Sunday, July 27, 2014

The Makers Of Dulcolax See Your Ass As A Penitentiary, And Their Mission As A Humanitarian One.

This, my friends, is an actual ad for the actual laxative Dulcolax, which ran in newspapers and bus stations in Singapore.

I am not making this up. There sit a pack of imprisoned turds, marking time around your asshole until they are, as the text in the corner says, set free by you.

"Well I should start shitting right away" you're probably thinking. My turds have done no crime, and therefore don't deserve to be doing time."

Not so fast there bubs, let me tell you what's gonna happen to those poor turds once that Dulcolax kicks in. It's a stimulant laxative, you see, and in this case, what's stimulated is the smooth muscle of the large intestine.

Which means those poor turds are gonna get crushed as the walls of their prison close in around them. Crushed until there is enough pressure to force them out of that little asshole in the floor. Look at the size of that asshole and look at the size of the turds. It ain't gonna be pretty.

I am going to go to bed now, but not before I say a little prayer for my turds. They are in for an ordeal the torturous quality of which I cannot even imagine.

Godspeed to you, innocent shit.

Friday, July 25, 2014

Once Again, Real Life Takes Away My Material. I Also Call Out Some Chicken Shit Compounding Pharmacists

Those of you who've picked up a copy of my awesome first book no doubt remember how I opened it with reminiscences of how I used to mock healthcare professionals who couldn't poison someone.  A doctor who tried to kill his mistress with strychnine for example, or a nurse who might use morphine to off a patient or two. It worked as humor because you'd assume that anyone who spent a few years studying the combination of how the body works and the chemicals the world of medicine puts into it oughta be pretty good at figuring out the poison thing. Basic stuff, right? Right in these people's wheelhouses and they screwed it up.....ha ha ha.....

Yeah....ha ha fucking ha.

The execution of a convicted murderer in Arizona lasted for nearly two hours on Wednesday, as witnesses said he gasped and snorted for much of that time before eventually dying. 
This drawn-out death of Joseph R. Wood III in Arizona prompted the governor to order a review and drew renewed criticism of lethal injection, the main method of execution in the United States, just months after a high-profile botched execution in Oklahoma.

And another one before that in Ohio. Right in the people's wheelhouses and they screw it up. Time after time. Once again I have underestimated the incompetence of others, and once again, real life robs me of comedic material.

Midazolam is the common denominator in all these fuckups, used with the narcotic hydromorphone in Ohio and Arizona and with a muscle relaxant (vecuronium) and potassium chloride (to stop the heart) in Oklahoma. So let me tell you a little bit about midazolam. It's what's known as a benzodiazepine, related to the Xanax and Valium so many people have made friends with. All in all they're a pretty good class of meds, gaining popularity in no small part because they are safer, particularly in overdose, than the class of meds they replaced, known as barbiturates.

Now, I'm gonna pause here, and place a large bet that even if you haven't had a day of any kind of medical training in your life, you can read that last paragraph and figure out the problem here, and offer a possible solution.

Some 6th grade dropout probably just said something like "um...maybe they shouldn't be using the safer one if they want to kill someone, and maybe go with that barbiturate stuff instead"...and that person... would be smarter than the Ohio, Oklahoma, and Arizona Departments of Correction.

 How many of you have had to have a pet put down? How long did it take? Seconds, not hours, yes? Guess what they use? Read that paragraph again and just take a wild-ass guess.

"Um......a barbiturate maybe?" the dumbest person on earth might say. And he would be right. Pentobarbital to be specific.

The olive in the martini here is that some states have figured this out. You won't hear about botched executions in Texas or Missouri because pentobarbital is exactly what they use.

So let's recap here. There is a successful model of a lethal drug that has a proven track record in both animals and humans. Yet some people in power think it's a good idea to go their own way and come up with a plan that uses a drug that is popular in medical practice in part because it is safer in overdose than the drug that is successfully used to kill lots and lots of living creatures.

And this is the world in which I try to satirize. Which probably says something about my intelligence.

Not that a midazolam/hydromorphone combination is completely inappropriate in theory. Pump someone full of enough of it and yeah, they should kick the bucket you would think. You know, assuming the meds were of the correct potency and actually were what they said on the label. Who knows? Maybe that was the problem here. Let's just check with the manufacturer and clear this right up....

...oh....wait. We can't do that. because no one quite knows who the manufacturer is. The prison people claim they're getting their goods from compounding pharmacies. Which means, if true, there's a colleague or two out there of mine who's a spineless, chicken-hearted, weak, cowering, thumbsucking, lily-livered, yellowbellied coward of a human.

