Sunday, August 29, 2010

The Republican Welfare Queen Poised To Become Governor Of Florida.

I've written about Rick Scott before. As a joke. Not quite a year and half ago Scott was just some rich clown running ads against President Obama's healthcare proposals. Ads that said any solution to the problem had to be built on the pillars of “choice, competition, accountability and personal responsibility"

One of the reasons Scott is so rich is because when he ran Columbia/HCA, one of the largest for profit hospital chains in the country, Columbia/HCA was ripping off Medicaid and Medicare to the tune of over a billion dollars. The company eventually settled with the government for over $1.7 billion, and Scott was ousted by his own board of directors for his role in the affair. He then decided to show how accountable and responsible he was by leading a lavish lifestyle in Naples, Florida. That's where we left Rick Scott a little over a year ago. A fool who surely would never be taken seriously ever again.

Last Tuesday Rick Scott won the Republican nomination to become Governor of Florida. I am not making that up. Lesson learned. from now on I do not stop kicking these fuckers until they are good and dead and buried and even then it might not be a bad idea to dig up the body and drive a few wooden stakes through their heart.

But, can I ask you something? If you're one of my colleagues who never hesitates to talk shit about the medicaid customers whose business puts dollars in your paycheck, who will never fail to judge a woman on welfare driving a late model car when for all you know she might have had to flee in that vehicle with the kids to escape a husband who was beating the shit out of her, why are you not outraged that Rick Scott is not only not in jail, but has a good chance at becoming chief executive of the nations fourth most populous state? Why would you treat Rick Scott better if he came in your store than you would the baby momma you think might be trying to game the system for some free claritin? Is it a math problem? Do you not realize $1,700,000,000 is the equivalent of around 34 million prescriptions you deem not worthy to be dispensed? THE AVERAGE PHARMACY COULD WORK FOR 169 YEARS BEFORE IT WOULD FILL ENOUGH PRESCRIPTIONS TO GENERATE THE AMOUNT OF REVENUE THAT RICK SCOTT'S COMPANY STOLE FROM MEDICAID AND MEDICARE.

But the real problem is that baby momma according to you. When she comes in your store she gets a sneer and contempt. If Rick Scott comes in he would get a "yes sir" and maybe even your vote.

Why is that? I posed that question in Drug Topics awhile back as well, and never got a decent answer. Because none of you have the balls to say it. Evidently I'm just gonna have to say it for you you fucking cowards.

It's because if Rick Scott came in your store, he'd look like you, or at least the kind of person you want to be. He'd be dressed well. He wouldn't speak with an accent but would speak with impeccable grammar. You wouldn't be scared of his mannerisms or find his culture threatening. You might even be intimidated by the air of authority someone who plays in his league would be sure to have. You would perceive Rick Scott to be above you on the ladder of society, so you would immediately fall into your assigned place.

The baby momma you would percieve as below you however. Different and beneath you, so woe onto that woman. This isn't about taxpayer dollars at all and you know it. You are at best a coward and at worst an outright racist. I'll bet you anything when you talk about that baby momma behind her back you find a way to let people know her race if she's not white.

You make me sick. And you're about to get the governor you deserve.

Friday, August 20, 2010

I Saw U2 Once In Columbus....

...wait, I should be clearer. Columbus, Ohio. A metropolis with over a million souls and still so bland one should always add the state at the end to avoid confusion. 

I saw them in the horseshoe, which is a monument to football that is no longer in the shape of a horseshoe. I don't remember if it was still horseshoe-shaped when I was there or not. I was distracted by a 30-foot lemon. 

At one point Bono gave a little speech between songs of the type that hasn't crossed his lips at a concert in probably a good decade at least. 

"So.....this is Columbus....." I'm paraphrasing here. Working off 13 year old memories.

"I've always wanted to see this town....."

faint cheer form the crowd....

"When I was a young lad in Ireland I had a girlfriend who went off to a place called Ohio State University. She came back with a red sweatshirt, and not much affection for myself.......

