Pharmacy. Jim Plagakis. Pharmacist

A very good friend and I were discussing the medical challenges that one of his family members was facing. She had been losing weight.
She had body aches and pains. There was a suspicious mass in her groin. She was always tired, but had a hard time sleeping. This young woman (30 something) was a mess.

First, she saw her primary care physician. An internist came next. Blood tests. NothingAn MRI, X-rays and probes and prods came up with nothing. Her father insisted that she see an endocrinologist. Nothing
Her brother runs a new age magazine. He suggested a warm and fuzzy physician. Finally something. This guy said that she had lymphatic issues (my words) and that a strict vegetarian diet and some Chinese herbs would do the trick. A psychic saw that she has an intestinal parasite.

I know, you guys are laughing. A psychic? Hey, come on! At last the psychic saw something.

I will keep you apprised on this story. The physicians shook their heads, turned their backs and moved to the next patient.
The guru guy and the woman out in the universe have actually made calls.

Then my friend said something very interesting. He is a hospital administrator and has some chops when it comes to objectively
assessing things medical.

He said, “Don’t let anyone tell you that practicing medicine is a science. It is not. It is by guess and by golly a lot of the time. Witch doctoring! A science deals in facts. These guys deal with hunches and intuition a lot.

Then he looked at me and said this, “You guys … you pharmacists are the ones who deal with facts. Pharmacy is the medical specialty that is closesr to a science than any of them.”

I agreed with him. Pharmacists have a lot of artist going on in our one-on-one dealings with patients, but we do deal with facts.

Doctor panache! Doctor at the top of a pyramid! Doctor arrogance! They actually believe that they are the captain of the ship and the rest of us are the crew. Galley slaves as Paul T says.

I tend to agree with my friend. Succinctly, a doctor at the front of their names does no necessarily mean that
they

always know what the hell they are doing. I’m putting this out there as fun. What do you think? Is this medical blasphemy? Heretical thinking?

I promise to let you know as the case above progresses.

I have had a pretty good career. I have been a retail pharmacist since my first day “alone” in August, 1964. It seems like a long time and I’m still doing it 22 hours a week.
I like to say, “Taking Jim Plagakis out of the pharmacy would be like taking the clown out of the circus.”

My career has been very satisfying, but not because I have counted pills for over 4 decades, not because I have read and interpreted prescriptions and not because I have done required rote counseling for the last 15 years or so. My career has been rewarding because of the chances I have taken.

Nothing in pharmacy is better than our interaction with the patients. Nothing! No dealing with a patient is as good as when I take a risk and do what I can to help someone.
Often they don’t want to listen, but fuck ‘em. I’m the pharmacist. I have years of experience. My vision is acute. When I see something, I am often gonna take a chance and tell them what they may not want to hear.

Sometimes, I get creamed. That can happen when you take risks. Back in the 1980s,
I was called out front by a pretty teenager. Physically, she was an adult. Voluptuous and eye-appealing. She was not the least bit hesitant to ask me about birth control methods.

Of course, I told her that condoms were the best choice. Both to help prevent disease and pregnancy.

“I don’t think that boys like them,” she said and now she blushed a little.

This was not a time for delicacy. My job was not selling shoes. “I don’t care what the boys want,” I said, “If he doesn’t like it, make him take you home.”

“Really?” She acted like this was a brand new option for her.

“Really,” I said. “I’ll show you all of the other options, but there is nothing better than condoms for a young woman in your situation.” Her situation, I suspected could include
multiple partners.

That was a win until her father came in a couple days later. How could a young woman who looked like that not be eighteen? I got creamed royally by the father. I was contrite and apologetic. He mentioned his wife’s name a couple times and that made me wonder if he wasn’t secretly pleased that I had armed hid daughter with information.

Last week, the wife of a man I talk sports with was in to get Rx for him. I had talked with him the week before about using Nicorette Gum. I used it in 1990 to quit smoking and am convinced that, as long as the teeth are good, it is the best choice for a smoker of multiple packs a day.

I went out front and sat down with the wife.

“How is Don doing with his legs?” The guy is 55 years old, a diabetic with neuropathy down there. He has had lesions on his lower legs that just won’t heal.

“He’s okay.”

What is this pharmacist doing coming over here and sitting down with me?
Pharmacists never do that.

“How about his legs?”

“They are okay, I guess.”

Pokémon 3: The Movie move What the hell, Plagakis. Go for it. “Listen to me, Gwen. Don is 55 years old.
His legs are a mess.”

