Paranoia

I was walking down the hallway today and saw a sign on a water fountain that said DONOT USE! Now, at first I thought that perhaps someone just forgot to put a space in between "DO" and "NOT." However, as the day passed I started to realize that perhaps they just misspelled "doughnut." It happens, spelling is hard, and often confusing.

I then wondered why doughnuts got their own water fountain. Yes, they are delicious, especially because they're pretty much a piece of cake shaped like a bagel with sugar coating the entire thing. That's pretty awesome, but why should that give them the sole right to a water fountain? The powers that be must be prejudiced against non-doughnut breakfast foods. They can't even argue "separate but equal," because the doughnut water fountain is closer to the bathroom and taller than the other. Can you imagine the strain bending over to drink from the smaller fountain will put on the average breakfast food's back? Do you think eggs can handle that when they can't even decide if they're healthy for you?

Cereal is completely screwed. Every time it wants a drink of water milk will spill out due to the increased angle it must dip to to receive the water, and we all know that milk is the life-blood of cereal. A couple drinks from water fountain and cereal will need a milk transfusion. Emergency rooms will need to stock more 1% milk, which is the universal donor of milk. The skyrocketing demand for 1% milk will cause hospitals to stockpile it, forcing them to use more energy to keep it refrigerated. Thus, more carbon will be spewed into the environment, causing more global warming.

Separate water fountains for breakfast foods is causing global warming. I brought this up to the Dean, and he gave me a blank look and told me to leave. I'm beginning to think that perhaps this is a conspiracy the doughnuts are using to destroy the world. Doughnuts are notoriously bad spellers, so it makes perfect sense.

Or maybe someone just forgot to hit the spacebar.

Our Role

I recently had a drunken conversation with another pharmacy student about the role we will play once we are pharmacists. My friends know not to bring up pharmacy when I'm drunk, because I can go on, and on, and on about anything pharmacy. I was baffled by my fellow student's stance on what we will be once we obtain our PharmD. He maintained throughout the entire conversation that what the doctor says is what is best for the patient, and that if a patient wants to put something in their body it isn't any of our business. He literally said "We are just the middle man. We just count the pills."

Wow. Just... wow. I can honestly say I would never think a single pharmacist or pharmacy student, or anyone who's worked in a pharmacy would ever, ever, think that. These are fighting words, and I'm never one to back down from a fight, especially when I'm drunk.

Our role as pharmacists is to make sure the patient is getting the best care possible. We provide a service that takes at least 6 years of schooling to be able to do, and we are considered doctors when we are done. It is our responsibility to know everything about every drug. It is our responsibility to not give a patient a drug that will harm them. I asked him if he would give a patient Imdur and Viagra because "the patient wanted to take both, and he's just the middle man." Of course, he failed his Top 200 test so I had to tell him that Imdur was isosorbide mononitrate. I then had to tell him that taking Viagra and nitrates is a BAD IDEA. I wonder if his total lack of knowledge towards drugs is why he thinks pharmacists are middle men.

We are NOT middle men. We are professionals. We have the knowledge to help people, we have the knowledge to kill people.

He somehow related his entire argument to the Bible, and Jesus. Once religion popped up I stopped listening to him entirely. Religion has no place in pharmacy. I don't dispense pills because Jesus loves me. I argued with him for an hour and a half and he threw away his entire argument when he mentioned Jesus.

Oh, and his wife is a recovering drug addict. I can't figure out exactly how ironic it is that he thinks he should dispense anything the patient wants when he's seen what drugs can do to a person. I'm going with "groin-grabbingly ironic."

Top 200

My first Top 200 test is coming up, and I've got a few ways to learn some of the weirder brand to generic names. Some are so crazy, like Micheal Scott crazy, that there's no way not to remember them once you make the connection. Here are some of them:

Lopid = gemfibrozil "I put some gem fibers on my low moped."

Altace = ramipril "You've got to ram that alt button when you're typing."

Diovan = valsartan "Val died in a van."

Depakote = divalproex sodium "Pro divers can dive deep with coats on."

Nasonex = mometasone "I want to meet Antonio Bendares' mom." Yeah, that one's a stretch.

Accupril = quinapril "Dr. Quinn, Medicine Woman, was accurate."

Lotensin = benazepril "Benzene groups have a low solubility in water, and water has a high surface tension." Yeah.

Novolog = aspart insulin "The Spartans went out like a Supernova in 300."

Xanax = alprazolam "Alprazolam kind of sounds like palindrome (no, it doesn't), which is what the word Xanax is."

Nasacort AQ = triamcinolone "I tried to court sin alone."

Dilantin = phenytoin "It would be funny to die lying in tin."


I have more, but I think you get the picture.