....so..... I am SERIOUSLY PISSED OFF AT THIS PLACE!!!!!!!!!!"

The crowd then broke into a thunderous roar......it was like they were saying....."YAY! HE HATES US!!!!!!"

I always thought that was weird. I wouldn't cheer if you hated me. 

Tuesday, August 17, 2010

The New York Times Joins In A Cruel Joke On The Profession.

And it's not even a particularly good joke. From last Friday's paper:

Eloise Gelinas depends on a personal health coach.
At Barney’s Pharmacy, her local drugstore in Augusta, Ga., the pharmacist outlines all her medications, teaching her what times of day to take the drugs that will help control her diabetes.
Ms. Gelinas, a retired nurse, also attends classes at the store once a month on how to manage her disease with drugs, diet and exercise. Since she started working with the Barney’s pharmacists, she boasts that her blood sugar, bad cholesterol and blood pressure have all decreased. “It’s my home away from home,” she says.
While some of the services being offered to Ms. Gelinas resemble those found in an old-fashioned neighborhood drugstore, others reflect the expanding role of the nation’s pharmacists in ways that may benefit their customers and also represent a new source of revenue for the profession. Some health plans are even paying pharmacists to monitor patients taking regular medications for chronic illnesses like diabetes or heart disease.
“We are not just going to dispense your drugs,” said David Pope, a pharmacist at Barney’s. “We are going to partner with you to improve your health as well.”

"I tried to get out of running this thing, but it wasn't really fair after The Chicago Tribune took their turn last year." said New York Times executive editor Bill Keller in my imagination. He then added that one mainstream news outlet has run some bullshit story about how pharmacists "aren't just dispensers anymore" around once a year for the last 10 years or so, maybe longer.

If you're a pharmacist meanwhile, you are probably dispensing around 50% more drugs per shift than you were 10 years ago.

Keller said he couldn't exactly remember how the periodic pharmacy bullshit story got started, thinking it may have been part of an April fools prank in 2000 hatched during a convention of the Society of Professional Journalists after a night of heavy drinking.

"I think Dan Rather got the idea to assign the story to an intern or something as a test of their bullshit skills, and the kid did such an incredible job he actually used it on air one night when it was a slow news day." Keller didn't say. "Anyway, we've been passing the thing around for awhile now. The funny thing is, some organization actually started believing it. I think it was the American Public Health Association or something?"

"We were very pleased The New York Times shares our vision of the future of pharmacy" said American Pharmacists Association president Harold N. Godwin only in my head. "The movement of our profession away from the count, pour, lick, and stick functions of the past and into the realm of being a full-fledged and respected member of the health care team is one of the most significant wellness trends in the nation."

"And it totally must be happening somewhere. Because I keep reading about it in the news."

Like other health plans, Blue Shield views pharmacists as having the education, expertise, free time and plain-spoken approach to talk to patients at length about what medicines they are taking and to keep close tabs on their well-being.

Keller said in addition to putting in a line about pharmacists and free time in this years story, he initially wanted to write of a world where every child gets a free puppy at age 6 and upon reaching puberty, unlimited oral sex from the Playboy centerfold or Chippendale dancer of their choice, but decided "that might be stretching it a little bit"

Reached for comment, your district manager told you that he expected if someone pulled into your pharmacy's drive through lane and wanted a ham sandwich, you would send it through that pneumatic tube thingy as soon as possible, if not sooner.

He also added that your staff's hours have been cut by 10%

Asked if it wasn't true that the decline of the independent drugstore has in fact been stopped by the trend toward custom compounding, which is a variant of the very old business model of buying things and selling them for more than you paid for them, and has had very little if anything to do with Medication Therapy Management, APhA president Godwin fictionally said ....."la la la.....I can't hear you...."

Monday, August 16, 2010

Reason Number 1,528,063 To Live In California

Because when you live in California you can be sitting around your condo and ask yourself, "hmmm....what do I want to do with my weekend?"

And the answer can be, "I think I'll go see Black Frances, lead singer of The Pixies, the greatest band ever, go sing in a redwood forest"

And then you get in your car and go see Black Frances sing in a redwood forest.

