Sunday, December 30, 2007

Blog note-

I realize that lately I've been referring to people (doctors, pharmacists, customers, etc.) using the masculine gender (him, his, he, etc.).

I just want to note to all the politically correct police out there that I'm well aware there are plenty of women doctors and pharmacsts. However, it is really a big pain in the ass (and generally sounds pretty stupid) to write he/she, him/her, his/hers all the time instead of just picking one gender.

I don't know if this is correct, but I was taught in school (elementary school, I think) that if you are not referring to any person in particular, you should use masculine pronouns by default. Whether that's 100% correct or not doesn't matter because that's the way I'm going to do it. It just sounds better than saying him/her, and it definitely sounds better than using "them" or "their" when you only mean to refer to one person.

That is all.

Another term for the pharmacy contract

A few weeks ago, I wrote about how I would love to make every customer sign a pharmacy contract before using our pharmacy. I just thought of another term to add to it.

- The pharmacy has the right to charge the customer for wasted time. For example, if the pharmacist explains why a copay is high or a drug is not covered, and you choose not to believe him and force him to call the insurance company, if it turns out the pharmacist's initial explanation was correct, you will be charged a fee for wasting the pharmacist's time.

I figure what to charge could be left up to the discretion of each store. My suggestion would be to charge the patient based on the pharmacist's per-minute salary. If the pharmacist makes $60/hr, you would charge the patient $1 for every minute wasted. Therefore, if some dumbass customer forces you to call the insurance company just so they could explain to you what you already know, and this phone call happens to take 10 minutes, you can charge the patient $10 for time wasted.

Saturday, December 29, 2007

People... Please talk to your doctors!!

I got 2 absolutely idiotic questions yesterday:

1) Customer brought in a prescription for an antibiotic and cough medicine. "Does this cough medicine have Codeine in it? I can't take codeine."

2) Customer brought in a prescription for a 2 week course of Bactrim DS. She had already been given a prescription by another doctor for a 2 week course of Bactrim DS 8 days ago. "This doctor didn't know I was already taking Bactrim. Should I take a second course?"

These are questions that should be asked BEFORE LEAVING THE DOCTOR'S OFFICE!

I want every patient in the world to pay attention to what I'm going to say: TALK TO YOUR DOCTOR!

I know that a doctor can be intimidating. A lot of doctors come across as being too busy to take time to talk to their patients. In addition, many doctors (whether consciously or unconsciously) give off this vibe that they're smarter than you are, they're doctors, and they're judgement should never be questioned, especially by a lowly patient.

However, as a patient, you must get over this fear and intimidation and ask the doctor whatever comes to mind about your therapy. Patients don't realize just how important a role they play in the whole healthcare process. If you have a concern about taking a medication, talk to your doctor about it. Let your doctor know what other kinds of medication you are taking. In addition, don't, UNDER ANY CIRCUMSTANCES, let a doctor write a prescription without telling you what drug he's giving you, and what it is used for.

Looking at my previous examples:

1) This woman went to the doctor looking for cough medicine. The woman knew she couldn't take a codeine product (due to GI intolerance). She knew that many cough medicines have codeine in them. Despite this, she waited until she got to the pharmacy (and actually until we already filled the prescription) before she asked whether the medication had codeine in it. Of course it did, and she would not take it, so we had to call the doctor's office, wait on hold for 5 minutes to speak to a receptionist, only for her to tell us that the doctor was with another patient and would have to call us back. Had she just asked the doctor that simple question before leaving the office, we would have avoided all of this trouble.

2) The woman with the Bactrim script knew she had been on Bactrim before. When she asked me if she should take another course, she said, "I think the new doctor thought I was taking Cipro before, so he wrote me a prescription for Bactrim instead." Then why the fuck didn't you let the doctor know this????? It's fucking asinine to ask the pharmacist this question. I don't know what you're being treated for. Even if I did, I don't have access to whatever susceptibility cultures you might have. What can I do besides track down the doctor and ask him the question you should have asked before you left his office?

This sort of thing pisses me off maybe more than anything else. The worst of them all are the people who are on Coumadin and don't tell their doctors that right off the bat.

Here is a lesson that I want everyone who takes Coumadin to learn:

If you are on Coumadin and you go to a new doctor or any doctor who would have no way of knowing you are currently taking Coumadin, the first words out of your mouth should be, "Hi, my name is so-and-so, I'M ON COUMADIN."

Because so many different medications interact with Coumadin, that knowledge is absolutely critical to a prescriber. All too often, I see Coumadin patients come to our pharmacy with a prescription for Cipro or Bactrim. In almost all cases, they failed to let the prescriber know they were taking Coumadin, and now the responsibility falls on the pharmacist to track down the prescriber and try to get the antibiotic changed.

Basically, the take home points of this post are

1) Don't be afraid to ask your doctor any questions or express any concerns over your therapy.

2) Always know what medications the doctor wrote and ask any appropriate questions BEFORE leaving the office.

3) Patients on Coumadin absolutely have to tell each and every doctor they see that they are taking Coumadin.

If Patients would just adhere to these simple rules, it would save a lot of time, confusion, frustration, and, not to mention, it would cut down on prescribing errors and adverse drug reactions.

Sunday, December 23, 2007

The worst thing is having your professional judgment and decisions questioned and overturned by a non-pharmacist store manager

A little over a month ago, our store was running a coupon promotion. As with any coupon offer, Medicare and Medicaid patients were excluded.

Well... one woman with a long history of being a royal pain in the ass came in and complained that the coupon offer was discriminating against Medicaid patients like herself. I explained to her that it was a federal law and not simply a store policy. She would not hear it. She proceeded to lash out about not only the coupon, but also about how the entire pharmacy staff was "incompetent." She said that her doctor told her that she hates the pharmacy staff and refuses to call in prescriptions to our pharmacy. The doctor supposedly makes an exception for this one woman because it's convenient for her to use our pharmacy. She wanted my name, the pharmacy managers name, the store license number, and any other information she could get so that she could go complain to the state board of pharmacy about how we were treating her.

I called a manager over to the pharmacy counter to help deal with her outburst. This particular manager was a good guy, and he stood up for the pharmacy and staff while telling the woman that the law prevented her from getting the 20% off coupon.

The conflict did not end here though. Unsatisfied, the woman went and complained to the manager of the entire store. Acting under the retarded principle that the customer is always right, the store manager gave her a 20% coupon and apologized for whatever inconvenience she had.

In doing this, the store manager (who knows absolutely nothing about pharmacy) made us all look like assholes. He broke the law in order to please one bitch of a customer who, being on Medicaid, can't afford to do much business with the store anyway.

Why do we even have these laws if they get overturned at the slightest complaint? I brought this to the attention of my pharmacy manager, and he actually took the side of the store manager. His rationale was that it's better to just quell her complaints now before she takes the issue to the board of pharmacy.

I was not at all satisfied with this explanation, and I let him know it. I made a decision... actually it wasn't even a decision since I was simply following the law. When I have absolutely no support from my pharmacy manager and my store manager in backing up what I believe was the correct response to her coupon tirade, it makes it look like I'm the one that was wrong and the moron customer was right.

This wasn't the first issue we've had at our pharmacy where our initial by-the-book judgement was questioned. Almost a year ago, another customer with a long history of being an asshole came in on a Saturday looking for a refill on his insulin. He had no refills remaining, so the pharmacy manager (a different pharmacist than the current one) told him that we'd give his doctor a call for him on Monday morning. He wanted his insulin at that moment and would not wait until Monday. The pharmacy manager asked him if he had any insulin left, to which the customer replied that he had enough for several days. Therefore, since the customer was not in danger of running out of insulin, the pharmacy manager told him that he would have to wait until we got refill authorization from the doctor.

The man flipped out. He started calling the pharmacy manager (Tom) a "pompous asshole" He said that Tom was on an egotistical power-trip, and he threatened to contact the board of pharmacy unless he got his insulin at that moment. Tom simply looked at him and smiled and told him that he will wait until Monday.

After firing off a few more insults (to which Tom kept smiling and gave him some smartass remarks back) the man walked away. During the following week, we got a visit from someone from that Board of Pharmacy. He asked Tom for his side of the incident. Tom told him the entire truth, and amazingly, it actually exactly matched what the customer had told the board. Tom had every right to tell that man we could not fill his precription. However, the guy from the Board of Pharmacy basically told Tom that this customer was "a very demanding man," and in the future, we should pretty much do whatever he wants just to avoid some kind of incident.

That was the stance from the FUCKING STATE BOARD OF PHARMACY!!!! "Just give him whatever he wants." They basically said, "We don't want any problems, so go ahead and break the law so we don't have to deal with it." However, you know that if we dispensed that insulin to him without a prescription, and he somehow had some incident due to a change of dose or medication that we weren't aware of, the Board of Pharmacy would be the first ones to throw us under the bus for it.

How can we use our professional judgement if whenever a customer disagrees with it, they can simply go over our heads and get our decisions overturned? That's not right, and quite frankly, it's dangerous. Otherwise, why bother even having all these dispensing laws?

What made me think of this after all this time was reading the Angriest Pharmacist's post about how he threw out a customer who treated him like shit. It got me to thinking how I'd love to be able to do that with a few of our customers. I've been sworn at, insulted, and borderline humiliated by customers, but if I say the slightest thing back to them, they can run to the store manager and get ME in trouble.

I firmly believe that in order for a pharmacy to be run safely and effectively, it has to be treated as a separate entity from the store. The pharmacy manager should have the final say on any issue that involves the pharmacy. Furthermore, unless a pharmacist's decision is blatantly wrong or endangers the saftey of a patient in some way, the decision should not be overturned if a customer decides to climb the ladder of authority. We cannot practice our profession while worrying that every decision we make will be undermined or overruled by someone above us.

Wednesday, December 19, 2007

Stressed out

Perhaps, I'm still reeling from my horrible Saturday, but all I know is that I've been really stressed out at work lately. We haven't been any busier than usual. There haven't been a lot of problems or asshole customers. I'm just feeling worn out.

On Tuesday, I hardly said a word to anyone all day. Normally, I joke around with my coworkers and talk about sports or whatever else comes up. On Tuesday, I just wanted to be left alone.

Really, I think some of it is the constant stream of questions that our clerks ask us. They can't seem to do anything on their own, and it's really hard to have to hold their hands while trying to do my own job. I just wish they'd start catching onto a few things that they should know how to do.

