Tuesday, November 30, 2010

Every Pharmacy. Everywhere. Right now.


The lady who doesn't know where she is, the one who needs her sleeping pills, anxious to talk to you about her grandson who hasn't called in 2 years, and the guy who says his copay went up when it didn't. Behind them all is the guy who's gonna ask you where the shoelaces are in about 30 seconds.

Yup. That about covers it.

OK, this started as fun and games, but I can't take looking at this picture anymore. I'm going to go to sleep and have a nightmare now.

Friday, November 26, 2010

From The "I Could Not Have Said It Better Given All Eternity" Department

"I am sorry to have to introduce the subject of Christmas. It is an indecent subject; a cruel, gluttonous subject; a drunken, disorderly subject; a wasteful, disastrous subject; a wicked, cadging, lying, filthy, blasphemous, and demoralising subject. Christmas is forced on a reluctant and disgusted nation by the shopkeepers and the press: on its own merits it would wither and shrivel in the fiery breath of universal hatred; and anyone who looked back to it would be turned into a pillar of greasy sausages."

-George Bernard Shaw

Happy fucking Black Friday.

Thursday, November 25, 2010

Great News For Those of You Not Yet Convinced Of My Greatness.

People unlike this person, who had this to say on my Amazon page:

This is THE book to get for your pharmacist this Christmas. And his boss. Reading the Drugmonkey's infamous blog has been the salvation of many a 12 or 13 hour shift in pharmacies all across America. His style of humor, a twisted combination of George Carlin, Denis Leary and Bill Maher, salted with righteous indignation, makes for both entertaining and enlightening reading. You will understand a lot more about the health care industry after reading this book than you think you do now.

I swear I didn't write that, but I do not disagree.

"Why should we take your word, or the word of anyone else for that matter?" you might be saying. "People suck, and I've been ripped off before a million times. Can't you give us a free sample or something, like the good honest people who make Doryx?"

Well, yes, yes I can. As of today the "Look Inside" feature has gone live on my Amazon garden. Click on the logo above the picture of the cover and you can take a little look around to see if this is worth your hard earned money. Or the money you found on the bathroom floor at work. Hell, it could be part of your welfare check or bonus you got while driving a large corporation into bankruptcy for all I care. Point is, you can click here and get yourself a free book sample. 

And the "find a typo win a t-shirt" contest is still on. The rules are pretty much self-explanatory. Find a typo, let me know, and if you're the first to point it out you get a Drugmonkey T-shirt. One has been claimed already.

I'm back at it for 12 hours tomorrow. I'm getting a sense it'll be a "Highlights From Today's Pill Counting Action" kinda day. The day after holidays usually are. Stay tuned.

Sunday, November 21, 2010

An Exploration Of Plastic Shows Why I Am Not A Total Communist

Childhood is the mold that will form the cast of your life. The impressions and experiences you have during your first few years on planet earth will shape your world outlook whether you like it or not. Whether you realize it or not.

In my case, plastic has a lot to do with my world view.

My dad worked at a factory making the stuff. Vinyl siding, hula hoops, cases for IBM computers, that kind of thing. I just now punched up the website for his employer and saw that they "specialize in thermoplastic raw materials in single, dual and tri-extrusions." I don't even know what that means, but I guess that's what Dad did for 40 years. The bossman started the plastic factory after World War II and went on to become one of the wealthiest men in Ohio, partly off the sweat of my father's brow. Good for bossman.

You heard me right. Good for him. People need stuff, and if you make stuff people need, and can sell it for more than you paid for it without being an evil bastard, you deserve to be rich. Bossman was able to do that. He got plastic to the people, made a shitload of money, and shared enough of it through decent salaries and a generous profit sharing program that someone who showed up at his factory and was willing to work hard and play by the rules could end up sending his slacker son to a private school to get a pharmacy degree. Slacker son then gets a decent job himself and you get your prescription filled by someone who knows what the hell he's doing and can tell when maybe you need a little more than the bare minimum of service. 

Everyone wins.

Now let's say sometime around 1984 Bossman would have decided to cash out and sell his factory to Plastic, Inc. You know exactly what would have happened. Or should. If you don't maybe you've been spending a little too much time doing things like watching "Dancing With The Stars" or straight guys who don't know they're gay playfight over an air filled leather sack. Turn off the TV for a minute and hang with me here:

For the sake of argument, let's say in 1983 the factory turned a profit of 10 million dollars. That made bossman happy, 'cause he got 10 million dollars. The first thing Plastic Inc. does however, is issue a memo that says its earnings target for 1984 is $12 million. Profit for the year comes in at $11 million dollars, making 1984 a failure.