The Difference

I had an epiphany the other day. It was about the extreme differences between the average 20-something-year-old "young man" and the 20-something-year-old "young woman." I put those terms in quotes because I don't believe anyone I know my age should be considered anything more than a teenager that... well... drinks as much as a teenager does, but in a different town. There's a subtle difference.

The difference between the 20-something sexes is their definition of "hanging out." Have any of you noticed that girls think guys want to hang out with them to just hang out? They honestly think we hang out with them because we enjoy their company. False. Guys my age do not, I repeat, do not, hang out just to hang out. We want something, and 99% of the time, that something is sex, or a good BJ, we're not too picky. Hell, a PB & J + HJ is usually enough. I have told this to a few girls recently and they just would not believe me. I tried to explain to them that, yes, if a guy wants to just "hang out," that means he wants to seduce you. There are a few exceptions to this, which I will get to.

These "young women" see things differently. If they don't find the male in question attractive, they assume that he doesn't find her attractive. Unless the "young woman" knows she's a bombshell, then she'll just assume everyone wants her. That's a given. But for some reason, most of these girls think that guys are just nice and caring people that don't want to explore the areas under their undergarments. This makes for some confusing and quite awkward moments when the guy goes for it and gets immediately rejected with a "What the fuck?!"

So let's just set the record straight here, and I'm going to be talking to the ladies out there from now on. When guys ask you to hang out, or to come over to his party, that means he's interested in you. The only exceptions are:

-He wants you to get with his friend, who is too cowardly to ask you himself.
-He wants to get with your friend, who he knows you'll bring along.
-He 's your relative (this exception is void in the south).
-You're his friend's girlfriend.

If you say yes and go to this guy's party, he thinks you like him. Period. That's how our brains work. It's not our fault. Now that the guy thinks you like him, this is where it gets messy, and sometimes sticky... (usually not...)

He will then ask you out on an honest-to-goodness date. This will be somewhat difficult for him, if he actually likes you. "What's the worst that could happen?" you ask, "A simple 'No,' and it's over."

Yeah, this is true, but it still fucking sucks. But wait, it's not over.

Now here comes the messy part, the part girls start to complain about. The guy won't give up. He will keep asking you out on dates. The terms "creeper," and "stalker," will be thrown around. For some awful, terrible reason, the guy will think you actually were busy that night, that you had to stay home with your sick dog, or go out with the girls, or even wash your hair. Because honestly, we know Friday nights are prime hair-washing nights.

Guys, I'm talking to you now. If you ask a girl on a date and she says "No," but doesn't say, "but maybe some other time, like this (specific day)?" It means she does not, I repeat, does not, want to date you. Tough luck dude, move on.

Guys don't understand that. A "No," is just a speed-bump. He'll keep building up the courage to ask the girl out and keep getting hit with the "No," for eternity, or until he finds someone better-looking than the girl in question. It's science. It's Darwinism.

The problem is with the perception of "hanging out." Guys refuse to believe girls don't want to fuck them. Girls refuse to believe that guys want to fuck them. This is a nation where most prescribed medications are for depression and pain. Coincidence?

OBRA 90

Out of our 4 lab instructors, only 1 of them seems to know what it's like out in the real world of retail pharmacy, either that or she's just a damn good teacher.

This week we filled 3 prescriptions for a fake patient, one was for pills, one was eye drops, and one was a compound that we had to compound. We then pretended one of our classmates was that imaginary patient, and counseled them. This is always interesting because it's painfully obvious who has counseled before and who hasn't. It's hilarious when the book smart quiet girl who's never even seen a pharmacy has to counsel me. Watching her stutter and stammer her way through OBRA while avoiding eye contact is entertaining. It then gets frustrating and scary when I realize this person will actually be a pharmacist someday. *shudder*

I've been doing a lot of counseling lately, but like every pharmacist I know, I don't follow OBRA. OBRA can sometimes seem so redundant that you literally watch the patient's eyes glaze over as they stop paying attention. We're supposed to introduce ourselves, give them the name of the drug, the dosage, and a million of other things. I think we have to offer to give them our 1st born son somewhere in there too. It's in the fine print.

When the instructor came over to listen to us counsel each other, I didn't introduce myself or tell them the strength of the eye drop that I was counseling on. Whoops. The instructor seemed impressed with my interacting skills, as she said "Well I can tell you've worked in retail, and I'm sure you've counseled before, but remember you have to introduce yourself and give the strength, which would be 5% for this one."

I gave her a look that must have told her my feelings on the subject, which are "Really? I mean, like, I know... But Really?"

She responded to by saying, "I know, but it's the law, and we have to teach you do things correctly." I was sympathetic. She just wants to teach, and she's a good teacher. I won't forget to introduce myself ever again.

Reform/Salaries.