Ideally, I'd love to personally train each and every one of them. However, I can't do that and work at the same time. It becomes too overwhelming, for me at least. I feel pressure to do everything quickly because I hate falling behind. Therefore, whenever a question comes up, I tend to just go over there and resolve it as quickly as possible instead of taking the time to teach them.

Part of the problem is that most of our clerks just do not catch on quickly to anything. I must have walked on of them through the same thing 10 times, and she still asks me how to do it every time the situation comes up. I feel like screaming to her, "HOW DO YOU STILL NOT GET THIS???" But, I'm sure that wouldn't go over very well.

Another source of stress is just the general interactions I have with my coworkers. When I'm just joking around and busting balls, I'm fine. However, I hate seemingly simple and harmless questions like, "What did you do on your day off?" or "How was your weekend?" I hate those questions because my answer is always the same. "I didn't do anything. I just sat around all day."

Generally (as one can discern from reading this blog), I have nothing worthwhile to do when I'm not working. I haven't been on a date since August. Other than a couple parties, I haven't done much of anything.

Moreover, I hate talking about my personal life. I still haven't met the eHarmony girl yet (although that's probably going to change very soon), but even when I do, and even if it goes incredibly well, I don't want to talk about it. That's always been my way. I hate discussing the things I do on my own time with people who aren't very close friends. I don't like explaining my actions. I don't like giving details. I generally don't want people to know what I think. When I started dating my ex, I didn't admit it to my friends until a few months later (even though they all knew).

I'm not sure why, but I always hold back. Sunday was the last day for one of the girls who worked in our pharmacy for close to a year. She was a really nice girl. I liked working with her a lot. In fact, her pleasant personality kind of made my day many times. However, I could hardly muster up a smile to say goodbye. I didn't want her to know that I cared one bit whether she left or not. That's so stupid because it makes me look like I'm cold hearted, but that can't be further from the truth. I just have a hard time showing and expressing my feelings. The truth is, I'll miss working with her. I wish she didn't have to get another job. I just couldn't express this. I don't really know why. I guess it just feels weird to me.

It's a continual conflict between what's really in my mind and how I actually act. I firmly believe that my true self is this gregarious, super-friendly, thoughtful person who likes to laugh and talk about all sorts of things. However, all anyone ever sees of me is a quiet, reserved, super-serious, and (at times) cold hearted person. I hate that I act like that. I want to let go and just be myself, but I'm so inhibited that it makes it impossible. My inhibitions are so deep set that not even tons of alcohol can cause me to lower them.

These inhibitions have prevented me from reaching the kind of success I should have had in all areas of my life. I always look at basketball as a microcosm of my whole life. Through countless hours of practice I had developed more skills than probably any player who ever came out of my town. Hell, when I was in middle school, I was probably the most gifted ballhandler of any person my age in the entire world. I religiously watched and practiced the drills in the Pistol Pete's Homework Basketball videos. By 8th grade, I had mastered just about all of Pete Maravich's ballhandling drills. I could throw perfect full court behind the back passes. In the open court, I could dribble the ball so well that I was just about unstoppable. I could dribble with either hand faster than just about any other kid my age could run.

As I've stated in a previous post though, I was never a star. I had a few great games. I made for some memorable moments. I drew oohs and ahhs from some coaches and spectators. However, it was always the same story with me...

"He's such a good dribbler and shooter, but he needs to look to score more."

"Mike, you need to shoot more. Stop passing up open shots."

"There's no reason you shouldn't be taking at least 15 shots per game."

"Mike, you need to play with more confidence. Don't worry about missing a few shots."

If any other person possessed the basketball skills I had, they would have DOMINATED everyone. I was afraid to use all of them. I had a million different kind of shots that I could take, and I made them a billion times shooting around in my yard, but I would never take them in games because I felt they were unorthodox. I could have gotten a shot off anytime I wanted to, but I barely shot the ball 10 times per game.

It's just an example of me holding back my true self. I was afraid of how good I could be, so I never allowed myself to be great. That's how my life is. I'm a great and fun person, but I'm afraid to show it.

I have no answers for this, and this long blog entry probably isn't going to provide any either.

Monday, December 17, 2007

The worst kind of employees

I'm becoming convinced that (in general) the worst employees you can hire are ones that don't really need the job. I'll explain...

We have a part time technician. Her husband is some corporate hotshot who gets an annual bonus that is roughly half of my salary. Basically, she doesn't need to work. She does it just to get out of the house and to give herself a little extra spending money. For the most part, she does her job well, although she tends to be a bit of a chatter box, which can sometimes lead to her telling stories instead of working.

Really, the only problem I have with her is that she calls out whenever she feels like it. If she gets up, and it's too cold, she'll call out. If her one of her kids has a sniffle, she'll call out. If she just wants to go shopping instead of come to work, she'll call out.

Maybe in some jobs, this isn't such a huge problem. In a tiny pharmacy, it can ruin your day. We're busy. We need employees. We don't have any built in redundancy. We can't simply just grab a cashier from the front end to replace her. If she doesn't show up, we're down a tech, and unfortunately, she's one of our only techs.

I was about to write that I'm convinced the best employees to hire are the ones who are desperate to work, but even that doesnt' seem true. Yesterday, I listened to one of our clerks complain about all day about how our manager didn't schedule her for enough hours next week and how she really really needs all the hours she can get.

Well, we were incredibly slow yesterday, and we spent half the day sitting around with nothing to do. She was bored, so near the end of the day, she kept asking me if she can leave early.

OK... let me sum that one up... She desperately needs hours. However, she doesn't want to work her full shift. Am I the only one that sees something wrong with this???? I kept telling her to just enjoy how slow it is because we barely ever get days like that. I told her that she's getting paid to basically sit around and do nothing, and I reminded her about how she continually complained about not having enough hours.

None of this mattered. Eventually I got sick of her whining, and I let her go home early. We were so slow that I didn't need her, but that's not really the point.

On a somewhat related note....

There's been a trend in my pharmacy that has to stop. Our company mandates that any employee that works 8 hours must punch out for a half hour lunch break. That means a person working 8 hours must be scheduled for 8.5 hours to accomodate that break. What's going on recently is that our technicians and clerks aren't punching out for their half hour lunch breaks, and instead are simply punching out and going home a half hour early. They still get paid for the 8 hours they worked, and they get to leave early.

This is pure bullshit. When we schedule someone 9-5:30, we expect the person to stay until 5:30. If they leave a half hour early, then we're short a person for that last half hour of their shift... which often ends up being one of the busier times of the day. Moreover, it's not like the person worked non-stop for 8 hours and didn't take a break. We're not crazy busy the entire day (at least not anymore), so it leaves plenty of time for someone to walk out, get a coffee, get a muffin, get a sandwich, etc. Basically, they end up getting paid for their lunch breaks.

This has to stop.

Saturday, December 8, 2007

A pharmacy contract...

It would never fly in the real world, but in my own imaginary pharmacy paradise, I would have every customer who fills a prescription do so only after agreeing to the terms of my pharmacy contract.

Here are some points I would include on this contract (in no particular order because I didn't feel like putting enough thought into this to make it look like an official document)...

In order to make your experience at our pharmacy as pleasant and beneficial as possible, we ask all our customers to abide by certain terms. These terms are designed to help ensure customer safety and privacy, as well as to help the pharmacy abide by federal and state dispensing laws.

1) Customers will be asked their names, date of births, and addresses every single time they drop off a prescription. Even if you've been going to the pharmacy for 20 years, we will still ask this information and require that you give it to us at the time of prescription dropoff. This is done to help ensure the accurate filling and dispensing of prescriptions. If you have a problem with giving out this information at prescription drop-off, find another pharmacy.

2) In the event that you run out of medication and have no refills remaining on your prescription, we can only give out a 72 hour supply of medication. This only applies to long term, necessary medication. That means we will not spot you a couple viagra without a prescription, nor will we give out an entire pack of birth control without approval from a prescriber. This means that CUSTOMERS are responsible for keeping track of refills on their prescriptions. If in the event you run out of refills and wait until you're out of pills before asking us to get approval from a doctor, we reserve the right to tell you "it's your own damn fault."

3) Prescriptions for controlled substances will be allowed to be refilled no more than 2 days before the customer runs out of medication. We will not fill a prescription for Vicodin, valium, xanax, or any other control earlier than this even if the insurance company allows it. Any exception must be verified and approved by the patient's prescriber before dispensing. If the office has already closed or if it's a weekend, the pharmacy will have to wait until the next day the office is open before dispensing.

4) In the even that a customer runs out of refills, the pharmacy can call or fax the prescriber requesting more refills. However, customers must keep in mind that the pharmacy is doing this out of courtesy to the customer, and is in no way responsible if the doctor takes a long time to approve the request or if the doctor decides to deny the request. Ultimately, it's the patient's responsibility to make sure his/her request for a prescription renewal gets approved by the prescriber.

5) There will be absolutely no talking on the cell phone while waiting in line at the pharmacy counter. Any customer talking on a cell phone will not be waited on until he/she hangs up the phone.

6) If you're copay is higher than you expected, it is not the pharmacy's responsibility to call your insurance company and figure out the reason. We may do this as a courtesy in certain situations. However, ultimately it is the customer's responsibility to contact the insuranace company in regards to questions about copays or NDC not covered rejections. The pharmacists have a good deal of knowledge about the general workings of pharmacy insurance companies. However, they do not know the specifics on every single plan that's out there.

In choosing to fill a prescription at this pharmacy, you have agreed to abide by the terms spelled out in this contract. Any complaints or grievances filed by customers who have violated any of the aforementioned terms will be ignored, ridiculed, or (in severe cases) result in the customer being denied future pharmacy services.

Sign Name Here____________________________________________________

(*** I think I'll add more terms as I think of them. Feel free to make suggestions. Together we can come up with the ideal pharmacy contract)

Wednesday, December 5, 2007

Possibly a good sign?

In recent weeks, my ex-girlfriend has made a few attempts at patching up our friendship. Notice I said friendship and not relationship. See... even before we started dating, we were good friends. We became best friends while dating and remained that way for an entire year after we broke up.

We've talked a few times recently, and we still have that good chemistry that we always did. No matter what she or anyone else says, we still have a connection and probably always will. We understand each other better than anyone else, so we're able to talk for hours about just about anything.

