Pharmacy. Jim Plagakis. Pharmacist

There come times in our careers when we have go to stop, pause, take ourselves off automatic pharmacist pilot and act like human beings. We have the opportunity to look at our customers and see more than faceless patients, collections of diseases and syndromes. They can be human beings who are in real need and not just a person who takes a drug costing $149.00 a month and is called polycyclodexrisperone. We get a chance, more often than we may notice, to make a real difference in the lives of other human beings. Some of us can see a patient walking down the pain/laxative aisle and know what drugs she takes and not have a clue what her name is.
Yesterday, the tech asks me, “Jim, Mister Zachary wants to know if you can loan him another 3 tablets of his medicines, enough for the weekend.”
I looked at the three work orders. Enalapril, Atenolol and HCTZ. We had already loaned him 6 tablets of each. “Which office? Why haven’t they returned our call? It is been almost a week.”
“They have returned our call.”
“Well?”
“They denied refills.”
“Did they say why?”
“He didn’t make it to his appointment a couple weeks ago.”
I looked out at Mister Zachary. Elias Zachary, to be exact. He was a thin black man, maybe 30 years old. He was sitting on a chair, leaning forward, his butt on the edge of the seat. Classic Type A behavior.
I went out front. “Don’t stand up,” I said, “Gimme a chance to rest my legs.” I sat in the chair beside him. This seems to work much better than standing over someone. Sitting beside them seems to soften the hard Mister Pharmacist edginess that comes with our job.
I shook Mister Zachary’s hand and asked him why he missed his appointment.
“No insurance. I lost my job.”
“Well, your health is important.”
“Groceries for my kids is important. My health is shit compared to that.”
I looked at him and smiled. This could not be a lecture. This had to be a casual conversation. “Man, the number one group in danger of having strokes is young, black and male.”
He looked at me.
“That’s you.” I shrugged.
“So you won’t loan me enough of my medicines for the weekend, huh?”
“What is your plan about seeing a doctor?”
“I’m not paying that guy $95.00 just to get my medicines okayed. I guess I’ll go to the emergency room, if I have to. Either that or go without.”
I did not want either. I did not want to contribute to one more $500.00 rip into the fabric of this country’s practically bankrupt medical system. I also did not want him to go without.
“He’s what I’ll do,” I said, “Forget about this doctor. I don’t get that he is looking out for your health. He’s after something else.”
Mister Zachary nodded vigorously.
“I’m going to fill your three prescriptions for a 30 days supply, just this one time, but you have got to get to some doctor before next month at this time.”
Kissing Cousins trailer
“All right,” He was nodding.
“Not just all right, man. You absolutely must do this. You may not have a job right now, but what are your wife and kids going to do if you have a stroke and they have an invalid on their hands at home? How are you going to feel if you can’t work forever?”
He frowned. “You serious?”
“I am serious, man. If you don’t have the money, there are free clinics in Houston. There are charities. There are churches. You must, absolutely must, see a doctor before next month.”
Will he? I believe so, but then, between the two Plagakis boys, the one named Jim is the eternal optimist.
Do you think that your average medical doctor or osteopath are looking out for this guy’s welfare? Do think he really give a shit. I say “Hell No!” That’s Texas for “You can be reasonably assured that the answer is NO.”
Give yourselves a break, you guys. Nothing feels better than serving a human being in need.
Don’t do what I do. Do what you do. And, make sure you tell us about it.

