I Went Into Pharmacy So I'd Have Enough Money To Attract A Hot Chick, Oh The Painful Irony.

I'd be willing to bet that more than one of you in the profession out there may get a bit.........surly when the pharmacy goes into full scale pill moving action. You've got prescriptions coming in by phone, by fax, by electronic Rx, being dropped off in person by numbnut members of the general public. Carrier pigeons are flying in through the drive through window carrying orders for Vicodin. They all wanted their meds 20 minutes ago, and they all want to talk to you for 20 minutes.

Now I understand if you are the type of person who reads a label that says you should take your antibiotic until it's all gone and still need me to tell you in person that you should take your antibiotic until it's all gone. Idiots like you keep me from being completely replaced with a robot. Any drug related interruption, no matter how trivial, basic, and yes..... stupid as it may be, I'm OK with. When the carrier pigeons are flying though, and you want to stop me to ask where the nearest lottery agent is, I will be mean. I have to be, otherwise nobody's drugs get out the door. Got that? It's been that way long enough now it's embedded into my very being. Non-drug related conversation = blowoff.

I found out just how deeply embedded this afternoon. I had a room full of pigeons pissed because they had to fly back to the clinic before dark. All hell was indeed breaking loose, and a woman caught my eye. Looking back I realize how hard she would have had to work to do this. My eye is almost impossible to catch when hell is breaking loose. Eyes locked, I had to say something or look like a dork. I hoped a simple "Hi, how are you?" would let me get back to work.

"You know" she says, "I was watching you just now and you have almost perfect skin"

"God damn it" says the drug monkey to himself, "I've got 30 prescriptions on the counter and an angry hoard of barbarians in the waiting room. Like I have time for this" The chick got the non-drug related blowoff, just like the lottery player.

It wasn't until the pigeons had flown off that I realized what had happened. The chick was hot. A hot chick had mounted a totally unprovoked hit on yours truly. This will never happen again, and I gave her the blowoff. This is what my job has done to me. I give the brushoff to beautiful women in order to meet the expectations of Corporate America.

I'm going to go drink a lot of scotch now until I get sick.

A Bit Of Irony From The Land Of The Kama Sutra

On one level I feel bad making light of this, as it probably came from the effort to understand why India has the world's largest HIV caseload:

Condoms designed to meet international size specifications are too big for many Indian men as their penises fall short of what manufacturers had anticipated, an Indian study has found.

The Indian Council of Medical Research, a leading state-run center, said its initial findings from a two-year study showed 60 percent of men in the financial capital Mumbai had penises about 2.4 cm (one inch) shorter than those condoms catered for.

For a further 30 percent, the difference was at least 5 cm (two inches).

Yeah. HIV is serious stuff, but um......BBBBWWWWWHHHHAAAAHHHHAAAAHHHHAAAHHHAAAAA!!!!! there's just no way I can't find this hilarious. I mean, c'mon, it took some pinheads two years to figure out their schlongs aren't ready for the era of free trade? What in the hell do you think they were doing for over 700 days? Measuring over and over again, hoping for a different result?

Women of India, all I can say is, I am here to help.

Pearls of Wisdom From Today's Pill Counting Action.

Actual question from an actual customer at the pharmacy counter, where we fill prescriptions and do other medicinal related kind of things:

"Do deer eat poinsettias?"

Now maybe this was really a compliment. Perhaps I give the impression of being someone knowledgeable of both medicines and animal behavior, but deer could live off the blood of 16 year old virgins for all I know. This really upset the customer. Not the possibility of hoofed blood suckers, which I had the good sense not to mention, but the fact that I didn't know if they munched on poinsettias. I think if 10 is the most livid I have ever seen a customer, this woman was easily a 6.

This was followed shortly by "What was going on on the 42 that had traffic so tied up?"

Not "Have you heard......", or "Do you know anything about......" It wasn't even a question really, it was phrased more like a demand. I started to wonder if the traffic problem wasn't somehow my fault.

Maybe they really do need to change pharmacy school to an 8 year program.

Late in the day I got "Where is the Airborne?" This one I did know. Airborne is a cold remedy whose sales figures in our store are inversely proportional to it's effectiveness. It's kept by the front registers.

This prompted a disgusted sigh from the customer. "All the way in the front? " The petulant man-child complained.

Yes. All the way in the front. Right next to the front door. The same door you will have to walk through if you are ever planning on leaving the store. Just watch out for the deer.

In Other News, The World Is Round, And Vicodin May Be Addictive.