Now here's what I think is the positive sign in all this... I really don't have much of a desire to be friends with her.

The hardest thing I ever did in my life was to stop depending on her as a friend and to unlink my life from her's. I'm not joking when I say that it nearly killed me. I was lost. I had no idea what to do. I felt hurt and lonely beyond all comprehension. I begged and pleaded to keep her in my life in one form or another because after all our time together, I just couldn't imagine my life without her.

For a long time, I would take any contact with her as a sign of hope. I would use it as an excuse to continue to hold onto what we once had. Now... she's telling me to call her if I ever wanted to get something to eat with her sometime. 3 months ago, I would have jumped at the opportunity. Now, I couldn't care less.

I don't need her as a friend, and I don't need her in my life at all. I've gone nearly a year without her friendship. It was tough (especially because I had few friends other than her), but I'm still living. Sometimes, I'm not that happy. Sometimes, I reminisce about days gone by. However, I'm pretty sure I've reached the point where I can move on and accept the possibility of a future relationship and future love. If I never saw or heard from my ex-girlfriend again, I'd be OK with it.

I've met a girl on eHarmony that I actually like. We haven't met in person yet, but I've talked to her several times. We get along well, and as long as I don't screw up on our first date, I really think there's potential here. I'm taking things very very slow at the moment, but I'm optomistic.

It's a little weird because it's the first time in pretty much 8 years that I've even considered the possibility of liking someone else. Even if this doesn't work out. Even if the whole thing crashes and burns on the first date, at least I've shown myself that I won't be stuck on my ex for the rest of my life.

Wednesday, November 21, 2007

"Left Brain Person"

I'm not a person that gets easily bothered by what other people say or think about me. You can call me stupid, lazy, ugly, tell me I don't know how to do my job, whatever, and it usually just rolls right off my back.

However, a coworker said to me today, "You're pretty much a left brain person, huh?," and it's bothering the shit out of me. She didn't mean it in a derogatory way. It was more of an observation than anything else. Of course, she added "you need to get a little more right brain activity." It wasn't a comment designed to make me reevaluate my life, but here I am... writing about it.

I'm trying to figure out why this comment irks me so much. It wasn't a shocking realization or anything. It wasn't like her comment made me all of a sudden realize I'm overly analytical of everything. It wasn't event an incredibly perceptive observation either. Pretty much anyone who knows me for more than 5 minutes knows that I think... a lot... about everything.

I think what bothers me so much is that when I think about it, there's absolutely nothing I do that is creative, artistic, or lively in any way. I don't cook that much, and when I do, I treat it like a fucking science project measuring out exact amounts of ingredients and setting timers to let me know exactly how long something needs to cook. I can't draw for shit. I am a good technical writer, and I do my fair amount of writing on this blog and another blog. However, my style of writing is workman-like. There's not much fluidity or beauty in the words I string together. Creative writing is completely out of my grasp.

In fact, the more I think about it, I can't actually think of a single thing that I have fun doing. I can't remember the last time I went out and had a really good time just doing something for the fun of it. Now, I like playing basketball, but even my approach to basketball is completely analytical and my fun is more based upon how well I shoot the ball or dribble the ball in a particular game than it is on simply the fun of playing. I play video games, but they aren't fun to me. In fact, I go about them as if it's my job to finish the game.

I don't enjoy the experience of anything. My ex-girlfriend used to ask me to go for walks around the campus all the time when I was at college. On nice spring or autumn days, our campus was quite picturesque. I used to tell her no most of the time. My reason: I walk around campus from class to class all day. Why do I want to do more walking than I have to? Even when I broke down and agreed, I never just enjoyed the relaxing stroll. I tried to walk quickly so that we can reach our endpoint as fast as possible.

I'm not a fun person. As a kid I was. As a kid, I invented a million different games to play with my friends. I was the one that had all the ideas. No one had fun unless I was there. I can't pinpoint when it happened or why, but somewhere along the line, I just became an entirely different person. For whatever reason, this extroverted, lively kid just shriveled up and crawled back into his shell. I stopped talking to people. I stopped voicing my opinion. I stopped letting people know what I liked and disliked. I hid the real me behind impenetrable walls.

So, when that coworker mentioned that I need to use my right brain a little more, it struck a nerve... because I know she's right. I don't lie to myself very often. In fact, I'm quite honest about my shortcomings, and I'm very conscious of the things I need to improve upon while being aware that some things (i.e. greying hair) are beyond my control. However, I must admit that I often try to convince myself that there's nothing wrong with my mind and personality. I keep making excuses for the way I act and the way I think, but in reality, I know I have a problem (maybe several).

My question is, how do I go about finding myself and finding meaning in my life? I really don't have any clue where to start. I figure I'll take small steps for now. My first step: Try to be nicer to everyone. I've always prided myself as a nice guy, and once upon a time, I truly was that. Now, I act nice around people simply because I'm supposed to and not because I feel any real desire to. I need to weed out the negative thoughts and pessimism so that I can just focus on the positive side of things. If I can do that, I think I can get my mind on the right track.

Monday, November 19, 2007

Pharmacist is the least sexy profession... least in the all important (just made up on the spot) pay to sexiness ratio.

Your average retail pharmacist now makes over $110,000/yr. However, the job has pretty much zero sex appeal. Think about it. How many guys have ever had women swoon over them when they mention they're a pharmacist? You don't get much more old fashioned and boring (at least on paper) than a pharmacist.

When you think of a pharmacist, what's the first image that come to mind? I've been around the profession too long to have a good idea what the common person thinks. However, I'd wager that the first image that comes to mind is one of those old fashioned drug stores you see in old movies. Behind the counter is an older gentleman with a conservative haircut and conservative clothes that aren't particularly stylish. He'd be smiling and saying hi to all the 70-80 year old women who walk in. "Hi Mrs. Smith, I ordered those vitamins for you!"

Of course, our imaginary pharmacist would drive an old Buick or something. No, German luxury cars for him. He'd live in a nice, quaint, not spectacular house with a conservative wife who bakes cookies and gardens all day and a couple honor roll kids.

Now, I could be wrong (and I did exaggerate on how boring the profession seems). However, is there anyone outside of the profession that thinks pharmacists can be fun and exciting people? When you're a lawyer, you get to wear nice, expensive suits, drive flashy cars and entertain clients at upscale restaurants in the heart of the city. Doctors have that whole "I'm saving the world" flair about them. Plus, everyone knows that physicians generally get paid very well. While I'm stereotyping here, I might as well mention the sexy nurse stereotype for women.

Pharmacists don't have any of this flair. I mean, even though pharmacists make plenty of money, doesn't it seem pretty odd to think that a lot of them could be out driving around in BMWs and wearing designer suits to fancy gourmet restaurants in their time away from the pharmacy? We look so uptight in our short white coats and our collared shirts and ties. If one happened to come across their local pharmacist dressed to kill for a night out on the town, it would almost be like finding out Clark Kent was really Superman.

Being a pharmacist is just not a glamorous profession. You'll never see a show mainly about pharmacists, but you'll see a million ERs, Gray's Anatomies, and Boston Publics.

This actually brings me to another thing I was thinking about today. Why hasn't anyone ever tried to make a show about a pharmacy? There's plenty of other stupid sitcom ideas that hit television. Why has this one never surfaced? From various pharmacists' blogs, you can tell that a lot of weird and funny stuff happens in a pharmacy on a daily basis. However, I think that's part of the reason we'll never see a show like that. The only thing funny stuff that happens in a pharmacy is due to the boundless stupidity of people. Whether it be a customer, a doctor's office, a coworker, or an insurance company, stupidity is the common theme.

Now, I can hear you saying, "but we love watching stupid people on TV. Why do you think we watch The World's Dumbest Criminals or Jerry Springer?" My theory is that those are examples of rare stupidity, and we like to laugh at them in disbelief. Pharmacy stupidity is so common that it borders on normalcy. From the patient who bitches about the pharmacy not having his medication in stock for the 4th month in a row, even though he had been told 3 times previously to call in his refills a few days before he runs out, to the doctor's office that no matter how many times you tell them it's illegal, still tries to leave Percocet prescriptions on the pharmacy voice mail, stupidity runs rampant.

After the 7th billion time you see the same stupid things happen, it stops being funny... and that's another problem... you hardly ever get any unique stupid situations. I swear, there are no unique situations in retail pharmacy. Every pharmacist who's been working more than 3 months in retail will have at least 1 example of any story any other pharmacist can think of. Within 3 months, you're guaranteed to catch someone trying to pass a fake narc script, have a customer chew you out for a problem that isn't in any way your fault, have someone show you a cut, bruise, or rash on part of their body that you really did not want to see, answer a variety of questions about bodily conditions that a sane person would not dream of bringing up in public, sit on hold with an insurance company for literally 30 minutes before finding out that the cryptic rejection message you received means the medication requires prior authorization, and of course.... my favorite... a customer dropping off 15+ prescriptions at the same time written by some numb nuts hospital resident that made some sort of mistake on just about every one of those 15+ prescriptions. However, because said resident read "PRINT NAME HERE" on the script blank and interpreted that as meaning "WRITE IN INDECIPHERABLE HIEROGLYPHS," it's impossible to track him down to find just what the fuck he actually wanted to give this patient (that's assuming the numb nuts even had any idea what he was doing in the first place).

See what I mean... there's just nothing sexy about this job.

Brilliant customer phone call of the day

Customer: "I just picked up a prescription for bactroban ointment. It says here on the label that I have 2 refills by November 19, 2008."

Me: "Ok...."

Customer: "But that's today!!!"

Me: "It's 2007 sir."

Customer: (long pause) "Oh shit... You got me there!!"

I give the man a little bit of credit though. Most people don't even bother to read the part after "2 refills remaining" that tells them on what date the prescription will expire.

Friday, November 16, 2007

Work is for work

I fucking hate it when I'm running around the pharmacy like crazy trying to do 10 things at once, meanwhile the people I work with are just standing around chatting about something of absolutely no importance to the pharmacy.

That was how the whole goddamn day went today. I understand that coworkers should talk, joke around, and genuinely be friendly with each other at work. However, if there is stuff to do, that takes priority over anything else.

