From The Mailbag; An Alert Reader Makes A Pretty Damn Good Guess As To Who I Might Be

In my e-mail box this morning was this picture, evidently from the Rite Aid employee newsletter, along with a formal accusation that the male pharmacist in the background "has to be" yours truly:

I can understand why someone would say this. I mean look at him back there. He is so not with the corporate program. Not only does he have the look of a person who wants to tear off someones head and shit down their neck while he is surrounded by the unique fake laughter of people whose soul has been crushed by chain retail, but I cannot rule out the possibility upon close inspection of this picture that that's his middle finger sticking up for the camera.

I can honestly say that I am not this man, nor have I ever met him. I have a feeling though that if I ever should, we would get along quite swimmingly.

Sometimes All The Happy Pie In The Sky Bullshit They Tell You In Pharmacy School Turns Out To Be True.

"We've been through this ma'am. I can't refill your Vicodin early. Handing out a 30 day's supply of Vicodin every 15 days is a good way to lose my license"

I've found that's the best way to phrase these conversations. It depersonalizes the problem. It also happens to be the truth. I really don't give a rats ass on a personal level if you take handfuls of Vicodin until your liver catches fire, just don't put my license at risk.

"I've been taking more than I should I know, but it doesn't seem to help."

"Then you really need to talk to your doctor about this ma'am. Maybe he'll want to try a different medicine for you, but the rate you've been going through the Vicodin can be hard on a person's liver, you can't keep this up"

"I see, well can I have this one filled then?" She then hands me a vial from another corpo-pharmacy chain.

"Sure. I'll have to give them a cal......." Then I see the med she wanted transferred. Naltrexone. For those of you in the profession that's all I need to say. For the rest of you read on:

The woman was a recovering alcoholic. She was given a prescription for Naltrexone from her treatment program to reduce her cravings for booze. Naltrexone also is an opioid antagonist. The woman's regular doctor had given her a prescription for Vicodin, an opioid, to treat pain. One doctor had given her a prescription that kept the other from working. Neither doctor knew what the other was doing. Neither corpo-pharmacy chain knew what the other had dispensed for her.

I straightened out the whole sorry-ass situation and the woman is more than likely pain free tonight. In pharmacy school, they tell you this is the type of thing you'll be doing all the time. If by "all the time" they mean "once a year, in a good year" then they would be right. Damn good thing too, as dusting off my DUR chops meant I was a good hour behind getting anyone else's pills out the door for the rest of the night.

One happy customer resulting in dozens more screaming "Why does it take so long!!??" That's why I will never take Naltrexone or anything else that reduces my craving for scotch as long as I live.

I'm Pretty Sure I Saw This On HBO A Few Years Back

LOS ANGELES (AP) —Arnold Schwarzenegger's broken leg was put back together with wires and screws Tuesday.

I think next he gets some sort of visor thingy that shows him who he should kill.

We're all fucking screwed.

I Take A Step Closer To Emerging From The Shadow Of Anonymity, In An Attempt To Solve The Bizarre Mystery Of The Luggage Tags.

I am a graduate of Ohio Northern University. The University is located literally in the middle of a cornfield in a place that I am convinced someone proposed as a joke no one ever got wise to. Unless you have graduated from Ohio Northern University yourself, you more than likely have never heard of the place. If you have taken a degree from the land of the polar bear however, you will never, ever, escape the clutches of the alumni office. Had Osama Bin Ladin attended ONU, you would be able to piss on his grave today, that is, unless he had decided to become a big donor.

I threw the alumni office off my trail for awhile by sending them an updated address when I moved that was in reality an adult bookstore in Atlanta, as well as the phone number of the Republican Party Headquarters in Birmingham, Alabama. The motto of Ohio Northern University is "Ex diversitate vires," which is Latin for "out of diversity, strength." I thought two institutions whose members are 90% white and overwhelmingly affluent that both state the need for diversity would enjoy talking to each other. I'll bet they spoke for hours.

Eventually Ohio Northern University decided they needed to track me down to continue their futile quest for my money though, and a letter soliciting funds came to my mailbox today. I have no idea how they found me, but that's not the mystery I'm pondering tonight. What has me flummoxed is the luggage tag.

