too often they observe that the pharmacist seemed so rushed that work could not be thoroughly checked. Examples of serious errors due to volume and workplace distractions have been published in the ISM Medication Safety Alert! Community/Ambulatory Care Edition newsletter.

We realize that there are many issues that need to be addressed to encourage greater adoption of pharmaceutical care and improve safety in community pharmacy practice, such as reimbursement for counseling. But the reality is that community pharmacy prescription programs and inducements for such (e.g., discount coupons) are detrimental to safety and the practice of pharmacy. We should not be educating consumers that the primary determining factor about where they should have prescriptions dispensed is speed.

Since NABP’s mission is to support state boards of pharmacy in protecting public health, ISMP requests that NABP explore and assist members in employing methods to eliminate inducements to consumers that insinuate or promise prescriptions will be dispensed within timeframes that may compromise patient safety.

Sincerely,
Lou Martinelli, PhD, PharmD
Chair, ISMP Board of Trustees

Michael R. Cohen, RPh, MS, ScD, FASHP
President, ISMP

Cc: ISMP Board of Trustees
Carmen Catizone, Executive Director, NABP
William T. Winsley, MS, RPh, Immediate Past President, NABP

The Revolution Will Not Be Televised.

2011-05-27T23:04:00.000-07:00

Rest in peace Gil Scott Heron:

A Few Random Thoughts That Should In No Way Be Confused With Those Of My Employer.

2011-05-23T21:55:00.000-07:00

I know the profession has its ups and downs. Its frustrations and pitfalls. But I was thinking today, I really take pride in the work my fellow pharmacists and I do day in and day out. It's such a pleasure to be able to serve people and to know that I'm making even a small difference in the fight against things like cancer, heart disease, diabetes, and HIV. To know that I can use the talents I have honed over the course of my career to contribute to the good health and wellness of humanity is a feeling almost impossible to describe to someone not lucky enough to be in a health care field. I'm a big fan of pharmacy.

I should mention though, that the other day my employer came out with a new social networking policy that made it very clear that we were to leave no confusion when we post something online that we are speaking only for ourselves, and not as a representative of the company. So please, don't assume my employer agrees with anything I've just said.

I'm not just a pharmacist though, I'm also a citizen of the United States, and I'd like to think, the world as well. That's why my heart was filled with joy when I heard the news that Osama Bin Laden is no longer a threat to the planet. I really swelled with pride knowing our brave troops had brought evildoer number one face to face to his maker. I'd like you all to join me in honoring our brave men and women in uniform who all played a part in this "Mission Accomplished!," especially the Navy Seals, who may be the most heroic people who have ever lived.

Again though, my employer feels it is very important for me to say that what I write here does not necessarily reflect their views. I'm not sure why, but they definitely want you to know that.

Life isn't all happiness and triumph over evil though. I think we can all agree that there are some truly awful people in society. Take pedophiles for instance. The crimes they perpetrate against our children are among the most horrific things one person can do to another. Pedophiles should be severely punished, not only for the acute physical trauma they inflict on our most vulnerable, but for the lifetime of emotional scars they leave behind. I am no friend of the pedophile.

And I am in no way speaking for my employer. If you want to know what my employer thinks of pedophilia, you'll have to ask them directly. I'd recommend talking to someone in the legal department.

I also recommend you always wash your hands after defecating. But that's just me talking.

A Heartwarming Story Of Johnson And Johnson And Their Commitment To Their Credo.

2011-05-19T00:11:00.000-07:00

It's a thing of beauty, that credo of Johnson and Johnson's. A shining example of how those in business can strive to make it in the competitive world of commerce while benefiting the world as a whole. The perfect illustration of why capitalism is the system that will lead us to the heights of human potential. You can almost cry reading over the Johnson and Johnson corporate credo.

You can also cry reading this press release from Doctors without Borders, but for a different reason:

Pharmaceutical giant Johnson & Johnson is putting the lives of people living with HIV at stake by refusing to participate in the Medicines Patent Pool, a mechanism designed to lower prices of HIV medicines and increase access to them for people in the developing world, said the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) today.

Wait, I'm sorry. I started off here talking about how great the J&J credo was without giving any examples. Here's how the credo starts off:

We believe our first responsibility is to the doctors, nurses and patients, to mothers and fathers and all others who use our products and services.

Well, I guess if you keep the price at a point where people can't afford your products, then technically they are not users, and you don't owe them anything according to the credo.

Still, there's a lot of good stuff in that credo. Now back to Doctors Without Borders:

Johnson & Johnson, which holds patents on three key new HIV drugs desperately needed throughout the developing world, has so far refused to license these patents to the Medicines Patent Pool. The Pool has been set up to increase access to more affordable versions of HIV drugs

Johnson & Johnson holds patents on HIV medicines rilpivirine, darunavir, and etravirine...Even at Johnson & Johnson’s so-called reduced “access” pricing, the cost of these drugs is prohibitive; darunavir is priced at $1,095 per patient per year, and etravirine at $913 per patient per year in the world’s least-developed countries, most of which are in sub-Saharan Africa. Many developing countries have to pay even higher prices.

I'll remind you here that 2,700,000,000 people on this planet currently live on less than $730 a year. I'll also remind you of another part of J&J's credo:

We must constantly strive to reduce our costs in order to maintain reasonable prices.

Could that be the scent of bullshit in the air? To Doctors Without Borders:

In December 2010, the National Institutes of Health, which holds the intellectual property rights for a manufacturing process for darunavir, put its patent for the AIDS drug in the patent pool. Johnson & Johnson holds the drug’s remaining patents, and is effectively blocking other companies from manufacturing and making darunavir available at prices affordable for patients in the developing world.

To the credo:

We are responsible to the communities in which we live and work and to the world community as well. We must be good citizens – support good works and charities and bear our fair share of taxes.

Yeah, definite bullshit.

Not all is lost though. It is thought that J&J's refusal to license it's products may drive a desperate black market in which amateur chemists and people who don't really know drug manufacturing from a hole in the ground would attempt to make versions of needed AIDS meds in basements, garages, under bridges and in kitchens.

Experts estimate the result would be a dramatic increase in the quality of medicines that reach the patient.

"Indeed, we have already seen a large quantity of unregulated darunavir making its way through the public health clinics of Johannesburg" said fictitious AIDS expert Joseph Kabinga. "None of which has been contaminated with mold, tiny shards of glass, bacteria, or manufactured in such a way that required its removal after installation. Which, of course, is more than you can say about Motrin, Tylenol, Benadryl, Zyrtec, Rolaids, Sudafed, St Joseph's aspirin, OB tampons, Pepcid, Topamax, Invega and the DePuy replacement hip."

"It is our hope that if we can persuade Johnson and Johnson to stop donating these products to us and simply allow untrained random people picked from the street to make them, the resulting improved product reliability would have an immediate and dramatic impact on the health of our people."

And it is my hope... that someone at Johnson and Johnson may actually read that credo of theirs one day, and perhaps even understand it. That maybe someday they will realize that selling something for a dollar is still better than not selling it at all and watching a person die. That idleness in the face of a preventable, demographic-changing epidemic puts an awful lot of blood on their hands. I wonder how the executives of Johnson and Johnson sleep at night. If maybe they don't stroll down the aisle of a 24 hour drugstore at three in the morning looking for a package of Simply Sleep™, only to find a hole in the shelf where their recalled product once was. I wonder if they then buy an alternative made by a company that actually believes that in meeting customer needs everything they do must be of high quality.

I'd like to think so, but part of me thinks they just don't care. And that they sleep like babies.

An Exclusive, Imaginary, Interview With KV Pharmaceutical CEO Greg Divis.

2011-05-11T03:09:00.000-07:00

Drugmonkey- Thanks for taking the time to talk with me Mr. Divis.

Divis- Thank you for the opportunity Drugmonkey, I'm really excited to share some wonderful news. We've cut the price of our blockbuster FDA approved product, Makena, by over 50%!! I know how passionately you believe in affordable, accessible health care for all Americans, so I'm sure we can both agree this is incredibly exciting!!

DM- Well, first let's back up a little bit for those people who may not be familiar with Makena and what it does. Maybe you could tell us a little bit about it.

Divis: Absolutely! Makena is our brand name for the drug 17-hydroxyprogesterone, and it's the only product approved by the FDA to reduce the risk of premature birth, a devastating event that happens to one in eight babies born in this country. Drugmonkey, that is one in eight babies too many. While we're proud that our FDA approved product will reduce the risk by around 20 percent, we will not rest until each and every child in the United States enters this world healthy and with all the advantages modern medicine has to offer.

DM- I see. And this price cut of yours is part of your effort to help you get some rest at night?

Divis- Well, I'm not sure I'd put it that way, but a 50 percent price cut will make a big difference for everyone involved!!

DM- A price cut to around $700 a week.

Divis- Yes.

DM- Meaning at one time you were charging over $1400.

Divis- A small price to pay for a healthy child I'm sure we can both agree.

DM- Do you think I'm stupid?

Divis- Excuse me?

DM- I said do you think I'm stupid? Do you think that I don't know that pharmacists have been compounding 17-hydroxyprogesterone themselves for years and selling it for around $20 a week? And let me tell you something about compounding pharmacies. They are not known as outposts for value. If they're charging $20, I can assure you the cost of this stuff is a tiny fraction of that. Where the fuck do you get off charging $700?

Divis- Ours is FDA approved!!

DM- Meaning?

Divis- Meaning Makena is manufactured in an FDA-regulated and FDA-compliant, sterile facility.

DM- You mean ones like a company such as Johnson and Johnson would use to make their medicines?

Divis- Yes.....wait... no!!

DM- Isn't it true you're just taking advantage of expectant mothers who aren't savvy enough to realize the only difference between your product and what a compounding pharmacy would dispense are the papers you pushed around to get some bureaucrat's seal of approval?

Divis- We feel that in the current political climate, people really want to depend on Big Government. That people are craving to be told exactly what to do by far away impersonal power.

DM- Good luck with that.

Divis- Say, are you writing this as a representative of the large corpro-pharmacy that employs you?

DM- I'm actually glad you asked that sir. You see, I've always operated under the assumption that you would have to be a fucking idiot not to realize that everything I write using my personal social media accounts represents only my own personal views. But evidently, my last, small shred of faith in the intelligence of the human race is not one that's shared by some large pharmacy corporations.

Divis- If it's one thing those of us in the business world know Drugmonkey, it's that there is no shortage of fucking idiots on this planet. They are a powerful force, and while that power most often leads to awesome destruction or at least incredible frustration, properly harnessed, it can bring you riches beyond your wildest dreams.

DM- And that, sir, is finally something we can both agree on.

Disclaimer- While the story of Makena is true, this interview took place only in my imagination.

Also, thank you to the alert reader who tipped me off to this story. A long time ago. If I had a paid staff i could get these things out quicker, and if you'd buy my book that would put me a step closer to having a paid staff. Just sayin'

The Irresistible Force And Immovable Object Are Both Defeated. By Me.

2011-05-08T21:55:00.000-07:00

It's hard to tell what started it on the right side. Some sort of irritation perhaps, a gas bubble, a cold draft, a need for a nap or some food in the stomach. No one but a mother can really know these things.

On the left it was crystal clear what the beginnings were. It was important to know what kind of potato chips to get for dinner.