I went to my uncle's cabin over Labor Day weekend to hang out at the lake and relax. My favorite part about hanging out with this certain family is that they're all staunchly republican, but occasionally they can see things from a different point of view, like mine, for example. My parents are both English teachers at the high school I graduated from, and I was raised as a democrat, although I am not exactly political. All politicians are corrupt in some way, shape, or form. Granted, it comes with the territory. I'm not here to bash any politicians, I'm just saying that it's not my type of thing. I like to be honest with people, which is probably why a lot of people think I'm an asshole.

My cousin asked me an interesting question as we were watching a town hall meeting where the senator was actually yelling at an average Joe in the audience for not following protocol and yelling obscenities. It was awesome. My cousin asked me what this health care reform was going to do to my job outlook. I told him absolutely nothing, people will always need their drugs, that will never change. He then asked me about my pay, if my salary would go down because of this reform.

Now that's an interesting question. I really didn't know what to say. I told him I would think about it and get back to him. I've done a little thinking, and I can honestly say that I think it won't affect our salaries one way or the other. The way I see it, it doesn't matter where the pharmacy's income comes from, that income is going to remain the same, or go up. I say go up because I've never had to call the Medicare or Medicaid office because they weren't paying enough on a claim. I've had to do that with private insurance claims. Erythromycin Ophthalmic ointment is the latest and greatest of these bang-my-head-against-the-wall calls. The price of the ointment went from $1.06 to $16.78 in the space of about 2 weeks, and Medicaid made it's adjustments, while not a single private insurance company did. They all seemed ignorant to the drug shortage, but I'm sure they'll know the minute the price goes down, and we'll be forced to unload the $16.78 ointment off our shelves at a loss.

Perhaps this is faulty reasoning. I will not even pretend to have a more than a basic knowledge of how insurance companies work and the various contracts they have with pharmacies and drug companies. If there's anyone out there who wants to shed some more light on the subject of reform and the possible effects it will have on pharmacist's salaries, I would like to hear all about it. Intelligent answers only, please.

When Will Teachers Learn?

My least favorite class is Pharmacy Lab. My favorite class is also Pharmacy Lab.

The best part of school is going into lab and learning how to do things we'll actually be doing when we're honest-to-goodness pharmacists, and that's pretty cool. I particularly like the labs that teach me something new that I've never experienced before, like IV bags. Coming from retail, I didn't have a clue how to mix IV bags until we had that lesson in lab. That was a fun day.

However, when we do important, yet boring retail shit like filling prescriptions in lab for a "refresher" is when I want to just excuse myself from class. The worst is when they teach us to do things incorrectly, or tell us information that just doesn't happen in the real world. They showed us how to fill amoxicillin 250/5 for a non-existent pediatric. The directions were 1TSP PO BID 10D (for acute otitis media). My teacher told us that the doctor should include what the drug is being used for specifically on the prescription. I actually laughed out loud. Doctors write what the drug is for on maybe, maybe, 2% of prescriptions, and my teacher refused to believe that. I wanted to ask her exactly where she obtained the knowledge that doctors write what's wrong with their patients on every script, but I'm sure that would just have embarrassed her more than she already was. Turns out I can be a nice person occasionally. Weird.

She also didn't understand insurance. My friend screwed up the days supply on one of his scripts and I jokingly said "Don't forget to reverse that through insurance, we don't want to get audited." She asked me what I meant. I found it unsettling that the person who was supposed to be teaching us how to work in retail didn't have a clue what the legal ramifications would be if a pharmacist sent the wrong days supply to insurance companies. I believe it's called fraud. She understood that the days supply needed to be correct, but didn't understand that had my friend actually sent that to insurance, he would've had to delete the script, reverse the claim, and re-bill it with the correct days supply. I did my best to explain it, but it was really really hard to do it without making fun of her, so I felt it best to just give up on it. Once again, I took the high road. It made me feel uncomfortable to be so nice, so I kicked the nearest helpless animal I saw when I left lab. It was a squirrel; I offered the little guy an acorn then punted his ass across the lawn. My day was better after that.*

One more thing I hate about Pharm Lab: Our work stations are desks. We have desks where we sit down, enter the scripts, and then count them out. Sitting down. We have to wear dress pants, dress shirt, dress shoes, and a tie to look professional and yet they let us sit down. Nay, practically force us to sit down. I just can't do it. I've worked in retail way too long to be able to sit down and comfortably count by fives. It just doesn't feel right, the counting tray is too high when I'm sitting down, so I end up on my feet hunched over a Protonix tray, not minding the uncomfortable feeling in my upper back because I'm used to it. I welcome the familiar feeling, even though it's much more extreme at lab than when I'm at work. I bet there's a two foot difference, but that feeling is still more comfortable than sitting down. Strange, huh? I'm going to make for a nice little Nazi for some corpo-pharmacy chain someday.

*Relax, the whole squirrel kicking thing didn't happen.