JP AT LARGE

At times, you really are needed

"You want me to write my name?" She looked like I had just asked her to recite the alphabet backwards. "I don't write good," she said.

"Just make your mark," I said.

"She proceeded to laboriously print her name—her signature looked like that of a young child just learning with a big fat pencil and paper with wide lines. She was the mother of a teenager. She epitomized poverty. Her heavy winter coat was worn, but clean.

The next part of the transaction was difficult. I had to counsel her on her medicines. The Z-Pack was easy. I explained how she was to take the tablets. She looked at the package for a minute and then smiled and nodded, indicating that she understood. The schedule V liquid medicine was equally easy. Then came the Advair. I knew that she would need some help, so I opened the box, removed the instructions and handed them to her. She licked her lips, looked up at me; then she looked back down at the pictures. Her shoulders slumped noticeably and she said, "I don't read good either."

This woman never looked up. She was obviously embarrassed. She just stared at the instructions. She needed me to rescue her—to show her how to use the Advair. I felt a little pressure because I had never even looked at the instructions. No one had ever asked me to coach them before. I was as ignorant as she was about the method; but I could read and follow directions.

An older, well-dressed woman standing behind her cleared her throat noisily and managed to make eye contact with me. She frowned, held up three prescriptions, and waved them at me.

"I'll be with you in just a minute," I said. "I'll take your prescriptions if you want." "I am in a hurry," she said.

"You may want to come back a little later." I looked her directly in the eyes, hoping that my look sent her the message I wanted to infer: Mess with me if you dare. "These probably won't be ready for 20 minutes or longer."

I looked back to the Advair woman. She had picked up the inhaler and was staring at it. I had the idea that this was as tough as a Rubik's Cube for her.

"I can't wait," the older woman snapped.

I turned toward her. "I will fill your order as fast as I can. First I have to finish up here."

She sighed. "I'll run some errands, but they better be ready when I get back."

Eventually the Advair woman indicated that she understood, but I honestly hoped that her son, who could read, would be patient enough to tutor her.

The grocery store woman returned after 45 minutes. I brought her prescriptions, rang up her order, and started to counsel her.

"I don't need your help," she slurred. "I know how to read and I am relatively intelligent." She dropped her $50 bill onto the counter even though I had my hand held out. "Why did you have to make me wait while you helped that woman?"

I waited until I had her eyes. "Because she did need my help," I said.

By Jim Plagakis, R.Ph.

THE AUTHOR  is a community pharmacist. He lives in Stowe, Vt. Please e-mail him at jvgakis@verizon.net and send a copy to drugtopics@advanstar.com.