This has been going on since 1965. I hated it then and I still hate it now. I will always hate it. The difference between 1965 and 2006, however, is me. When in was in my 20s, I was liable to be hooked and reeled in like a stupid fish. I reacted with absolutely no consideration given. Man, I was like a pinball machine. Chang, flash, chinga, ching, flash, flash. I was young though.
In 1965, I could be expected to react to what I perceived as an insult. I’d quit what I was doing, walk right out front and get some face time with my enemy. I’m gonna set this sunuvabitch straight right now.
The affront I’m talking about is this. A guy, almost always a male, presents 4 prescriptions and wants to know how long. The clerk has been well trained. She knows that I have 6 other Rx on the counter. This guy’s four makes it ten prescriptions. She knows that the telephone can ring at any time. So she tells the patient, “Your prescriptions should be ready in half an hour.”
“Why so long?” The customer directs his question directly to me.
“Prescriptions take time, Sir and there are 6 prescriptions ahead of yours.”
“I don’t see anybody else than me here.”
“They are coming back.” I want to say, They are smart enough to go do other errands, but I keep quiet.
“Why does I take you so long when all you have to do is take the pills from a big bottle and put them in a little bottle.”
He had me. I bit and he had his hook firmly set in my jaw. He reeled me in. “I don’t know why it takes you so long.” Yuck, yuck, yuck!
This idiot is going to find out. I am out of the pharmacy so fast the clerk is spun around trying to watch me. I’m in the guy’s face, totally violating his personal space, and probably spraying a fine mist from my mouth as I come close to shouting at him.
“Pharmacists do way more than just take pills from one bottle and put them in another.” I am young, strong and lean. He is middle years, overweight and soft. I move in and he either fights or flees. He steps back. (A bonus for you retail pharmacists in 2006. Use this personal space violation properly and you gain a significant advantage. Remember, the pharmacy is YOUR house, not his)
“Pharmacists are highly trained professionals. Our job is to make sure that you have the correct medication and that you take it correctly. It takes some time.”
And .. back then, it certainly did. No computer. The labels all had to be hand-typed. You had to hand-prepare the receipt. Prices had to be calculated by hand. Calculators were ten years in the future. You could not expect the doctor to put legally required information on the prescriptions. You guessed it. The pharmacist did it. Each Rx, by hand. You used a Bates stamper on each Rx. You used a date stamper. You initialed each Rx. You wrote the cost code and the retail price. To warn the other pharmacists, you wrote all about what a jerk this guy is on each Rx. As a side, you add one dollar to each Rx just to punish him for being such an asshole. (I’m not kidding about that one.) Whew. No wonder it took so long.
I am not longer a youth, lean and with testosterone dripping from my pharmacy chops. I have more sense.
Yesterday a guy said it, “You just take pills and put them in a small bottle, why so long?” He chuckled. There were other people waiting for prescriptions and this jackass thought he was entertaining all of them.
“That’s how long it takes,” I said. I didn’t even look at him.
“A half hour?”
“There are people ahead of you.” I was not about to go out front. First, it was a waste of my time and energy. Second, it was not my job to educate this guy.
“A half hour?” He said it twice. Very versatile, this asshole.
“I have 6 prescriptions to do before yours.”
“Why does it take so long?” The other customers were not finding this guy to be interesting at this point.
“Five minutes per prescription, I said. 6 plus your 2 makes 8,” I said. “Your 2 will be ready in 40 minutes.”
“But she said a half hour.” He was really complaining. “Now it is 40 minutes to put a few pills in a bottle.” He looked to the group for support and got nothing. They were all on my side, probably because their Rxs were in line ahead of his.
I put a grave doctor-giving-bad-news look on my face. “Actually,” I said, “Looking at these prescriptions, I am going to have to do some extensive counseling,” I smiled at him. “Yours probably won’t be ready until 2:30.”
He looked at his watch, looked up and squealed. “That’s 50 minutes.”
“Actually, looking at your prescriptions, I can see that they will take some special attention. Make it 2:40.” I smiled again.
“That’s an hour.”
I really wished I could add a few dollars to his total, but, alas .. 3rd parties and copays.
He huffed and puffed and blustered and then left the store. The other customers were holding back their smiles. I had enough chips in front of me to go to 3:00, at least. The only smart thing this guy did was to stop and get the hell out of there. I made sure I held his Rxs behind the counter until 60 full minutes had passed. Only then did I release them for sale.
Who said that pharmacists have no power?

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