From the "your government in action" file, via trade mag Pharmacy Today:

In a 91-page report, the U.S. Department of Health and Human Services (HHS) Health Resources and Services Administration (HRSA) confirmed what practitioners have known for the past few years: The profession is realizing an acute pharmacist shortage, and it is expected to persist for some time.

Let's see, a few months back, a company that wouldn't spring to replace burnt-out light bulbs in it's stores offered me $30,000 not to quit. Yet somehow the production of a 91 page report by the federal government was necessary to let people know there is a shortage of pharmacists. I can only dream of the day when we have a similar shortage of pinhead desk jockeys running up the national debt.

My favorite part of the story was this line:

Despite the possible role of the all-PharmD degree program in this shortage......

Um....... possible role? A few years ago, the 5 year Bachelor of Science in Pharmacy degree was phased out in favor of a mandatory 6 year Doctor of Pharmacy. This article seems to think that adding an extra year of school, along with another ten thousand dollars or so of student loan debt, might.....just might, have something to do with the worsening of the pharmacist shortage.

My God, they really could be on to something.

The old, the sick, and the addicted are not to worry however, as the leaders of the profession are solving the problem in the exact same way they solved the exact same shortage in the 90's. From the trade magazine Drug Topics:

Even as pharmacists are still divided on whether the profession should have moved to the Pharm.D. degree, there are some industry insiders who believe that an eight-year entry-level degree is in the offing. Fueling this belief is the fact that a majority of students today enter pharmacy schools with several years of undergraduate education and many expect that a prior B.S. (or B.A.) degree will be a requirement in another 10 years.

Hell yeah. Personally I think they shouldn't let anyone work behind a pharmacy counter who doesn't have a full blown degree in medicine with a minor in dentistry, that's what I think. I bet if you made them go to school for 20 years, there would be more pharmacists than you could shake a stick at. Of course anyone currently with a pharmacy license should be grandfathered, but a kid starting in the profession today really needs to have put in a 2 year residency in cardiac surgery, and to have written a hundred page thesis on a previously unknown characteristic of medieval Scottish literature. That will solve the pharmacist shortage.

In the meantime, giant corpo-pharmacy chains, who value drug knowledge above all else in their hiring decisions, should continue to bring wheelbarrows full of cash to my feet in order to convince me to work for them. Right up until the last light bulb burns out baby.

My Hero Does Not Take Any Shit From Gas Pumps.

From my favorite newspaper column ever, News of the Weird:

In September, police in Madison, Wis., said Milo G. Chamberlain's blood-alcohol content was .425, which experts said normally is attainable only by those either dead or in a coma, but he was picked up, quite conscious, allegedly causing a disturbance at a Marathon gas station, where he reportedly got into a fight with a gas pump before being restrained by passersby. Police said Chamberlain responded to each of their questions only by rattling off strings of numbers of no particular pattern.

No matter how big the freaks of my workday, News of the Weird never fails to let me know it could have been much worse. I highly recommend it to anyone in the profession.

Best.....Workday.......Ever!

Friends, the karma-go-round has finally swung my way. I have never had and never will have again a day as awesome as this one. The middle sucked ass for all the usual reasons, but listen to how it started and ended:

I'm making my way through the parking lot in my usual caffeine craving haze this morning when I hear "THAT WAS MY SPACE!!!!" Looking over to my left, I see a wrinkly old woman reaching into someone's car through the window to bitch slap the driver. Sweet! Elderly road rage! But wait....it gets better.....upon closer inspection, I realize I know both combatants, as they are both regular customers. The bitch slapper is in a couple times a week to treat the world as her servant, and the bitch slapee is a 40ish nurse who never hesitates to act like she knows far more about her meds than anyone else on planet earth, only to have her husband call later that night to ask a question.

Are you getting this? Two shit-ass customers going at it right in front of the store! I couldn't lose!

Now I suppose I could have intervened in some way, called the shopping center security perhaps, but really, I think the only thing worse than getting bitch slapped by an 85-year old woman is having to be rescued from being bitch slapped by an 85 year old woman. I enjoyed the moment and went in to start the workday, thankful for the little gift fate had bestowed upon me.

After work I went over to the K-mart to buy some of what the K-mart specializes in so well; miscellaneous crap. I was still wearing my shirt and tie and all, and no doubt looked rather assistant manager like. This was confirmed when a random numbnut steps in front of me to demand to know where the batteries are.

"Fuck if I know" Was what the numbnut thought the assistant manager said to him. He's probably filing some sort of complaint with K-Mart headquarters as I type this.