That's right bubs. I'm calling you out. Signing a contract of death with the state is one thing, but doing so while insisting on the protection of anonymity is a whole other level of pussydom. Come out come out where ever you are deathdruggist, because if you can't stand the heat you're generating, you never should have gone into that kitchen and started cooking.

And just in case you are ready to point a finger back at me, I'll point out that I ended my awesome first book by telling the world how to get an abortion using a common anti ulcer medication, and I'll put the backlash whackadoodle anti-choice zealots are capable of generating up against anything you'll face any day of the year.

That part of the book still holds up by the way. No doubt because there I wasn't trying to mock an increasingly unmockable world.

Friday, June 20, 2014

This Is The Business Expertise I Remember From My Former Employer.

From The Motley Fool:

the biggest reason for the profit shortfall is what now appears to be overly rosy guidance for cost-saving benefits tied to Rite Aid's recent deal with generic distribution giant McKesson.

That deal transferred the company's responsibility for buying and distributing generic drugs to stores from Rite Aid to McKesson. When the deal was announced, Rite Aid argued that McKesson's bigger buying power and sophisticated distribution network (allowing for daily shipments direct to stores) would lower purchasing costs and inventory.

Unfortunately, that argument fell short this past quarter given that the company's cost of goods sold totaled 72.1%, up about a percent from a year ago.

You know, I work with McKesson myself, and I've always kinda liked them. They've always treated me fair, they have a lot of resources available for an indy out there in the big, bad, drugstore marketplace, they even gave me a free plant when I opened my account that's still alive.

I don't like McKesson anymore though. Because according to this they kinda fucked my former employer.

Which means I now LOVE them!!


I'll probably kiss my McKesson driver Monday and he'll have no idea why.

Tuesday, June 10, 2014

My Preliminary MTM Conclusion

So...working through some numbers this night, I see that my MTM revenues to date have netted me about as much revenue as....

Ten extra prescriptions.

Pushing the figures a little further, I remember that when I'm in the happy pill room by myself without technician, ten prescriptions in an hour is a pretty good pace.

And...I've probably spent more than an hour doing the MTM stuff.

Which means....the paradiem  we've been living with since Nirvana was a fresh new band, of desperately grabbing as many prescriptions as we can at any price (including now actually paying for the privilege of filling them in some cases...long story) is actually still ahead of the bright new future of pharmacy being engineered for us by the visionaries of the profession.

To recap, in case you missed it. I can probably make more money in an hour cranking out prescriptions than I can working my MTM cases.

No wonder the chains went ape shit over the flu shots with hardly a peep about making sure Grandma is taking her Lipitor.

I've gotta get that damn Medicare immunization application done.

OK, thanks for helping me work through that folks. Goodnight.

Holy crap I can't believe I'm a businessman now.

Friday, May 23, 2014

Your Small Penis Is The Key To Understanding A Key Tactic Of Right Wing America's Arguments.

Because make no mistake, the right wing media machine is set to dominate the nation's news agenda. In a few short years they've gone from Glenn Beck being the crazy babbling uncle in the journalistic attic to being able to manufacture stories that get traction in normal people's dialogue.

Don't believe me? Bengazi.

Don't worry though, democracy may be at stake, but your small penis will stop them. First though, we'll have to learn a little bit about how they operate.

One of the favorite tactics of the conservative cable goons is the old "some people are saying" trick. It has its origin in the writings of people like Hunter S. Thompson, who wrote this for Rolling Stone while covering the 1972 presidential race.

“Not much has been written about The Ibogaine Effect as a serious factor in the Presidential Campaign, but toward the end of the Wisconsin primary race – about a week before the vote – word leaked out that some of Muskie’s top advisers had called in a Brazilian doctor who was said to be treating the candidate with ‘some kind of strange drug’ that nobody in the press corps had ever heard of.” 
It is entirely conceivable — given the known effects of Ibogaine — that Muskie’s brain was almost paralyzed by hallucinations at the time; that he looked out at the crowd and saw gila monsters instead of people, and that his mind snapped completely and he felt something large and apparently vicious clawing at his legs. 
We can only speculate on this, because those in a position to know have flatly refused to comment on rumors concerning the Senator’s disastrous experiments with Ibogaine.

After the campaign, Thompson had this to say:

“I never said he was (taking ibogaine), I said there was a rumor in Milwaukee that he was. Which was true, and I started the rumor in Milwaukee. If you read that carefully, I’m a very accurate journalist.”