And while you're waiting to get in you meet someone riding their bike down Highway 1, probably the most scenic road in the country if not the world, and they ask what's going on.

You give them the scoop and your extra ticket and have an afternoon of all around awesomeness.

Shit like that doesn't happen in Nebraska my friends. And not only because there are no redwood trees there.


Saturday, August 14, 2010

Another Dark Day For Lloyd Duplantis Of Gray, Louisiana. And A Bit Of A Frustrating Day For Myself.

Lloyd Duplantis is the pharmacist who got on National Public Radio during the height of The Era of Bush Induced Insanity to declare that he refused to sell birth control pills "in the name of science." Seriously. He said that. And a mere 5 years ago there were enough people who believed him, and not the actual science that shows the use of oral contraceptives leads to a lower lifetime risk of cancer, that his ilk was having a major influence on public policy. Lloyd Duplantis scared the piss out of me 5 years ago, and I decided I had to do what I could to make sure his attempt to turn our profession into a home for religious fundamentalism did not go unopposed. Today, the little blog garden you see before you is gathering hits at a far greater pace than the website of his organization, Pharmacists For Life International, my writing secured me a regular platform in the nation's leading trade magazine, and we have this news out of the nation's capital:

WASHINGTON — Federal drug regulators on Friday approved a new form of emergency contraceptive pill that prevents pregnancies if taken as many as five days after unprotected intercourse.
The pill, called ella, will be available by prescription only. Developed in government laboratories, it is more effective than Plan B, the morning-after pill now available over the counter to women 17 and older.
That pill gradually loses efficacy and can be taken at most three days after sex. Ella, by contrast, works just as well on the fifth day as the first after sex.

I win. As do the women of America. Lloyd Duplantis of Gray, Louisiana has turned out to be just another schmuck who's 5 minutes of fame is over, his only accomplishment the jump-starting of my writing career. For which I'll always be thankful.

Moving on...

Studies have found that many women fail to realize they are at risk for an unplanned pregnancy after unprotected sex.

No way. I've always said you'll never go broke betting on stupid, but there is just no fucking way that can be true.

Studies have shown that more than one million women who do not want to get pregnant are estimated to have unprotected sex every night in the United States

Wow that's a lot of sex. Why do you suppose The New York Times had to go and rain on my parade like that? Rubbing in the fact that of the over one million drillings that are going on in the country this night, none of them will be involving my oil rig. That was just mean of them.

No matter. Even though I will fall asleep this weekend alone, I will wake up in a world a little bit saner than that in which I fell asleep five years ago. Where science is once again the primary factor in the drug approval process, where impassioned political arguments now involve money, and not how many people we should be killing in a country that never attacked us. Where presidents can speak in paragraphs and Proposition 8 has been overturned. Lloyd Duplantis seems like nothing but a bad dream now. About as scary as a Belgian waffle.

Maybe this means my blog is more powerful than Jesus. If so I think it should be getting me laid more.

Tuesday, August 10, 2010

Highlights From Today's Pill Counting Action.

Spent the day training our new pharmacy grad Jerry. His dad was a pharmacist. Says it's all he ever wanted to do. Seems like an enthusiastic, compassionate kid. Had him spend the morning getting used to being 'the pharmacist' by verifying prescriptions and counseling patients. He's very good with people.

After lunch when things quieted down, I decided to give Jerry a dose of reality. I told him it's a great job. Pharmacists get to promote good health. But in the back of your mind, liability always lingers.

So I gave him a couple of important tips...

  • When in doubt, question the prescriber
  • Store 'look alike, sound alike' drugs on different shelves
  • Make sure you repeat back all verbal orders

I also asked Jerry about his professional liability insurance. I explained how it's always a good idea to have additional insurance, especially since services like immunization and MTM are becoming more mainstay in pharmacy practice.

_______________________________________________________


What? Why are you looking at me like that? Because that's the greatest blog post I've ever written? Because in a few short paragraphs I've managed to capture the essence of what being a real world pharmacist is like in today's heathcare environment? 

