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.