Today, I worked with a certain particularly lazy pharmacist. I was on the phone trying to get the insurance information for a patient who did not have her ID card (which was INFURIATING by the way). While I was on hold for nearly 10 minutes, I was typing prescriptions for people waiting in the store. The other pharmacist, had just finished checking the the voice mail. She brings the 5 scripts from our voice mail over to me, and goes, "here are some gifts for you, hahaha." Then, she went over to the other side of the pharmacy, took out a photo album and started looking through it with 2 of our techs.

So, here I am, phone on one ear, typing scripts for waiters, trying to answer various customer questions (Where's the Advil????), and trying to make sure that the scripts for the waiters got done in less than 15 minutes. In contrast, that stupid pharmacist was laughing and looking at pictures. What the fuck is that about?

She could have been helping to fill those scripts I was typing. She could have helped customers who had questions. She could have typed the fucking voice mail scripts that she took. There were a million things to do, but she chose to do jack shit. Furthermore, she had 2 of our techs doing the same goddamn thing.

Then... she had the nerve to look over at me when I was just about to boil over with frustration from being jerked around by the stupid insurance company, and she said, "Am I needed over there?"

YES, YOU'RE FUCKING NEEDED!!!!! Stop talking, stop fucking around, and just do your fucking job.

Let me be fair though. I can't just single out one lazy coworker. The laziness runs rampant in our pharmacy. Earlier in that day, I had to listen to one of our techs relive a terrible grocery shopping experience. She must have told 3 people the same damn story. It took 10 minutes each time she told it during which she did absolutely NOTHING!!! We had a line 10 people long, the phone was ringing off the hook, drugs needed to be pulled, but she stood with her arms crossed and told a fucking story.

When you're at work, you fucking work. You're not there to socialize. You're not there to make friends. You're not there to tell stories or to show off pictures. If there's a little bit of down time, and you get a chance to do those things, then fine. However, if there's ANYTHING else that needs to be done, the job takes priority.

(exert edited out to maintain anonymity)

ugh... OK.. I'm done venting. Happy thoughts.

Wednesday, November 14, 2007

I haven't written in a while

I admit, I've been lazy with keeping up this blog. I really haven't had much to write about. No new developments in my life. The pharmacy hasn't changed much. I don't really have any interesting stories or complaints.

I suppose I have made one pretty big realization about myself as a pharmacist in the last couple weeks. I never thought it would happen to me because I was an exceptional student, and I have an inquisitive mind. However, within the last month or so, I've realized that I've completely lost all interest in the clinical aspects of pharmacy. I'm starting to forget a lot of the things I've learned in school, and quite honestly, I couldn't care less. They're pretty much useless to me besides from showing other pharmacists how smart I am. I don't make any effort to learn the little details about new drugs coming to market. My mind is now on the business of pharmacy, which is something I never imagined.

Now, I want you all to know that I still care about my customers. I still care about their health, and I still go out of my way to help everyone, no matter how reprehensible they might be. I've just lost my interest in the science of pharmacy. Think about it, what new, original, and most importantly useful drugs have come out in the past couple years or are coming out in the near futuer? Nothing I can think of. Every drug that was supposed to rewrite drug therapy guidelines got canned. Ximelagatran was supposed to make warfarin therapy obselete... until it was shown to cause liver failure. Pfizer's torecetrapib (HDL raiser) was supposed to revolutionize the hyperlipidemia guidelines. The drug never made it to market.

I haven't really paid much attention to cancer or HIV drugs because I don't really see too many of them in my realm of practice. Perhaps great things are happening there. I have no idea. However, there haven't really been any major advancements in the treatment of your usual longterm illnesses (diabetes, hyperlipidemia, hypertension, etc.) in quite a long time. What came out recently? Januvia? I'm sure that's useful to some people who need an additional 0.6% lowering of their A1c, but it's not mindblowing in any way. Tekturna? It may be the first direct renin inhibitor, but as of right now, there's no reason whatsoever to use it instead of an ACE Inhibitor or an ARB.

Then, there's the "me too" drugs like Xyzal (levocetirizine). It's just the active isomer of Zyrtec (ceterizine). On a related note: Don't you love that cetirizine chain? First there was Atarax (hydroxyzine). The most actice metabolite of hydroxyzine is ceterizine (aka Zyrtec). Zyrtec is a racemic mixture, but the active isomer is levocetirizine (aka Xyzal). Can they specialize it anymore???

Let's not forget Vyvanse (lisdexamfetamine). Yes folks, it's another ADHD drug. Its developer, Shire Pharmaceuticals, is trying to say there's some evidence in a small trial that shows it may have less abuse potential than the other ADHD drugs, but it's still a CII.

It just seems like drug development for the prevelant longterm illnesses has stagnated, so I've lost all interest in learning about the new crap that's coming out. I've become much more interested in figuring out ways to run the pharmacy more efficiently. I've taken an interest in the financial issues of retail pharmacy because, let's face it, expanding the knowledgebase of your average retail pharmacist isn't going to ensure the survival of the profession. We have to figure out how to survive in an era of lower and lower reimbursements.

The more drug info that I forget, the better I get at my job. In a perfect world, would it be great if I could call up every physician that puts their elderly patients on amitriptyline and remind them that highly anticholinergic drugs in the elderly is a bad idea? Of course. In the real world, that'll get you nowhere fast. I've learned to just make sure that the amitriptyline we use is from the generic manufacturer that gives us the best deal.

Alright... I wrote a little more than I planned, but that's not a bad thing. I'll try to come up with new things to write about.

Monday, November 5, 2007

The Dumbest Questions

Of all the stupid questions I get asked during the course of a day, the ones I find the most irritating are when customers pick out an OTC product, bring it to the counter, and ask me how much they should take. I don't know exactly what they're expecting me to tell them that they couldn't ascertain by simply reading the label on the box. Hell, when they hand me the box, I immediately look for the directions on the label and tell them to follow them.

One lady called the pharmacy today to ask how much OTC miralax she's supposed to take. "Did you read the directions on the bottle?" I asked her.

"No, there are no directions on the bottle," she responded.

"Ma'am, there has to be directions on the bottle. Does the label peel back?"

"Oh, Yes it does. I see the directions now."

Basically, this woman required a pharmacist in order to tell her to peel the label back to find the directions. At no time in pharmacy school that I can remember was I ever taught to peel the label back on an OTC medication bottle to find the dosing. I know it's hard to believe, but I figured that one out all by myself.

That actually brings me to another point. Despite the fact that it doesn't take an Einstein to figure out to peel back the label, I don't think it's the best idea for the manufacturer to put that information in an area that isn't in plain sight. When a person is out in the OTC aisle trying to compare products, they need to be able to easily see the active ingredients and dosing for each product. The active ingredients, dosing, and indications should be immediately visible on all OTC products. All the other crap can be hidden under the label.

Wednesday, October 24, 2007

Medicaid Recipients

My store is running a promotion: Get 5 prescriptions filled at the pharmacy and get a 20% coupon for the store. This is really a great promotion if you think about it. First of all, it's a great deal to our customers because 20% off groceries can be a lot of money. Secondly, it's pretty unique in that it's a case where we are using the store to draw customers to the pharmacy instead of using the pharmacy to draw people into the store.

Like any other promotion or coupon give-away, the offer excludes medicaid and medicare recipients. Well, this has been a point of contention for several of our customers. Some have said that we are discriminating against medicare patients. One lady completely flipped out on me and one of our store managers over the whole issue. We tried to calmly explain to her that we don't make the rules and there's nothing we can do, but she got pretty belligerent. She started yelling about how no one in the pharmacy knows what they're doing, and how she'll never fill another prescription here ever again.

(On a side note: This woman complains about something and threatens to leave every single time she picks up a prescription, but bless her heart, she always comes back.)

This entry isn't about me complaining about how my tax dollars funding these medicaid patients. Nor will I take a popular stance on how people just abuse the system and pump out kids all the time in order to get more money from the government while doing nothing but sitting on their asses. Quite honestly, I think the Medicaid program is a good thing, and I have no problem with my tax dollars going to fund it. I will never complain about people having multiple kids while on Medicaid because I don't think I have any right to tell a woman when she can have a child and when she can't.

I can understand how a person might be stuck on government assistance for a long time. Not everyone is smart enough or physically capable of making a comfortable living. Sometimes, it has nothing to do with intelligence, but rather the way and the environment in which they were brought up. Many people never get the same kind of opportunities I had. Believe me, I'm well aware of just how fortunate I am to have been raised in a comfortable, middle-class household. I'm grateful that my parents instilled in me the value of education, and I'm grateful that they invested their time and money in making sure I had every opportunity to succeed in life. Many people don't have this kind of family support, and it's understandable that some end up on Medicaid.

However, the one thing I will never understand is when Medicaid recipients (and I certainly don't mean ALL of them) expect to have things handed to them. The woman that went nuts on us gets all of her medication for free, she gets tax breaks, she gets government assistance to pay for her food and housing, yet she still has the nerve to bitch about a freaking 20% off coupon. Instead of being happy and grateful for whatever help she can get, she complains and holds her hand out for more. Worse, she thinks she deserves more.

All I know is that if I were on Medicaid, I would work my ass off trying to get off it. I would make it my singular goal in life to stand up and make ends meet on my own. I would be happy that I was able to get some help from the government, but I wouldn't be looking for any additional handouts.

In any case, I never lost my cool with the woman. I never got flustered. I didn't fire back at her in response to any of her criticisms. I just let her rant and rave, and I'm sure the next time she comes into our pharmacy (and there will be a next time), I'll listen to her complain about something else. Even when she told me I didn't know how to do my job and insulted the entire staff, I never wavered. I know that I will never be able to reason with her and yelling at her won't accomplish anything.

In the end, she'll continue to believe the world owes her everything, and I'll never be able to understand how someone in her position could think like that.

Monday, October 22, 2007

Thoughts on Miami

I just got home from a five day trip from Miami. While down there, I made several observations that I would like to share.

1) You know how you see celebrities and models on TV and think that women like those don't really exist? Well, they do, and they're all in Miami. It's unbelievable just how many drop-dead gorgeous women are there. An average woman in Miami would be one of the hottest women anywhere else.