A baby screaming out to the world versus someone doing their screaming into a cellphone. Two of the biggest pain in the asses in the universe were squaring off right in front of me this pill counting day. Head to head. Mano y mano. Just like Godzilla versus King Kong in one of those late night horror flicks.

Except, isn't one of the monsters in those flicks usually a force for good?

To my right a baby's world was collapsing. It's face turned crimson as it struggled to let the world know of the horror it was facing. A soiled diaper I theorized. If I was sitting in a pile of my own shit I might be tempted to scream like that too.

To my left I heard "I DON'T THINK THE PRINGLES ARE ON SALE!!"

I now received a warning that my customer waiting for his Bactrim prescription has been taking warfarin from another doctor. I cranked up the phone while able to hear every detail of the numbnut to my left's potato chip decision making process. Knowing that sound travels equally well regardless of direction, I felt good about my employer's HIPAA compliance procedures.

Things were getting no better in the baby's world.

While waiting to be put through to the on call physician, I realized the baby's mother was not waiting for medicine. She had no prescription and was not looking for an over the counter remedy. She appeared unfazed as her offspring assaulted the ears of all around. She pretended to be shopping for 7-UP but I knew her real purpose. She was an agent of the grim reaper sent to claim the life of the oldster in my waiting room. Obviously, a drug interaction was how it was supposed to go down. Satan himself was probably appearing before the wee one, terrifying him with visions from the depths of hell in order to distract the pharmacist from the risk of major bleeding.

The cellphone talker was not part of any Satanic plan. He was just an ass, but I'm sure Satan welcomed the additional backup.

The on call doctor was reached and was clueless. He sheepishly took my suggestion of cephalexin and I only had to ask him to repeat himself twice. Cellphone man wanted to know if he should grab some milk while he was in the store. I wondered how people in the 70's ever managed to put dinner on the table. Maybe that's why they were less obese back then. They never knew if they needed milk or should buy the potato chips that were on sale.

Satan sent one last wave of panic through the infant, probably hoping he could get me to grab the wrong bottle from the shelf. It was decided that milk was needed and the old man's name was called.

He was disappointed it only took 13 minutes. He was hoping for a gift card.

Highlights From Friday's Pill Counting Action.

2011-05-04T00:49:00.000-07:00

The day began with a phone call. I heard the ringing as I approached the drugstore gate, fumbled with my keys, logged into the various types of electronic equipment throughout the happy pill garden and put on the cheesecloth lab coat provided by my employer, through it all the ringing continued. It must be very important.

"Thank you for calling corpro-pharmacy, this is Drugmonkey, may I help you?"

"IS THIS ROBERT?"

I had told the nice lady my name as part of my phone answering and it was not Robert.

"No ma'am. This is Drugmonkey"

"ROBERT????"

I've worked at my current gig for almost 5 years now, and no one named Robert has been employed here during any of that time. The man I replaced had been here two decades, and his name was not Robert either. I knew what I had to do.

"Robert's not here today ma'am"

"PAUL????????"

I have no idea who Robert or Paul might be, but told the nice lady we did stock eyeglass repair kits. As I hung up the phone the Assistant Manager walked by. "I just want to set someone on fire" he muttered as he went off to the storeroom. I've learned not to ask.

You know how infants have that specific type of new baby smell? You know you do. There is nothing that quite smells like a baby, except for this old man who came to the counter about an hour into my shift. What the hell could an 80 year old man be doing that would make him smell like some sort of combination of diapers, baby powder, spit up and formula? I know the obvious answer is that he was incontinent and wearing his own giant baby diaper or something, but other old men who pee their pants don't smell like this. I went out and bought a soda after he left just so I could tail him and smell baby man again to make sure my nose wasn't messing with me. The baby smell mystery may occupy me for the rest of my life, or at least the next week or two.

The morning also brought a prescription for Zocor to be taken as needed and hard evidence that not every doctor has received the Darvocet memo yet. Also a message from an insurance company that read as follows in its entirety: "INTERACTING MEDICATION: 50111043401" Some computer programmer out there probably really thinks he's saving lives.

A customer came to the counter to tell me he had trouble sleeping, and I suggested he might try the original formula of Unisom, which works a little better than the various diphenhydramine preparations in the sleepy section. "I don't want a sleep aid!!" he snapped, so I softly sang him a lullaby as I waited for the next man to come to the counter.

He had his cellphone with him, and on it was a picture of a prescription. It was for Vicodin and the guy seriously thought I would just give him some based on the picture on his phone. I know it's traditional to say you should give them an A for effort, but this one merited a C-plus, max.

During lunch I noticed the ladies at the nail salon wore lab coats of higher quality than I did and was halfway through my sub when I noticed that the man repeatedly saying "How you doing Bob?" was talking to me. He told me the Benadryl I had no recollection of recommending to him had really done the job. I wondered if maybe Bob was the name of some sort of non-evil pharmacy twin. I kinda hope so. I always wanted the role of evil twin.

A lady was waiting for me when I came back so she could ask me the following question, again verbatim: "This is a nose spray? So I should just spray it in my nose?" I wondered what she would have done without me as I fielded the next question from another man, "She's got plenty of Aleve, right?" He was looking right at me. I was expected to provide an answer as to the quantity of Aleve necessary for a woman I had never to my knowledge met. "Can you ever really have too much?" I said, and the man bought a bottle. Just a damn shame I don't work on commission.

I had pretended for a few seconds that the hot chick who was making a beeline for the pharmacy a few minutes ago was coming for me. I now heard her scream into her cellphone "Fine, no condoms!!!" and storm off. It really is best not to always get what you wish for.

After sundown two drunks got into an argument. "Get away from me!! the lady said "I just want to be left alone!!" Whereupon her....partner?....boyfriend?.....brother?.....sheltermate? staggered to the counter to let me know "She's disabled"

"I HAVE FIBROMYALGIA!!! She yelled, and I believed her. No one is as eager to let you know about their condition as the fibromyalgics.

I looked to the other side of me and saw someone asleep in the blood pressure machine. The phone rang and someone wanted to know if they could lower their cholesterol by eating shrimp. I was doing my best to explain that the opposite would be more likely to happen when I heard the happy couple going at it again in the waiting area.

"DON'T POINT THAT AT ME!!!" The fibromyalgic drunk lady yelled. Her partner was holding a walking stick from a nearby display and saying "bam! bam! bam!" Blood pressure man slept through it all.

And somehow I got through it all. Every prescription got out the door and every person was told that nose spray does indeed go up the nose. I closed the gate and wondered about baby man and Robert to the point where it threatened to keep me up that night. I sang myself a soft lullaby and started to let go of the day. To take solace once again in slumber, a place where no one will ask me where the bathroom is.

The lullaby. It works better than Unisom.

If I Were Emperor Of The World, This Is What Would Happen, Which Is One Of The Reasons I'll Never Be Emperor Of The World.

2011-05-03T00:27:00.000-07:00

Let me be clear. I will shed no tears for Osama Bin Laden. If there is a God or Buddha or Zeus or any kind of supernatural karmic force in the universe, Osama Bin Laden is rotting in hell where he belongs. He met a violent end and was shown no mercy, which is as it should be.

But to my friends in Afghanistan I would say I'm sorry. I'm sorry we put you through this while we were chasing after this guy. Ten thousand of you who didn't ask for any of this are now dead, three times as many people than were killed on 9/11. Many times more have been maimed, shattered, scarred and devastated. And every person directly affected had a mother, a father, a wife or daughter or son. A best friend or lover. That's a lot of bad karma in motion.

This is my promise to you though. The bad karma is broken tonight. Osama Bin Laden was blowback from our policy of arming the Taliban in order to gain an advantage in the global chess game we were playing with the Soviet Union, and there will be no more blowback. From this day forward your affairs are yours, and the only business we will mind will be our own. If you would like a friend to help you progress towards a modern, sophisticated society and all the advantages in daily life it provides, we will be happy to be one. If you prefer to have no further dealings with us, your decision will be respected. No longer will we intervene to pick winners or losers among the people who seek to govern you or anyone else in the world. From this day on you are truly independent, which means you are free to make bad decisions. May you choose wisely.

Because there could be no better memorial to the people who died on 9/11 than a world in which the next Osama Bin laden finds it impossible to get any recruits. From this day forward that is the world we are working towards.

And to my friends in Iraq, I'll say this. That last guy was an idiot. Seriously stupid. You kinda have to live here to understand what happened and even then it's a little hard to comprehend. Hopefully we have learned what happens when one so dumb is given so much power. We're very, very, sorry. If there is a God or Buddha or Zeus or any kind of supernatural karmic force in the universe, one day George Bush will be sharing a room in hell with Osama Bin Laden.

Peace be with you.

It's A Little Sad Opening Up The Mailbag These Days.

2011-04-28T00:27:00.000-07:00

Of course these days "opening up the mailbag" means "checking your email" which means "glancing down at your Blackberry." And ever since my latest column in Drug Topics about Walgreen's POWER program appeared a few days ago, it seems like every time I glance down at the Blackberry there's another message from a Walgreen's pharmacist telling the same story.

We're too rushed.

I can't keep up.

They're breaking me.

It's not safe.

It's getting worse.

I read a tale today that absolutely made my hair curl, but I won't share it with you. Walgreen's is big and bad and has all the resources a multi billion dollar cash flow can put at their disposal you see, and while I'm not particularly worried about what they could do to me, I decided it's not worth risking what they might do to some poor schlep who's just trying to feed his family and needed a shoulder to cry on. Walgreen's was not amused at the appearance of the letter from one of their pharmacists that started all this, and I'm still not sure of the exact contents of the conversation they had with Drug Topics' editor.

So words that would have appeared on this page never will. Perhaps if I really wanted to share them I would go to your doctor and buy his prescription records.

That last sentence wasn't the nightly scotch kicking in. It seems as if we have a little different definition of free speech rights these days than you might remember from civics class. From yesterday's Los Angeles Times:

A Vermont law bans pharmacies from selling doctors' confidential prescription records to drug makers. Firms say they have a free-speech right to buy and sell information to market their products.

At issue is whether states can forbid pharmacies from selling to drug makers the confidential prescription records of physicians. Armed with this information, drug company salesmen have targeted doctors who are not prescribing new and costly brand-name drugs.

A Vermont state lawyer, backed by the Obama administration, argued that no one had a 1st Amendment right to this "inside information."

But Chief Justice John G. Roberts Jr. said the state was "censoring" the message of the drug company salespeople.

Thank God. If only someone would have stopped Hitler when he cut off Bayer's access to medical records in the Third Reich. I basked in the glow that surely must have been the smiles of the founding fathers beaming down from heaven as I read this story.

Then I deleted what was going to be my original post about Walgreen's. That is the state of free speech in turn of the 21st century America. Words are stopped and your prescription records are sold. And although the words "freedom of speech" appear clearly in the Constitution and the word "corporation" never does, it doesn't matter.

Because they are breaking you.

And it's getting worse.

The Fact I'm So Not Surprised Kinda Bugs Me A Little.

2011-04-26T10:46:00.000-07:00

From The Orlando Sentinel, slogan "covering all the news we can get for free from the surveillance cameras of others"

Sanford police are looking for a man who urinated on more than 100 unopened cough-drop packages at Walgreens last week.

The man went into the store at 2501 S. French Ave. at about 10:30 p.m. Thursday and walked to the cough-drop aisle.

