Highlights From Today's Pill Counting Action

The day started with the following actual question from an actual customer who required a doctor's authorization for a prescription refill. He was wearing a Superman t-shirt.

"My doctor's not there today, do you think they'll call in it by this afternoon?"

I didn't try to explain why, I just told the nice customer probably not. I've learned trying to explain why only makes it worse.

I did manage to get a hold of a doctor who was in the office to let him know he prescribed penicillin to a patient who's "tongue swole up real bad" the last time he took penicillin. The nice doctor switched the prescription and the customer thanked me for my efforts by complaining how much more expensive the new med was. I tried to explain that anaphylaxis is remembered long after price is forgotten, but the nice customer was in a bargain hunting mood. The new med was erythromycin. It cost $3 more.

Superman called back in a couple hours, asked for me by name, and waited five minutes on hold until I could get the phone so he could ask:

"Has my doctor called yet?"

Me: "No."

Customer: "OK, I think I'll drive over there."

Mid afternoon brought the following conversation:

Customer: "This new medicine is 100 milligrams. Can I switch back to my old one?"

Me: "Well how has your blood pressure been on this new medicine?"

Customer: "It's been good. That other med never really got it under control."

Me: "Is that why your doctor switched you?"

Customer: "No, the other one made my tongue swell up."

The tongue swelling thing seems to come in cycles.

Me: "So......your old medicine never really got your blood pressure under control, and made your tongue swell. Why do you want to switch back?"

Customer: "This new medicine is 100 milligrams. My old medicine was 20 milligrams"

This was a serious issue to this person. I tried to explain and wished for the simplicity of a conversation with Superman.

Be careful what you wish for. He called back to let me know he was in the parking lot of his doctor's office but couldn't find the entrance.

This was followed by a call from a customer who told us they accidentally took the store's bathroom key home with them. This key is attached to a piece of wood probably three-quarters of a yard long and colored bright blue. You can see it from a mile away and fit it into probably less than 5% of purses ever made. Not to mention a bathroom key is the type of thing you do not want to handle any more than necessary. Yet someone took it home. I thought to myself that we had reached the rock bottom of stupidity.

I should have remembered you can never go broke betting on stupid. Five minutes later I saw the bathroom key in the breakroom, right where it belonged. The only thing dumber than taking home a store's bathroom key is thinking you took it home when you didn't.

Superman never got his Vicodin. Release the scotch.

Good News For The American Health Care System, Which Is The Best In The World

At least according to a certain dumbass president, who said the following on May 1st, 2006:

America has the best health care system in the world, pure and simple.

We got the best medicines, we got the best doctors and we have the best hospitals. And we intend to keep it that way.

I won't mention the lack of English language skills on display here. I'm numb to that by now. I will mention how the facts have a habit of continually getting in this man's way. From the UK Guardian:

A combination of expensive health insurance and an ever-increasing rate of obesity appear to be behind a startling fall by the US in the world rankings of life expectancy.

Despite being one of the richest countries in the world, America has dropped from 11th to 42nd place in 20 years, according to official US figures.

The worst life expectancy figures are in Africa, with Swaziland at the bottom, at 34.1 years.

Best health care system in the world. Yup. Pure and simple. I think really there's only one way a patriotic American who cares about their country would react to this news:

IN YOUR FACE SWAZILAND!!!!! WE'RE NUMBER 42!!...... WE'RE NUMBER 42!! WHHHOOOO HOOOOOOOO!!!!! USA!..... USA!..... USA!

Oh Man..... my chest hurts all the sudden after all that jumping around taunting Swaziland.....I better sit down for a second.....

While I catch my breath, perhaps you could ponder the fact that in addition to dropping like a rock in life-expectancy rankings, our bridges no longer stay up, most of the damage caused by hurricane Katrina came from 40 year old levees that failed, and most of us were poorer in 2005 than we were in 2000. Maybe you will realize that your country is, quite literally, falling apart. Then maybe you'll take a look at the counter to the right of this page.

Hunter S. Thompson wrote towards the end of his life that he was surprised and embarrassed to be a part of the first American generation to leave the country in far worse shape than it was when he first came into it. I am saddened to be part of the second. I will remember that counter when I hear of the next bridge collapse, and so should you.

In Other News, The Sun May Rise In The West Tomorrow Morning.

From this morning's New York Times:

A former assistant treasurer of the Roman Catholic Diocese of Cleveland is to go on trial Monday, accused of taking part in widespread financial mismanagement and looting of church funds.