2) More about the women: These gorgeous women go to bars and clubs wearing next to nothing, and then they give you a dirty look if they catch you sneaking a glance at their cleavage. Seriously, what the fuck??? If you don't want to be treated like a piece of meat, then put some fucking clothes on. One girl there wore a blue dress that wasn't even long enough to cover her entire ass. I had to do a double take just to make sure I wasn't seeing things. I wasn't even thinking of her as a sex object. If anything, I was completely embarrassed for her. I mean, half her ass was showing. I didn't get to see the front of the dress, but there was no way in hell that thing covered her goods. It was kind of disgusting.

Then there are the women who sit on the beach topless for hours on end in plain view of EVERYBODY. Then, when they decide to go in the water, they clutch at their tops every time a tiny wave comes... you know, because the waves might knock their tops off and someone might see their breasts. Pretty freaking stupid.

3) BMW 6-series in Miami are like Honda Accords anywhere else. I must have seen 10 Bentley GT's when I was down there. Eventually, the novelty of seeing Ferrarris, Porsche's, Lamborghinis, Mercedes, BMWs, etc, wears off. However, when you first go down there, every time you see a Bentley, you try to get a look at the driver because you're wondering which celebrity or athlete is behind the wheel. Then, you look and see some nobody in a wife beater. It's dissappointing and a little irritating because you wonder how the hell this guy can drive a Bentley while you're stuck in an old Accord.

That's pretty much all I have to say for now. I also had a semi-epiphany in Miami, and I plan to write about that in the near future. I'm tired now, so it will have to wait.

Monday, October 15, 2007

Peak Oil

I wrote this several months ago for another blog. For whatever reason, I feel like posting it here.

Here is a cold hard fact: We are either at peak global oil production or going to reach it in the next 5 years.

I don't think people understand the implications of that fact. Let me say this is another way: Within the next 5 years, we will be on the downward slope towards completely running out of useable oil on the planet earth. Most geologist estimate that somewhere around 2030, our planet will be completely out of financially feasible oil reserves.

Ever since Al Gore's movie (An Inconvenient Truth), the nation and the world has been obsessed with the idea of global warming. Everyone is talking about "going green" to stop the release of greenhouse gases that are destroying global ecosystems, melting glaciers, and causing our storms to become more intense. The idea is noble... but HORRIBLY misguided.

The real crisis facing the human race is not climate change. It is, infact, RUNNING OUT OF OIL. Perhaps we don't quite appreciate how much of our modern lives is entirely dependent on the assumption that energy is cheap and limitless. Just about every single thing we do in this country can be traced back to oil.

Let me give you an example from just one day in my life. When I woke up this morning, the first thing I did was turn on the television. TV runs on electricity. Electricity comes mostly from oil (or other fossil fuels). Then I checked my email on my computer that consumes electricity that we get from oil. Let's not forget that many of the parts in my computer are made with plastic that can only be made from oil. Oh yeah... my computer was made in a factory using electrical and mechanical processes that need to be run with energy we get from burning oil. The same could be said about my television. Taking it a step further, both my TV and my computer were most likely made over seas, then had to be shipped to this country on big cargo ships that use tons of fuel to keep them running. Once they reached this country, they had to be loaded onto trucks that run on gasoline and transported to their destinations hundreds (if not thousands) of miles away.

That was just the first 5 minutes of my day. Are you starting to understand the crisis we face as a civilization? The United States especially has a huge problem. The model of suburbia was made possible because of cheap, abundant oil. 10 years ago (even now!) no one thinks much of anything about getting in their car and driving 20-30 miles to work every day. Imagine a world where gasoline is so scarce that it costs $100 per gallon. Now, even if your car got 30 mpg, it would cost you $100 per day to drive to work. A lot of people don't make much more than $100 per day at work. Our towns and houses are so spread out that public transportation is literally impossible to implement. What would we do? We'd all have to go back to living within a couple miles of where we work, so that we could either walk or ride a bike.

That brings up another thing... what will happen to our jobs??? I'll talk about my job. I work in a pharmacy. We get drugs and other pharmaceutical products that are made all over the world. First, the drug companies require cheap energy to power their research facilities. They also need plastics for their research equipment. Once they've researched a compound, they need machinary in order to mass produce it. Once the drug is mass produced, it needs to be packaged and shipped to distribution warehouses using ships, trucks, planes, etc. From there, they need to be transported to my pharmacy in order for me to dispense them.

The pharmacy is entirely dependent on our computer systems. We use the computer to keep track of patient profiles, to order meds, and pretty much everything else. This all runs on electricity provided to us by cheap oil. Imagine if oil goes away or becomes prohibitively expensive. Drug companies wouldn't be able to research new drugs. They wouldn't be able to continue making their present drugs due to the cost. If they can't make the drugs, then what am I going to dispense. What will happen to my job? I have no idea.

Think about how much we complain now about present gas prices. It's over $3.00 per gallon now, and everyone is going nuts. Let me put it to you this way... I just filled up my tank for about $43 the other day. My car has only been averaging about 21mpg (even though it's supposed to be getting 30 hwy mpg). Even with that less-than-stellar gas mileage, I can drive 300 miles on 1 tank of gas. For $43, I can travel 300 miles. Think about that. That's really really cheap. Think about how long 300 miles is. That gets you almost 1/3 of the way down the east coast line... and we think that's expensive. The documentary I just saw put it in these terms. 1 cup of coffee can cost about $3 depending on where you go. 1 cup of gasoline, even by today's prices, costs you about 20 cents. Gasoline is less expensive than bottled water right now. It's essentially the least expensive liquid we have, yet we complain about how ridiculously expensive it is. In 10 years, depending on how far along the downward slope of oil production we are, gas could be $15 per gallon.

What kills me is that NOBODY IS TALKING ABOUT THIS!!!! We hear about global warming every damn day, but no one even mentions how we're a little over 20 years from being completely out of econimically feasible oil. If something isn't done quickly, our lives are going to change dramatically. There are 6 billion people on this planet right now. It's estimated that without fossil fuels, the planet can only support 1.5-2 billion people at most. Without cheap oil, we cannot produce enough food to feed everyone. We won't have enough jobs to employ everyone. There's going to be another great depression that brings about starvation, rioting, and panic. BILLIONS of people are going to die because our way of life is just completely dependent on oil.

Technological advancement will come to a halt because we won't have enough cheap electricity. In actuality, technology will digress. Planes will be a thing of the past. Microchips, computers, televisions... they all are only possible because of how cheap energy is. Without cheap energy, those can't be produced. Our great cities will have to shrink down to a more manageable size. The suburbs will be completely decimated because they will be too spread out and far away from grocery stores and businesses. All the things that oil is responsible for that we take for granted will go away.

This may sound very much like a doomsday prediction. That's because it is. We've had our heads up our asses (or perhaps more appropriately up the oil companies' asses) for so long that its probably too late to solve the problem. We've never invested any time or money into alternative energy sources because oil was so abundant that it was practically free. Now we're faced with trying to find enough energy to power our modern day of life without using oil. The alternatives we have our bleak at best.

Wind Power- wind farms are starting to pop up in the midwest. However, wind is inconsistent, and even the biggest wind farms produce an amount of electricity that can only be described as a drop in the Pacific Ocean of our current and future energy demands.

Solar Power- While it is very true that the total amount of solar energy that falls on our planet in 1 day is 20,000 times more than the amount needed to power our civilization, we've yet to find a great way to harnass that power. Current solar panels only convert about 12% of solar energy into electricity, and that is under absolute ideal conditions. Obviously, you can't make solar energy in the absence of sunlight, so we'd have no electricity at night or on cloudy, overcast days. The deserts of the southwest USA are ideal for collecting solar energy, but unless we develop some way to transport all that electricity to every other part of our nation, it won't be enough. Solar panels are also very expensive to make, so as long as there is cheap oil, no company is going to invest the money to research and develop better ones.

Hydrogen- This is the big one everyone is talking about. "We'll use hydrogen to power our cars." Well, there are a lot of problems with that. First off, unlike oil, there is no hydrogen just laying around our planet. In order to isolate hydrogen, you need to separate it from water through electrolysis. As implied in the name, electolysis require electricity. Therefore, it requires electricity just to create hydrogen. Right now, we actually spend more electricity in oil to create a hydrogen fuel cell than we actually get back from using it. That's not going to help us. Even if we somehow do perfect this process and make it more energy efficient, we have the whole transport process. We have no infrastructure to transport hydrogen. We have no easy way to store it. In addition, it's nowhere near as good of a fuel as gasoline for our vehicles because hydrogen is such a small molecule that it will actually diffuse through our storage tanks even when we aren't running the engine. If you let a hydrogen fuel cell powered car sit for one week then tried to run it, you'd find that it would be out of fuel.

Biodiesel- Global warming people love this option. "We can substitute biodiesel for gasoline." In short... no, we can't. For one, it requires a lot of bio-products to make biodiesel fuel. It's absolutely impossible to make enough biodiesel to replace the gasoline that is required by the 700 million internal combustion engine automobiles that are in the world. Secondly, it requires a lot of oil just to make a gallon of biodiesel fuel.

Ethanol- See biodiesel. Currently, it takes 3 gallons of gasoline to produce 1 gallon of ethanol fuel. Plus, we'd have to have a cornfield the size of the US to get enough ethanol to power our country.

Nuclear- Other than the safety and environmental issues regarding nuclear power, I'll say this: In order to meet the world's current energy demand using just nuclear power, we'd need 10,000 of the largest nuclear power plants built. With all those power plants, we'd burn through the earth's supply of Uranium 235 in 20 years. 20 years is obviously not going to help us.

As you can see, no single alternative even comes close to replacing oil, except one... Coal. We have tons of coal reserves. Probably enough for a couple hundred years, infact. However, if we use that coal, then you'd really see global warming speed up at a catastrophic rate. Therefore, it's really not a viable alternative.

So... as it stands, we are a little over 20 years away from full-on oil crisis, and we don't have a single option that will even come close to meeting our energy demands. In other words, everyone should enjoy their cars, computers, and comfortable way of life while we have it because in our lifetimes, the shit is going to hit the fan, and everything we took for granted is going to come crashing down.

