Friday, June 29, 2007

Lonely Times

This post will pretty much have nothing to do with pharmacy. No one is reading any way, so it's not like I have expectations to meet.


I mentioned in my first post that I haven't been in a relationship since I broke up with my longtime girlfriend nearly 2 years ago. To make it clear, I did not break up with her. She broke up with me. However, the breakup was more of a step back to try to figure things out than a clean split. We remained very very close friends for a year after the breakup. We still hung out together often, and we talked on the phone nearly every day. We loved each other, but we were in different places in life, so we couldn't make a real relationship work.

I just assumed that once things settled down for the 2 of us, we'd get back together. I never wanted to leave her completely. I didn't even attempt to date anyone else. I wasn't in the market for a new girl. I just wanted to finish pharmacy school, get licensed, and then once all that was squared away, turn my attention back to her and us.

Unbeknownst to me, she had different views. While she initially wanted to get back together with me, I guess the process took too long. She decided that she had to move on, so she started dating other guys. I never knew about this. All I knew was that she was calling me every night, and we'd still go out to dinner and to the movies all the time. She never told me she was seeing other people until last November. When I found out, I went into panic mode because I realized for the first time that I might really lose her. I told her that I still loved her and wanted to be with her again, but she told me she no longer felt that way. I was crushed.

We remained friends for another couple of months. Then, in January, she sort of fell out of contact with me for a little while. After a week of not hearing from her, she sent me an email telling me that she was unloading her emotional baggage and was now seeing someone. I begged and pleaded with her to give us another chance, but she flat-out refused it. I was so heart broken that I wanted to die. I was going to marry this girl. We talked about marriage all the time. We were together for nearly 6 years. My life was so intertwined with her's that I couldn't possibly imagine living without her.

Fast forward to today.... It's been over 6 months since I've seen her. I don't sit around all day crying like I did for the first couple of weeks. Instead, I feel numb inside. I loved her with every bit of my heart, and now that she's gone, I've lost a bit of myself. That's something I can never get back. Even if I do meet someone else, it will never be the same, and I'll never be able to truly love again because my heart is still with her.

I'm sorry if this sounds sappy. I know that most people reading this are thinking, "Man, why don't you grow a pair?" Well, I wish it was that easy. On most days, I'm OK with it. On most days, I think there's hope for me in the future. However, every once in a while, something will trigger me to think about her. Then, when I think about her, I always end up picturing her with that other guy, and it drives me crazy. Some other guy is taking her to dinner. Some other guy is talking to her on the phone. Some other guy is getting her affection. Some other guy is having sex with her. Maybe the worst part is that she's out there doing these things with another guy. While I'm sitting her on a Friday night checking my email and my cellphone every 30 seconds to see if someone, ANYONE acknowledged my existence, she's out with her new guy and enjoying every second of it.

There are a lot of things I'm very confident about. I'm extremely confident that I'm smarter (or at the very least as smart) than anyone I've ever met. I'm confident in my knowledge that I'm a good and decent human being. I know that I treat everyone with respect, and I also know that my demeaner and professionalism command respect from others.

One thing I'm not at all confident in is my ability to be a good boyfriend. I always loved her, and I treated her well, but I made our relationship more difficult than it had to be. I never thought the little things mattered, so I didn't make an effort to buy flowers or shower her with gifts. We never went anywhere or did anything exciting. A huge part of it was that I was broke when I was in pharmacy school. Now, that I'm out of school and making the big bucks, I want to go out and do things with her that we never had the chance to do before. However, she wouldn't give me that chance. Now, she could be out doing all those things with someone else and thinking to herself, "Wow... I never realized what a crappy boyfriend Mr. RPh was until I met John (not the actual name)." Being a competitive person, I want to prove to her that I'm more of a man than that guy, but I can't, and it eats at me.