Back then it was funny because of course no one would take that Ibogaine story seriously. But just like the old lady who gets up at a town hall meeting and says "the government needs to keep their hands off my Medicare,"  what was once ridiculous is now considered mainstream.  Listen for echos of Thompson in these actual quotes from Fox News transcripts:

7/14/11, commentator Eric Bolling: "There Is No Question That The Ground Zero Mosque Is In Fact A Victory Mosque."

The same Eric Bolling, 4 days later on Fox Business news: "Some Have Called" Park51 "A Victory Mosque."

On November 21st, 2011 Fox' Martha MacCallum reported "People Are Saying" Obama "Did Not Show Leadership On" Deficit Deal."

Who are some people? Mostly Bill O'Reilly from the day before: "Where Is President Obama On Leadership? He Should Have Laid Out His Vision."

I could give you plenty more examples, as there is no shortage of this kind of thing on Fox, but you get the idea, and you might be saying to yourself, "Wow, that Thompson example is just what I need to expose this bullshit for what it is."

You may be right for a few of the higher functioning ones, but remember who you're dealing with here. If you want to get to the majority of them, you're going to have to go with something far more visceral. Something that plays into their constant need to have something to fear.

Their small penis.

It's actually pretty simple, whenever you find yourself in front of the Fox News with one of their Cro-Magnon fans, just insert the phrase "your small penis" anytime after you hear "people are saying"

For example, Gretchen Carlson's "Some Would Say That It's The Unions That Have Crippled The U.S. Economy And Led To The United States' Debt." Becomes "Some would say you have a small penis"

Later, when they hear Sean Hannity say "And, less than 24 hours after some say that President Barack Obama virtually spat in the face of the State of Israel... " you tell your co-watcher "less than 24 hours after some say you have the smallest penis on the planet....."

Don't think you'll actually be promoting any intellectual growth or understanding of logical fallacies with this though. It'll be effective, eventually, but only because they will develop a Pavlovian fear of the phrase "some say," as it will trigger unwanted awareness of their organal inadequacies.

Take your victories where you can get them my friends, and pick up a copy of Fear and Loathing on the Campaign Trail '72. If for no other reason than to be ready for the next trick the fiends at Fox will have up their sleeve.  

Saturday, May 17, 2014

As The Nation Turns It's Attention To Horse Racing, I Retell The Story Of The Greatest Kentucky Derby Ever.

I've told this tale before, but I so love this story, and as much as it's possible to be in love with a horse, I love Mine That Bird.

Mine That Bird went into the 2009 Kentucky Derby a 50 to 1 longshot. His trainer was surprised to find out the horse had qualified, and loaded him up in a horse trailer and drove his pickup truck from New Mexico to get him there. Sports Illustrated didn't even bother to find out anything about him for its feature article on the race. He *did* get a mention in New York Newsday however, whose writer said he "should just stay in the barn"

And when the race started Mine That Bird lived up to expectations. Here's the You Tube Video of the race, and you'll see Mine That Bird so far back at one point that the announcer says another horse is in last place, because he can't even see Mine That Bird. the rest of the video, and keep an eye on the inside rail as they come around the final turn.

Some days, when I was unemployed and looking increasingly unemployable, as life started to look increasingly bleak,  I'd watch that video just to lighten up a little because I desperately didn't want to go through a whole day with nothing good in it. No matter how bad the suckfest got. That horse never failed to being a little smile to my face.

Someday I want to meet Mine that Bird, give him a big hug around his horse neck and get his hoofprint autograph.

Wednesday, May 14, 2014

I'm Amazed Sometimes At The Stuff That *Didn't* Get Me Fired.

Blogpost Original Airdate, May 23, 2011. 

A Few Random Thoughts That Should In No Way Be Confused With Those Of My Employer.

I know the profession has its ups and downs. Its frustrations and pitfalls. But I was thinking today, I really take pride in the work my fellow pharmacists and I do day in and day out. It's such a pleasure to be able to serve people and to know that I'm making even a small difference in the fight against things like cancer, heart disease, diabetes, and HIV. To know that I can use the talents I have honed over the course of my career to contribute to the good health and wellness of humanity is a feeling almost impossible to describe to someone not lucky enough to be in a health care field. I'm a big fan of pharmacy.

I should mention though, that the other day my employer came out with a new social networking policy that made it very clear that we were to leave no confusion when we post something online that we are speaking only for ourselves, and not as a representative of the company. So please, don't assume my employer agrees with anything I've just said.

I'm not just a pharmacist though, I'm also a citizen of the United States, and I'd like to think, the world as well. That's why my heart was filled with joy when I heard the news that Osama Bin Laden is no longer a threat to the planet. I really swelled with pride knowing our brave troops had brought evildoer number one face to face to his maker. I'd like you all to join me in honoring our brave men and women in uniform who all played a part in this "Mission Accomplished!," especially the Navy Seals, who may be the most heroic people who have ever lived.