Perhaps if we started making preparations 20 years ago, we'd have a fighting chance of evading disaster. Even today, nobody is thinking about this. Car companies are still putting out 300 horsepower family sedans. Electronics companies are putting out all new gadgets. Everything is going on as if the problem doesn't exist. Our leaders are aware, but instead of spending money to develop the technology that might save our future, we're going into the middle east to fight wars over whatever oil there is left. Believe me... Iraq has absolutely nothing to do with terrorism. It has nothing to do with Sadam Hussein. It even has less to do with providing freedom for the population. We want to set up a democracy there, and in the middle east in general, that will allow us to have access to their oil. As oil becomes more and more scarce, you can expect us to be involved in more and more conflicts with whatever countries have reserves.

In the end, it all goes back to oil... and when you really look at the writing on the wall, we're all fucked.

Sunday, October 14, 2007

George Carlin on Religion

I wanted to make this post for a couple reasons. For one, I've been listening to George Carlin standup comedy for the last few days and laughing my ass off. I haven't listened to a Carlin act in a while, and I almost forgot just how fucking funny he is. This clip is from "You Are All Diseased," which I think is his best one. Other noteable parts of "You Are All Diseased" include airport security, cigar smoking, angels, germs, and the advertising lullaby.

The second reason is that I can't possibly explain my view of religion any better than Carlin did right here. There's really no need for further ellaboration.

Wednesday, October 10, 2007


When I stepped out the door of the pharmacy today, my vacation began. I don't have to report back there until Tuesday the 23rd.

Of course, today had to be a crazy/busy/frustrating day. I knew there was no way I was going to get off easy. We worked short staff for most of the day. We're really pressing for good help in our pharmacy. Too many of our employees are students or have other jobs that prevent them from working a lot of hours. The ones who are able to work a lot don't know shit about the job.

There's this one women I work with who is as dumb as a brick. She's almost 70 years old and works whatever hours she can get in our store. She used to work as a front end cashier, but someone had the bright idea of putting her back in the pharmacy.

Don't get me wrong... she's a very nice lady. She's just stupid. She never owned a computer, and is entirely incapable of learning how to use one. Therefore, she needs help doing the simplest things. What irritates me the most is that she cannot even do a task as simple as pulling a script out of the bin and ringing a customer out without asking for a pharmacist's help half the time.

Here's how her average customer interaction goes:

customer: I'm here to pick up a prescription for John Smith.

dumb lady: Michael (she always calls me that, and it irritates the shit out of me)... Do you have anything back there for John Smith. There's nothing in the bin.

Me: Did you check the computer???

dumb lady: (runs to computer, looks up profile) It says it was filled yesterday.

Me: What's the medication?

dumb lady: Lipitor.

Me: That's done. It should be there.

dumb lady: I looked. It's not. I'll check again. (looks through bin again and comes up empty)

Me: (I stop doing whatever I was doing, go to the bin and pull it out in 2 seconds).

dumb lady: (exasperated) Michael!!! Where was that???

Me: In the "S" bin, exactly where it should be.

dumb lady: Ohhh... I was looking in the wrong bin the whole time. hahahahaha

This freaking exchange or some variation of it happens all goddamn day long. She can't help it. She's just a moron.... and I know that it sounds like (and is) an insult, but it's the truth. I don't hate her for it. I don't think her a bad person. I don't yell at her or make her feel bad. She's just not very bright. Again... she's extremely nice. She's just stupid.

She's one of those people that made it through her whole life because she was cute. You can tell that when she was young, she was really good looking. She probably had guys lined up that would do anything she asked. She's very personable and pleasant. Her good looks and pleasant personality got her wherever she wanted to go in life despite her being so stupid.

She makes my day frustratingly difficult though. The worst part of it is that I'm her favorite. She asks me before she asks anyone else, so I'm the one that has to deal with this shit all the time. She's so inefficient that it almost feels like her presence subtracts an employee instead of adds one. Therefore, on a day where we were already short staffed, she makes it seem like we're down another person because I have to do her job for her and always pay attention to what she's doing in case she screws up.

Whatever though... I'm on vacation!!!! No pharmacy frustration for nearly 2 weeks.

Tuesday, October 9, 2007

Someone game me flowers

Well... someone gave the pharmacy staff flowers.

Apparently, there is one person in the entire world that knows it is Pharmacist Appreciation Month. Hell, I didn't even know until a customer showed up with flowers a couple days ago. She was the daughter of one of our most frequent customers. Her mother is generally a nice person, but her advanced diabetes has caused her vision to deteiorate significantly, so she can get confused and irritable sometimes. The daughter told us she was giving us the flowers as a way of saying thanks for taking such good care of her mother. She said she knew her mother could be a handful, but she knows we do our best for her.

Having one customer like that makes me feel my job is worthwhile. Most (not quite all) of our pharmacy staff works very hard do give each customer/patient the best service and care possible. Often, with all the incessant complaining about wait times, prices, what is and isn't covered by insurance, and plenty of other things, it seems like people don't appreciate us. This one customer showed us that we are appreciated.

I've been at this store for a year, and now I really feel like I've gotten to know a lot of our regular customers, and they've gotten to know me. I feel almost like part of a community, and that's how it should be. Afterall, it's called "community pharmacy." Most of us have gotten into the habit of calling it retail. I think that's the wrong attitude to take. We should be taking advantage of our opportunities to interact with the general public.

That's really the key to advancing this profession. Fuck residencies and all the other clinical bullshit that pharmacy schools try to shove down the throats of pharmacy students. We don't need to vie for the respect of other healthcare professionals. We need to be more respected by our customers. We need customers to feel comfortable calling us for advice. We need customers realizing that we are the medication experts, and if they have a question about one of their meds, we are more qualified than anyone else to answer it.

It doesn't take much... A change in attitude can go along way. You have to be always be willing to go that extra mile to help someone. Instead of just pointing a customer to aisle 20 when they ask for benadryl, go out and show them where it is and talk to them about it. Show the customers that their questions are welcomed and not an inconvenience to you. Just show you care.

That's the most important message I can give anyone going into community pharmacy.

Monday, October 8, 2007

Here goes...

This was originally intended to be a pharmacy blog, but it has morphed into a diary of my thoughts and feelings that I don't tell anyone else. Since it's anonymous, it's pretty much the perfect place to just get things out without too much worry. In this post, I'm going to open up a bit more than I ever have before.

I'm hurting... bad. It's been a sudden onset thing. It's something that I didn't really expect. Nothing really brought it on. It just hit me like a ton of bricks. I'm anxious. I'm restless. I'm just not in a good place right now.

Basically, I'm horribly lonely. I have friends, but they're not like me. They don't value the same things. They don't like the same things. Even my best friends that I grew up with really are more acquaintances than close companions. I developed those friendships because I was a good basketball player, and that made me acceptable to the "cool" kids in school. The problem is that I was never a cool kid. I'm one of the nerds (even though I never studied). I like books. I like science. I like to have philosophical discussions. I like debating current issues. Basically, I like using my mind, whereas my friends just aren't at that same level as me. I'm not a partier. I don't go to clubs. I drink, but I don't really enjoy it. I do it because I have nothing better to do, and going to the bar is really the only social activity I do these days.

I don't have the "skill" to pick up girls at a bar, and quite frankly, I have no desire to. While most of my friends (and let's face it, most guys in general) look for a good looking girl and hope her personality is acceptable. I'm the exact opposite. I look first and foremost for personality and intelligence. I just hope that the smart girl with the great personality is a cute one. For me, a girl who I don't really pick out as being particularly cute when I first me her can become really attractive if I like her personality.

That's the way it was with my ex. She doesn't jump out at someone as being hot. She was really small (4'10" 82 lbs). Her teeth weren't really straight, and her face isn't beautiful. I mean, she's not unattractive. No one would say she's ugly. She just doesn't jump out at you. However, after becoming friends with her and really getting to know her, she just became unbelievably sexy to me.

I digress...

I'm just dying to have a connection with someone. I've been single for 2 years now, and for that entire 2 years, I wanted to get back with my ex. I still do. I still love her. No question about it. I also know that it's over for good. There is no going back. She doesn't want what I want. We've been through it dozens of times. She was adamant about it. It hurts. I can mask it for a while, but it always stays right under the surface, and the slightest little event can bring it out.

I went to a wedding last saturday and spent the entire night miserable. I was miserable for so many reasons. First, the last time I went to a wedding, I was still with her. Secondly, I saw the bride and groom and wished I could find someone to love and who'll love me that much. Third, I saw my friends dancing, smiling, and having a good time and wondered what stops me from being that way. A bunch of us got a hotel room to party at after the reception was over, but I left early. I just had to get away from there.

I don't want to be desperate, but I almost am. I have options now. I know a girl who likes me a lot. She's a pharmacist that's about the same age as me. There's a lot of things we have in common, and since she's a pharmacist that works for the same company as me, we have a lot of things to talk about. Overall, she's not my type though. She's very religious, and I'm about as far from that as possible without being disrespectful to others. She can be pretty annoying too. Despite the incompatibility, I'm seriously considering asking her out. I just feel such an overwhelming need for a companion right now that I'm just about ready to take any opportunity that comes my way.

I resubscribed to eHarmony. A lot of people don't like the way eHarmony does it's matching. They think the people on the site are too conservative. Well, you know what? I'm conservative... not in my political views, but in the way I go about doing things. I'm a simple guy who's idea of a fun time is dinner and a movie. I don't want to meet a million people. I'm not looking for someone to hook up with. I'm looking for someone I could potentially have a long term relationship with. That's just who I am. I'm just a nice guy. I'm quiet, reserved, non-confrontational, respectful, fiercely loyal, honest, and all those other nice guy things.

All I know is that I can't just sit around hoping that someday my ex will miraculously come back. It's not going to happen, and the longer I wait and hold on to that last sliver of hope, the more miserable I will be. I haven't made any effort to meet anyone in the last 2 years. I keep thinking that I'm young, and I have plenty of time to find someone and settle down. However, one by one my friends and coworkers of similar age are getting married, and I realize that I don't want to wait until my mid 30's to get married and start a family.

Therefore, starting today I'm at least going to forget whatever embarrassment I feel from online dating and just give it a chance. I really don't have any other way to meet someone, and I don't want to be lonely anymore. I'll think of this as an investment in my own happiness.

One thing is for sure, I can't keep going through life like I have been for much longer.

Sunday, October 7, 2007

I think I have some sort of disorder

I don't know exactly what kind of disorder it is, or if it even has a name. All I know is that I realized why I can't have fun in large, noisy groups.