Police say the unknown man looked around, unzipped his pants and urinated on 110 packages of cough drops.

Here comes the least surprising part of the whole story:

Afterward he walked to the pharmacy and tried to fill a prescription, but didn't have the correct paperwork.

I bet Walgreen's was really mad when they had to mark those cough drops down to half price.

Thanks to the alert reader who tipped me to the story.

A Big, Big Highlight From A Lifetime Of Pill Counting Action.

2011-04-13T23:21:00.000-07:00

I saw her walk down the aisle and took in the world of difference. She was radiant and glowing and with it and well. She's been a regular customer for years, and it wasn't always that way. I've seen her haggard and tired and world-weary. Once when it was obvious something was wrong I simply asked her how things were going and she burst into tears, anxious for someone to talk to. I call them "monkeywrench moments," moments when you know a person needs a good chunk of your time and you give it to them, knowing full well it's gonna throw a monkeywrench into the rest of your day. She got all the time she needed and I got a counter full of unfilled prescriptions and three phone calls on hold in return.

I've seen her battle the hold hydrocodone can put on a person and I've seen her forced to deal with mental health demons of the type I wouldn't wish on any person on this planet. Demons I've seen destroy people close to me, so I knew exactly how tough she was, even if she didn't know it herself. To her it was just getting through one more day. A couple months ago we had a talk about the risk of weight gain versus the possible benefit of a new med. Today as she picked up a refill it was obvious the benefits were winning. I made a joke about taking all the credit.

"You really did help me." she said with a look of earnest seriousness in her eyes. "You always answered my questions and never made me feel judged. Seriously, thank you."

Those last two words were worth more than the entirety of dollars that will show up in my paycheck this year my friends. Those last two words are the profession of pharmacy. And in this world of drive through prescriptions guaranteed in 15 minutes or less, of $1.50 dispensing fees and coupons for dog food given out with every flu shot, every once in awhile, like a weed that manages to poke through a crack in an asphalt covered parking lot, you'll still have a chance to actually practice pharmacy.

Take it. Grab that chance the way a starving bear grabs a piece of raw meat. It will most likely annoy your corporate masters, but I promise you it will be worth it.

Before she left she hugged me. The only time I've ever let a customer hug me. I figured we'd both earned it.

You May Have The Wrong Idea About Rite Aid's 15 Minute Prescription Guarantee.

2011-04-05T00:34:00.000-07:00

CAMP HILL, PA- In a fictional news conference held today to counter real criticism of the company's new 15 minute prescription guarantee, John Standley, President and CEO of struggling drugstore operator Rite Aid gave a surprising explanation for the new initiative. Taking the podium half an hour late "Due to unforeseen circumstances" Standley told reporters "When organizations such as the Institute for Safe Medication Practices say things such as 'the message from pharmacy chains is clear, it's all about speed.' they miss the larger point of our plan. While there is certainly a customer service component involved, the main idea here is customer assurance. Namely, assurance that Rite Aid will stay in business long enough to successfully complete the filling of your prescription."

"Let's face it." Standley didn't add. "This place could go under any minute now. And having us close up shop while waiting for medication could range anywhere from simply inconvenient, to, in the case of a narcotic dependent customer in need of a fix, absolutely harrowing. Well that won't happen at Rite Aid. Let me give my word to everyone out there that we will close the in window at each of our stores at least a quarter of an hour before any Chapter 7 bankruptcy filing, giving us time to take care of the needs of each and every person in our waiting room before we join the ash heap of business history"

"I can say this because for me, it's personal. I understand the anxiety a customer goes through in that period between dropping off a prescription and completing the register transaction. Will someone from the sheriff's office come in and start seizing assets in order to satisfy a creditor? Could a bank possibly swoop in and conduct a foreclosure? Will they have to sell off inventory in order to make the next junk bond payment? These are all very good questions. Ones of a type I sometimes ask myself while checking 5 or 6 times a night to make sure my paycheck was credited to my bank account."

"My 4.5 million dollar paycheck" He didn't say as he went on. "I got paid four and a half million dollars to lose over half a billion last year. Isn't that something?" Standley then didn't wistfully stare off into space before being interrupted by a reporter asking about the wisdom of repeating the Domino's Pizza 30 minute delivery guarantee fiasco.

"Domino's mistake was that they never put in writing that they in no way intended for their employees to shortchange safety." Standley never said. "We have made it clear in official corporate communications that we expect our pharmacists not to sacrifice accuracy in order to meet our time requirement, meaning that when one of them does and the lawsuit comes, our butts will be covered."

"Besides, we don't have any money anyway. We went over that, remember? You can't get blood out of a turnip"

When reached for comment, a spokesman for CVS laughed hysterically for five minutes.

Friends Don't Let Friends Vote Drunk.

2011-04-01T21:56:00.000-07:00

I Was Trained To Hate The Man I Most Admire.

2011-03-31T01:08:00.000-07:00

Mine wasn't a peaceful childhood, and it's not important to get into all the details, but I never saw anything like the look on Dad's face that night. Rage. Absolute teetotal rage. I didn't understand it, I was just relieved it was directed towards the man on the TV and not at me for a change. A little boy most always follows his father's lead in such things, and it behooved me, self-preservation wise, to also act enraged by the man on the TV's very existence. So I gave the perception of pleasure that night when Leon Spinks took the heavyweight boxing title from the man who so offended Dad, Muhammad Ali. It bought me a night of peace, but it didn't feel right. I couldn't get that man's picture out of my head. Couldn't stop thinking about how he could have provoked the anger of someone I knew to be very angry in a way I had never seen. I had to know. The next day I did what comes naturally to the nerdy, I checked out a book from the school library and started to learn.

It started with the basics. The man I saw defeated that night had been arguably the greatest boxer of all time. But there is more to Muhammad Ali than just what happened in the ring. He rose up from the streets of Louisville to win an Olympic championship on the other side of the world, then came home with a gold medal around his neck that wasn't good enough to get him served at a whites-only restaurant in his hometown. There have been two brief moments in my life when I've had a glimpse of what it's like to be a minority in White America, once when people wouldn't stop staring when I was out with a Filipina, and another time at the store when I was accused of being Jewish like it was some sort of horrible crime. Both times pissed me off like you wouldn't believe. So while I'll never understand what it's like to put up with that kind of crap 24/7, I do understand why that gold medal was thrown into the Ohio River.Why Muhammad didn't take it anymore. He didn't have to. He was young and strong and didn't have to cower to the power in order to survive.

He didn't have to accept the religion of his taunters. He found his own.

He didn't have to become a cog in the machine of the American Empire, and did not accept being inducted into their armed forces. "I ain't got no quarrel with the Vietcong. No Vietcong ever called me Nigger." he said, capturing the entire decade of the 60's in fourteen words.

Not that it was easy. His stand ensured that he would have to endure all that the power could throw at him. What would have been his best years in the ring were taken away when he was stripped of his boxing license. He was hated, despised, loathed and held to be the most contemptuous figure on the planet by all the redneck masses brainwashed into thinking they had a stake in the power structure of the status quo. People like my father, who cheered every time Muhammad Ali took a blow.

Except Muhammad was strong and the blows couldn't break him. "What's my name!!" he taunted an opponent who insisted on calling him Cassius Clay. "What's my name!!" he shouted to the man he refused to knock out in order to continue the punishment for a full fifteen rounds.

His was name was Muhammad Ali, and when he was allowed to finally resume earning a living, he found George Foreman in his path. Foreman was younger, bigger, and had absolutely destroyed opponents the now over the hill Ali had barely beaten. Finally, the redneck establishment would get their wish. Muhammad Ali would at last be beaten into submission. Everyone knew he couldn't best Foreman in a physical match.

Including Ali, who outsmarted Foreman and had him lying on the canvas after eight rounds.

Best.

Fight.

Ever.

The 60's were a fading memory by then, and Ali's history was soon to be the subject of revision. When it became conventional wisdom that Vietnam had been a mistake and that the overt racism of that era was a blot on the history of this country, Ali went from reviled to popular to....by the time it was time to light the torch to start the 1996 Atlanta Olympics, revered.

And he forgave us. Muhammad Ali stood up for what was right and fought and held strong against all the force society could throw against him, and when that society finally realized, but never really admitted, that he had been right all along, he forgave us. A very Christian like move. There are many Christians who could learn a thing or two from Muhammad Ali.

That's why I keep a picture of him by the desk where I do my writing. When I feel spent and the weight of the world is ready to wear me out, sometimes I look at that picture and hope one day I can have half the character and strength and wisdom of Muhammad Ali.

Who went on later that year to regain his title from Leon Spinks. Much to the frustration of my father.

Highlights From Friday's Pill Counting Action.

2011-03-23T00:54:00.000-07:00

I rolled out of bed already missing my dear friend Mr. Scotch, the empty glass on the nightstand being the only evidence of the comfort he had given me the night before. I've always thought of scotch as my guy friend and the elegant martini as a woman. I don't know why. Perhaps because martinis are far more likely to leave me with a headache. The apartment was dark, with a faint smell of secondhand smoke and the headphones in the other room still sending the sounds of The Dead Kennedys into the air. It was comfortable, just the way I like it when I've barricaded myself in from the rest of the world. I dreaded what I was to do next.

I opened the blinds and saw a rainbow, which as my Judeo-Christian friends know is God's promise not to drown us all again. I wondered why he chose today to rub it in.

I walked through the front doors of work and saw the store's manager standing by the cash register, all alone. Cashier call-outs had left him the only employee in the place. He used to be a District Manager for another chain, and as I watched him standing there so sad and lonely I marveled at how the mighty had fallen. He was ringing out a 12-pack of beer for a man who said last night's rain meant he wouldn't have to go to his job on the road crew today. He was planning on staying home to drink.

Why did I spend all those years in college again?

So I could give expert advice on people's perspective purchases. Like the lady with the bucket. She wanted my opinion on a goddamn bucket. So I gave it to her....the main advantage is that you can use one to carry water around without having to keep your hands constantly cupped. I shared an insider tip as well; make sure there are no holes in it. Being condescending without actually sounding condescending is just one of the skills a good college education can provide you.

Half an hour into the day the former District Manager turned lonely cashier called to ask if maybe I could let Supertech come to the front for a few minutes so he could go to the bathroom. Only those of you who have experienced the universal idiocy that is every District Manager, in every chain, everywhere, can fully appreciate how much joy I took in having Supertech take the next three phone calls, then mildly suggesting that maybe, when she got some time, she could slowly make her way to the front, perhaps straightening a shelf or two on her way up there.

About 10 o'clock Express Scripts' claim processing computer went down for about an hour. About 4 o'clock, when the problem had been fixed for about 5 hours, we got a message from corporate saying Express Scripts might be having problems. It came in right as I was reviewing a warning that Suboxone, a medicine used to ease the symptoms of narcotic withdrawal, should be used with caution in patients who are narcotic dependent. I miss the days when limits on communication technology meant we actually had to have something to say before communicating.

"I'm at Atlantic and Park Avenue." The man on the phone said. And since there isn't a street by either name in my town, I could only assume I was talking to the little man from Monopoly. I'm happy to report he sounds well for as old as he must be.

I asked the next customer how he was, and he replied "Old and crappy."I instantly had a new favorite customer. I answered the phone and the lady asked me how to spell "syndrome." In your face Firefox spell checker. Some people still appreciate the kind of personalized, hand crafted, spell checking that only I can provide.

