last refills

(I recall some advice a friend on twitter once gave me. She basically said you should write to have fun. She also said that writing was an act of sharing.  These rules are much better than my old ones.

 So I will share two years that I spent at my last retail pharmacy job in a series of little posts.

I am going to try not to care about the writing.  I’ll try not to track my hits, my relevance, my topicality, and whether or not  I dispense useful information, coherence, or  good grammar.

I will just quietly post a message on twitter as I finish each episode.

And I promise myself I will have fun with the writing.

LAST REFILLS: Episode 1- “I need my Blood Pressure”.

(Sometime during August, 2010)

The old cashier gripped the glass coffee pot as though she was an angry wife swinging a rolling pin.  Every morning she would enter the pharmacy’s bathroom, taking the glass coffee pot with her, and 20 minutes later she emerged with a pot full of cloudy water. Annie, the store manager, held her breath as Emily proceeded to pour this into the coffee maker.

None of the pharmacy staff liked to think about what other activities may have occurred in the bathroom before she came out with the water. They lived in mortal fear of that coffee. But they feared Emily more. They drank without complaint, all the while eyeing packages of acidophilus for the remainder of their shifts.

Annie looked down at the other end of the store and saw a group of customers waiting for them to open, standing outside the front door.

                  …Oh Christ, Lou, the building’s landlord, was out there too. Now she would have to hear about how he and his partner were the town’s saviors when they owned the pharmacy.

The staff did not much respect Annie as a manager. Whenever she spoke to an employee, she struggled with her sentences. The words couldn’t quite break the chains of indecision that held them shackled to her brain.

                  “Emily”, Annie managed, “see if you can move all the Halloween items to the…”

Annie suspended her sentence, lifted an item from the tote near her feet, and left the rest of her thought to suffer forever in solitary confinement. She tried something else.

                   “Emily, Uhm, Are you wearing your name badge?”

Emily glared back and folded her beefy arms across a massive chest, and Annie got so nervous, she put out the hair straightener where the lice treatments were supposed to go. Emily reminded her that the store should have opened 15 minutes ago.  Emily knew they couldn’t open until the pharmacist arrived. Annie also knew enough to watch everything she said to the people who worked in the store. A large drama could start with a small word. It was why she often stopped herself in mid-sentence.

Frances was the pharmacist who was on the schedule. She was late again. She practiced pharmacy by a set of random rules, which frustrated the customers and the pharmacy staff.  One of her rules was that she would only fill prescriptions printed on blue paper, the color of New Jersey’s official state prescription blank. If the customer had a non-blue prescription from another state, they would have to go down the road.

Another rule was about the use of the phrase, “by mouth”. All of her prescription labels had to contain the maximum number of “by mouths” allowed by the laws of grammar. This is how she wanted her prednisone labels to read:

                                On day one take five tablets by mouth in the morning, and five tablets by mouth in the evening, on day two  take four tablets by mouth in the morning and three tablets by mouth in the evening, on day three take three tablets by mouth in the morning and two tablets by mouth in the evening, on day four  take 1 tablet by mouth in the morning and ½ tablet by mouth in the evening, on day five take ½ tablet by mouth in the evening, and on day six stop taking tablets by mouth.

Should a tech missed just one “by mouth”, Frances would make them retype the entire thing. 

 Most of the store preferred her partner, Godwin, but Godwin had no business practicing retail pharmacy. He could not keep up with the volume of work. Godwin liked to use biblical phrases as his computer password.  In the beginning, when he first started, his password was “the lord is my shepherd I shall not want”, and every time he checked a prescription, he had to type that phrase into the computer.

 When that didn’t work, he changed it to “vanity, vanity, all is vanity”. Even that slowed him down too much.  One day a technician suggested that he just use “Jesus”. Another employee argued against that idea, because he noted that Godwin had only been picking quotations from the Old Testament.

                   “Why not use “David” then?

 All the store business suspended, while staff and customers thought up secret passwords for the town’s pharmacist.  Godwin said he thought “David” was too simple but would consider using “the house of David”. At that point the night cashier suggested “the house of blues” and a customer with a UTI asked him to stop participating in the discussion. In the end he chose “Jesus”.  Godwin was reborn, and the store referred to him as Jesus, from that day forward. 

 Though she was better at managing the work flow, Frances was only preferred by a few customers and even less employees. She would push the staff to follow some corporate directive during the most difficult parts of their shifts. Suddenly, the techs would have to inventory the creams and lotions. Then she would stop that, and have them phone customers reminders to refill their Lipitor.  After two calls she would send someone home to reduce payroll. It all depended on which e-mail she happened to be reading. The staff became two staffs. Either you followed Frances up a mountain of e-mails, or you followed Jesus, because when his shift ended, at least he would treat you to a last supper.

                ****

  “Are they going to open sometime today, I need my blood pressure.”

  “Where was it when you left?”

  “I don’t know that machine wasn’t on the table, when are you going to fix that leg?”

  “My leg is fine, it’s my toe, got all swelled up.”

  “The leg ain’t fine. the table wobbles.”

  “I wobble because of the acid in my toe; I can’t even tie my laces.”

  “Lasix? Who said anything about Lasix?  I need my atonall,”

The short woman turned to the shorter man and repeated herself, but louder and slower.