Lawyers for the defendants in this trial and a related case, however, say top church officials are to blame; in documents filed in federal court, the lawyers say the diocese’s former bishop and a priest used secret accounts to embezzle millions of dollars from the diocese. Such accusations are “scurrilous,” the diocese has said in a written statement.*

Federal prosecutors say the most shocking part of the case is the absence of pedophilia.

"We were doing our routine child abuse screening of Roman Catholic dioceses" said United States attorney Dirk Mendoza, "When a 7 year old boy told us how the parish priest just bought a new Mercedes. Naturally we assumed we were about to hear a tale of how the priest then drove the boy to a church retreat and made him feel shameful for tempting a man of the cloth into committing unholy sexual acts. But all we heard about was the new car."

The FBI noted that the Cleveland diocese has had only 8 reported cases of child sexual abuse this year, far below the average of 267 for a diocese of it's size.

"As amazing as it may sound, the officials at the Diocese of Cleveland seemed to be largely interested only in money." Said Mendoza. "Sex with children was a very low priority with them"

Mendoza added that the FBI was working on the theory that the embezzled funds were used largely to finance deviant consensual sex with adult female prostitutes, and to pay for the occasional abortion due to contraceptive failure.

"This is certainly the most boring case of my entire time on the Catholic crime beat." Said the prosecutor.

(* Everything before this is true. Everything after is made up.)

"But Drugmonkey" I Can Hear You Saying, "Where Have All The Freaky Customers Been?"

Well don't you worry your pretty little head, there has been no shortage of freaky customers. Most nights I can drown their memory in scotch, but sometimes the memories learn to swim. The image of the extremely hygienic old woman about to have a talk with her granddaughter has learned to swim.....

She came to the counter and wanted a douche, and not just any douche would do. It had to have some sort of cockamamie acid preparation in it. This reminded me of the time in college when during a physiology lecture, right after the professor mentioned the normal pH of the vagina made it acidic, a voice came from the back of the room of a person thinking out loud and talking at a higher volume than intended......

"That's why it tastes like that." He said.

The old woman at the counter wasn't interested in any taste tests though. Seems her granddaughter had a yeast infection, and she had all the answers.

"IT'S BECAUSE THESE KIDS TODAY....THEY FOOL AROUND AND DON'T CLEAN THEMSELVES AFTERWARDS" She proudly proclaimed. "I KNOW....I USED TO WORK IN A PHARMACY AND IT WAS MY JOB TO MAKE THESE DOUCHES"

You know how sometimes you can be busy as hell for hours.......the phone ringing off the hook, people lined up to the front door, prescriptions coming in non stop via phone, fax, e-mail, passenger pigeon and telegraph.....and finally....finally.....it looks like you might get 5 minutes to take a piss.....and one person comes to the counter.....and you know you've lost your chance to urinate for the rest of the day? That was the deal with this old douche maker.

She wasn't looking for advice, she would settle for nothing less than an acid douche to present to her granddaughter along with a talk on post sex cleansing rituals. My job was to provide the acid along with any talking points I thought would be useful for the young lady.

You know how it went. I am under a professional obligation to tell anyone who asks that douching is not recommended in any way shape or form these days, that regular rinsing away of a woman's natural defenses can actually make an infection worse. You also know that this woman would not be happy with anything less than a vaginal sandblaster. She left angry, and I never got to piss. I was pretty annoyed with the whole situation until a tumblerful of scotch made me realize something just now:

It could have been worse. I could have been the granddaughter.

Your Taxes Are Not Only Going To Baby Mamas Trying To Get Free Tylenol, But Also To Help Those Killing Your Troops. I Wonder Which Upsets You More.

We do looooooove our troops in the good 'ol USA. Just not quite enough to do much to keep them alive. You've probably all heard stories like this, from 2004, a year into George's war:

Soldiers headed for Iraq are still buying their own body armor — and in many cases, their families are buying it for them — despite assurances from the military that the gear will be in hand before they're in harm's way.

To their credit though, those troop lovin' Republicans who were in charge of everything at the time really got off their asses and made things happen. Here's a story from over a year later:

Nearly a year after Congress demanded action, the Pentagon has still failed to figure out a way to reimburse soldiers for body armor and equipment they purchased to better protect themselves while serving in Iraq.

Soldiers and their parents are still spending hundreds and sometimes thousands of dollars for armor they say the military won’t provide. One U.S. senator said Wednesday he will try again to force the Pentagon to obey the reimbursement law it opposed from the outset and has so far not implemented.