The climax of the day though, was every retail workers nightmare. A lost child. It starts with the first request, unique in the accent that is placed on the last syllable. john-NIE? In any language it is understood that this is a mother trying to re-establish contact with her offspring. The woman had been waiting in line patiently behind her stroller, and now that it was time to pick up her prescription Johnny had dropped off her radar screen.

"Johnny? Where are you?" Silence fell over the pharmacy as everyone within earshot discreetly started scanning the aisles.

"JOHNNY......JOHHHNNNNYYYYYYY????"

It was a shade short of panic now. Johnny wouldn't get in trouble if he was somewhere he wasn't supposed to be. Mommy just wanted to find him. Now.

"JOOOOHHHNNNNNNNNYYYYYYYYY!!!!!!!!!!!!"

We have a drill for this kind of thing. Just as I picked up the phone to tell the people up front not to let anyone with a kid out the door, there was a soft, sleepy, "What?" from the stroller. The stroller that had been in front of Mommy the whole time. Mommy opened up the flap that covered the thing and there was Johnny wiping the nap's eye-snot away.

She was picking up Norco. Which is as surprising as the fact that God still hasn't gone back on his promise not to drown us all again. It's supposed to rain again tomorrow. Hope springs eternal.

A Real World True Story Medical Professionals May Find Entertaining, But Not The Least Bit Surprising.

2011-03-18T21:42:00.000-07:00

Because we've all waited on this lady.

I can guarantee you she has an established relationship with her pharmacist. And that it is not a good one.

From "News Of The Weird", which I've mentioned before is the best newspaper column ever:

Responding to a domestic-dispute call at the I-77 Motor Inn in Fairplain, W.Va., in October, sheriff's deputies encountered Melissa Williams naked from the waist down and holding a knife. Two men in the room (one, her estranged husband) said Williams had threatened them. "(S)omebody," she reportedly said, "is going to eat my (vulgar anatomical reference) or I'm going to cut your (expletive) throat." The sheriff's report also noted that one of the men approached Williams to comply but was repelled by Williams' "horrible vaginal odor." In November, Williams was sentenced to 90 days in jail.

Yeah...pretty sure I waited on her today.

Exciting News About Potassium Iodide.

2011-03-17T22:42:00.000-07:00

FENTON, MO- In an unusual and hastily planned news conference this afternoon, Fleming and Company, manufacturers of ThyroShield, an over the counter supplement used to protect the thyroid gland in case of a radiation emergency, announced today the product has been given a second official indication by the FDA.

"Starting Monday, March 21st, we are proud to announce that ThyroShield will become the first and only clinically proven agent in the diagnosis of moronism" said Fleming President Phillip Dritsas. While we did not seek this new approval, we are pleased to help in the fight against this horrible affliction"

Sources say that while no formal clinical studies were done to prove ThyroShield's effectiveness in the detection of the thinking impaired, the mad rush of people clamoring for the product in order to be protected from what would be, at most, a smaller dose of radiation than they would be exposed to by standing beside a microwave heating up a TV dinner left no room for doubt. "If you live more than 4,000 miles away from a nuclear accident and feel you must, at great inconvenience to yourself, obtain our product this very second, you are the textbook definition of a goddamn moron" said Dritsas. "Conversely, if you live less than 100 miles from such an occurance and insist on not taking any poassium iodide preparation, you are also dumber than a sack full of kelp."

A sack that many morons, desperate for any source of iodine, would probably eat after watching the latest news from Japan.

ThyroShield is expected to quickly grab most of the moron detection market, which up until now has been dominated by medications such as Oleptro, Moxatag, Pexeva, Doryx, and Acanya that are used off-label for that purpose. These meds, while useful, are mostly effective in identifying morons in the medical professions willing to prescribe them, identifying an idiot in the general public only when they are willing to pay their full retail price.

Moronism affects an estimated 60% of the American population, including anyone who doesn't realize this article is made up. There is no known cure.

A Guest Editorial From Greg Wasson, President And CEO Of Walgreens.

2011-03-16T00:47:00.000-07:00

We really have you stupid shits eating right from our hands.

Look, running a drugstore isn't rocket science. It all comes down to a basic premise, you buy things and then sell them for more than you paid. The less you pay/more you can charge for something the more money you make. It's as simple as that. Thing is, we realized long ago we were never going to be able to contain our costs the way that goddamned hick from Arkansas was able to with his Wal-Mart. Little fucker built up his business betting people would confuse his place with ours and he was right. Anyway, we need a different strategy to be able to compete in the retail jungle, and that's where the monkeys in the white coats we keep in the back come in.

You really think it makes us different. The pharmacists in the back and the mortar and pestle we use in our logo. We'll blow smoke up your ass about having 8,000 "points of care" across the country and 70,000 "healthcare service providers" and you dumbasses eat it up. Whatever it takes to get you to waddle into the store to stock up on the 2 for $5 canned Spam we have on sale this week, or maybe the 39 cent 20 ounce sodas. Shit. I don't give a fuck. Buy the $2.40 potato chips or a flu shot for all I care. Just as long as you leave behind some money.

What I've found over the course of my career is that the best way to get suckers to buy buy buy is to lie lie lie. When I told the trade magazine Drug Store News that it was our vision to "own well" I fully expected their writer to grill me about our decision to sue the city of San Francisco when they banned tobacco sales in pharmacies. It wasn't fair we said, because it allowed those pricks over at Safeway to stay on the tobacco profit gravy train. We went to court to be treated just like any other retailer, but then we wax eloquently into the PR machine that we're some sort of special wellness center. And you brain dead sheep lap it right up! That writer never said a word! He just took dictation and wrote me up a seven page blowjob!

This shit is getting easier every year too. “We are on the front lines of health care with [more than] 70,000 healthcare service providers and growing, We have [more than] 8,000 points of care across the country. What we are building is the most complete national network of integrated healthcare providers and locations in the country.” Now get in here and buy some of our new private label beer you fucking lush. We make more on it than we do on Budweiser, and the fact you're getting it from a place that values wellness so much can make you feel better about washing your life away.

So yeah, that's about all you need to know about how to make it in the drugstore business. I just saved you the time and money it would have taken you to get an MBA. You're welcome. Why don't you use some of that cash and stock up on some Camels and the 2 for $5 Oreos we have on special this week. Because we're committed to stand beside you every step of the way on your wellness journey.

Fucking idiot.

Note- Greg Wasson wrote these words using a word processor that exists only in my imagination.

My Obsession Rises Yet Again.

2011-03-09T23:17:00.000-08:00

Not like the sun mind you. The sun is regular and dependable and my obsession is not. The sun is also useful and life giving. Necessary. My obsession is not. It was planted in my mind long ago, and like a shingles virus, it stays out of reach until I am weakened, then it rears its ugly head. Last night as the gin started to soak into my grey matter it pounced yet again.

"How would you kill someone with a newspaper?"

Many years ago you see, I was watching one of those prison documentaries of the type that are on MSNBC late at night and I heard an inmate claim to have done just that. Kill someone using only a newspaper. He seemed quite proud of himself, and I don't really blame him, as I have no idea how you'd pull that off. I waited for the explanation and it never came. I've thought about it periodically ever since.

Roll it up into a point and jab at their liver? The eyes maybe?

Soak it it water and hold it over the victims face, smothering them?

Twist it into a type of paper rope perhaps, so you could strangle them.....

It's been a good 5 years I bet and those are the best ideas I've been able to come up with. I have a feeling when I hear the answer it's gonna be something incredibly simple and I'm gonna feel really stupid.

Thing is, I have a newspaper within easy reach most of the time now at work. Ironically enough because I couldn't take the cable "news" channels like MSNBC anymore and started a subscription.

So, I've been thinking about how to kill someone with a newspaper a little more often than I used to. A lot actually. Someone asked me again today if you have to go to college to become a pharmacist and I desperately wished I knew how to kill them with the newspaper that was 12 inches from my hand.

I wonder if it's very physically challenging, because my back's still kinda sore.

It's Been Personal Between Me And The Crazy-Ass Jesus Freak Women Hating Goons On The Right For Awhile Now. Soon It May Be For You As Well. Not To Mention Deadly.

2011-03-08T01:44:00.000-08:00

The only thing more infuriating than this story is the fact that if you don't subscribe to Mother Jones magazine, you're probably unaware of it:

A law under consideration in South Dakota would expand the definition of "justifiable homicide" to include killings that are intended to prevent harm to a fetus—a move that could make it legal to kill doctors who perform abortions. The Republican-backed legislation, House Bill 1171, has passed out of committee on a nine-to-three party-line vote, and is expected to face a floor vote in the state's GOP-dominated House of Representatives soon.

I will stop here for a second and point out the words "party line vote" and hope you might keep them in mind the next time you think labels on the ballot don't matter.

Now, where was I?

The bill, sponsored by state Rep. Phil Jensen, a committed foe of abortion rights, alters the state's legal definition of justifiable homicide by adding language stating that a homicide is permissible if committed by a person "while resisting an attempt to harm" that person's unborn child or the unborn child of that person's spouse, partner, parent, or child. If the bill passes, it could in theory allow a woman's father, mother, son, daughter, or husband to kill anyone who tried to provide that woman an abortion—even if she wanted one.

"This simply is to bring consistency to South Dakota statute as it relates to justifiable homicide," said Jensen in an interview, repeating an argument he made in the committee hearing on the bill last week. "If you look at the code, these codes are dealing with illegal acts. Now, abortion is a legal act. So this has got nothing to do with abortion."

Of course not. Absolutely nothing to do with abortion at all.

the Family Heritage Alliance, Concerned Women for America, the South Dakota branch of Phyllis Schlafly's Eagle Forum, and a political action committee called Family Matters in South Dakota—all testified in favor of the amended version of the law.

I bet the reason so many virulently anti-abortion groups came out in favor of this bill is because it has nothing to do with abortion. I hate it when they don't even respect you enough to put the effort into coming up with bullshit that is even the slightest bit plausible.

"Drugmonkey I'm ahead of you on this one." Some of you might be saying. "I know my local TV news cannot be counted on for anything other than 20 minutes of weather and stories about cats who play the piano. So I count on print media to stay informed, and I know that South Dakota bill has been shelved. That was really a close call."

And you would be right. Unfortunately you're about to learn why you can never, ever, let up in the fight against these people:

Just when abortion rights supporters thought they had beaten a controversial bill they believe would legalize the killing of abortion providers, it has cropped up again—this time in a more expansive form that has drawn the concern of law enforcement officials.

Last week, South Dakota's legislature shelved a bill, introduced by Republican state Rep. Phil Jensen, which would have allowed the use of the "justifiable homicide" defense for killings intended to prevent harm to a fetus. Now a nearly identical bill is being considered in neighboring Nebraska, where on Wednesday the state legislature held a hearing on the measure.

Beat them down once and they come back in a more expansive form.

The legislation, LB 232, was introduced by state Sen. Mark Christensen, a devout Christian and die-hard abortion foe who is opposed to the prodedure even in the case of rape.

Of course this has nothing to do with abortion at all.

Unlike its South Dakota counterpart, which would have allowed only a pregnant woman, her husband, her parents, or her children to commit "justifiable homicide" in defense of her fetus, the Nebraska bill would apply to any third party.

Anyone. Take a look at the next 10 people to wander up to your pharmacy counter and imagine any of them with a license to kill.

