Another Gift From Me To The Profession. A Practical Way To Deal With Corporate Short Staffing.

We've all been there. We've all looked up from our place behind the counter and seen a herd of screaming, foaming at the mouth barbarians. Chaos at the cash register. Anarchy at the in window. And a line of prescriptions to be done with no one available to work on them until things settle down.

And don't even ask for whom the phone rings. It rings for you.

I know it seems hopeless, and it is not unheard of for things to break down completely in these situations. I once worked at a 24 hour store that was behind for a solid month. You went in there at 3 in the morning, and you would have seen me in there cranking out prescriptions at full capacity and still not getting through the pill pile by the break of dawn. It doesn't always have to be this way though. Sometimes a little outside the box thinking can go a long way to keeping the capsules flowing.

Next time you're on the brink of breakdown, here's what you do. Walk over to the cash register and fuck something up. Just start pressing buttons at random until the thing locks up. Then page for one of the front end managers. Act stupid and humble when they arrive. You just don't get much practice running this goddamn thing, and could you bail me out?

My favorite fuck up is "accidentally" hitting the cash button when the customer wanted to pay with a credit card. That means the manager now has some skin in the game, because if that drawer doesn't balance, they're wasting a lot of time before they get to go home trying to track down why.

Then, when the front end manager starts to tinker with the register, and this is the most important part, WALK AWAY. Also evacuate any techs and cashiers you have from the area. Immediately go and answer the phone, start typing the pile of prescriptions into the computer, anything. Remember there is plenty of work to be done. Find some that is physically the furthest away from that cash register as possible and get to it.

It is regrettable that that manager must be sacrificed. That crowd of people will tear him to bits just as surely as if he were swimming with a school of sharks and developed a nosebleed. But the important thing to remember is he won't be able to get away. Once he fixes your fuck up and looks up to see.......no one....he will not have the testicles to leave an unmanned cash register in front of the crowd of crazed lunatics, who are now madder than ever for having to wait for him to fix the problem you created. The net effect? You now have an extra cashier. Leave him there until you make measurable progress towards catching up or your conscience breaks, whichever comes first. On Sunday I had the shift supervisor acting as my pharmacy cashier for a good 45 minutes. Poor bastard didn't have a choice.

Here's the best part. If you're good enough at it, that manager won't even realize how you fucked him. Again, the object is to act a little dumb. A little, "wow, I don't know what would have happened if you hadn't have come back" will go a long way towards keeping him from even realizing you just made him your bitch, and make it much easier for you to do it again.

I theorize this is similar to how pimps get started.

You Know What Happens When You Put Off Asking A Guy About His Jar? You Can Lose The Chance. Forever.

Blogpost original air date: November 21, 2006. Update follows.



The Melatonin Chronicles......Or Bizzaro Dream #2

The bizzaro dream is coming, I promise, but first the necessary background:

Detroit was ground zero for the dark, seething underbelly of the 60's. Everybody remembers the happy hippies of Woodstock, but we have tried to forget the very real anger that was just as much a part of that era. While the flower children were doing their thing, singing how we should just just smile on our brother and learn to love one another right now, Detroit bands like The Stooges and MC5 were letting us know what it was like to have your teeth kicked in by the cops and then be charged with assault. My kind of music. Now I love the MC5, but I haven't been listening to them much lately. You know how it is, music works it's way to the back of your collection for awhile, only to be re-discovered years later. Last night, however, the MC5 came back into my life as I slept.

In my dream, I had decided that it was time for me to learn to play the bass guitar, and so I had signed up for some classes at the local community college. The instructor enters the classroom, and it is none other than the bass player for the MC5. Sweet! I will finally be able to ask him about the jar!