Did you see the part where the Pentagon opposed the reimbursement law from the start? Nice. The Senator who was trying to get the military to spend some chump change out of the Defense budget to protect their own people was Christopher Dodd. He's running for president this year. As a Democrat. He won't win.

You know who doesn't have trouble getting body armor from the United States though? Iraqi insurgents. The American corpo-media doesn't seem to want to to tell you this, but across the pond in the UK it's front-page-above-the-fold news. To the Guardian of London:

The US has lost track of about 190,000 weapons issued to Iraqi security forces since the 2003 invasion, some of which will have ended up in the hands of insurgents, according to an official report published in Washington. Among the missing items are AK-47 rifles, pistols, body armour and helmets.

The 20-page report - Stabilising Iraq: Department of Defence cannot ensure that US-funded equipment has reached Iraqi security forces - says the Pentagon and the multinational force in Iraq responsible for training "cannot fully account for about 110,000 AK-47 rifles, 80,000 pistols, 135,000 items of body armour and 115,000 helmets reported as issued to Iraqi forces as of September 22 2005". (emphasis mine)

While I freely admit I do not support the troops, I also am not standing in the way of them buying their own equipment nor am I openly arming the people who are killing them. That actually makes me more of a troop supporter than the Defense Department. I also just broke this news to you, while those troop supporting journalists at Fox News spend 24 hour news cycles talking non stop about a bridge that fell down or coal miners that are stuck under the ground. I'll even give you this link, in case you think that $500,000,000,000 a year for the military isn't quite enough.

I really suck at not supporting the troops. I think it should be my New Years resolution in 2008 to do a better job.

Big Pharma To You: "Thanks For All The Money We Used For Executive Bonuses, Here Are None Of The Medical Breakthroughs We Promised"

So I guess this could be considered good news, in the same sense that the end of a brutal physical assault could be considered good news. From last Wednesday's New York Times:

A quiet coup is taking place in American medicine cabinets. Prescription bottles bearing catchy brand names like Zoloft and Flonase are being pushed aside by tongue-twisting generics like sertraline and fluticasone propionate.

While the trend is already pinching the profits of big pharmaceutical companies, it is rare good medical news for American pocketbooks.

Patents provide 20-year protection from generic competition. But because companies often apply for patents in early stages of drug development, before drugs are approved, pharmaceuticals may have fewer years of what is called effective patent protection.

And now, as nearly every big drug maker watches its best sellers fade away, there are fewer potential blockbuster drugs waiting to take their place.

Did you see the part about fewer blockbuster drugs waiting to take their place? Feel like a sucker yet? If you or your insurance company paid out the ass for Norvasc, Flonase, Ambien, Zantac, Claritin, Prlosec, or any other no generic available in the 90's med you should. If you had the bad manners to complain about the price back then you more than likely got a condescending lecture about how your money was necessary to finance the ever so expensive research and development that brought these meds to market. Many of my colleagues in the profession reading this have probably given those lectures. Some may also believe it.

Except that drug companies spend almost twice as much on marketing as on research and development. What you were told you were buying was the next big medical breakthrough. What you got were commercials telling you to ask your doctor about Clarinex, which doesn't work any better than (now over the counter) Claritin, or Celebrex, which is no more effective than ibuprofen. Back to the Times:

“At the end of the day, it’s basically a failure of innovation,” said Richard T. Evans, a consultant with the firm Avos Life Sciences, a research and consulting firm for the drug industry.

Don't worry though, Big Pharma may be in a slump, but they are not about to give up:

“I don’t think we would support the contention that there’s a lull,” said Caroline Loew, the industry group’s senior vice president for scientific and regulatory affairs. Citing diseases like Alzheimer’s, Parkinson’s and cancer, she said, “The companies are tackling diseases that are extremely complex. The biological mechanisms are very poorly understood. By definition, that sort of science, which is very much emerging science, is going to take longer.”

How is Big Pharma getting ready to kick some disease ass? Here's an example:

Pharmaceutical giant Pfizer Inc. announced Monday it will shutter its massive research and development facility in Ann Arbor and cut 2,410 jobs in Michigan by the end of 2008

Now, I would have thought the way to overcome extremely complex diseases that are poorly understood would be to expand your R&D facilities. I guess that's why I never made it in the world of research. Who knew the answer was actually to eliminate them?