"Wow that really sucks for those doctors." some of you are saying. "I'd really hate to be in their shoes." Which will make me a little sad. Because I don't want to do this, but I'm gonna have to give you a reality check. I'll try to do it gently. I'll need you to fire up your thought process for this.

Ready?

Now, we're already in a world where pharmacy's leading trade magazine is printing the propaganda of the right, namely that the scientific consensus on when pregnancy begins is not when an embryo implants into the uterus, when in fact that is the overwhelming scientific consensus. So, close your eyes and imagine a world 10....15....20 years from now, when a bill like LB 232 has been passed somewhere and a razor sharp lawyer has just won an acquittal of someone who slaughtered an abortion provider "to save the fetus"

Now imagine those 10 people at your pharmacy counter again. Convinced that pregnancy begins at the moment of fertilization and not at the moment of implantation. And asking if you sell the Plan B.

And with a license to kill. You.

Imagine that for awhile, and I have a feeling your motivation to fight these fuckers may just get a little boost.

At least I hope so. For your sake as well as mine.

So, I'm Very Late To This Party, But When Your Back Is Killing You, This Is The Best You Can Do.

2011-03-03T02:23:00.000-08:00

Watch this first for context:

And now this. This is so wrong.

My back is actually a little better today. I'll put up a real post soon.

The Article Too Hot For Drug Topics.

2011-02-24T00:02:00.000-08:00

So, yeah, some of you know I spend some time cooking up words for the industry's leading trade magazine, Drug Topics. I admit I try to be a little edgy and push the envelope a bit in my columns for them. After all, I firmly believe if you're not pissing someone off with what you're saying, you're probably not saying anything very important.

Evidently I finally pushed them too far though, although not with the piece with which I thought I would. I've been working on a a column about Walgreen's POWER program, and although they decided to take out my favorite line about being at a bar and overhearing the company's CFO, it looks like that one's gonna run.

Walgreen's CFO, you see, has been busted for drunk driving twice. That line was absolute gold and you'd have to see it in context to fully appreciate it. Oh well. It's nice to have these professional writer type problems I guess.

The article that got rejected was about worstpills.org, which I thought was tame compared to the Walgreen's one. Evidently though, it got a little too close to the industry that actually buys ads in trade magazines. Don't get me wrong. I'm not the least bit angry at Drug Topics. They've been very good to me and the chance to make some money without having to mortgage my soul is one I'm happy to have. Given a choice between pissing off the pharmaceutical industry or one of the corporations responsible for destroying our profession, I'll choose pissing off Walgreen's every time.

I just thought it would be a shame to let the article go to waste. So here it is:

I don’t have to tell you retail pharmacists are overworked. The constant whir of the fax machine, the never-ending ring of the five phone lines, the three customers demanding our immediate attention, that’s been the story line in our profession since long before my first day as an intern. Actually, the more I think about it, the more surprised I am you’re even reading this, and the more I wonder.

Where are you getting your drug information? If you’re looking at these words, I’ll guess you’re getting a good part of it from the advertisements on these pages. Which worries me a little.

Not that there’s anything wrong with a drug manufacturer taking out an ad to tell pharmacists about the introduction of Zegerid (omeprazole/sodium bicarbonate), or to make a sales pitch touting the benefits of Lexapro (escitalopram) mind you. As someone who ends up with some of the dollars generated by these ads, I wholeheartedly encourage such behavior. Let’s not kid ourselves though. By educating us about their products, the corporations that take out these ads are aggressively advocating for their interests, which is exactly what they should be doing under a competitive capitalist economic system.

In this competition though, who is advocating for the interests of our patients? After all, no sane corporation would ever take out an ad to let us know they think Fanapt (Iloperidone) isn’t as effective as older medications for the treatment of schizophrenia, or that the risk to benefit ratio of propoxyphene probably doesn’t justify it remaining on the market. You’ll never see a commercial on “60 Minutes” telling you to ask your doctor about alternatives to sleeping pills.

That is, however, exactly the kind of information and opinion you’ll find at the website worstpills.org. Part of Public Citizen, a nonprofit consumer advocacy group founded in 1971, worstpills is as aggressive in advocating for the interests of patients as Merck and Schering are in advocating for the interests of Zetia (ezetimibe). As a profession that serves as a bridge between the makers of medicines and the people who take them, we should welcome a no holds barred argument between the two sides, the same way the American judicial system values intellectual combat as a way to find the truth. I would love nothing more than to see the pharmaceutical industry and worstpills.org in a steel cage death match.

Unfortunately it wouldn’t be a fair fight. One side has a multibillion dollar advertising budget, the other is supported by foundation grants, publication sales, and member dues. One side fields a sales force army to make in person contacts with health care professionals across the country, while I have never had a representative from Public Citizen ask for some of my time at work. Some days there are so many direct to consumer drug ads on the evening news I feel like I should get continuing education for watching, while if it weren’t for the occasional e-mail reminder, I might forget about my subscription to worstpills.org entirely.

Which would be a shame, because I consider the money I spend to access worstpills.org as a sound investment in my professional career. Because of worstpills.org, I was able to sound a warning to doctors who asked my opinion of Avandia (rosiglitazone) well before stories about that controversial drug made the papers. I told a friend of mine to forget about their Darvocet (propoxyphene/acetaminophen) prescription and just go with some Tylenol instead, and I was able to get some sober, clear headed advice regarding Tamiflu, (oseltamivir) during last year’s H1N1 flu mania. I don’t always agree with the opinions of worstpills.org, but I have found them to be valuable.

So by all means, look over the ads you find in this magazine, pay attention to the messages that bombard your customers every time they turn on the television or open a magazine, and give the sales rep at your counter a few minutes of your time. You’ll probably learn something and be glad you did. But then, make an effort to get some balance in your drug information from sources that have different biases than those you are used to. Make them compete for your attention and opinions.

I know you’re busy, but you’ll be glad you did.

Highlights From Pill Slinging On The Day Of Love.

2011-02-17T00:21:00.000-08:00

Although I've never needed it, yet, I took comfort in noticing the liquor store opened at 8 in the morning. I sat in the drive through at Jack In The Box, and waited for my extreme sausage biscuit, and saw the old man with the scraggly beard leave the store across the street with a brown bottle bag tucked under his arm and felt much the same way a trapeze artist must feel when they look down and see a safety net far below them. Getting some extreme sausage in the morning before a twelve hour day has been a ritual of mine for well over half a decade now, but it was only today I noticed the liquor store across the street opens at 8 AM. Comforting as it is, I don't think it's a good sign.

I put the sausage in my stomach and slowly strode forth across the parking lot to face the day. Halfway to the front door a midget woman flagged me down. Not really a midget I guess, but pretty damn short.

"Excuse please.....can you help? I park but afraid to put in reverse."

That was the condensed version. Her actual communication took far longer. Her car wasn't quite lined up with the parking space but she didn't want to back up. She actually did seem afraid. Did I park her car for her because I have a desire to help my fellow humans or because I have the alcoholic child's pathological desire to please people at all costs? As I struggled to wrest myself from the front seat that was set for a person a good foot and a half shorter than me, I couldn't help but to think it was the latter. Afterwards she hugged me, which added insult to injury.

Once inside the pill garden I noticed a little pin doohicky had fallen out from the handle used to crank the pharmacy gate open. It's half an inch long and it's impossible to raise the gate without it. For some reason I went to the hardware section of the store and McGuyvered a solution instead of standing around and staring at where the pin used to be like everyone else. The district office called to let me know how much they appreciated the type of employee who can think on their feet like that and save them the time and expense of a service call.

BWWWWWWAAAAAAAAAHHHHHHHAAAAAHAHHHHHAAAAAHHHHHHAAAAA!!!!!!! Oh God I kill me. Anyone who believed that last sentence has never worked retail a day in their lives.

The first customer of the day payed for an 8 dollar prescription with a hundred dollar bill and the second wanted to know if her prescription was ready yet. "The machine said I could pick it up after noon" she said. It was 9:15. Yeah, knowing I could walk right out the front door and buy a bottle of gin at this hour definitely made it more tolerable.

At the mid-morning mark I was presented with a prescription for Nuvigil, a stimulant used to keep people awake, and temazepam, a sleep aid, both with instructions to take one in the morning. I wondered if the purpose was to let them fight it out to see who'd win. I looked up and saw what looked like a 17 year old kid carrying a heart shaped box of copro-pharmacy chocolates and wondered if that was really gonna get him laid as I sat on hold with the doctor's office.

At the mid-afternoon mark I decided I would invent a new type of prescription vial. My revolutionary device would let the patient see all the way to the bottom, which will allow them to be fully aware of when they are getting low on their prescription and therefore able to call a few days ahead of time to have it ready, instead of the current system, in which 80% of non-Vicodin patients seem to be totally unaware of when they have taken their last tablet. Coupled with my other idea, a ground-breaking new prescription label that would clearly state when there are no refills left, patients will now have all the information they need to competently manage their prescription affairs. I mean.....no one but a complete dumbass would let their prescription run totally out if they could clearly see there were no tablets left to take and no refills remaining.

BWWWWWWWAAAAAAAAHHHHHHAAAAAHAHHHHHAAAAAHHHHAAAA!!!!!! Seriously, I really do kill me. Where's the gin?

The second and last time I was required to perform a professional function on Valentine's Day was when I explained to a woman why her doctor discontinued her potassium prescription when he switched her blood pressure med to lisinopril. I was interrupted twice while doing this. Once by a man who wanted to know where the bathroom was and again by a lady who wanted to find the bendable straws. Potassium lady eventually accepted my explanation, but didn't seem nearly as grateful for it as the lady who had me park her car.

I ended the day wondering how much I could make as a valet, but secure in the knowledge that I had to make it to the liquor store by eleven. I've known the closing time of the liquor store for years.

I Cannot Let This Affront To Democracy Stand. I Am Prepared To Riot In The Streets Of Fort Wayne, Egypt-style, And I Ask You To Join Me.

2011-02-14T22:52:00.000-08:00

Thanks to The PharmD Student who tipped me to the story.

"Someone Is Making A Big Profit Out Of Woo Woo"

2011-02-08T22:33:00.000-08:00

Meanwhile, my employer gets a $1.50 dispensing fee from your warfarin prescription:

A Modest Proposal For The Cleveland Cavaliers Basketball Team.

2011-02-05T22:31:00.000-08:00

Dear Sir/Madam/Whoever is in charge of your train wreck,

I don't have to tell you times are tough. The housing bubble and its resulting ills have hit this country hard, and Cleveland harder. Unemployment and its resulting ills have settled upon your city like a two foot blanket of snow. You face despair, homelessness, crime, drugs and violence each and every day, and things aren't good off of the basketball court either. I write you this day not to wallow in your misery however, but to ignite the flame of hope. When you have hit bottom there is only one way to go, and today I offer you a solution that I am confident will contribute to the long term improvement of your bottom line.