I'd love to take credit for this work of brilliance. Really, I would, but actually I plagiarized it. Took it word for word from an advertisement in the July issue of Pharmacy Today, an official publication of the American Pharmacist's Association. 

You should have known APhA was involved the second you realized there was no connection to reality.

At any rate, it would seem that The Organization No One Cares About™ has decided they want a piece of this pharmacy blogging action, but haven't quite realized blogging requires the use of a computer. Here's a copy of their ad: 







































"Make sure your blog has a happy ending" it says at the bottom of the ad. I'm pretty sure the people at APhA are just fucking with me now. Although they did get in a good line about MTM becoming more mainstay in pharmacy practice. That line was comedy gold.

I scoured the Google after seeing this, and it turns out Jerry has a blog of his own. Here was his entry for July 5th:

Showed up for my first day at work and I've never seen anything like this numbnut they had running the place. He spent a good hour talking about the "sacred trust" that is given to pharmacists while 30 prescriptions backed up waiting for him to get off his ass. I finally shoved him out of the way to get some drugs out the door. My Dad was a pharmacist, so I know damn well no one gets paid until we get the medicine to the cash register. Dipshit spent 30 minutes deciding what to do when the computer warned him about an interaction between enalapril and hydrochlorathiazide (They're available in the same pill for Christ's sake!)  while I was taking 15 goddamn phone calls. They told me one of the techs got fired last week for actually taking a swing at this douchebag, and honestly, from what I saw today, I don't blame the guy. I think I'm going to buy some extra liability insurance if I'm gonna be stuck cleaning up this stupid fuck's messes for the rest of my career. I also think I'm going to start drinking. 
Oh, and that tech they fired? They're not going to replace his hours. Fuck my life. 

Welcome to the profession young Jerry. It seems you'll fit in just fine.

Saturday, August 07, 2010

A Plea To The Martini

Please just wash it away.

You used to.

You used to gather up the blackness in my brain and flush it like the winter rains flowing into the sewer.

Please?

I'd feel better and go to sleep happy and wake up feeling like I was born again.

You haven't done that in awhile.

I wish you would.

Because the blackness...is sticking. I don't know what to do to dissolve it.

You used to dissolve it.

I hate you.

A customer told me today I made an important difference. I wish I could believe him. The next one asked me where the milk was.

I wish I could believe him.

I used to know the storm would pass.

Tomorrow I go in for more.

He said to the empty bottle.

Monday, August 02, 2010

Book Review #4. If You're Healthy And/Or Alive, It May Have A Lot To Do With A Poor Black Woman You've Never Heard Of.

Because if you're healthy and/or alive, chances are you've benefited from medical research at some point. Maybe you've never contracted polio. Maybe you did contract a nasty infection of some sort and were cured with an antibiotic. Perhaps you had a lab test that saved you from an agonizing death. If so, you can probably thank Henrietta Lacks, a woman who did die an agonizing death from cervical cancer at Johns Hopkins Medical Center in 1951. You probably don't know why you should be thankful though, and if it weren't for Rebecca Skloot's The Immortal Life Of Henrietta Lacks, which I finally got around to reading last week, you probably never would.

The book is the story of how a slice of Henrietta's tumor, taken without her knowledge or consent as she was dying, became the HeLa cell line, the first human cells to be successfully grown in culture and the foundation for a plethora of medical research. Henrietta's cells have been sent into space, blasted with radiation, infected with who knows how many pathogens and continue to this day to be a workhorse of science. There are more than 17,000 patents based on HeLa cells, and you can spend anywhere from $100 to almost $10,000 on HeLa products for your own science projects if you're so inclined.The family will get none of that though, and no one even bothered to tell them any of this was happening. Think about that for a second. Someone took a piece of your mother, grew her in a lab and now parts of her are bought and sold all across the globe. And no one bothered to tell you. The family had no idea for 22 years. They found out when one of them had a chance conversation with a man who worked at the National Cancer Institute. "I ordered them from a supplier just like everybody else" he said.