Pfizer obviously is on to something, imitation is the sincerest form of flattery you know:

Last week, the big drug maker Johnson & Johnson announced it would eliminate up to 4,800 jobs

The CEO of Johnson and Johnson by the way, one William C Weldon, was awarded a bonus of 3 million dollars in fiscal 2006. Probably for all that innovation that has Alzheimer’s and Parkinson’s on the ropes. Or for coming up with a slightly different version of a schizophrenia med that has been on the market for years. Ask your doctor if Invega is right for you. Don't mention Risperdal though.

So, let's review:

High prices for you, because innovation is expensive.

Innovation takes a nosedive.

William C Weldon and Hank McKinnell, the former CEO of Pfizer, receive combined bonuses of $5 million while laying off 7200 people whose job it was to help innovate.

Feel like a sucker yet?

Fun With Google Search Terms, Part 2

A few of the phrases typed into the mother of all search engines that led travelers on the information superhighway to the rest stop where you find yourself at this very moment. I swear I have not changed a word:

I hate Ford

I hate Paul Harvey

I hate my employer

I hate Walgreens

i hate you! go away blogspot

I HATE YOU

"drugnazi" "drugmonkey" "perfect skin" (this was typed in twice over the last month. I can't help but wonder if the perfect skin lady still might be carrying a torch for me)

Toilet that Oprah loves

vietnamese bun columbus ohio

top retarded adult resorts dominican republic

turkey baster full of sperm

lesbians and turkey basters

leave me alone

urinate out window world of warcraft

urinary tract infections and jet skis

anal bleaching kit buy

But my favorite.....by far my favorite...search phrase that someone typed into Google to get to my little blog garden is this:

"i got my hydrocodone filled on July 17th. When can I get it refilled?"

Someone actually typed that in a search engine expecting to get an answer. What they got instead was my blog.

Tell you what, I feel bad for the anonymous hydrocodone seeker, and I'm in generous mood. So like a magician who gives away the secret to his tricks, tonight I will give away the secret formula that determines when a hydrocodone prescription can be filled. Ready? Here goes:

a=(0.345x-@3^908/3.141)p~o/wagsux(rad69maryceomilf*cvs7865#bites

OK I'm bullshitting you. The real formula is a little easier.

1) Look at your label

2) Follow the directions

3) When your bottle is empty, it may be refilled, assuming you followed step 2

This post alone may cut the number of calls I get at the store by 25%. Bring on the scotch.

Random Remembrances From A Return To Ohio

"United Airlines would like to welcome you to Cincinnati" crackled the creaky old PA system in the creaky old aircraft, and my heart sank. I looked around and was engulfed by the plainness I had tried to keep at bay by playing Frank Zappa in my mind's jukebox for the last couple hours. Say what you will about Frank Zappa, but he definitely ain't plain folk. The people around me were descendants of the farm. I'd say children of the corn if that didn't imply something different thanks to Hollywood. I found a ticket stub from where I saw the Stooges last April stuck in the notebook where I write down these random thoughts. Iggy Pop was telling me to stay strong.

Then I remembered that Cincinnati's airport was actually in Kentucky. That made it temporarily better for some reason.

Tight connection to make the last pond skipper to Columbus, Ohio, and I had to do an OJ Simpson to make it to the gate on time. When I say that I don't mean I slit someone's throat. Those of you a little older will remember the commercial OJ used to be famous for before he killed a couple people. If you're the guy I ran over in front of the Burger King, I'm really sorry. I'm sure you'll agree with me sir that half-hour layovers when you have to get from one side of the airport to the other should be illegal.

Got settled in for the last half-hour flight and was informed what to do in the unlikely event of a water landing. Nice to know the airline was prepared in case some giant windstorm unprecedented in the earth's history were to blow the plane 150 miles off course and force it to land in Lake Erie. Either that or it was just another random moment of corporate impersonality. I think you know which. I was definitely on the other side of the river now, most assuredly in buckeyeland and on my way to Columbus, Ohio. If you ever want to annoy someone from Columbus, make sure to always attach the "Ohio" after their city name. They totally have a complex about that. It's a metro area of over a million people that has done absolutely nothing to distinguish itself from anywhere else. I heard a story not too long ago about a girl who was killed by an errant hockey puck in Columbus, Ohio, and I could almost hear the Chamber of Commerce shouting..."SEE? THINGS DO HAPPEN HERE!!!! REAL THINGS!!!!" U2 once played a concert at the football stadium in Columbus, Ohio, and the fact a local TV news crew met them at the airport to make their arrival the lead story on that nights newscast actually underscored the problem the TV crew was trying to help out with.