I propose that you immediately terminate the employment of every player on your active roster and replace them with a team consisting entirely of myself. I will perform the duties of every position; forward, center, and guard, and will play the entirety of every game. Furthermore, I will do so for a salary of $2 million a year, a savings of approximately $49 million from your current payroll. This may appear at first to be quite a radical move on your part, but my projections show that had this plan been put in place at the beginning of the current basketball season, the net result would only be eight fewer wins for your team at this point. Sacrificing quality in order to achieve cost savings has long been a tradition in the business world, and I feel the time is right for the Cleveland Cavaliers to join the predominating corporate paradigm. When you do, you are most certain to find out what many successful companies have found out before you, that the elimination of quality is good for profits. In your case, the spectacle of a 6 foot tall white guy taking on the entire roster of the Los Angeles Lakers would surely be far more entertaining than the product you are currently marketing. Ticket sales are likely to see a significant increase.

I also would be returning to my native Ohio to continue my basketball journey. Making it possible to market me as the anti-LeBron James.

I would be available immediately after giving the customary two week notice to my current employer, and have been working out regularly for the last three years, although I don't see what possible difference that would make. I do see a future for us as bright as the Cuyahoga River aflame on a clear winter's night.

I look forward to the chance to improve both of our finances.

Sincerely,

Drugmonkey.

A Quickie From The Morning Paper

2011-02-04T01:49:00.000-08:00

They have a thing about making certain stories available only in the print edition, and not online, but I swear I'm not making this up:

WaterPlus includes a collection of prominent locals. In addition to Weitzman, the new group includes such well known figures as Nader Agha, Harvey Billing, Bob Massaro, Dick Rotter, and George Schroeder, among others.

BWWWWWWAAAAAHHHHHHHAHAAAAHHAHHHAAAAAAAA!!!!!!!!!!! Dick Rotter!!!!!! BWWWWAAAAAHHHHHHAAAAAHHHHHAAAAHHHHHAAAAAAA!!!!!!! Well of course Dick Rotter is well known. Who can ever forget his work in the basic training Gonorrhea film used by the US Army for over 40 years? Classic stuff, that appearance by Dick Rotter was. And who knew you could make a living making porn for people with a leprosy fetish? "I Left My Schlong In San Francisco" was groundbreaking in its day. I've often wondered what Dick Rotter could be up to these days.

I'm kidding. I don't know who the fuck Dick Rotter is. But I have a feeling the paper wouldn't be as likely to be calling him well known if he went by Richard.

I Owe The Pharmacists For Life International A Big Apology.

2011-02-02T23:22:00.000-08:00

I'm sorry Pharmacists For Life International. I thought you just hated women. When you cranked up your public relations machine a few years ago to draw attention to the cause of "pharmacist conscience," putting Karen Brauer in front of the nation's TV cameras and Lloyd Duplantis behind the microphone of National Public Radio, I thought your objective was to put a stop to or at least a dent in the number of abortions that take place in this country. I was mistaken, and again I apologize.

Fortunately the legislature of the state of Idaho didn't listen to the likes of me when they passed a health care worker conscience law of the type you fought so hard for. It didn't take long for a pharmacist to take advantage of that law, less than a year actually.

On Nov. 6 a Walgreens pharmacist refused to fill a prescription ordered by one of Planned Parenthood's Boise-based nurse practitioners. The prescription was for a Planned Parenthood patient for Methergine, a medicine used to prevent or control bleeding of the uterus following childbirth or an abortion.

This is awesome. I can see now that this is one step closer to what is now our common goal. I'm so sorry I was so wrong, that I couldn't see that you were simply using the dim-witted twits in the anti-abortion movement as pawns in your brilliant chess match. That prescription for Methergine, you see, doesn't do a damn thing to stop an abortion whether its filled or not. Hell, probably at least half the time you see one it doesn't have anything to do with an abortion at all, stopping bleeding the way it does after a natural miscarriage or regular childbirth with complications. And when it is abortion related? By the time you see the prescription it's too late if you're interested in stopping one, because the abortion has already happened. So what the pharmacist was doing by refusing to fill that Methergine prescription then, was assuming the power of cop, judge, jury and executioner against someone who they thought might have done something they didn't like. Literally, executioner. That Walgreen's pharmacy customer could have bled to death.

Sweet. Because a lot of my customers do things that I don't like, and I cannot wait to use my new God-like powers just as soon as the Idaho Board of Pharmacy rules against Planned Parenthood in its complaint against that Walgreen's pharmacist. I'm hoping Pharmacists For Life International can now maybe team up with The National Rifle Association so we can just start shooting people dead at the pharmacy counter. I'll go after the Type-2 diabetics first, then probably the fibromyalgics. I'll probably off a smoker or two as well just for shits and giggles.

And I'll have The Pharmacists For Life International to thank. For making pharmacy the single most powerful profession on the planet. I can't believe I was so foolish not to have seen their plan.

Definitely beats the shit out of anything APhA's ever done for us.

Thanks to the alert reader who tipped me to the story.

I Must Have Missed The Outcry About The Rape Panels.

2011-02-01T23:57:00.000-08:00

I mean, I totally remember the blue in the face teabaggers getting their boxers in a bunch over death panels. Sara Palin and her ilk telling us that Big Government was gonna be deciding whether to pull the plug on Grandma, deciding whether she would live or die. Scary stuff.

Also total fiction.

Which is good news for rapists. Because if we keep Grandma in a coma and unable to fight back, someday she might just be fair game for an unlimited gangbang thanks to the Republicans those teabaggers put in power. From the website of Mother Jones magazine:

Rape is only really rape if it involves force. So says the new House Republican majority as it now moves to change abortion law.

For years, federal laws restricting the use of government funds to pay for abortions have included exemptions for pregnancies resulting from rape or incest. But the "No Taxpayer Funding for Abortion Act," a bill with 173 mostly Republican co-sponsors that House Speaker John Boehner (R-Ohio) has dubbed a top priority in the new Congress, contains a provision that would rewrite the rules to limit drastically the definition of rape and incest in these cases.

With this legislation, which was introduced last week by Rep. Chris Smith (R-N.J.), Republicans propose that the rape exemption be limited to "forcible rape." This would rule out federal assistance for abortions in many rape cases, including instances of statutory rape, many of which are non-forcible.

Other types of rapes that would no longer be covered by the exemption include rapes in which the woman was drugged or given excessive amounts of alcohol, rapes of women with limited mental capacity, and many date rapes."

Victory at last for lobbyists working for the manufacturers of Jim Beam and Rohypnol no doubt.

That was a snarky comment, but there is one line in the article that will bring joy to the hearts of rapists everywhere:

The bill hasn't been carefully constructed, Levenson notes. The term "forcible rape" is not defined in the federal criminal code, and the bill's authors don't offer their own definition.

Should this bill ever pass however, that definition will come. And when it does, most of you know how it'll go from there.. "Forcible rape" will become synonymous with "real rape," the distinction meaning if you didn't fight with all your might against a 300 pound lunatic high on PCP, then your violation isn't to be taken quite so seriously.

And if you were drugged to the point of not being able to fight back, well that's just too bad slut, you shouldn't have been wearing that miniskirt anyway.

And who better really, to come up with that definition than a panel of government appointed bureaucrats working to implement the will of politicians?

A rape panel. It's far closer to reality than the death panels ever were, and the ensuing silence says volumes about the value we place on women.

You've come a long way baby.

Thanks to the alert reader who tipped me to this.

An Exciting Announcement. We May Witness The End Of Heart Disease In Our Time.

2011-01-26T01:28:00.000-08:00

Because if Rite Aid has shown us anything over the last few years, it's that once they set their mind to accomplishing a task, nothing, absolutely nothing he said, will stop them. Like the way they've made their stock the most affordable of any of the major drug chains. "We decided in the late 90's that to expect the hard working families of America to pay over $45 for a share of stock, which is in reality nothing but a piece of paper, was just unfair." A company spokesman never said. "So we undertook a long term program to bring value to those who aspire to own a piece of our vision, and I'm proud to say that as of today, we have cut the price of that ownership by over 95 percent. I think all of us can take more than a little pride in a mission accomplished."

Now the company has taken that laser-like intensity and turned it on the nation's leading cause of death. Part of this press release is cut-and-pasted from the public relations newswire. Part of it is real only in the world that is my imagination. I'll trust you to know which is which.

Rite Aid Takes Aim at Heart Disease in Honor of American Heart Month

CAMP HILL, Pa.--(BUSINESS WIRE)-- Rite Aid, the nation’s third largest drugstore chain, is launching a national education and prevention campaign against heart disease in observation of American Heart Month in February. Stores nationwide are now selling $1 red paper dresses to benefit the American Heart Association’s Go Red For Women movement, reminding customers that they can get free advice and blood pressure readings, and distributing free "Roadmap to Healthy Heart" guides.

The paper dresses will be available at all of the stores cash registers, at least 70% of which are located right in front of large displays of cigarettes and various other forms of tobacco.

The educational components of Rite Aid's heart health program include:

A 12-page guide available in stores and online at www.riteaid.com that offers a "Roadmap to a Healthy Heart," including seven simple steps that can reduce heart disease and stroke. It also breaks down the numbers behind heart disease risk factors such as the so-called "good" or "bad" cholesterols and the "ugly" danger of triglycerides. Guides also discuss diet's role in heart health – including the average American's elevated salt intake.

The guides will most likely be placed close to the stores weekly advertising circular, which currently features cookies by Archway and Mrs. Fields, Planters whole cashews or mixed nuts, Storck bagged candy (excludes Sugar Free), and Rite Aid brand pretzels, cheese puffs or popcorn at the special price of a dollar a bag after $1.50 +up reward.

Assuming you can figure out what the hell a +up reward is.

"We think the time is right to make this important statement about how seriously we take the devastating impact heart attacks, stokes, and other forms of cardiovascular disease have on the lives of every American." Rite Aid President and CEO John Standley never said. "While the number one goal of any corporation is to turn a profit, it feels good to know that we can also dedicate ourselves to looking out for the health and well being of our customers."

"We'd like to think we do both equally as well."

I Resort To Theft For Content. As I Am Both Too Lazy And Too Drunk At The Moment To Do Original Work. I Think I Stole Well, However.

2011-01-25T03:29:00.000-08:00

A day in the life of a Pharmaceutical Sales Rep
Author unknown

WEEK ONE – I can’t believe that right out of college a Fortune 500 company has hired me! My major in Biology and Minor in Elizabethan Poetry sure must have helped. I think the fact that I was the head cheerleader in college proved my abundance of team spirit. To be making $50,000 a year at age 23 isn’t too shabby. And I get a new car too!

WEEK TWO - My bosses seem real nice. I haven’t met anyone else out in the field yet. Got a lot of information to study before training starts. There is a lot to know about hypertension, I tell you that. It is so interesting to learn how each mechanism of our drug works. I wonder why they even need sales reps when it is obvious that our ACE inhibitor is the best. The information they have given me to look at shoes how it is so superior to the competitors. This job is going to be a piece of cake! I bet the doctors are going to love seeing me come their way.

WEEK FOUR – Boy, those tests were hard but I passed all of them. Going to Florida for a big company meeting. This is awesome. A free trip to Orlando. Theme parks. Meeting other reps from around the country. There are a lot of other drug reps that were cheerleaders. That’s weird.

WEEK FIVE – The meetings were inspiring! There were thousands of us chanting our company name! The lectures on our products just proved I picked the best team to join. There is no question we possess the most effective and unique products available. I can see myself working for this company forever. Nothing is going to stop me from climbing their ladder into a higher administrative level.