Last night, I was at a friend's wedding. I was having a good time, talking, eating, drinking, all that good stuff. Then, the music started to get louder and the dance floor started filling up. All of a sudden, my happy mood turned into one of unrelenting stress. It ruined my mood for the rest of the night.

It kind of sounds like Social Anxiety Disorder, but the number of people isn't really the problem. What happens is that once the music gets loud, the bass starts thumping, and people are all over the place dancing, my mind goes on high alert. I keep catching movements out of the corners of my eyes, and I have to look to see what it is. Any time I hear a noise, my attention is immediately drawn there. I spend the whole time looking from place to place to see who's doing what and where. My senses get overloaded, and I'm just unable to focus on anything, whether it be dancing, having a conversation, or even eating.

My inability to focus makes it sort of like Attention Deficit Disorder, but the only time it pops up is in a very noisy place with a lot of people moving all around. Secondly, I'm almost 100% sure that even in that situation, if you gave me a test, project, or somthing else I have to focus on, I'd be able to block the rest out. It's just when I have to participate in what everyone else is doing that my mind enters alert mode.

All that being said, even if it was some sort of weird disorder, I would never even consider taking drugs or seeking professional help for it because it really doesn't affect my life all that much. It just pops up at weddings, parties, noisy bars, clubs, etc.

Actually, that's not entirely true. It pops up in the pharmacy too. When the phone is ringing, there's a long line, and lots of other things to do all at the same time, I have a hard time focusing. I end up bouncing from place to place trying to take care of everything. For example, I could be in the middle of typing a script, and I hear the phone ring. The ring sounds like a blaring siren to me. It completely interrupts my focus. I look around to see if anyone is picking it up, and if no one answers by the second ring, I have to answer it myself. I just can't stand to hear it ring anymore.

It also pops up on the basketball court for me, but instead of being a detriment, I think it helps me. Being a point guard, it's very important to know where everyone on the floor is at all times. Since I have this intense need to know who is around me, where they are, and what they're doing, I'm able to keep track of all the players on the court. This helps me pass the ball. It helps me dribble through defenses. It even helps me find openings to get my shot off.

Actually, now that I think about it, it affects most of the things I do. I'm the same way driving, which is why I've never had an accident or gotten a ticket. I'm intensely aware of what other drivers are doing. I even spot things on the side of the road that might have the potential to run out in front of my car.

In any case, it's an interesting observation.... to me at least. It sort of bothers me that I can't have a good time at bars, clubs, parties, or weddings, but that's not really my scene anyway. I much prefer more quiet get-togethers.

Sunday, September 30, 2007


Jim Plagakis posted an entry on his website that talked about how young, female pharmacists handle making much more money than the guys they date. It's a very interesting read, and I recommend everyone to check it out. I just figured I'd write about my experience as a young, male pharmacist who makes a lot more money than most of my friends.

I'd be lying if I told you that my primary motivating factors for finishing pharmacy school weren't the big dollar signs at the end. People talk about seeing the light at the end of the tunnel. I saw money. The company I interned with (and now work for) paid pharmacists roughly $50/hr for the time period I was on my rotations. I remember constantly sitting down and calculating my daily, weekly, monthly, and yearly salary using that hourly figure. It worked out to just over $100,000/yr.

It was a figure I almost couldn't even imagine. For my 6 years in college, I felt like I was rich if I had $700 in my bank account. Making that amount of money in just a little over a day of work blew my mind. My friends, most of whom graduated with 4 year degrees and were just starting to get jobs when I was getting ready to finish my 6 years, were talking about making $40-50 grand per year. I would be making more than double that.

I'm ashamed to admit it, but I bragged about it. Not a lot, mind you, but probably just enough where most of my friends knew how much more money I'd be making than them. When I finally got licensed and started getting my pharmacist salary, I was eager to show everyone the brand new $30,000 car I bought. I didn't mean to shove it in their faces. I just wanted people to check out my car because I liked it a lot.

The extra money allowed me to take part in things I didn't normally do because of my previous conservative spending ways. I started sitting in for weekly poker games, in which the buy-in was $40. Most of my friends I played with were making $12-15 per hour. With $40 buy-ins, $40 rebuys, and some pots getting in the hundred of dollars range, this was a lot of money for these guys to be gambling. I'd go to the card game and drop $40 on a hand without even thinking about it. After all, that wasn't even an hour's pay for me.

It wasn't long before a few of my not-so-close friends started referring to me as "Moneybags" because I made so much more money than everyone else. This is when I realized that I needed to stop even giving people any idea of the kind of money I made as a pharmacist.

Now, being a realist, I know that making $100,000 per year doesn't make me filthy rich. It makes me comfortable as a single guy. I can't afford a really really nice house or a BMW 7-series. I can't go out and spend $3,000 on a watch or a suit. However, compared to my friends, I'm rolling in dough. I don't think I have one friend that even makes half of my salary.

Therefore, the money occasionally seems to be a point of contention with my friends, and it hasn't helped make me even the least bit more desirable to women (not that I really think it should). Not that I'm ready to give away my salary, but sometimes I wish I had a job where I made a lot less. At least then, I wouldn't feel so different than the rest of the people my age.

I kind of lost my initial chain of thought midway through this post, so I'm going to stop now...

Saturday, September 29, 2007

I have a confession to make

I know this sounds crazy, and it certainly seems to go against the popular opinion of pharmacist bloggers. However, I must admit that I actually like retail pharmacy.

I'll give you a minute to process what I just said.... In fact, I'll even say it again in case you didn't get it the first time. I like retail pharmacy. Honestly, I do.

I didn't like it initially. In fact, I hated working in retail ever since I started as an intern in 2004 up until the end of last year after I got licensed. I used to complain, and rightfully so, that retail pharmacy had nothing to do with what I learned in pharmacy school. In fact, I would have been just as prepared to be a retail pharmacist if I went to pharmacy technician classes instead of pharmacy school. As I stated in a previous post, you don't need to know a whole lot about drugs to be a retail pharmacist. 90% of the questions you get asked can be answered with tylenol, benadryl, or senna + docusate.

It took me a while to come to grips with the fact that I would never use most of the drug information I learned. This was hard for me to accept because I was an exceptional student. Coming out of school, my knowledge base was as good or better than anyone in my class. Plus, I had good problem solving abilities, and I had (and still have) a talent for being able to explain things in simpler terms that patients can understand.

I was going to do a residency. I had gotten my applications together and got a couple letters of recommendation from my preceptors. One of my preceptors pretty much said I was the best student she had ever had on her rotation, and she all but begged me to do my residency at her site. I ended up abandoning the residency idea after going to my school's "interview day" (which is pretty much a day when representatives from all the chain stores and local hospitals come to your school and tell you how much money they want to pay you to work for them). It was just impossible for me, a broke college kid, to turn away from the 6-figure salaries of retail.

While I loved the money, my pride was hurt because I knew that a lot of lesser students in my class were going to do residencies, and they would be looked at as the "smart" pharmacists and drug information experts. Then I heard which students got the residency positions to which I was going to apply, and it really bothered me knowing that I would have been 1,000x better than any of them in that position.

You can tell that it still bothers me a bit, but it doesn't bring me down like it used to. Basically, I had a change of mindset that allowed me to get beyond this. I stopped worrying about being respected by my clinical pharmacy peers. Now, the only thing I worry about is how I'm perceived by our customers and my coworkers. There's this notion that clinical pharmacy is an exclusive area that not every pharmacist has the ability to do successfully. Well, the same is true of retail pharmacy. Not every pharmacist is capable of handling the rigors and tress of retail. I can. Most of my preceptors, who were supposed to be these great leaders for the profession of pharmacy, could not. What actually separates me from them is that I could just as easily have done either clinical or retail. I choose to stay in retail, because in the end, I like it better.

Yes, asshole customers suck. However, there aren't really all that many assholes out there. We just tend to remember them more than the nice ones. Generally though, I like my days in the pharmacy. I like the fact that we're really busy, so 10 or 12 hour shifts just fly right by. I like having 3 days off per week. I like thinking of ways to better organize the workflow, so that my day goes by more smoothly. I like figuring out the glitches in our computer software that no one else can.

So call me crazy, but I actually like my job.

Posting drunk

So, I just got back from going to the bar with a bunch of friends. After 3 beers, 2 Long Island Ice Teas, 2 strong Jack and Cokes, and an Alabama Slammer, I can safely say I'm a little drunk. I don't get drunk very often, and when I do, my personality doesn't really change at all. I just get stomach sick and less coordinated. Perhaps, I loosen up a little bit, but not enough to do something out of character.

In any case... While I was there, this really cute girl was sitting with a couple friends in a booth no more than 10 feet away from our table. She had a really pretty smile, nice hair, nice eyes, and just very pleasing to the eyes overall. She kept looking over at our table and specifically looking at me. I knew she was looking at me. She knew I was looking at her. She was just sitting there waiting for me to go over and talk to her. Her and her friends sipped their last drink for like an hour just waiting.

Did I ever go over? No, of course not. Why? Because I have no balls. Now, I know that a bar isn't the greatest place to meet women, but I'm pretty sure just by the way this girl presented herself that she wasn't some slutty girl just looking to hook up with someone. She seemed genuinely nice... at least from what I could discern by looking at her. Even if I was wrong, what harm could have come from just going over, talking to her, buying her a drink, maybe asking if she wanted to dance? I had nothing to lose. Hell, I would have probably been the best guy she could have met in that entire bar, at least from the point of view of respectability.

In a nutshell, that's why I sit home alone on weekends instead of having a girl to go out with. I'm too afraid to make that first move, even though I know exactly the right things to say and the right way to act. The girl tonight was so pretty and had such a sweet smile. Even one of my friends was telling me that she looked like she wanted someone to go over and talk to her. We were making eye contact with each other all night. All those things weren't enough for me, so instead of getting to know some pretty girl, I spent the night getting drunk with a bunch of guys.
I've been truly single for a little less than a year now. I say "truly single" because for the whole year after my ex and I broke up, I thought we would get back together, so I didn't even consider dating anyone else. So, in that 10 or 11 months, I've had exactly 3 dates, none of which were with girls I was even remotely interested in. It's perplexing that I, a decent looking, smart, caring guy with a well-paying job, hardly have any attention from the opposite sex. I keep telling myself that all I have to do is put myself back in the dating pool, and I'll, at the very least, be able to get some dates.