"Um...the jar?" I hear you saying. You see, the first MC5 album I bought years ago had a rather, um....disturbing picture on the back. Here it is:





That jar has fascinated me from the day I first laid eyes on it. What could possibly be inside? Would I really want to know? The way the dude with the afro is pointing at it it almost looks like he's soliciting spare change so he can take the bus home after the gig. In my dream though, the mystery of the jar was about to be solved! I sat patiently though class, barely able to concentrate on the lesson knowing that this obsession of mine was about to be put to rest. After class, as I made my way up to the front of the room my heart rate quickened with anticipation........

Then I woke up. And my heart really was beating fast. Why the fuck would my brain be thinking in the middle of the night about a band I haven't consciously thought of in years? Why would the mystery of the jar surface now after lying dormant for so long? DAMN YOU JAR! I WILL UNLOCK YOUR SECRET SOMEDAY!

I'm thinking I should talk to my doctor about Ambien, and, um, maybe a few other things.

Update, February 20, 2012. Sent to me by a dear friend via Huffington Post:

LOS ANGELES -- Michael Davis, the bassist of influential late 1960s rock band MC5, has died of liver failure, his wife said Saturday. He was 68.

Rest in peace good sir. I hope the act that follows you in life is more substantial than the one that followed you here: 

Highlights From Recent Pill Counting Action.

I was excited when I first heard of the 15 minute prescription filling guarantee, as the prospect of seeing outer space has always excited me. Visions of visiting distant galaxies and alien civilizations danced in my brain. I thought about the incredible learning experience I was about to undergo as I boldly went where before no man had gone.

What do you pack for time travel?

As some of you may be aware, Einstein's theory of relativity predicts that altering time is indeed possible. That if one were traveling faster than the speed of light, because that speed remains constant in your perception, other things must change in order to keep the equation of the universe balanced. One of those things is time. I wondered when the maintenance people would show up to fit our pharmacy with the powerful rockets that would enable us to calmly fill prescriptions, taking all the necessary and prudent precautions to make sure it is done right, while altering the timespace continuum to make it appear to you it was never done in more than a quarter of an hour. No matter how many people were in front of you. No matter how many times the phone would ring with someone demanding our immediate attention. No matter the number of times the old lady would come to within 5 feet of me while evaluating your drug interaction report to ask me if the Swiffer could be used on a hardwood floor. Once maintenance installed the rockets, none of this would matter.

Then I remembered that Einstein's plan actually made it possible to travel to the future, meaning 15 minutes of your time on the rocket ship would translate to maybe an hour in the rest of the universe. This would make the prescription filling process even slower, and I realized all that the 15 minute guarantee really meant is that you got a five-dollar gift card if you bitched that I took too long. Then I realized the five dollars wasn't my money and never thought of the 15 minute guarantee again.

Until today, when I finally noticed all the 15 minute guarantee signs had been quietly taken down. The store manager said this had been done long ago and that a 15 minute "pledge" was soon to come. A pledge is like a guarantee except you don't get paid. Which means I care even less about it. I moved on to matters more important.

I heard my Supertech ask a customer what their phone number was. "Yes" was the reply. It was gonna be a highlights kinda day.

The next customer asked me if I got to go home soon. It was 9:30 in the morning. Yup. Some days have highlights written all over them.

I got a report that the Pharmacy Manager was recording video of the store's management team not working hard enough to suit her using her cell phone. I wondered if maybe she had invented some sort of reverse speed of light backwards time thruster that gave her enough minutes to do this type of thing. Because I've got more than enough shit to worry about in the happy pill room without going around getting all Dick Tracy on the people up front. I was snapped out of this train of thought by the customer waving a bottle in front of my face asking if she could take this if she were pregnant. The bottle contained prenatal vitamins.

Shortly thereafter a man asked if he could use a thermometer to take his temperature and then put it back on the shelf and another person came to the counter with a parrot on their shoulder and bird shit all over their shirt. He asked if he could borrow the phone and I handed it to him. I asked what number he needed to dial and he said he didn't know in a tone of voice that indicated I should. This kind of thing doesn't even phase me anymore. Twenty years in the profession has made me numb to a man covered in birdshit who expects me to read his mind. Pharmacy students make of that what you will.