WEEK SEVEN – Another field rep had me shadow him for a day. He seemed a little down when I met him, however he seemed to perk up once he saw me. I am sure it is a pick-me-up for him to mentor someone new. He kept asking me why I would pick this job. Then he asked if I could handle personal rejection. Of course I can handle personal rejection. I remember when I didn’t get picked for junior prom queen, I cried for weeks but I eventually got over it and became stronger in the long run. Most of our day was spent on the road talking or trying to get in to different medical offices. We only got to meet two doctors. Boy, were they in a rush. I don’t think the field rep did a very good job. Our product is so good, he needs to get right in those doctors faces! I can’t wait until it is my turn.

WEEK EIGHT – First day by myself. Met Dr. Smith. He must be stressed because he cut me off in the middle of my sentence and walked away. He must have forgotten I was there because he never came back. Dr. Johnson was just the opposite. It was great. It seemed he wouldn’t stop talking tome. In fact, he wanted to meet me for dinner to just talk about my drug. What was really funny is that he forgot what drug I was selling, but promised he would write it no matter what it was. I am one hell of a salesperson!

MONTH THREE – I am not sure why some doctors won’t even meet with me. Tjey want some samples but that is all. Had lunch with a group of internists. They didn’t even show up and I spent $200 on lunch for their staff. They weren’t even that thankful either. That was kind of rude.

MONTH FOUR – Still having trouble getting in to see some doctors. Dr. Ryan told me off and was extremely irritable. He said I was too forceful. I sat in my car and cried for a half an hour. I know I can do better at this. I think our drug is pretty good. I just need to be more assertive

MONTH FIVE – Rode with my boss who watched my every move. I was really nervous. Still couldn’t get into some offices. What was worse was that my boss kept interrupting me like he was making the sale himself. Listen, buddy, if you want my job you can have it. When he left I cried for fifteen minutes.

MONTH SIX – Had another dinner program for doctors. Only a few showed up. The speaker wanted his money right then and there like I was the one who was paying him out of my own account. Then the mother f$%^r started talking positively about our competitors! Whore.

MONTH SEVEN – The marketing people wanted us to have a “birthday party” for our ACE inhibitor. It has been on the market for three years now and they recommend we use the birthday hats and napkins that they gave us. It has our logo and drug name on it. They said the doctors would love it. Who the f$%^& do they think they’re kidding? As if I am going to get the few doctors that even give me the time of day to light candles and wear hats because our lousy “me too” drug is three years old and selling like sh*%? Do these marketing people even know what’s going on out in the real world?

MONTH EIGHT – Dr. Smith, who was so rude to me. Wants to know if I have any baseball tickets to the upcoming series. I wonder if the phrase “kiss my ass” means anything to him. Saw Dr. Johnson recently. After the “episode” which occurred at our last dinner, I have purposely stayed away from him. The restraining order still remains. He needs to get a life.

MONTH NINE – Went back to our bulls&%# meeting in Florida again. Who are they fooling with this AMWAY crap? This is all cult worship anyway. In fact, I’d rather drink Kool-Aid laced with cyanide than sell this piece of s&%$ drug. We met in small groups and they tried to teach us new points that would persuade any doctor to use our drug. Talk about a circle jerk. Got drunk most nights I was down there.

MONTH TEN – The company is getting on my case more and more. They want to know what I am doing every minute of every day. They want signatures. They want programs. They want my first born.. My boss is a prick and if he interrupts me one more time I’m going to kick him in his balls.

MONTH ELEVEN – Slept with Dr. Johnson. Fu&$ it, I needed the numbers. I am also giving away stocking stuffers of goodies to any doctor that will write my loser medication. Whatever it takes to make bonus. Dr. Flock again tells me he is writing my drug. What a f%&$ing liar. We buy the prescription numbers right from the pharmacy so I know what his numbers actually are and this guy bulls%ts me right to my face. I think he wants to sleep with me.

MONTH TWELVE – Slept with my boss. I needed to keep him off my case. One more dinner program and I will put the cyanide in the doctors’ drinks myself. Every time I get new marketing material, I throw it right out in the trash. Our company sucks. I know I hit all the numbers but they changed the threshold at the last minute and screwed me out of my bonus.

MONTH THIRTEEN – This job sucks. If I see another pompous physician I will kick him right in the balls like I did my boss. I will die before I ever feed a bunch of overweight and ungrateful staff members again. Told my boss to go screw himself of screw Dr. Johnson and leave me the f&*$ alone. Threw my keys to the generic minivan at him and walked away with my pride. Never again will I work for a pharmaceutical company.

MONTH FIFTEEN – Took a job at our rival. They got some new stuff in the pipeline. The money is even better than my old company. Called Dr. Johnson and will meet him Tuesday night for dinner.

A Difference Between Generic Meds And Why Your Customers May Not Always Be As Crazy As You Think.

2011-01-19T01:28:00.000-08:00

"Bullshit Drugmonkey." You are saying. "My customers are fucking psycho. The only people who worry about which particular generic they are getting are crackheads who want the same color promethazine with codeine syrup that the rappers sing about."

I hear you. Trust me, I hear you loud and clear. And the one thing I can tell you without the least bit of uncertainty is what you and I have both heard a million times: generic meds are the same thing as the brand name. The same ingredient put into your body in the same amount. Period. Without a doubt.

Now that we have that settled though let's play a little game. I call it "find the mile-wide loophole in what I just said." Read that last paragraph again and think it over. If you need some help think about extended-release products and what I didn't say.

If you need another clue here you go:

Didn't say anything about rate did I? This chart is from the FDA's own data regarding the anti-depressant Wellbutrin XL and a generic distributed by TEVA Pharmaceuticals sold under the name Budeprion XL. Look at the plasma concentration at two hours and five hours and tell me these meds are the same. The FDA put this out in response to numerous consumer complaints that the 300 mg TEVA generic led to relapses of depression and increased side effects. That wasn't a typo. The complaints were about the 300mg version and the FDA responded by studying the150mg tablets. "Because of the potential risk of seizures at higher doses, the 300 mg strength was not studied" said the FDA, which makes perfect sense in a bizarro alternate universe where you wouldn't study the thing you want to learn about out of safety concerns after you had already declared the thing you want to learn about to be safe and effective.

Someone actually did study the 300mg tablets people were actually complaining about though, and if you were able to sneak past the paywall of ConsumerLab.com and read their report this is part of what you'd see:

So... when someone actually took a look at the actual product people said affected them differently, and not a similar product used as a stand in by the FDA "for safety purposes," the differences were even greater than what the FDA found. Interesting. I won't say anyone was trying to hide anything, because I don't have any evidence for that. I will say that if you were trying to hide something though, what the FDA did might not be a bad way to go about it.

I also won't say that the differences the FDA and ConsumerLab found are clinically significant. It is entirely possible that what the FDA and ConsumerLab came up with, as striking as it may appear, would have no noticeable clinical effect.

I will say however, that when I dispense and you take a generic drug, we both expect it to be the same as its brand name equivalent, and that dumping 49% of a 24 hour dose over the course of four hours as opposed to 25% is not the same. It's almost twice as much. Which makes me wonder if maybe there's not a reason at least a few of my customers are so damn psycho.

It's also why I've started ordering Watson's version of Wellbutrin XL.

Last Week I Discovered My Inner Divinity

2011-01-12T00:58:00.000-08:00

I never realized until last week just how much I had in common with Jesus.

I've written before about the dramatic tension that has gripped the happy pill room. What should have been a 10-minute problem has gone on for the better part of a couple months now. Personalities have clashed. Feelings have been hurt and egos wounded. I won't assign any blame other than to say that when the Pharmacy Manager leaves the problem leaves with her. The Pharmacy Manager took some time off last week, which meant the tension that gripped the pharmacy melted away like the fog giving way to life-affirming sunshine.

Sadly, this return of levity and happiness came at a great personal cost to myself, as no relief pharmacist was found to cover the manager's shifts. I took the burden of my world upon me then, sacrificing my body to make my environment a better place for all that inhabit it. Selflessly giving myself so that others may live in peace. Just like Jesus.

I also heal the sick. I bet if I ever meet Jesus we'll have a lot to talk about.

I'd probably ask Jesus what was up with the showgirl that was in the store Thursday. I'm not kidding. A woman in total Las Vegas feathery boob and crotch covering walked into the back room and was promptly marched right back out by the assistant manager. I long to know the story of the showgirl in my store and I bet Jesus could tell me.

One thing Jesus probably couldn't do though, is figure out our system router had lost power the way I did when our computers started acting all screwy for no apparent reason. There's not a lot in the Bible about Jesus being a technophile, so I could probably teach Jesus a thing or two. I hope he's not the kind of guy that would rope me into upgrading his computer to Windows Vista though, because I'd probably feel obligated to so I wouldn't be eternally dammed.

People pray to me though, just like Jesus. They beg for early Vicodin and for faxes to come through from their doctor's office. They pray for prior auth approvals and lower co-pays. Sometimes, when they pray for something they already have coming to them, I go ahead and grant their request, in order to enhance my omnipotent image. Most prayers directed to me go unanswered though, just like if you were directing them to Jesus.

I'll never ask you to eat my body or drink my blood though. That's just gross.

Nurses pray to me too. "I hope this is right" said one immediately before she began to phone in a prescription. I kinda hoped it was right too. I was nearing the end of my streak of twelve hour days and it would be much easier on my tired mind and body if the prescription were right. Not to mention my liability insurance.

Right after that came the French prescription. The French prescription was my crown of thorns. The words were in French, a language which is not English, because the prescription itself was written in France, a country that is not the United States. It was dropped off by a Frenchman who upon landing here had to go though a procedure where a person in an official looking uniform inspected him and his belongings before he was allowed to continue. This happens because different countries have, by definition, different laws regarding nearly everything, not the least of which being business and commerce. This point was lost on the Frenchman, who had no idea why I could not fill a prescription written in a language I do not understand. The Frenchman pressed the crown onto my head over the course of a vigorous debate over the conduction of cross-continental healthcare and when he was done I found a cup of coffee placed next to my computer by my trusty technician, who smiled and then went on about her work like nothing ever happened.

I have the best staff in the world. Neither Jesus nor the Pharmacy Manager better ever try to fuck with them.

He Failed You Sarah

2011-01-10T20:56:00.000-08:00

His ammunition spent, the assailant stopped to reload, the authorities said, inserting a 31-round clip into the chamber of his Glock semiautomatic pistol before raising the gun again.

And in what was perhaps the only fortunate event of the day, the spring on the second clip failed. Two other men in the crowd lunged at the gunman and tackled him to the ground.

All indications were that he was trying Sarah, so maybe you'll cut him some slack for that.

I, and most of you reading this who are a member of one of the health care professions, learned long ago that when you are in a position of responsibility you have to be careful what you say. I just had an alcoholic customer finish drinking himself to death after his doctor told him "an occasional drink wouldn't hurt anything" That doctor was a dipshit, and Sarah Palin is a dipshit as well.

Or else she really does want people to shoot into crowds and kill 9-year old girls. I never thought I would be hoping so hard for Sarah Palin to be so stupid.

Last summer, Ms. Giffords’s Republican opponent, Jesse Kelly, had a campaign event in which voters were invited to “shoot a fully automatic M-16” with him to symbolize his assault on her campaign.

Sadly, Sarah isn't the only dipshit.