Once again though, it's a friday night, and I'm home alone, and other than that pretty girl from the bar, the only thing I can think of is how I wish I was still with my ex. Drug Monkey told me once that someday I'll just wake up and not care if she's dead or alive, and it will be the greatest feeling in the world. It's been almost a year, and I'm still waiting for that day. I hope it comes soon so the next time I'm at the bar and some pretty girl with pretty eyes and a pretty smile is looking at me, I'll have the cajones to say something to her.

Monday, September 24, 2007

I need to learn my crap

One thing that has been made abundantly clear in the last few months is that I know next to nothing about treating constipation. This creates a problem because it seems like every freaking question I get asked is what to use to make someone shit.

The only thing I know about laxatives is that every person receiving opioid pain relievers should be on senna and docusate. Other than that, I have no idea when to use an enema as opposed to miralax. I don't know whether miralax works better than mineral oil. And where the hell does bisacodyl fit in all this.

I can tell you how the laxatives work. I just have no idea when to use one over any of the others. Moreover, I never understood this whole obsession with bowel movements. Maybe I've just never had a problem moving my bowels. I don't know. Whatever it is, it seems like people are obsessed about being "regular," whatever the hell that means.

I'm just sick of all these constipation questions. Why can't someone ask me about their beta blocker or ACE inhibitor? I know that stuff. I've had a million classes and rotations that deal with them. I think I had one 50 minute class on constipation in my entire time in pharmacy school. I'm not adequately prepared to talk to people about their shitting habits.

While we're on the subject of questions I hate.... I hate it when a parent comes to me and asks me for advice on what medicine to give their 2 year old who has a cold. I know that dimetapp or triaminic will help. I know that the doctor is going to tell them to get one of those products. However, because of the labeling on the box, I can't recommend them without a doctor's approval. See, the labeling for antihistamines says to consult a doctor in children under 6 years old. The labeling for phenylephrine (a decongestant that may or may not work) has no dosing for children under 12. Even though I can find the proper dosing for any antihistamine product, I can't give out that dosing information without a doctor's approval because that falls under the category of prescribing, which is something pharmacists can't do.

Actually, now that I think about it, I almost never get asked a question I'm comfortable answering. I often get asked by older people what to use for arthritis. Now, I know most pharmacists would quickly point them in the direction of the ibuprofen or naproxen. I, on the otherhand, think about how NSAIDs aren't particularly great drugs in the elderly population due to the risk of GI bleeds as well as studies that have shown NSAIDs actually increase the risk of falls in the eldrly. I usually recommend against NSAIDs in patients 65 or older unless recommended by a physician. If I'm forced to give an answer, I'll recommend tylenol. "But I've tried tylenol and it doesn't help!", they say. The only thing I can tell them is to talk to a doctor.

Same thing with OTC sleepaids. I don't recommend tylenol PM, Simply Sleep, or any of those antihistamine sleepaids to many people and certiainly never to older people. If a relatively young person has trouble falling asleep every once in a while, I'll tell them to try some benadryl, but only if they're going to use it occasionally. In older people, antihistamines like diphenhydramine (benadryl) and doxylamine have too many anticholinergic side effects to recommend. People are almost never satisfied with this answer.

Cough and cold meds: We all know that dextromethorphan does absolutely nothing to suppress coughs, so even though I do recommend Delsym and Robitussin DM regularly, I do so knowing that they don't really work. Furthermore, guaifenisen (Mucinex) has never been shown to do much of anything to break up congestion, but it's still out there being marketed for it. How can I not recommend the product if it says "RELIEVES CHEST CONGESTION" right on the box.

In any case, I have today off after working Friday, Saturday, and Sunday. I'm going to watch some baseball, drink a couple Sam Adams' Octoberfests, and just generally relax for the next couple of days before I have to go back to work Wednesday.

Saturday, September 22, 2007

My once promising future...

What seems like ages ago (really only a little more than 10 years), I used to be a pretty good basketball player. In fact, I was better than pretty good. I could do things on a basketball court that pretty much no one else my age could do.

I started playing basketball when I was 7 years old. I didn't seem to have much natural ability. I wasn't immediately one of the best players. However, that all changed when I watched the movie Pistol Pete: Birth of a Legend for the first time. It was a story about Pistol Pete Maravich's first year playing on his high school team. That movie, for better or worse, changed my life forever.

I watched in awe as the actor who played the young Pistol Pete dribbled the ball through his legs, around his back, threw around the back passes, between the leg passes, spun the basketball on his finger, and did all the things that made Pistol Pete famous. I must have watched the movie 1,000 times, and I spent literally hours every single day just practicing the dribbling, passing, and ballhandling drills I saw in the movie.

I was 9 years old when this obsession began. During this time, my basketball skills grew exponentially. Meanwhile, my social skills went to waste. I didn't chase around girls at recess. I didn't play games with my classmates. I dribbled a basketball. I dribbled to the bus stop. I dribbled every second of recess. I dribbled back home from the bus stop. I dribbled up and down my driveway for hours when I got out of school. The basketball became a part of me. All my hopes and dreams revolved around that ball. It not only became a part of my identity, but it actually took over my entire identity.

Needless to say, with that much time spent practicing my ballhandling, I far surpassed EVERYONE my age. I didn't get the courage to use one of my "fancy" dribbles in a game until I was 11 years old. By that age, I had practiced so much that it had become second nature to me, so in one game where a kid tried to reach for the ball to steal it from me while I was in the backcourt, I just quickly put the ball behind my back and discarded the defender like he wasn't even there. I remember feeling shocked that I actually did that in a game. However, that shock quickly faded into the realization that I was completely ready to showcase my talents.

From that point on, I put on a show in rec leagues that a lot of parents will remember to this day. Kids from other schools who I never met knew about me. Word spread around the league that there was this little guard who can dribble a basketball like no one else.

There's this one game in particular that always stands out in my memory. I was in 7th grade at the time. We were playing against the best team in the league. This team had a guard on it that was supposedly the best defensive player in the town. He could shut down anyone supposedly. Well, it took about 5 minutes for the whole gym to realize that he never played against anyone like me. Every time he reached for the ball, I'd leave him behind with a between the legs crossover. I'd set him up going one way then quickly put the ball behind my back to get passed him. I'd bait him to reach for the ball and double clutch crossover to go by him. I could do whatever I wanted with the ball, and there was nothing he could do. It came down to the last 3 minutes of the game, and we were hanging on to a slim lead. My coach told me to basically keep the ball and make them foul me, so I'd have to shoot freethrows (I was an excellent freethrow shooter). Well, I spent the next 3 minutes dribbling around double teams, going between my legs and behind my back all over the court while they desperately tried to get the ball from me. They never could, and we won that game.

Playing on my middle school team brought similar acclaim for me. I was a one man press breaker. We didn't even work on how to break presses. The only thing we worked on was how to get me the ball, so I could dribble through it. I was a little guy, but players were afraid to guard me. I remember one coach put a player in and told him to try to cover me full court. The player went to the coach, "I can't guard him. He's too fast."

I come from a predominantly white town, and we entered our team into an inner city league that was predominantly black. The first team we ever played in that league was this all black, super athletic team that thought they could full court press the white boys out of the gym. I dribbled through their press I think 6 or 7 times in a row before the coach decided it obviously wasn't going to work. He then put a player in the game that the whole team knew as "Speedy" (obviously because of his speed). His job was to follow me everywhere I went on the court. To put it simply, I made "Speedy" look pretty bad. After the game, even players on my own team were pretty impressed saying to me, "Mike (I wasn't Pharmacy Mike back then), you were too fast for "Speedy."

My coach at the time was a guy who coached Middle School and High School basketball in some of the most talented areas of the country. He was now in my area because he moved there with his son. He coached his son's teams whenever he could, and I happen to play for on his son's basketball team. He used to tell people, "I've seen a lot of really good guards in the years that I've coached and played basketball, but I've NEVER seen anyone like Mike."

I won MVP awards, Most Outstanding Player awards, All-Tournament Team awards, awards for having the most potential, free throw shooting contests... you name an award, I got it. So you might ask yourself, if I was so good at basketball, then why the hell did I not become a high school and college star? Why did the accolades stop once high school began? What happened?

I'll tell you what happened.... All the time spent living and breathing basketball alienated me from my classmates. With a basketball in my hands, I was king. Without a basketball, I was so painfully shy that I wasn't able to talk to a girl without shaking like a leaf until my sophomore year of high school. The realization that basketball was the reason I was socially undeveloped compared to kids my age devestated me. It made me hate the game I had loved for most of my childhood. However, no matter how much I resented the game for what it made me, I couldn't escape it. Afterall, it was my entire identity. Therefore, I continued to play, except I didn't enjoy it anymore. I stopped practicing. I developed a major confidence problem, and while I was a decent player in high school, I never became the star that I was capable of being. I wilted under pressure from my teammates and coaches. I shut down emotionally on and off the court.

My schoolwork never suffered because school was always ridiculously easy for me. However, every other part of my life did. I'm still recovering from it to this day. It seems like such a long time ago, but the disappointment and regret is right there under the surface. I've made great strides to get back to near social normalcy. I'm proud that I'm a pharmacist not because pharmacy school was difficult to pass. I'm proud because being a pharmacist is a position of leadership, and the fact that I've come so far to be able to competently lead a pharmacy by myself on a Saturday when I'll fill 300+ scripts with only a few clerks and no actual pharmacy technicians is nothing short of amazing to me. Ten years ago, I wouldn't have thought it possible.

Even still, I can't help but think back and wonder what if I had spent less time with basketball and more time doing the normal things kids do. Maybe I wouldn't be sitting here typing this at 25 years old only having had 1 serious relationship (albeit a 6 year relationship) and only 2 or 3 people I can consider good friends. Maybe I wouldn't be a pharmacist. Maybe I'd be a doctor or have some other very important job where I can actually help to make a difference in the world.

I continue to wake up every morning, go to work, come home, only to wake up again to do it all over again..... and again, and again, and again. I think the only thing that keeps me going is the hope that one day, I'll get the opportunity to showcase all of the abilities of the person I know I can be, but have always been too afraid. I think it might be like that first behind the back dribble. Just one day without even thinking, I'll do or say something that lets my abilities and personality shine, and from that point on, I'll be able to live without my senseless inhibitions.