I listed all of his complaints. “He needs to keep his job and he has trouble walking”.

She looked off, her eyes clouded.

“If he wants to keep his legs, he needs to quit smoking NOW. Otherwise, there is a good chance that they’ll have to cut them off before he gets to 65.”

Now, I had her attention. “Don’t tell me that.” Her eyes widened. “It’s not funny.”

“No. It is not funny. It is liable to happen.” I talked with her. She smoked 3 packs a day herself. She has wanted to quit for a long time.

IF YOU HAVE NEVER SMOKED, YOU WILL NEVER KNOW HOW HARD IT IS TO QUIT. So, treat these addicts with some kindness. The really DO NEED your help.
Give them an opening and they’ll be gone. Their hunger for nicotine will overwhelm their desire to quit. Nail them down!

“You have to quit with him,” I said. “He’ll never quit with you sitting there smoking.”

“Really?”

“Really,” I said, “Talk with him. You don’t want your husband to end up an invalid.”

I don’t know. When she left the store, I felt like I had the upper hand. With smokers you never know. They are all for quitting at eleven, right after a fix. They even throw away their cigarettes. At noon, they are digging in the garbage.

We’ll find out about Don and Gwen when they proudly tell me that it has been a week since their last cigarettes. Or not!

I took a chance. I had to. I did what I could. I feel okay about it. Had I not, every time I saw them I would know that I could possibly make a difference and did not do it.

The Good! This felt very good, warm and fuzzy as we used to say in the 70s.

A nurse (I think she was a nurse. Maybe she was the doctor’s 15 year old daughter)
called in an Rx for a patient whom I always enjoy talking with. An older woman with limited resources. She is always very pleasant and respectful. Too much so. Do I deserve this kind of deference? Marion always buys a Milky Way bar. This candy bar is her weekly indulgence, just like you may go for a Carmel Macchiato at Starbucks to the tune of $5.00+ a few times a week. Marion treats herself to one Milky Way candy bar once a week.

The nurse ordered lovastatin. I took the Rx and said, “You might want to tell the doctor that simvastatin, generic Zocor, is available now and that it is dirt cheap.”

“Why would I want to do that?” A sort of huffy response. There was the sound of a slurp. Her Carmel Macchiato?

“Because simvastatin is a better drug than lovastatin.”

“I think that the doctor knows what drug is better.”

Oh for crissake. “Listen, just tell her what I said, okay.” I tried. We can do two things that can really be of assistance to poor patients. We can save them money and we can recommend better drugs that may be less expensive drugs when we can anticipate the outcome being better for less money. In this case, the cost was similar, but the drug is probably better.

Two hours later and a pleasant voice on the telephone introduced herself as the doctor.
“Thanks for looking out for my patient,” she said, “Change that Rx to the generic Zocor.
I’ll be changing all of my patients to it.”

Wow! All it takes is the trimtab to change the course of a monster ship, sometimes.

***************************
The Ugly! I filled two prescriptions for a woman of means who could afford practically anything. She was known to be cheap, very cheap. She had probably never even had a
Milky Way bar. The price of Carmel Macchiato would cause her to have a stroke.

The prescriptions were for lisinopril and HCTZ. She refused the lisinopril.

“Why don’t you want both prescriptions,” I asked her.

“I just want my blood pressure medicine, the little orange pills.”

“They are both for your blood pressure,” I said. “The lisinopril is more important than the HCTZ. You needed to be taking ……”

She dismissed me by turning her back on me. She actually spun around and put her hands akimbo on her hips. Who did this pharmacist think he is?

I tried one more time but it was like trying to sniff the perfume on your girl friend’s neck during a hurricane. She heard not a word. I was not a trained medical professional. I was not a pharmacist. I was not to be trusted. I was just some BOZO who filled her prescription.

Bullshit, I thought, I am going to be a tattle tail and call her doctor. Then she will find out which drug is the more important. Serve her for turning her back on me.

I took the time to track down the doctor on the phone and actually get him on the line.
He was an older guy and impatient. I quickly told him how this woman was sabotaging his therapeutic intentions and believed it was over a few bucks. I know, that business about the dollars was editorializing, but I couldn’t help but be a little petty. This woman would make King Midas look like an NFL football player with handfuls of cash in a strip club in Vegas.

Using the words “therapeutic intentions” may have been too complicated of a
distinction for this old guy.

“What do you want me to do about it?” he said.

“You are the doctor,” I said.

“And you are the pharmacist. Mind your own business.” Slam.

Neverwas film