That brings me to where I am now. I feel like the loneliest guy on the planet. I sit alone in a one bedroom apartment all day on my days off. No one ever calls me. I don't really have anyone to call. I have nowhere to go, nothing to do. I make all this money, and I have nothing to do with it. Life sucks for me now. I'm trying to come up with a way to make life more meaningful, and I figure a blog like this could sort of give me some direction. I'm hoping that I'll eventually develop a following of readers (my hopes aren't all that high though).

I'm starting to lose my chain of thought. I promise my next post will be geared towards pharmacy or the news in some way. I just had to get this out of the way.

Tuesday, June 26, 2007

Curse My Conscientious Heart

At my pharmacy, being a good, hardworking, conscientious pharmacist reward you with staying 2 hours later than your shift ends because there are still 30 scripts waiting to be typed and a never-ending line at the registers. I can't, in good conscious, leave my fellow pharmacist coworkers in a precarious situation like that, so I stay until we are all caught up.

It shouldn't be this hard, but the store is filled with incompetent employees. I'm not blaming them, mind you. It's not their fault that no one ever got a chance to train them to use the computer software. It's not their fault they don't know when to look in the "big" section when the customer is picking up a prescription that's too big to fit into the bins. Instead, I blame the management (which doesn't include me) for hiring so many non-technician personnel. Our pharmacy fills over 2,800 scripts per week, but we only have 3 licensed pharmacy technicians that work a significant amount of hours. The rest of the staff are untrained clerks. Therefore, the pharmacists pretty much do everything.

It's really tough. I spend half the day spinning around in circles going from PC terminal to PC terminal, answering phone call after phone call (and that goddamn phone never stops ringing!!!!!), checking our voice mail for prescriptions, helping to solve insurance problems etc.

The sad part is, the more pride you take in your job, the worse the stress becomes. I feel guilty not going above and beyond to solve someone's problem or answer someone's question. I bend over backwards to help all our customers (no matter how loathsome they might be) because I feel it is part of my responsibility as a pharmacist.

On the otherhand, you could have some lazy pharmacist who doesn't bother to call doctors when the insurance requires a prior authorization, won't call insurance companies for vacation overrides or to obtain eligibilty information when customers don't have their cards or if they have the wrong ones, etc. That pharmacist doesn't care enough to help his customers, so his day is made easier by not taking that extra step.

Perhaps, I'll learn that the only way to survive this profession is to become one of those pharmacists. I've only been licensed for less than a year, so I haven't quite become completely bitter with my job. I never had the rosy-idealistic view of the profession that they try to instill in you in pharmacy school. I always knew that retail pharmacy was a bullshit profession for the most part.

Think about it: How much do you really have to know to type what the doctor wrote down, grab a bottle off the shelf, count out a few tablets, then label the vial?? I know some technicians that could run a pharmacy better than most pharmacists simply because they have some common sense, and they've been doing the job for a long time. Most of retail pharmacy is learned through experience. Right after I graduated, I still didn't have the slightest clue how to deal with insurance companies. I had all this clinical knowledge, but clinical knowledge has next to nothing to do with retail pharmacy. If you understand insurance companies, you're an excellent retail pharmacist.

As for customer questions... just about anyone is qualified to answer a question about what to use to treat poison ivy. Stuffy nose, Sudafed. Allergies, Claritin or Benadryl depending on whether you want something non-drowsy. Pain, tylenol or motrin. That covers just about everything you'll ever have to know. Anything else, you can look up just like every pharmacist does. I got a question today, "Can topamax cause your face and feet to feel numb and tingly?" I didn't know for sure off the top of my head, but having Lexicomp on my PDA, I could look it up in less than 10 seconds. I could have given my PDA to the store's porter, and he could have figured it out.

Moreover, even if you use your vast clinical expertise and catch a significant interaction, upon calling the doctor, the response is almost always "that's fine, we'll monitor." Just about the only time doctors will switch a med is if it interacts with a patient's coumadin. Other than that, they couldn't give a shit. I've been ridiculed several times for even bring up a cytochrome P450 interaction to a doctor. "What? Did you look that one up in your little pocket reference?," said one physician after letting out a good chuckle. Now, unless I get a big red DUR warning screen, I don't bother calling. In fact, I probably only call the physician on 5% of the severe DUR warnings that I get. It's just pointless to waste my time when I know for certain the doctor will just shrug it off.