BBBBWWWWHHHAAAAAAHHHHHAAAAAHHHHHAAAAAAAAA! Holy crap I'm in such a good mood I just might skip the scotch tonight.

It's A Strange Magnet, This Blog Garden Of Mine.

Some days the blog just writes itself. These are all honest-to-God-I-swear-I'm-not-making-them-up google search terms someone entered that led them to the spot on the internet where you are now:

- Does he hate me?

- Goddammit I hate you.

- Pharmacist I hate you

- Can OTC Excedrin kill you?

- Can Advicor kill you?

- Can you kill yourself with Zopiclone?

- Frequency of showering.

- Weed and diphenydramine HCL

- I am dastardly (This one came up twice. I can offer no explanation)

- Uniform bitches (This came up 3 times. Again, no explanation)

- Longest schlong (This one I do have an explanation for. The fact I have the world's longest schlong is common knowledge.)

- Dominatrix (Lesson learned; put that word in a post's headline and your hit count for the day goes through the roof)

- Augmentin XR syphilis dose

- Crystal meth foaming at the mouth bleeding

- Crystal meth effect on body bowel movement

- I'm a woman with an adams apple

I don't think there's any further comment necessary on my part. Goodnight.

I Have A Cool Idea For A Game.

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"He Puts His Pants On One Leg At A Time"

It's a tired old cliché meant to remind us that every person, or every man at least, no matter how powerful or important he is, is also at some basic level no different from anyone else. We all put our pants on one leg at a time.

Well I don't. I sit on the edge of the bed, roll back a bit on my ass, and stick both legs through my pants at the same time. This makes me superior to any other man you'll meet. Remember this.

At A Time When 47 Million People Have No Health Coverage, A Story About Being Insured To Death.

You might think that a dedicated liberal such as myself would be spending his time writing about those people in our country with no health insurance, perhaps exploding the myth that the uninsured really do get the care they need. Well you know what? You'd be wrong. Today I'm just a little tired of hearing poor people whine about losing a leg to diabetes while the real victims of our health care system suffer silently. I ask you, who is looking out for the golf-course set? Not the people who walk around while playing golf mind you, but those who ride around in the little electric carts to get their exercise? Who will right the injustice piled upon those who feel no need to yell out "FORE!" to warn others of their errant balls, secure in the knowledge that should their inconsideration result in someone kicking their ass, the resulting medical bills will not be the slightest inconvenience?

The drugmonkey, that's who.

Today I share a tale of anemia, overtreatment, and death. Anemia, a condition characterized by a lower than normal number of red blood cells circulating in a person's blood, left untreated can make a person so lethargic they are practically unable to move or think. Based on this, I think 98% of my customers may have anemia. The condition has been treated since 1989 with a drug called epoetin, sold under the brand names Epogen and Procrit. Proper treatment with the med can make a big difference in people's lives, and does for nearly a million people in the US every year. Yay.

Thing is, according to the New York Times, "The amount of epoetin received by the typical American dialysis patient has nearly tripled since the early 90's." Obviously there must be a good reason for that you must be thinking. Maybe like there's lots of data to show that higher doses lead to better outcomes. You would be wrong. There was no data to support these doses for over 10 years, and when someone finally did decide to see what their effect was they found people receiving higher doses of epoetin were 34 percent more likely to die or suffer heart problems then people receiving a lower dose.

This "dose inflation" by and large did not happen in Europe, where around 15 percent of kidney dialysis patients die every year, compared to 22 percent here. USA!... USA! ...USA!

So why on earth would doses of epoetin go higher and higher with no evidence that it's actually helping anyone? The drugmonkey has two possible explanations.

1) A healthy adult man has about 14 grams per deciliter of hemoglobin (red blood cell stuff) in their blood, and even though 10 to 12 grams is sufficient for dialysis patients, doctors have decided over time that matching the lab results for the average man should be better for patients.

OR

2) From the Times article:

...patients may be receiving too much epoetin, in part because dialysis clinics make bigger profits for providing larger doses. Studies show that the clinics make little, if any, profit on the actual dialysis services they provide for Medicare patients, who are the vast majority of patients.

I'll let you decide which is more likely. While you're pondering it over, ask yourself what would have happened if dialysis clinics made less money by giving higher doses.

So on one hand, we have an estimate that lack of health insurance is the third leading cause of death among this country's near elderly. On the other, we have kidney patients being pumped full of meds at doses higher than they need, doses that could very well be harming them, in order to support our for-profit health care system. And for some reason, you are supposed to be afraid of the words "socialized medicine." You are literally being scared to death America. Wake up.

Read more here and here.