Along with the form letter that explained how easy it was to send money to Ohio Northern University but not why you would want to do so, was this exciting, to someone, offer:

Now You Can Include The College of Pharmacy in Your Travel Plans

Now, regardless of where you travel, you can show that you're the pride of the Raabe College of Pharmacy at Ohio Northern University! When you send us your business card, we'll laminate it, attach it to a strap and send it back ready to use -all compliments of the College of Pharmacy. Not only will you have something to identify your luggage, but wherever you go, a piece of ONU will journey with you! Simply mail us your business card to include ONU in your travel plans. Thanks for your support!

Whose idea was this? Why? That's what has me lying awake tonight. Why on earth did someone think giving away a luggage tag was the slightest bit worth doing? A couple of points make the mystery just a bit more unfathomable:

1) The luggage tag was in no way dependent on you sending in any money, say the way NPR will send you a coffee cup in return for $75. You could get the luggage tag and not send them a dime.

2) The luggage tag offer was not part of the form letter itself. It was printed on a separate card stuffed in the envelope, making it more expensive and time-consuming than you may realize.

This doesn't happen often my friends, but I am truly stumped. What is the purpose of the luggage tag?

I am embarrassed to have come from this place.

Well Tonight Thank God It's Them Instead Of You.

You got the best line in the whole song Bono. Of course back then you deserved it. You're sorely missed you Irish bastard, all the more so because you're still around.

We're not so different Mr. Bono, you and I. We both saw how the world shits on people who don't deserve it and were beside ourselves as to why. I decided that I wouldn't do anyone any good if I couldn't put food in my own stomach though, and I'm sure you felt the same way about your band; doesn't do any good to bug someone if they're not listening I suppose. But by the time our personal dollars had been stabilized we both found ourselves swept away by forces we no longer controlled. I took a job for corpo-pharmacy and your concerts were promoted by Clear Channel Communications. You sell your red iPods and I write a check to Oxfam and on the day we die the world will be shitting on people who don't deserve it. I miss you Bono. I miss me too.

Merry Christmas fuckers. Tonight thank God it's them instead of you.

Highlights From Today's Pill Counting Action.

I thought I had made my point sufficiently when I said that Elestat was an antihistamine, but evidently not. The next words I hear were "so that would be good for itchy allergy eyes?" I almost dropped the phone.

"Uh, Drugmonkey" those of you in the profession are saying to yourselves. "That's pretty low on the scale of stupidity we deal with, as a matter of fact, that's exactly the kind of question members of the general public should ask their pharmacist."

I was talking to a doctor. A doctor was asking me if an antihistamine would be good to treat allergy symptoms. Many members of the general public know an antihistamine is exactly what you would use. A few members of an elementary school special ed class would know this, but the doctor wanted to double check.

Not a podiatrist. Not a Nurse Practitioner. A medical doctor. She charges $95 for an office visit.

Later on that afternoon a guy at the counter says he twisted his ankle "a little bit" and wants to know what the Drugmonkey recommends. It's obvious from second one that the customer is a member of the more money than brains demographic.

It became a little more obvious a few minutes after I told him to ice it down and take some Aleve when he returned to the counter.

"I found the Aleve" he said. "But could you tell me where the Ice It Down is?"

Just in case you had any doubt left that Americans are empty headed machines programmed to do nothing but buy. At least he didn't ask where the wrapping paper was.

Nothing Warms My Heart Like A Good Piece Of Hate Mail.....

....unfortunately this is all I have to work with tonight:

So do you have any emotions besides discontentment and passive-aggressive rage? Now I know what blog to read when I want to feel angry and depressed. If you hate your life so much, hell, give me your job, I'll take it.

-future pharmacist

It's not even a hate mail really, just more of a "you suck" kinda message....*sigh*

Isn't it cute though how he signs off "future pharmacist"? Seriously, can't you just see his back straightening up and his head tilting up a bit as he swells with pride upon uttering those words?

Do you suppose he still gets beaten up for his lunch money?

The fact that our little friend will have absolutely no trouble finding a job exactly like mine does break through the discontent and passive aggressiveness and bring a tad of joy to my heart though.

Thanks for caring enough to write in.

I Fall Off The Wagon, And In One Fleeting Moment Of Happiness, Become Convinced The World Is Coming To An End.