The first thing to go is the profit sharing plan, as all profits must now be directed to placate angry shareholders. This wipes out the college fund for the slacker son. Raises are cancelled and lunch is cut from an hour to 45 minutes. A hiring freeze is implemented, meaning all employees are doing more work for the same amount of pay. Grumbling is heard up and down the assembly line.

Profit for 1985 is $11.5 million, an amount that would have bought bossman a yacht, but which sends the price of shares in Plastic Inc through the floor, as the corporation has now missed its earnings target for two years in a row. Retirees are replaced with agency temps and the speed of the assembly line increases. Lunch is now half an hour and insurance premiums increase 15%. Leadmen on the factory floor are reclassified as managers, meaning they can work unlimited hours for no overtime pay. The grumbling grows louder and someone from the International Union of Plastic People starts hanging out in the parking lot. As the old saying goes, companies that have unions generally deserve them.

Profit for 1986 is $7.4 million. IBM calls and wants to know why the quality of their dual extrusions sucks donkey turds. Plastic Inc. deals with the problem by sending someone from marketing to razzle-dazzle IBM, as opposed to putting money into making a better product. The plastic case on your new computer melts the day after its warranty expires.

In 1987 Plastic Inc. moves all operations to China. The only person involved in the last few years who made the kind of money bossman used to make is the hedge fund manager who shorted a million shares of Plastic, Inc's stock.

You kinda remembered the old plastic factory as you drove by its empty shell on your way to pick up your asthma medicine. If you remember right, the old man working as a greeter at the Wal-Mart where you get your prescriptions filled used to be a Leadman there. The pharmacist working that day is here from Cambodia on an H1N1 visa, and while no one doubts he's doing his best, he has trouble with your accent and has no idea what you mean when you say you "took two hits off your puffer" and it didn't work. He just kinda smiles at you as you talk and you leave the counter wheezing. Slacker son punches you in the face in the parking lot after you refuse to give him a dollar for cheap scotch.

Plastic Inc. is able to produce siding for 10% less than it used to. It is later found to be contaminated with lead.

Everyone loses.

Does any of this sound familiar to you? Does it? Because in case you haven't noticed, we're living it. We've let the corporations take over our lives and now, we're living it. The funny part is, the corporations have convinced you you don't have a choice. That if you don't let them fuck you in the ass unlubed civilization as we know it will collapse. A real person gets 20 years for forcible sodomy. An artificial one gets free speech rights.

Thing is, you do have a choice. Your interests and the corporations do not always coincide. Society's interests and the corporation's do not always coincide. You can realize that and not automatically defer to the corporation. Or you can keep your mouth shut and watch the football game.

Which may be a reason this year's Rose Bowl is brought to you by Vizio™

Wake. Up.

Thursday, November 18, 2010

The Greatest Pharmacy Book Ever Published, In The Last Month Or Two, Is Now Available On Amazon.

Take a look if you're so inclined. Combine it with something else and you got yourself free super saver shipping:

http://www.amazon.com/Your-Prescription-Takes-Damn-Long/dp/1453887695/ref=sr_1_1?ie=UTF8&s=books&qid=1290145362&sr=1-1

"Drugmonkey" you might be saying to yourself, "I live and breathe pharmacy all year long, but when it comes to this special time of year, I'm looking for something a little more. An indulgence for myself or a gift for another that will truly capture the spirit of the season."

I hear you. An actual excerpt from the actual book:

If I Were Rudolph The Reindeer, I Would Have Told Santa To Go Fuck Himself.
I would have been like. "You bastards have given me shit my whole life and NOW you want me to bail you out?? You can kiss my reindeer ass"
Then I would have been like "You know, while I was excluded and ostracized all those years, I worked on a few reindeer games of my own, since you would never let me play any of yours" 
There would be a crazy look in my eye.
Then I would take off and fly around in circles while Dancer and Prancer and the rest of those asswipes sat grounded with all the undeliverable toys on the shipping dock. Every once in awhile I would swoop down and kick them in the head or maybe bite them in the back while yelling "WHAT CHA THINK OF MY NOSE NOW MUTHA FUCKER?? TELL ME WHAT YOU THINK OF MY NOSE!!!!!"
I guess that wouldn't be a good way to mark Jesus' birthday though. I mean, hell, Jesus would never punish you years after the fact for being a bad person.

That's just one holiday highlight wrapped up in my book's pages. There are others. And lots of pharmacy stuff too.

A kindle version is coming soon. About a week most likely. I'm off to scotchland now.

Monday, November 15, 2010

Hey! Buy My Book!

I can say that now because my book is real! Seriously. The rollout starts today my friends. You can buy a copy at the createspace store right here, right now. An amazon.com listing is coming in about a week, and it should be good to go on the kindle in about 14 days.