The book is far more than a tale of science however. Let me be clear. While it took me forever to open the book after I ordered it, once I did I couldn't put it down. It reads like the best of fiction while pouring knowledge into your head whether you realize it or not. Ever wonder why there are so many African-Americans in Northern cities when slavery was an institution of the south? The Great Migration is probably the most significant event you'll never read about in an American History book, but you'll see it illustrated here as Skloot traces Lacks' ancestry from the plantation through the modern mean streets of Baltimore. You'll be taken back to a time when doctors could be both humble enough to make their own lab equipment and arrogant enough to purposely inject patients with cancer cells just to see what would happen. You'll gain a perspective of how utterly horrifying mental institutions were a generation or two ago and of what life is like for today's urban poor. There are a million subtle lessons in this book, none of them uninteresting.

Most important though, are the lessons in humanity as you follow the Lacks family's struggle to understand and come to terms with what happened to Henrietta. At one point a researcher who used HeLa cells to develop fluorescence in situ hybridization, a technique Skoot says "to the untrained eye simply creates a beautiful mosaic of colored chromosomes," presented a giant print of Henrietta's cells to her daughter, Deborah. Henrietta had died before Deborah had any memory of her, and "more than anything" she said earlier in the book, she wanted to learn about her mother and what her cells had done for science.

"You know what I really want? I want to know, what did my mother smell like? For all my life I just don't know anything, not even the little common little things, like what color did she like? Did she like to dance? Did she breastfeed me? Lord I'd like to know that. But nobody ever say nothing." 

Deborah's brother, Zakariyya, spent time in jail for killing a man and struggled to deal with violent tendencies his whole life. "Maybe her cells have done good for some people, but I woulda rather had my mother. If she hadn't been sacrificed, I mighta growed up to be a lot better person than I am now." He told Skloot.

You are now properly set up for this excerpt:

Deborah stood from the bed where she'd been sitting with her grandsons' heads in her lap. She walked over to Zakariyya and put her arm around his waist. "Come on walk us out to the car," she said. "I got something I want to give you."
Outside, Deborah threw open the back of her jeep and rummaged through blankets, clothes, and papers until she turned around holding the photo of Henrietta's chromosomes that Chistoph Lengauer had given her. She smoothed her fingers across the glass, then handed it to Zakariyya.
"These supposed to be her cells?" he asked.
Deborah nodded. "See where it stained bright colors? That's where all her DNA at."
Zakariyya raised the picture to eye level and stared in silence. Deborah rubbed her hand on his back and whispered, "I think if anybody deserve that, it's you, Zakariyya."
Zakariyya turned the picture to see it from every angle. "You want me to have this?" he said finally.
"Yeah, like you to have that, put it on your wall," Deborah said.
Zakariyya's eyes filled with tears. For a moment the dark circles seemed to vanish, and his body relaxed.
"Yeah," he said, in a soft voice unlike anything we'd heard that day. He put his arm on Deborah's shoulder. "Hey, thanks."
Deborah wrapped her arms as far around his waist as she could reach and squeezed. "The doctor who gave me that said he been working with our mother for his whole career and he never knew anything about where they came from. he said he was sorry."
Zakariyya looked at me. "What's his name?"
I told him, then said, "He wants to meet you and show you the cells."
Zakariyya nodded, his arm still around Deborah's shoulder. "Okay." he said. "That sounds good. Let's go for it." Then he walked slowly back to his building, holding the picture in front of him at eye level, seeing nothing ahead but the DNA in his mother's cells"

That is world-class wordsmithing my friends, and it's exactly what you'll find throughout this book. Buy it, borrow it, whatever it takes, but read The Immortal Life of Henrietta Lacks. I suspect the only people who won't get anything out of it are the illiterate, and maybe those with Alzheimer's. And after the people with Alzheimer's are cured with the help of HeLa cells, they'll be able to enjoy it as well. Which is a little freakishly ironic when you think about it.

Anyway, read the book.

Amazingly, The Dead Kennedy's Never Worked Retail Pharmacy.