"Drugmonkey you don't understand" the conservatives are saying. Conservatives start off every rebuttal by implying we don't understand, for they are much smarter and much more wise to the ways of the world than we shall ever be. "Sara and Jessie were talking metaphorically." They will put a particular emphasis on the word "metaphorical," implying that maybe we should look it up later. The only reason a conservative can comprehend that you are not one of them is that you are not smart enough.

I am smart enough to know that you don't tell an alcoholic an occasional drink is OK though, and also smart enough to know you don't put this in front of the general public and then act like you don't know what will happen:

Look at that and then ask yourself what would happen if it had been on the Nation of Islam's website in the runup to last fall's election. You'd be calling for Louis Farrakhan's nuts on a platter right now, that's what you'd be doing.

So I guess I'm a little confused as to why Sara Palin's tits shouldn't be served up on a platter.

Unless they really do want us dead. Then it would all make sense.

As Much As I'm Sure You'd Love To Continue To Hear My Opinion About The Troops, I Think I'll Write About Last Week's Pill Counting Highlights Instead.

2010-12-27T23:59:00.000-08:00

What is your name? Can you think of a simpler question? Seriously, I'm used to people who don't have any idea if they've ever set foot in one of the thousands of stores operated by my employer. I've also accepted the fact many people will come to the counter convinced they are at a CVS, which wouldn't be so bad save for the fact I don't and never have worked for CVS. But how the hell can you mess up the question "What is your name?"

The guy did. Took him a good couple of minutes to get the answer out. The education crisis in this country is real and will soon overwhelm us all my friends.

These types of problems are best left to the technicians though, as my massive brainpower is needed for the medical type questions. Like the lady at the blood pressure machine who asked me if a reading of 180 over 130 was too high.

I fired up my superbrain and told her yes, that reading was without a doubt too high. That she needed to see a doctor.

"Well my last reading was 150 over 112, so maybe my pressure isn't really that high."

I told the nice lady that even 150 over 112 was too high, and she really needed to see a doctor.

"But I don't want to see a doctor" was the reply. Unfortunately I was still expected to find a solution to this problem.

So I whipped out my counting spatula, which also doubles as a magic wand, lightly tapped her on the forehead, and sent her on her merry way, telling her she could be secure in the knowledge that her blood pressure would never be a problem again. My only regret was that she just didn't tell me she'd rather not see a doctor right off the bat. Could have saved us both a little time.

While this was going on I overheard a man talking to my trusty technician.

"We don't seem to have any prescriptions for you, was there anything you needed?"

"No."

Why a person comes to the prescription counter when they are not in need of a prescription is one of life's little mysteries. But it happens. More often than you would think. I suspect CVS might be behind it.

There has been a bit of drama in the happy pill room of late amongst the staff. Nothing major. The type of petty politics that will happen when any group of people share a close space together for a few hours every workday. Long story short, there was a bit of a spat between the pharmacy manager and one of the technicians. The same technician who saves the used aluminum soda cans we use during the workday to cash in for the recycling deposit. After the spat, the manager reached into the recycle box, pulled out the two cans she had emptied that day, and put them into the regular garbage. I suspect my pharmacy manager will be promoted soon, and am confident she will fit into the corporate world quite well.

A deaf lady signed "Where's the bathroom?" and I understood her perfectly based only on the look upon her face.

The prescriptions were backed up like a 90 year old man on Oxycontin and I didn't have time for this shit. Have you ever called another store for a prescription transfer and wondered how the hell the person on the other end of the line could possibly have the same license as you? I know you have, and it seems to be happening with increasing regularity. Like the people who don't know what the words "NO REFILLS" on a prescription label could possibly mean though, I've come to accept it. Every once in awhile they still manage to surprise me though. Since this store was on the other side of the country, I was getting some basic information, the kind of thing that happens in every pharmacy, every day of the year.

"So what's your ZIP code?"

"My what?"

"Zip code. The last part of your address."

"Uhhhhhhh.........can you call back later?"

I gave up on the human with a college degree and professional license and looked up the zip code of mystery on my smart phone.

And the machines took a step closer to the day when they will rule us all.

Got Some Mail About That Last Post I Did.

2010-12-23T02:01:00.000-08:00

Ahhhh....feeling the love....I knew I was poking a skunk with this one. But I gotta tell you, after thinking about it, the hate mail has changed my mind.

If my cellphone ever goes off at a military funeral, I might as well go ahead and answer it. Because if I repeat some mindless pap afterwards about guns, God, and country that will evidently make everything all right.

Your issue is with the government, not the soldiers. They are ordered to do a job, whether they like it or agree with it is not taken into account. 'not going' as you suggest is considered desertion and is an offense punishable by court-martial and imprisonment. Dishonorably discharged soldiers have a status similar to convicted felons in many states. "Not going" is not an option.

Yes it is. Lemmie present a couple cases to you.

Solider number one thinks to himself, "man, this war is bullshit, I don't agree with a goddamn thing we are doing here, but I'm gonna keep up with it because that's my job and what I've been ordered to do."

Many people die as a result. Some of whom had no part in this fight.

Solider number two says "man, this war is bullshit, I could no longer live with myself if I continue to carry out orders that are contrary to fundamental principles of humanity. Although it entails a great personal sacrifice, I shall no longer enable this unjust war, because some principles are more important than any individual. Although it may cost me my standing in society, I will no longer take part in the madness."

Which one of these people is the more courageous? The more honorable? The answer is obvious, but if you need a hint, going along to get along is rarely a sign of courage.

Why the misdirected anger? The vast majority of military personnel I have known choose the career because of the pay cheque.

* Smacking forehead* that's exactly why I am so angry at them.

"Hey, go kill that guy and I'll pay for your college tuition"

That's honorable? Really? Because if it is I will happily choose the path of dishonor.

I'm curious as to whether you would apply these same arguments to the soldiers who carried out the Tienanmen Square massacre or the policeman who broke up the Iranian Green Revolution of 2009. I hope you wouldn't. Repression is repression, injustice is injustice, and those who carry it out are wrong. The wars being fought in our name are unjust, and those carrying them out should not be supported.

Having said that though, there really are times you should let the call go to voice mail.

From The "Support Our Troops" File.

2010-12-22T03:09:00.000-08:00

Which I don't. That's right. If you're a troop the only time I will support you is if you decide to find another line of work. You are necessary for the continuation of a policy I despise, and if you would stop doing what you are doing, that policy would end. So, yeah, I'm a little unclear as to why I should be cheering you on.

I would like to think though, that if I ever ended up at one of your funerals, I would have enough respect for the sanctity of life, even yours, that I wouldn't be...

...checking my cellphone behind your grieving widow. I'd also put on a tie and probably wear a suit. I'd definitely come up with something better than a t-shirt. Because unlike this douchebag, and unlike the people who hired you to kill for the empire, I realize that every life lived, by default, is worthy of a minimum level of respect.

Looks like you might need to relay that message to some of your supporters.

Report: Everyone Stupid.

2010-12-13T22:22:00.000-08:00

TUSCALOOSA, ALABAMA (Drugmonkey News Service)- At a noontime press conference today, researchers at The University of Alabama released the results of a new study that, for the first time, shows 100 percent of the world's population is completely, unambiguously, and incurably stupid. The results sent shock waves through the international psychological community, as dumbfounded researchers scrambled to redefine accepted definitions of intelligence.

"Traditionally, we have worked off of what is called the 'percentile' model," lead researcher Dr. Beverly Thorn didn't say about the study that doesn't actually exist but you know easily could. "Meaning that we always assumed that 50% of the population was of below average intelligence, and 50% was above. It was truly startling to find that each and every human being on this planet has an intellectual capacity below that of sandstone."

"We're not really sure how that is possible," she didn't add. "This science stuff is really hard."

The biggest surprise in the report was the finding that you, too, are dumber than a three toed sloth. Your chronic inability to figure the correct tip at restaurants was the scientist's first clue to your idiocy. However, it was the time you once drove the wrong way into a narrow big-city alley and had to pay a homeless man to stop traffic so you could back out without killing yourself that definitively showed that for your own safety, you should always be kept away from open flames.

Outside experts were initially skeptical of the findings, with some pointing out that Alabama has long been known as the world capital of dullards, periodic challenges from West Virginia notwithstanding. "At first we thought those hicks were probably just looking around town and reporting what they saw," fictitious Oxford University professor Dr. Alvin Sturges said. "But analysis of the data shows that it's a wonder that any person can manage to cross the street, no matter if the intersection is in London, Buenos Aries, New York City, or an unpaved path in rural Botswana."

"It does offer insight into my first two marriages though, and gets us tantalizingly close to a unified theory of Kim Kardashian"

After presenting her findings, Dr. Thorn asked for questions from the assembled journalists. Receiving none, she left through an emergency exit, setting off a fire alarm that resulted in a three car accident when a motorist ignored the sirens of the responding ambulance.

Those In The Employ Of George Bush Are Evidently As Good At Identifying Supporters As They Are In Identifying Countries Responsible For 9/11

2010-12-12T22:17:00.000-08:00

Because I got a letter yesterday soliciting a contribution for the George W. Bush Presidential Center. Seriously. W thinks I'm gonna give him money. After all I've written about him over the last five years, I pop up on a list of people who may be willing to part with their pay in order to show their gratitude for everything he did to this country.

Suddenly I'm not afraid of the power of the surveillance state at all.

You know what I think would be fun? A mash-up kinda thing. Like alternating actual words in that letter with actual things that have appeared in this blog. Here we go:

As we break ground on the George W. Bush Presidential Center, every effort is being made to ensure longtime supporters of President and Mrs. Bush are involved from the outset.

December 11th, 2007- I Bet I Could Defeat George Bush In A Boxing Match. What I would have to do is use my jab to keep Bush on the outside, because you know damn well if he got in close he would fight dirty. Elbows, kidney punches, ear biting, he would do it all. I would definitely have to establish my jab early. And watch out for any attempted waterboarding or extraordinary rendition attempts between rounds.

You have been a great friend to president and Mrs. Bush and it would be an honor to be able to show your name on the list of those who have accepted.

June 7th, 2008- "It's been a core belief of mine that the federal government should stand for killing people" George Bush once didn't say in an interview. "Sometimes that requires an active killing policy, like in Iraq. In other instances, it's best to just let things take their own course, like during Hurricaine Katrina, or health care, where lots of people no doubt are dead because we don't really have a plan."

"I really like dead people" concluded Bush.

Your steadfast support though this often tumultuous period was of enormous help to President and Mrs. Bush.

May 24th, 2008-

You most likely get the idea by now far better than George The Lessor ever will. Nonetheless, let me try to spell it out in a way even he might understand:

Mr. Bush,

I hate you. Every fiber of my being down through the marrow of my bones despises the very thought of your essence. You can have my money when the budget you wrecked with your bullshit tax cuts comes back into balance. When you find those weapons of mass destruction you used to scare the sheeple of this nation into becoming a bloodthirsty lynch mob. When the 100,000 people you killed, who had no part in the fight you started, come back to life. I'll send you a check just as soon as the blood comes off your hands you homicidal, psychopathic, pathetic shell of what a human could be. Your letter came with a certificate "confirming me as a Charter Member" of your presidential center. Please find it enclosed. I'm not telling you what I stained it with.

Sincerely,
Drugmonkey

I figure Cheney will probably ask for a few dollars sometime next month.

My Kindle Nightmare Is Over, Which Means Your Dream Reading Experience Can Begin.

2010-12-07T22:50:00.000-08:00

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.