I'm not kidding you. I wrote a book. And you can buy it right now.

Why should you? Because it's hilarious. Like I've said, most of it is regurgitated blog material, but I don't have to tell you this blog is a goddamn gold mine. All I had to do was get me one of those prospecting pans and stand in the creek for awhile to come up with 201 pages of solid gold.

Why else? Because with every copy sold an angel in heaven loses its wings, falls out of the sky, and crashes right on the pointy little head of Lloyd Duplantis of Gray, Louisiana. The ending of the book is original material, and if you were shocked, humiliated and/or downright frightened when Lloyd, Karen Bauer, and the rest of those goons at Pharmacists For Life International tried to hijack our profession a few years ago, you'll be happy to know this book's ending will have them frothing at the mouth. The ending of this book may just teach them a thing or two they wish they hadn't learned.

A thing or two they definitely don't want you to know. Guaranteed.

And on top of all that, you might win a free T-shirt. My dear e-friend ThatDeborahGirl has been kind enough to offer to send me ten Drugmonkey based T-shirts she made as part of her screenprinting class. Since I am not only this book's author but chief copy editor, I worry that I might have missed a typo or two. So here's the deal, buy a book, find a typo, point it out to me, and get a free shirt. Everyone wins. You get a shirt and I get out of hiring a copy editor.

And Lloyd Duplantis gets to live with the fact that if it weren't for him inspiring me to do this, the information at the end of this book may have stayed buried forever.

So yeah, you should totally buy a copy now.

Monday, November 08, 2010

The Death Panels Among Us.

Unaccountable authority figures directing helpless patients into suboptimal care. Uncaring, unkind bureaucrats making life and death decisions based only on concern for the dollar. Life and death he said, which means people die based on edicts from the health care authorities. Like dead dead. Buried in the ground with worms picking your bones clean kinda dead. A future that I'll have to grant my teabagger friends, would be frightening if it ever came to pass.

And by "would be frightening" I mean "is frightening." Because that future is already here. Not in a socialistic Obamacare kinda way, but in a totally free market AstraZenecare kinda way.

Meet Dan Markingson, who is now dead.

Dan had issues, severe mental illness issues. Issues of the type that would lead him to write poems like this:

"I'm especially eager to attend this storm and SLAY those who deserve slaying.
I will choose victims immediately...
I HAVE NO EMOTIONAL ATTACHMENTS. I KILL FOR FUN!!"

Not surprisingly, Dan was committed and put on Risperdal in an attempt to make killing a little less fun for him. In Minnesota though, where Dan lived, a person can get a "stay of commitment," meaning that as long as they agree to follow their doctors orders, they will not be institutionalized.

So far, so good, right?

Six days after he was hospitalized, Dan's doctor asked the court for such a stay. The next day he recommended Dan enroll in an industry funded study of atypical antipsychotics.

Uh-oh. Most of you can probably sense where this is going. For those of you who need some clarification, I'll bring in the Bullshit Exposure Through Dramatization Players:

The scene, a large state mental hospital on a dark and stormy night. Three policemen burst through the front door carrying an obviously deranged and agitated individual.

Patient: Ah! The voices inside my head! They make me want to kill people! This sucks!

Policeman: We can't have you killing people son. You have to stay here now.

Patient: I don't want to stay here and I don't want to kill anyone, even though it would be great fun. Isn't there another way?

Doctor: Here. Take this.

Patient: Wow. I feel better now. Can I go?

Doctor: Absolutely. As long as you agree to follow my orders. Now sign this paper that will enroll you in a clinical study. I'm technically just recommending you take part, not ordering, but if you disobey my orders you stay here with a roommate who eats his own poo and thinks it's kinda fun to kill people too. So you really should sign.

Patient: What?

Doctor: Right by the X. I highly recommend it, and I have the power to have you committed.

The patient then signs.

The study that was highly recommended to Dan was designed to compare the effectiveness of Seroquel, Zyprexa and Risperdal, three newer "atypical" anti-psychotic medications that compete in the highly lucrative crazy market. Nothing wrong with that I guess. It's actually a good thing to have head to head effectiveness data in a country where all a med has to do is beat a placebo to be approved. This study was also designed and paid for by AstraZeneca, the maker of Seroquel.

Uh-oh. Here comes the list of entirely predictable facts.

- The study was too small to reliably detect any differences between the three meds. "In scientific terms this study is of very little value" said the editor of the British Journal of Psychiatry.

-It measured "effectiveness" by how many people stopped taking their drug. As long as you took your pill every day, it was effective. And if you stopped taking it, the reason why was not noted. "It does not make scientific sense to do a study and not measure one of the most important outcomes." said Dr. John Davis, professor of psychiatry at the University of Illinois-Chicago.