A man not covered in fecal material tried to talk me into giving him a Vicodin refill early by saying, "I gotta be honest, I just like taking it." Part of me appreciated this so much he almost got it.

The rest of the day flew by and towards the end I finally got a chance to look at the faxes that had been zapped from the corporate mothership that morning. Among them was one that contained only two things, my name, and a "0%" next to it. I really sucked at something. Perhaps this is the latest craze among the MBA's, motivating your people by making sure they have no idea how you are evaluating them. Or maybe the rest of the fax is on that rocket ship, gleefully whizzing by supernovas and giant planets at twice that magical speed of light, to be delivered sometime in the distant future. Out in space where I longed to be.

Perhaps if I read the work of Einstein in more depth, it will contain my answer. I plan on starting right now. 

My Favorite Lamp.

I didn't think anything about giving him the ProAir inhaler really. Probably didn't even remember doing it 5 minutes after it happened. I knew the man's wife was bedridden and suffering from Chronic Obstructive Pulmonary Disease, and while it was a source of minor irritation that he had let his refills run out on a Friday night, he was a regular customer and a decent enough guy, and I knew he had his hands full taking care of the woman he married. No big deal really.

"Don't worry about it Bob, we'll just take off a refill when we get the prescription." And Bob was on his merry way. I do remember he said thank you, which is more than a lot of them do.

The next time he was in he asked me what my favorite color was.

I told him blue because I tend towards that color when making wardrobe choices. An ex-girlfriend told me once it was a good color for me and that was that. I didn't think anything about it really. Just said blue and filled his prescription for OxyContin. Or tried to. Goddamn prior auth. It was when we got the PA form back I said a little curse just in case there was a God. "Diagnosis" the doctor had scribbled at the bottom, "terminal liver cancer." Go straight to hell Jesus. Seriously. This guy was decent and hardworking and all he wanted to get out of his day was to be able to take care of his sick wife when there wasn't another soul to help them. Nice one there omnipotent master of the universe. Whatever you are you are not just. You crated an awful, ugly world where we all get by on the occasional scrap of joy and where none of our stories will end well. 

A couple weeks later there was a blue box on the pharmacy counter. "Bob left this for you" the manager said. Inside was a blue lamp from IKEA and a note:

"I just wanted to thank you for being such a help to my wife and I over the years. In particular, I'll never forget the weekend you let her have her inhaler when I was foolish enough to run out of her refills. It showed a level of professionalism and caring that I really appreciate. Maybe once I feel better we can go out to lunch. My treat."

I never thought about that inhaler, and I never really noticed Bob all that much. He was just one of the endless blur of people that whirl through my workday. But to Bob I was an integral part of his life. That is the power of our profession. The dosage of Bob's OxyContin was twice as strong as last time. There's not going to be any lunch.

I wrote this by the light of that blue lamp, and every time I turn it on I'll remember Bob's stand against the ugliness of life. How he spit in the eye of the darkness as it inevitably took him down. His futile struggle for decency.

I owe him that much.

I Have No Idea How This Stayed Under My Radar For So Long. And You Walgreen's Pharmacists Thought The Flu Shot Quota Was Bad

You HAVE to let this video run until the talk of Walgreen's starts. Or skip until around 3:25 in:

The Colbert Report
Get More: Colbert Report Full Episodes,Political Humor & Satire Blog,Video Archive

Thank you to the Moody Shrew, who finally tipped me to this

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

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

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

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

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

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

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

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

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

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

The only reminder you're alive.

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

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

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

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

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

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

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

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

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

"Is this the pharmacist?"

"Yes"

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

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

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

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

"I'd try the Aleve"

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

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

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

"Aleve"

A final confirmation was still required.

"Yeah?"

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

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

BWWWWWWAAAAAAAAHHHHAAAAHHHAAAHHHAAAHHAAAAA!!!!!!!!

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

Goodnight.

The Republicans Finally Prove Me Wrong.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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