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    The trick is knowing where to look


    David Stanley
    There are a lot of things not to like about retail pharmacy, and you don't need me to tell you what they are. Cranky customers, pointless paperwork, microscopic reimbursements, and creeping deprofessionalization, just to name a few. You know the drill. All of that pales, however, compared to the feeling I get when a favorite patient dies.

    The other day I opened the paper and was greeted with the obituary of a woman who had been coming into the store for a few years now. I would happily have taken yet another cut in third-party dispensing fees not to have seen it.

    I had always assumed it was something like tartive dyskinesia that had bent her body so cruelly, but I was wrong. According to the day's paper, it was Lou Gehrig's disease that took her life, and I felt like a bit of a failure to find that out only by reading it after she was gone.

    Day-to-day bravery

    I thought a lot about her afterward as I went about the workday routine.

    I remembered the way she would call ahead for her prescription total so that she could show up with her check already made out, proving that while her body was under assault, her brain was still sharp enough to find a way to spare her the embarrassment of trying to write out a check or fumble with money at the counter.

    I thought about the time I saw her in the makeup aisle, buying mascara, making a stand against the ugliness of the world.

    I hadn't seen her in a few months, and I thought about what those last few months must have been like for her. I don't have to tell you that Lou Gehrig's is a horrible way to go.

    I liked her, and there was no way I could have changed what happened to her. The fact no one else could have either didn't make me feel any better.

    Courage of another sort

    My day continued. I verified another prescription for $1.50, told a man where the potato chips were, and wondered why I got into this profession.

    I was snapped out of it when my technician told me there was someone at the counseling window. Another regular customer and another one I kind of liked, despite his habit of asking for Norco refills early each month.

    I knew from his profile the kinds of mental health demons he was battling, and I understand the urge to self-medicate. So while the Norco was never filled early, more than once the guy had walked away from the counter with my sympathy. Today he was picking up a prescription for Suboxone.

    "I'm finally going to deal with this. I just wanted to tell you, you've always answered my questions and never made me feel judged."

    He grabbed my arm and stared straight into my eyes, "Thank you. I mean that."

    Whiplash on a word

    To all the other problems of retail pharmacy I could add emotional whiplash. From one extreme to the other in less than 2 minutes. I may end up looking for a chiropractor, but that moment was worth more than all the $1.50 dispensing fees I will ever collect in my lifetime.

    "Oh, by the way, you told me once I shouldn't take that Norco with Tylenol. Is it okay with this?"

    I answered this question just as I had all his others and then dove back into the prescription pile. I wondered if that man knew the hard work he was up against to beat a narcotic habit. I know he doesn't realize how how hard I'm rooting for him. Sometimes you just feel like you have to take a stand against the ugliness in the world.

    Choose your view

    The next lady to come to the counter asked me about shoelaces. The next phone call was someone from corporate, tracking the status of a report and acting as if nothing in this world could be more important.

    I didn't mind.

    David Stanley is a practicing community pharmacist in California. He can be reached at
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    David Stanley, RPh
    David Stanley is a pharmacy owner, blogger, and professional writer in northern California. Contact him at [email protected]