Anyway... since I sort of got off on a tangent, I'll end this here.

Monday, June 25, 2007

They Don't Teach Prescription Writing in Medical School

Before I get into the meat of this post, listen to this customer complaint today:

Customer: "I'm here to pick up 2 prescriptions my doctor phoned in."

Tech: (After checking the computer and asking me whether I had anything yet to be typed for her) "Your doctor hasn't called anything in for you yet."

Customer: (now angry) "Maybe I'll go to Walgreens to get my prescriptions."

Tech: (confused) "Did your doctor call in your prescriptions to Walgreens? Would you like me to call them?"

Customer: "No, I've never been to Walgreens, but maybe I'll start going there now."

The customer then stormed off. Apparently, it's our fault that her doctor did not phone in her brand new prescription to our pharmacy in a timely manner. Next time, I'll remember to break out my good old pharmacist clairvoyance and call this complete stranger's doctor before she gets a chance to show up.

On second thought... even if I had that power, I wouldn't do that. Fuck her.

Another thing that pissed me off today were the endless prescription problems. Why is it that the only profession that truly knows how to write a prescription properly is unable to prescribe??? Do they teach prescription writing in medical school? Hospital doctors are the absolute worst at this. They work in a place with a kabillion other doctors and practitioners who prescribe. The prescription blanks contain no information other than the hopital to which the doctor belongs. Sometimes the hospital's phone number isn't even on the blank!! Despite this, the fuckhead doctor thinks it's perfectly valid to scribble everything on the script in such a way that not even a CIA handwriting expert could decipher what it says or to whom the writing belongs.

This leads to the always fun task of calling the hospital. Those in the profession know exactly how exhilirating this can be. For those who've never had the pleasure of doing so, I'll paint you the average scenario:

Upon calling, the first person you'll talk to is someone from the hospital answering service who can do nothing but tell you the patient was, indeed, at the hospital on the day the script was written. Being otherwise useless, said receptionist will transfer you to her best guess as to the department the patient was seen when the script was written. Usually, they send you to the ER first. From there, someone will pick up the phone, have no idea what you're talking about, and place you on hold. 2 minutes later, a different ER person will pick up the phone, look through some computer and decide that the person was seen in wing 2, so she'll transfer you to that department. Someone from wing 2 picks up the phone, whereupon you'll have to recite the same spiel for the 4th time ("Hi, this is Mr. RPh from Busy Retail Pharmacy. I'm trying to clarify the directions and find out the doctor who wrote this prescription for Pain-in-the-ass Patient. What? Do I know which doctor wrote it? No, I'm sorry. I can't even make out a single letter in the signature. Can I hold? Sure, I'm now only about 20 scripts behind thanks to Doctor Fuckhead's inability to write more legible than a 2 year-old, but don't you worry... I'll hold.")

Anyway... after being transfered around a couple more times, you end up finding out that the script, even though written on a hospital blank, wasn't from the hospital, but instead was written at the clinic just down the road from the hospital. They can't transfer you, but they'll give you the number. Finally, you call the clinic and find out Doctor Fuckhead was actually Doctor Smith, and he didn't really mean to write the prescription for Tylox 5/325 (which doesn't exist). He actually meant Percocet 5/325, which has the same active ingredients, but the different dosing somehow qualifies them to be entirely different products. Technically, you can refuse to fill this script because doing so requires the pharmacist to make an alteration to the prescribed drug on a Narcotic script (a big no-no according to the DEA). However, you just don't feel like dealing with the stupid run around again, so you just mark it on the script and try to catch up with the work that piled up during your 20 minute transfer-fest.