      “I…need…my…blood…pressure.”

The two of them disregarded the tall man beside them. They were all waiting for the pharmacy to open.  If he had still been working the prescription counter, the tall man would have cared for all their concerns.  But now he was unknown to them.

This little red building was still half his, so he checked on things from time to time. But he didn’t see the point. Frank, his old partner, had never set foot here again.  Since that day they sold their pharmacy business to a big chain that swept into town.

Frank was a difficult partner. By the end they had stopped talking. Frank  had no business sense and failed to see the big picture.  But the taller man, Lou, had seen the big picture early on. When they first started the business, people didn’t have pharmacy insurance. At that time, medicine might be expensive, but it always had to be affordable. You charged what your customers could pay. And you still made money.

When insurance got involved, the costs got quietly shifted around to everyone who worked, whether they needed medicine or not.  And this was a golden time for doctors, pharmacists, and patients. Doctors could prescribe whatever they wanted. Insurance would pick up the tab.

It was Zantac and Prilosec that started the beginning of the end. Because patients only saw a co-pay, drug makers could charge anything. At that time, the prices for Zantac then, later, Prilosec were unprecedented. But nothing could touch these drugs when it came to controlling gastric pain. Record numbers of prescriptions were sold and insurances picked up the tab. 

In time, business realized that this spending was not sustainable. Insurance had to reduce costs to keep the massive profits rolling. Conveniently, chain drug stores were drifting in. These big companies could afford to accepti obscenely low reimbursements. But why would they take less? So, they could increase store count and then they could buy out the smaller pharmacies that could not compete.  It was a golden time for chain pharmacies and insurance companies.

 At first, Frank refused to sell. Lou was ready to hold a gun to his head. He kept seeing their windfall drift further way. The two of them stopped talking. It divided their store and business suffered even more. Eventually, the constant rush from the big pharmacies eroded Frank’s resolve, and he finally agreed to sell. Lou chuckled quietly. He remembered that the crazy bastard closed his eyes and cried the day the chain handed them the checks.

****

 The windows of the old red building in Eastborough, New Jersey, glared at the little line of customers. The drug store was firmly footed at the far end of Main Street, a street mainly used by to get to some other town. For most of its history, Eastborough lived in a state of competition with the slightly less working-class town to the west.  This escalated when the New York, Susquehanna, and Western Railway laid tracks which further divided the towns, two hundred years before.  After the tracks went down, uppity Westborough named a newly built post office after itself, rather than the common name that both had used previously.  Soon each side was claiming its own schools, churches, and town music bands.

 The battle became especially pitched during the rivalries of the two town’s bands.  It reached a crescendo in 1920, when a resident of the Eastborough formed a popular cornet band which played each summer in Stone Gardens, located off of Main Street, less than a mile from the little drug store.  The band’s proudest moment occurred in the summer of 1940, when the town erected a band shell near the banks of the Lenape River. Even some of the larger North Jersey newspapers printed pictures of the band conducting its Saturday night serenades to people sitting on the banks of the calm water deposited into the hot August night.

 This all came to an end in the flood of 1968, when the river swallowed the band shell, which was never seen again. Because of its location near the river, Eastborough would always be at a disadvantage. The river snaked around the town. At least once a year, when the rains were heavy, it would tighten its coil and hiss out the excess rainwater flooding the low lying roads. The western side of the rail road tracks was always untouched by this.  The floods eroded away the resolve of the better-off people, and those that could, left the town forever.  

In 1979 the iron quarry located at the base of the town closed.  When it collapsed, it took the jobs but left its scattered gravel which had given the only park in town it’s name: The Stone Gardens.  When the 21^st century started, many of the adjoining towns saw their populations swell. An influx of super sized stores surfaced onto the expressway that lay in Western Borough. Instead of patronizing the stores of Main Street, people flocked to Targets, Lowe’s, and Staples, and the tinier stores drifted deeper and deeper down the Lenape river to eventually board themselves.

***

 Each afternoon at four, Emily walked around the drugstore with the remains of the day’s coffee. The tall, pimply kid was working the front register.  He told Emily hello, but he was looking past her. He was focused on Lisa with her shiny black hair and dark eyes.

Emily turned down the cough and cold aisle where Lisa, a shift supervisor, was talking to a customer in Spanish. She did not want to share her coffee with these two

 The front door open and the store’s delivery man entered.  She quickened her pace to the manager’s office, to avoid talking to the driver. 

                “Whores. All of them.”, she thought.

  In the manager’s office, she poured out some coffee into Annie’s mug.  Downstairs in the pharmacy, the tech had nothing going on. She was scanning the internet from her phone, tracking some merchandise that she sold on a web site that her brother had built for her. The belts from china were a hot item.

 If Frances wasn’t distracted by the paper she was holding, she would have told the tech to count the oral inhalers.  But Frances was in shock. She stared at the fax in disbelief.  Each day, the district office faxed the latest version of the store schedule to all the pharmacies in the district.  Jesus had been crossed off the schedule. District had removed him from staff and replaced him with some other guy’s name. It was effective the following Sunday.  Emily entered the prescription department without speaking, and quietly filled their cups with last refills.