So 48 hours without alcohol is enough really. Ending a late night at work and not having to go back until mid-afternoon today I really didn't see the point in not starting the scotch a-flowin'. So I popped the cork on a bottle of Laphroaig and put on my favorite Jimi Hendrix vinyl, a live recording from the Isle of Wight festival in 1970. Because of organizational fuckups that day, Jimi didn't take the stage until almost 3 in the morning, and the record has a total 3 in the morning feel about it, which was perfect because that was the approximate time my one-man party got started. Three LP's later, I accidentally opened the curtains and saw this:


I have not altered this picture in any way. It is the result only of me popping my head outside, pressing a button, and trying above all else not to drop the camera out the window. Anyway, once this sight hit my eyes, I came to the only logical conclusion a scotch-fuzzed brain jam packed full of Jimi could.

The gates of hell were opening. This was the end of the world. I was free at last.

O reader, can you even comprehend the complete and total body orgasm this thought sent through me? I mean, not only was the world finally about to know if this was the first or second coming, but I wouldn't have to be at work tomorrow! Who could possibly need a prescription on the day of the Apocalypse? I was about to trade the torments of my customers for the plagues of hell. In the words of George Jefferson, I was moving on up baby!

Then the clouds parted, I passed out, and the alarm went off a few hours later. I went to work as usual.

-A man tried to use his third $20 prescription transfer coupon and argued over the meaning of "limit one per person" for half an hour.

-I was asked 15 times in 45 minutes where the bathroom was.

-An old woman called to say she didn't have her medicine. While she acknowledged that she must have bought it once I told her we had her signature on file as having picked it up less that a week ago, the problem I was supposed to solve was I'M SICK AND I DON'T FEEL LIKE GOING OUT TO THE CAR AND LOOKING FOR IT!

-On the bright side, an Asian dude honest to God bowed to me after asking me something or other about his Flexeril. Maybe things will turn around, or maybe the world will end tonight.

A guy's gotta have dreams.

More Eli Lilly Pud Sucking

Yesterday I worked a 12 hour shift with a head cold, went home and crashed for the night before I had a chance to even throw any scotch down my throat. This is good news. By definition, an alcoholic cannot function without regular infusions of booze, and the fact I was able to go a good 48 hours without any should put any doubt concerning alcoholism and me to rest for a good month or two.

The bad news is, when you pause to sleep you are at serious risk of missing the latest revelations of Big Pharma's pursuit of any and all dollars at the expense of public health. Last night, while I lay dreaming of things like Whitney Houston and The MC5, The New York Times zapped a story to my e-mail box I almost deleted the next morning in a Nyquil induced haze. Fortunately for you I didn't, and when the nighttime, sniffling, sneezing, coughing, aching, fever, so you can rest medicine wore off, this is what I saw.

Eli Lilly encouraged primary care physicians to use Zyprexa, a powerful drug for schizophrenia and bipolar disorder, in patients who did not have either condition, according to internal Lilly marketing materials.

A little background for those of you not in the profession. While it is perfectly legal for a doctor to prescribe any drug for any condition they see fit, it is illegal for a drug manufacturer to advertise or market a med for any use other than it's official indications. Zyprexa has two official indications; schizophrenia and bipolar disorder. Remember this.

in 1999 and 2000 Lilly considered ways to convince primary care doctors that they should use Zyprexa on their patients. In one document, an unnamed Lilly marketing executive wrote that these doctors “do treat dementia” but “do not treat bipolar; schizophrenia is handled by psychiatrists.”

Boy that sucks for Lilly. If they could only find some way to get those dementia-treating primary care doctors to write prescriptions for Zyprexa. One way would be to prove that Zyprexa actually can benefit people with dementia. Another would be to break the law and market to those primary care docs for an unapproved indication. Do you really need me to tell you which way Lilly chose?

As part of the “Viva Zyprexa” campaign, in packets for its sales representatives, Eli Lilly created the profiles of patients whom it said would be suitable candidates for Zyprexa. Representatives were told to discuss the patient profiles with doctors. One of the patients was a woman in her 20s who showed mild symptoms of schizophrenia, while another was a man in his 40s who appeared to have bipolar disorder.

The third patient was “Martha,” a widow with adult children “who lives independently and has been your patient for some time.” Martha was described as being agitated and having disturbed sleep, but without the symptoms of paranoia or mania that typically marked a person with schizophrenia or bipolar disorder.

Write your own joke here about a marketing campaign dreamed up by middle aged white guys named "Viva Zyprexa"

A Lilly spokesperson wasn't joking though when they said:

Lilly had actually intended Martha’s profile to represent a patient with schizophrenia. But psychiatrists outside the company said this claim defied credibility, especially given Martha’s age. Instead, she appeared to have mild dementia, they said.