So why even bother to do a study that experts call out as junk science? Here's a clue.

In 1997, when Dr. Andrew Goudie, a psychopharmacologist at the University of Liverpool, asked AstraZeneca to fund a research study he was planning, a company official replied that "R&D is no longer responsible for Seroquel research—it is now the responsibility of Sales and Marketing." The official also noted that funding decisions would depend on whether the study was likely to show a "competitive advantage for Seroquel."

So....evidently some studies are to learn, and some are for show. So a sales rep can wave a shiny brochure under your nose that has a chart on it showing one bar dramatically different from the others.

So, after being stabilized on Risperdal, Dan Markingson was enrolled in a study in which he was randomly assigned to take one of  three subject medications. He was barred from being taken off his assigned drug, prohibited from being switched if the drug he was taking did not work. Other meds used to control depression, anxiety, or agitation were restricted. I'll let Mother Jones take it from here:

After Dan was enrolled, he stayed at Fairview for about two more weeks. By that point, Olson thought Dan's symptoms were under control, but (Dan's mother) Mary was still very worried by his erratic behavior. She recalls meeting with the doctor: "Olson came in and sat down and opened his file and said, 'Oh, Dan is doing so well.' And I said, 'No, Dr. Olson, Dan is not doing well.' I think he was taken aback." Even so, on December 8, 2003, Dan was transferred to Theo House, a halfway house in St. Paul. He was required to sign an agreement confirming that he understood he could be involuntarily committed if he didn't continue taking his medication and keeping his CAFE study appointments.
At the halfway house, Dan often stayed in his room for days. On March 26, 2004 nearly four months after his discharge from Fairview, his thoughts were still "delusional and grandiose," according to a social worker's note. An occupational-therapy report from April 30 detailed Dan's condition: "Personal appearance disheveled. Isolated and withdrawn. Poor insight and self-awareness." Entries in a personal journal that Dan kept during this period don't show any obvious changes, suggesting that he was improving little, if at all. Mary felt he was becoming angrier. "He was so tense, with this ready-to-explode quality."

About a week later.....

Dan had stabbed himself to death in the bathtub with a box cutter, ripping open his abdomen and nearly decapitating himself. His body was discovered in the early hours of the morning by a halfway-house worker, along with a note on the nightstand that said, "I left this experience smiling!" Later, when the blind on the study was broken, researchers found that Dan was being treated with Seroquel, the drug manufactured by the study sponsor, AstraZeneca.

Which would be sad enough if Dan had died in the pursuit of knowledge. Unfortunately, Dan Markingson died in the pursuit of a graph where one bar could be printed in color and be much bigger than the other two. A graph that then could then be waved under your nose for a few seconds in the hope you wouldn't look all that closely at it.

So perhaps, my teabagger friends, you need to worry less about the fictional and improbable death panels you fear under a future of Obamacare, and focus more on the AstraZenecare death panels of the present.

Just sayin'

Read the whole Mother Jones magazine article here. 

Thursday, November 04, 2010

A Civil Rights Issue I Can Totally Get Behind, Or More In Front Of I Guess.

The struggle for equality is never easy my friends. You must remember always that the forces of the status quo are powerful. They do not give up their privilege easily. They will fight you every step of the way, and the first time you challenge them you will most certainly be crushed.

Still, you must fight. You must get off the mat and fight. That is my message to the good people of Pittsfield, Massachusetts:

Voters in a western Massachusetts city have decided not to lose their shirts over at least one ballot question. Pittsfield voters soundly rejected on Tuesday a measure pushing for women to be allowed to walk around town topless.
The nonbinding question, which was only on the ballot in Pittsfield's 3rd Berkshire District, urged that district's state representative to introduce legislation amending the state's nudity definition.
Under the proposal, females of any age would be allowed be unclothed from the waist up in public anywhere males are allowed to be similarly undressed.

To the Pittsfilder's who struggle for justice, I can only say:

I am with you in this fight. Godspeed to you my friends.

I'm Hoping Jello Might Write Another Sequel. Before Jerry Dies Or Something.

Another thing that makes California the coolest place on the planet. How many other states can say the Dead Kennedy's ever wrote a song about their Governor? None. That's how many.

And it's also the kick assingest song on the face of the earth.


Granted, it's not the most flattering profile, but I will point out the sequel, written after Reagan became president, was called "We Have A Bigger Problem Now"

My favorite line....."DIE!!!! on organic poison gas....."

I know I've been neglecting you guys. I hope to get back into the swing of things this weekend with a good old fashioned Big Pharma pud sucking story....

Enjoy the vid. It's best played loud.