The wave of the future is supposed to be this e-prescribing, where a doctor just punches a prescription into his PDA, and it gets beamed electronically to the pharmacy. It's supposed to cut down on prescription errors. In theory, it sounds great. Pharmacists won't have to guess at doctor's terrible handwriting. In practice, you gets scripts like this (actual prescription order):

Drug: Hydroxyurea 500mg
Dispense: 5 capsules (30 days)
Sig: 80mg/kg per day

This prescription is impossible to fill even if I knew the weight of the person to which it was prescribed. Your guess is as good as mine as to how the prescription got sent in that fashion. I assume the doctor chose the drug, and then messed up on some sort of preset dosing form, but who really knows???

You also get scripts with directions that read like this:

Lipitor 10 mg
Dispense: 30 tablets
Sig: 1 tablet with food by mouth daily by mouth at bedtime with food.

If you have a really lazy pharmacist, that's what the directions will end up saying on the patient's prescription bottle.

See... one of my coworker's theory is that the average brain can only contain so much information. Four years of premed, 4 years of medical school, 1 year internship, and 2 years of residency pretty much fill doctors' heads with so much medical information that common sense gets crowded out.

Personally, I think that most doctors aren't any smarter than anyone else. They're just big, overachieving nerds who spent all of their academic life doing nothing but studying all day. They're not brilliant. They just work a lot harder at it than the normal person, while not truly having superior intellect. Of course, from my experience in retail pharmacy, I've come to learn that the average person is a fucking moron. Hence, most doctors are morons that just work a lot harder than the average person at not looking so dumb.

I need food.

Sunday, June 24, 2007


This is my first attempt at an anonymous blog. I've been working as a pharmacist for a busy retail chain store for a little less than a year, and in that time, I've accumulated a lifetime's worth of stories about idiotic customers, insurance companies, drug companies, etc. Since that stupid pharmacy has dominated the last year of my life, I haven't had much chance to share my ridiculous thoughts, so I figured this would be the place. The blog will probably start out slow as I search for topics to discuss, but fear not, give me a couple weeks, and I'm sure I'll gain a full head of steam.

Let me start my first blog post on a non-pharmacy related topic:

I'm single. I've been single for a little less than 2 years coming off of a 5 and 1/2 year relationship with a girl I thought I would marry. Not getting into specifics (I'll save that for another time), she went to Law School, thought to herself that she's rather hang out with scumbag lawyers who spend big bucks wining and dining clients at "hip" downtown bars and clubs instead of being with a regular, down-to-earth, pharmacist-to-be like myself. Am I bitter? Yeah, a little bit.

Anyway... Like I said before, I've been single for nearly 2 years. I also haven't been laid in that same amount of time. Now, on almost every level, this doesn't make a lot of sense. I'm not socially awkward. I'm only as weird as the next guy. I'm not bad looking. I'm in good shape. I'm intelligent. I have a good job. I have a 6-figure salary, and a nice car. I have a nice, thick head of hair. On paper, I should be batting the girls away with a stick. In reality, I get nothing.

You know what though? I'm almost alright with that. I suppose I've never been smooth with the ladies, so I never expected to have beautiful women throwing themselves at me. What really gets to me is when I'm out somewhere (grocery store, mall, movies, wherever) and I set my eyes on a drop dead gorgeous example of the opposite sex. You know, the type that makes you just stop for a moment and mutter "damn" under your breath. Then my gaze shift over a couple feet and see her standing with some pasty white guy wearing a wife-beater and torn up jeans, who looks like he hasn't shaved or bathed in 2 weeks. Without fail, the guy is driving a circa 1990 Honda Civic with a missing hubcap on at least 1 wheel.

Compare and contrast here.

Me: Clean cut. Clean shaven. Athletically built. Wearing bananarepublic clothes. Driving a luxury car. Got cash to spare.

Him: Just think Kurt Kobain without the talent or money.

If the guy treated her incredibly, it would be one thing. Most of the time, these pasty white scumbags treat women like shit. However, they never seem to be without a hot young girl on their arms. This made me realize what seems to be the key to dealing with women. It doesn't matter if you wear a wife beater, just as long as you wear it with confidence.

I honestly can't think of another explanation.