Again though, my employer feels it is very important for me to say that what I write here does not necessarily reflect their views. I'm not sure why, but they definitely want you to know that.

Life isn't all happiness and triumph over evil though. I think we can all agree that there are some truly awful people in society. Take pedophiles for instance. The crimes they perpetrate against our children are among the most horrific things one person can do to another. Pedophiles should be severely punished, not only for the acute physical trauma they inflict on our most vulnerable, but for the lifetime of emotional scars they leave behind. I am no friend of the pedophile.

And I am in no way speaking for my employer. If you want to know what my employer thinks of pedophilia, you'll have to ask them directly. I'd recommend talking to someone in the legal department.

I also recommend you always wash your hands after defecating. But that's just me talking.

Tuesday, April 29, 2014

Ripped Out Of Today's Headlines, By Me, Eight Years Ago.

In light of tonight's news about the botched execution in Oklahoma, I think we can all agree here that I am some sort of prophet:

Original Blogpost Air Date: June 13, 2006

Government Can't Even Not Create A Bureaucratically Screwed-Up Policy When They Kill You.

Ok, so I'm being a living stereotype this morning, an elitist liberal leafing through his copy of The New York Times, when I come across a story about a death row inmate appealing his sentence to the Supreme Court. Nothing unusual there. Can't blame a guy for wanting to live I suppose. Buried in this story though is a piece of evidence that shows just what a fucking genius I am. Stick with me here. I've been against the death penalty for a long time now. Partly because of the whole "an eye for an eye and the whole world goes blind" thing, but mostly because, and I have 2 different ways of phrasing this depending on who I'm talking to:

1) If you're a member of the general public: Would you trust the same organization that runs the DMV to have the power of life and death?

2) If you're a member of a medical profession: Would you want the same people who run the Medicaid program in your state to decide if you live or die? (OK, their decisions may decide if some people live or die, but in a different way)

Actually I have 3 different ways of expressing my thoughts. Sometimes I'll say that capital punishment is just another big government program that doesn't work very well. That line seems to work especially well with Republicans.

It is the particulars of this man's lawsuit that proves my brilliance. It seems his argument is that the way a lethal injection is carried out in his state is cruel and unusual. According to the Times:

The focus of concern is two of the three chemicals that make up the lethal cocktail used by most states. One is sodium pentothal, an anesthetic, which Mr. Hill argues in his lawsuit is insufficient to make the procedure painless.

The second is pancuronium bromide, which causes muscle paralysis but does not block pain or interfere with consciousness. Studies indicate that while inmates who receive this drug look calm and peaceful as the third chemical, potassium chloride, is administered to stop the heart, they can actually feel intense pain without being able to express themselves.

Anyone who knows even a little bit about drugs is probably saying to themselves right now... "WTF?" Anyone ever hear of long acting barbiturates? as dirt, and a little IV push sends your condemned gently drifting off to an eternal sleep. The sodium pentothal they already use is a short acting barbituate. Crank up the dose of that alone and you'll do the trick with no problem.

But no. Some bureaucrat gone wild had to come up with an unnecessarily complicated cockamamie 3-step procedure that leaves open the possibility of having someone suffer a heart attack while feeling everything and being able to express nothing. Less effective, more complicated, more expensive. Remember this the next time you're in line at the DMV. At least sooner or later you'll walk out of there alive.

Wednesday, April 16, 2014

An Ethical Dilemma.

So, let's say one day you're on the road and your baby starts to come down with a cold. And you, the master of all things pharmaceutical, know exactly what product to get to relieve her suffering. Unfortunately, the only place that seems to carry the product to help the woman you love is an outlet of a certain chain drugstore. A chain you're very familiar with. A chain you used to work for. A chain with whom your association did not end well. This leads to quite the dilemma indeed. Namely... you stuff the product in your right or left coat pocket before you walk out the door?  I went with left, but something tells me right is the proper protocol in these situations.  

Monday, April 14, 2014

From The "Someone Couldn't Afford Their Abilify" File

An actual comment just zapped to the email box. Completely unedited.

All pharmacists r murderers plain as that the antidepressants the barium drinks for upper and lower gi they know what's in that stuff they r like the nazis just following orders i call them murderers to thier faces traitors to humanity the nerve of killers acting like birth control is the issue also old dictionary says its witchcraft

I want a copy of that old dictionary. I have a feeling the way to get it involves eating mushrooms or something though.