“It’d be very unusual for this to be a schizophrenic patient,” said Dr. John March, chief of child and adolescent psychiatry at Duke University medical center. “Schizophrenia is a disease of teenagers and young adults.”

So, we're expected to believe that Lilly, a company full of scientists from top to bottom, scientists who spend their entire lives studying diseases of the human body, diseases like schizophrenia, put out a profile of what was supposed to be a patient with schizophrenia with symptoms that do not match schizophrenia?

And OJ is looking for the real killer as you read this.

"So what" I can hear Republicans and other bitches of the drug industry saying. "It's a pointless rule anyway."

Is it? This is the first thing you see when you open a Zyprexa package insert these days. When studies finally were done on elderly patients with dimentia, years after Lilly was marketing "Martha" to those primary care docs, this is what they found. Read it and tell me how pointless it is to make sure drug companies have the science to back up their advertising claims:

Increased Mortality in Elderly Patients with Dementia-Related Psychosis

Elderly patients with dementia-related psychosis treated with atypical anti psychotic drugs are at an increased risk of death compared to placebo. Analyses of seventeen placebo-controlled trials (modal duration of 10 weeks) in these patients revealed a risk of death in the drug-treated patients of between 1.6 to 1.7 times that seen in placebo-treated patients. Over the course of a typical 10-week controlled trial, the rate of death in drug-treated patients was about 4.5%, compared to a rate of about 2.6% in the placebo group. Although the causes of death were varied, most of the deaths appeared to be either cardiovascular (eg, heart failure, sudden death) or infectious (eg, pneumonia) in nature. ZYPREXA (olanzapine) is not approved for the treatment of elderly patients with dementia-related psychosis.

The Last Thing The Voices Inside My Head Told Me Was That I Was Getting Fat

It's been awhile since I've done a "Big Pharma Sucks Pud" post, but that has nothing to do with Big Pharma sucking less pud. A Drugmonkey's got things to do you know, and keeping track of Big Pharma pud sucking can be a bit of a time trap. Tonight we'll get back into the pudsuck swing of things though thanks to Eli Lilly, a company that says on the first page of it's website that:

We are committed to providing answers that matter - through medicines and information - for some of the world's most urgent medical needs.

Sweet. So let's say there's a question like, "Does Eli Lilly's anti-psychotic medicine, Zyprexa, cause people to develop diabetes and lead to weight gain?" Lilly has said over and over again that there is no link, and did so again on Friday. There you go, an answer that matters.

You'll notice, however, that there wasn't anything in that Lilly commitment that said the answers would be truthful. From today's New York Times:

The drug maker Eli Lilly has engaged in a decade-long effort to play down the health risks of Zyprexa, its best-selling medication for schizophrenia, according to hundreds of internal Lilly documents and e-mail messages among top company managers.

Lilly’s own published data, which it told its sales representatives to play down in conversations with doctors, has shown that 30 percent of patients taking Zyprexa gain 22 pounds or more after a year on the drug, and some patients have reported gaining 100 pounds or more. But Lilly was concerned that Zyprexa’s sales would be hurt if the company was more forthright about the fact that the drug might cause unmanageable weight gain or diabetes, according to the documents, which cover the period 1995 to 2004.

Some of you are probably saying, "Well yeah, but Zyprexa beats the crap out of those older antipsychotics" That's the answer Lilly would give. Here's the answer that matters though, from the same story:

The drugs are known as atypical antipsychotics and include Johnson & Johnson’s Risperdal and AstraZeneca’s Seroquel. When they were introduced in the mid-1990s, psychiatrists hoped they would relieve mental illness without the tremors and facial twitches associated with older drugs. But the new drugs have not proven significantly better and have their own side effects, said Dr. Jeffrey Lieberman, the lead investigator on a federally sponsored clinical trial that compared Zyprexa and other new drugs with one older one.

Others of you are probably thinking "Schizophrenia is serious stuff Drugmonkey, and if someone packs on a few pounds it's worth it to stop their delusions that the CIA is putting pictures of their granddaughter on balloons and selling them at the county fair in cooperation with Queen Elizabeth"

Try again:

Lilly did expand its marketing to primary care physicians, who its internal studies showed were less aware of Zyprexa’s side effects. Lilly sales material encouraged representatives to promote Zyprexa as a “safe, gentle psychotropic” suitable for people with mild mental illness.