I couldn't help but to notice there was a card in the seatback pocket in front of me that said "Final assembly of this aircraft was completed in Brazil" I wondered why they had to tell me this. I'm sure they wouldn't have told me this unless they had to.

It occurred to me that I've done more than my share of flying now, and I've never actually seen anyone use the barf bag. Has anyone?

I watched the stewardess get ready for landing and saw that she got shoulder belts AND a lap belt, while us paying customers only got the later. I find this unacceptable. If I'm going to die in a fiery aircraft inferno, I want the stewardess just as dead. I watched her almost in a trance like state as she made her way to the front of the craft, and the words "Welcome to Columbus, Ohio" snapped me back to reality. Looking at the barf bag wouldn't help me anymore. The door opened, the hazy, hot, humid atmosphere of the Midwest in summertime came in, and a ton or two of accumulated lifetime family baggage came crashing back down upon my shoulders. I spent the week with that baggage pressing down on me. It was hard to move with that weight on my shoulders. It was hard to breathe, and it had nothing to do with how incredibly fucking hot it was. The baggage swirled around me, and I couldn't sleep, not even in the daytime. My last day in Ohioland I was awake from noon eastern until 4PM Pacific the next day. Thirty-one straight hours without even the crutch of crystal meth.

In short, it was hot, the family baggage pulled me to earth with incredible force the whole time I was there, and I set a personal record for consecutive hours without sleep. At the airport on my way back someone cut in line in front of me and I knew I must be headed back to California.

I'm glad I went.

A Reminder Of My Distant Past Foreshadows My Near Future.

The man in overalls and the greasy baseball cap came up and started with "I'm here from out of town....." It's never good when a customer starts with those words. He talked in an accent I hadn't heard in awhile. An accent I have worked many hours to scrub from my own vocal cords. I looked at him and saw my past. "Durndest thang.....I had muh pill bottles set out all on the kitchen table and just left 'em thar" I looked at him and saw everything I ran from.

His daughter came up and there was a conference between me, her, and the old man's central profile. He wasn't involved so much. We eventually figured he needed his sugar pills as well as the ones for his tingly feet. A little boy came up and said "Pa! they got a chair outside with a roof over it!" I think the boy was talking about some sort of plastic made-in-China lawn furniture with a gazebo on display out front. I looked at the boy and saw me. I remember the first time I saw a shopping mall. It amazed me. I remember the first time I saw a big city skyscraper. It amazed me. I can very much remember a time when I would have been amazed to see a chair with a roof over it. Now I work with some of the wealthiest people in the world in one of the most beautiful places on the planet, and these people aren't amazed with anything. It's been a long time since I've been amazed with anything myself. I ran away from a place full of good people to a place full of the brain-numbness that only affluence can bestow.

I'll be leaving this weekend to go back home for a week. When I landed in California, I made it a point to say that the Golden State was my home now. It's not. I'm flying to Columbus, renting a car, driving it deep into the heart of Appalachia, and then giving my Mom a big hug.

I'm glad the old man came in the store.

The Real Reason I Am In Favor Of A Single Payer Health Care System. It means Big Profits For Big Pharma, That's Why.

Don't take my word for it. Take the word of Big Pharma. From yesterday's New York Times:

Amgen claimed a profit margin of almost 100 percent on its foreign sales, but only 15 percent on its American sales.

That's right, not only does every other industrialized country manage to cover all their citizens, spend less on health care, and have better health outcomes than we do (USA!.... USA!.... USA!), but according to the drug companies themselves, there's a shitload more money to be made for them overseas than in the USA, where drug prices are an arm and a leg higher. Those Amgen figures are echoed by Eli Lilly, Pfizer, and Merck. I guess we should consider ourselves lucky the pharmaceutical industry wants to do business here at all, since they make so little money in the United States. Evidently Big Pharma just really cares about the health of the American people, since they are willing to stay in such low-margin environment.

Either that or those figues are nothing but a bullshit tax dodge. According to the Times article, the companies that happily accept billions of tax dollars from your government, the companies that used their political muscle to have it written into law that your government is prohibited from even asking for a price break to cover Medicare Part D recipients, have now learned to shift their profitable assets overseas to avoid paying into the pot they suck so much out of. Using the figures from the Times, Pfizer alone would have avoided $10.8 billion in taxes. Getting Pfizer to pay it's fair share would be like getting a coupon for 1 free month of war in Iraq.

At least it's supposed to be your government. The word "corporation" does not appear in the Constitution, the first three words of which are "We The People." If you're a person, do something today to hold your government to those words.