"Well," yet more of you might be thinking to yourself. "It's not like Lilly doesn't have you covered if your blood sugar does end up going through the ceiling." In this case you would be right. From a press release detailing Lilly's 3rd quarter 2006 sales results:

Diabetes care revenue, composed primarily of Humalog(R), Humulin(R),Actos(R) and Byetta, increased 9 percent, to $712.4 million, compared with the third quarter of 2005. Diabetes care revenue increased 14 percent in the U.S., to $408.6 million, while diabetes care revenue outside the U.S. increased 3 percent, to $303.8 million.

According to the press release, diabetes care products represent the second largest source of revenue for the company, behind only........Zyprexa.

Got that? Lilly's blockbuster drug just happens to cause a side effect that Lilly's other drugs will treat. Funny how that works out. I suppose next we'll be reading about how Lilly is mounting a hostile takeover of the Hershey company so they can start giving out free decadent dark chocolate samples with every bottle of Humalog insulin sold.

Oh.... and the only reason we know about the Lilly Lies™ program is because of greedy trial lawyers. Seems like folks who weren't happy about being turned into diabetic lardasses hired a few who managed to pry the truth out of Lilly's clenched fist with a subpoena or two. The lawyers are also the only reason we know about people dropping dead from Vioxx. You may want to think about that before you unquestionably accept the next round of "lawsuit madness" propaganda that will surely be shoved down your throat. Without the greedy legal bastards, the greedy corporate bastards win unopposed. We need both sets of bastards watching each other if we want the answers that matter.

And You Think You Had A Retard At Your Pharmacy Counter Today

"No Sir, I'm Sorry, we don't have anything that will get the blood off your hands"

The Whitest White Boy In The History Of Whitedom Feels The Anti-Semitic Sting

The holidays.....oh if we could only keep that Christmas spirit flowing all year long. Celebrating the Big J's Birthday by pretending, if only for one month out of the year, that we give a shit about the message he was trying to send us. January through November we may adhere to the dog-eat-dog creed, but for that one glorious month we all rejoice in the fraternal bonds of our shared humanity.

Like this customer I had at the counter today. He was full of the Christmas spirit. He was truly excited about his favorite time of year, and asked me about my holiday plans.

"I'll be right here" I said. Which is the truth. Corpo-Pharmacy is dumb enough to offer double time for filling 10 prescriptions and I'm dumb enough to cash their check.

"Oh that's terrible" he said, very concerned for his fellow human being. "It's not right to make people work on Christmas"

"I don't mind" was my reply. "I'll just buy myself something nice with the holiday pay" Which again was the truth. Visions of scotch were dancing through my pharmacy brain.

"What are you, Jewish?" the lover of humanity replied. His voice now dripped with absolute contempt.

Now I have a sister who's into the genealogy for whatever reason. She's traced my DNA back to the whitest country on earth. I went to a Presbyterian church when I was a kid and it was while attending a Methodist college that I became an atheist. So naturally I answered the man's question with the words;

"Yes I am"

"Figures" He says. Then he turns away and mutters something about Hanukkah. I seriously think there's a good chance this man will never be back in the store because he doesn't want to do business with the dirty Jew boy.

Yesterday I would have told you there's nothing left the general public can do that would surprise me. I suppose it's a testament to my glow in the dark whiteness that today I was proven wrong.

I wonder how hard it would be to burn a Star of David on someone's lawn.

Tonight's Immaturity Moment

Important news from the field of AIDS prevention reported in this morning's New York Times:

Circumcision appears to reduce a man’s risk of contracting AIDS from heterosexual sex by half, United States government health officials said yesterday

Circumcision is “not a magic bullet, but a potentially important intervention,” said Dr. Kevin M. De Cock, director of H.I.V./AIDS for the World Health Organization.

I have a feeling that doctor really knows what he's talking about.

My Skin! My Perfect Skin!

Sometime around the 10-minute mark in my insurance company help desk holdathon, I took the pen in my hand and used it to hit myself in the forehead. I don't know why, I just did. It seemed to be the most sane action of any that were going on around me at the time. Not the end of the pen you write with mind you, that would leave a mark, which would be bad. I used the end that clicks to move the ink cartridge in and out. When the pain stopped it felt good. So good in fact I thought briefly about doing it again until the help desk lady distracted me by finally answering the phone.

Well it's just a damn good thing I was careful about what end of the pen I used to make the pharmacy insanity a little more bearable. Washing up after my first chance to take a piss many hours later, I wondered why they couldn't clean the friggin' mirrors in this place more often. Then the dot on the mirror moved with my head. Crap. Drawing closer to the looking glass I saw that if I had set out with the express purpose of creating the perfect bindi I could not have done a better job than I did with the non-writing end of a ball-point bic in a moment of insurance company induced frustration. Looking at it again just now, I think it may have finally started to fade a bit. Either that or the scotch has started to blurr my vision.

I hope this doesn't mean my penis will shrink.

An Open Letter To My Old Boss.

Hiya boss,

You may be surprised to be hearing from me. I know it's been awhile, and the last words we shared weren't exactly filled with happy thoughts, but I thought of you today and thought I'd drop you a line. You see, about an hour before closing time tonight I had to call one of your stores for a prescription transfer. Being on hold for 20 minutes before speaking to a clerk for 10 seconds who put me back on hold for 10 minutes to speak to the pharmacist really brought back the memories. I always wonder when I'm in a holdfest like this, which I am a couple times a week, what would happen if I were a customer calling to ask if it's a problem that my grandma accidentally took a couple extra doses of amitriptyline. Not that you or any of your ilk give a rat's ass about anyone's grandma. The only thing that gets your willy hard is the thought of more prescriptions flowing through your place at a lower cost to fill per unit. That's why you were so overjoyed when your chain bought out the last independent pharmacy in town and added 25% to our workload literally overnight. The day you told us we could have one extra tech to handle the 300 extra prescriptions a day your deal would mean for us was the only time I ever saw you smile. Good times. Remember the time the 18 month old girl got the nitroglycerin pills intended for an 87 year old man? Boy, I sure do. The only thing worse than making a mistake on a prescription is dealing with the fallout from a prescription mistake that you DIDN'T make. Did I ever tell you why your drawer was short that day? You see, the parent of the child who could have died wanted the money refunded that they spent for the pills that could have ended their daughter's life. Fair enough. So, I followed your company policy and paged a member of management. I always thought it was a bit odd how you had no problem leaving me alone all night in a room with a couple thousand OxyContin, but thought it necessary to have a community college dropout be the one to return fourteen dollars and ninety-nine cents, but hey, you write the paychecks. The customer whose child could have died didn't see it that way though, and was about ready to kill someone himself by the time we paged the dropout for the third time. That's when I opened the drawer, handed the man who's child could have died two twenty dollar bills and told him I was sorry at how this whole thing went down from beginning to end. That the customer saw I was breaking your pointless policy for him was probably the only thing that prevented a lawsuit. You're welcome.

I wonder if you remember our discussion afterwards of what happened. Probably not, because you really didn't even seem to hear a word I was saying at the time. I told you how that store was breaking it's employees and endangering the public. That your company was woefully negligent and it was only a matter of time before someone would hold the place to account. I asked you what your plan was to improve things. You said.....you'd give me $30,000 not to quit, thereby missing entirely the point of me threatening to leave in the first place. With that money you could have hired another full time employee, but you thought the best way to keep someone else's child, mother, or grandfather out of danger was to throw some Benjamin's into my bank account and keep everything the same. I know it's physically impossible to fuck yourself, but I don't regret telling you to do so.

I hear not much has changed for you or your company, but things are much better for me now. I have a new job in a store that does about a quarter the prescription volume of your place, a store that's considered to be a laggard in it's district. You see, my new boss, he's no different from you. The only thing keeping him from running me and the rest of the staff into the ground is the company's inability to drum up enough business to do so. Stockholders are angry, but the people who do come in the door are well taken care of, the exact opposite of the stockholder/customer relationship at your place. Funny how that works. I'll let you get back to work now. I know you have important things to do, like maybe meeting with the corporate lawyer to discuss how much is a fair price to offer the parents of a dead child.

Just make sure to get a confidentiality agreement. You don't want the stock price adversely affected.

Sincerely,

Drugmonkey

It Always Does Me Good To Realize There Are Bigger Sellouts Than Myself.

Today on the corpo-pharmacy radio network I heard Neil Diamond singing his personal intrepreation of that Christmas classic, The Little Drummer Boy.

You don't even have to click on the link below to see why I find this a bit odd. Just look at it.

http://www.jewishmusicgroup.com/artist.php?id=37

Shouted To Me From Across Across A Crowded Store

I'M LOOKING FOR A DOUCHE BAG!!!!!!!


Well lady..... most of the douche bags I went to pharmacy school with ended up working for Walgreen's. Perhaps you should try your luck there.

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.