Jim Plagakis lives in Sarasota, Florida. You can e-mail him at jpgakis@hotmail.com.

Jim Plagakis, RPh

"I don't have to answer those questions." I looked at him. "You know that." 

"But I will," I said. "I just left work, and I haven't had anything to drink."  

I wanted to turn the AC back on and get home. "Do you want my license and proof of insurance?" 

He took the documents to his police cruiser. A few minutes later, he handed them back to me and asked, "Where do you work so late?" 

I frowned. "I know," he said. "You don't have to answer that." 

"But I will," I said. "I'm a pharmacist. I work at the drugstore at the end of Seawall Boulevard, at Holiday Drive." 

"At work? Come on, man. Why did you stop me?"  

"You crossed the line," he said. "I followed you from 14th to 33rd. You crossed the line five times." He hesitated. "I know you weren't on the phone. Were you texting?" 

"Let me blow into the tube," I said. "I want to go home. I had a tough shift. I worked really hard tonight, and I just want to go home and put my feet up. I'm very tired and very hungry."  

I held up the white jacket I was taking home for laundering. I showed the company insignia. I pointed at my nametag. 

It was in the middle of the week, going on 11. There were couples in short pants and thin cover-ups, holding hands and walking on the seawall, but very little vehicle traffic. The cop wanted to talk. I relaxed, but it was hot and the air in the car was stagnant. 

Articles

An encounter with a police officer reminds JP that the world sees pharmacists only as pill counters.

Late at night and over the line

I couldn't resist. I touched her arm lightly when I asked how I could help her. I think that she liked that. Her eyes twinkled as she smiled at me. "My memory," she said, "It's foggy."  

"No, I meant prescription drugs." It's true that plenty of people who smoked dope when they were 20-somethings in the 1960s are still doing it in 2012. When I counsel older patients on their prescription drugs, however, I rarely consider that they may be using recreational drugs. 

"I do not take prescriptions. I want only natural herbs. My friend told me that something called Gingle could help with my fog problem."  

"Ginkgo," I said. "It's supposed to help with memory. At least that's what Varro Tyler claimed, and he was the most famous pharmacognosy expert of modern times." I had to explain what pharmacognosy is. 

"Good, I want a bottle." She looked at me. "It will be okay with my A-fib?" 

Hang on, Sloopy. "Are you taking a blood-thinner?" 

"Just a tiny pill. It's natural. I don't take drugs." 

"I don't think you want to take ginkgo," I said, "It can cause bleeding, and you're already on a blood thinner." 

"But why? If it's just an herb, how can it cause bleeding?" 

"I don't know how it causes bleeding. It's in Varro Tyler's book, and we can trust him. No ginkgo for you. I'm sorry." 

A sizable segment of the medication-using public seems to have decided that "natural" is better than anything pharmaceutical. But nature isn't always harmless.

Natural doesn't always equal harmless

"You can stay until I'm ready to close," the nonpharmacist manager had said. "But the tech is hourly. She has to go."  

So what did he get? A pharmacist calling in sick because she was feeling overwhelmed. 

We are quickly moving in on a professional/business crisis point. Readers who have followed my thoughts know that I distinguish between the two. You also know that I believe that we can't have one without the other. We deal in a product, so we will always be engaged in a business, but the business has grown like Topsy. It has turned into this terrifying obesity that is crushing the 

It seems like many years ago a girl too young to be a mother stood at the counter. A toddler clutched her leg, crying. The girl's face was drawn. She looked terrified. The child's prescription was for prednisolone liquid, a graduated dose over a period of days. She had picked up the medication in the morning. It was midafternoon. 

I had not counseled. I rarely counseled, back in the day. I said, "What's the problem?" 

Her eyes widened. "I don't know what to do." 

"Not that difficult," I said, "Just read the label."

Her eyes filled up and she began to cry. She couldn't read. 

Professional failures like that happen every single day, all over the place. They happen because we are so invested in keeping the Prescription Mill running fast and smooth that we neglect our most important job. But we have to make a profit, don't we?  

The business is very close to failing. Can't they see it coming? When we are not able to deliver the prescriptions that our culture demands, turn out the lights. 

Approximately 10,000 Americans turn 65 every day. There are more than 330 million citizens who believe they are being cheated if they visit the doctor and don't leave with a prescription. The question is: 

If we can't deliver, there will be no more retail pharmacies. Just dispensaries, many more of them mail order.  

The business of pharmacy is crushing the profession. The bean counters are running the Prescription Mill right into the ground. And if we don't stop them, who will be left to do our jobs?

Pharmacy's crisis point

"Hold on," I said. "I'm not a doctor. I do not diagnose." I stepped back, but I was too late. She had already lifted the heavy right breast. 

"It is probably a fungus," I said, and repeated, "I am not a doctor."			

"First, button your blouse, Ma'am. Remember, this is a drugstore, and we do not have privacy."  

I always help poor people. The pharmacist is their last resort. We are the only medical professionals who can give them free advice and some relief for only $20 swiped from their grocery money. 

I said, "That part of your body rarely sees the light of day."			

"Never," she said. "My breasts are big and that crease at the bottom is never dry." 

"I can help you, but my advice won't be worth much if you don't follow it."			

"I promise, but I don't have much money."			

I assured her that she could afford to follow my advice. I told her to wash and dry the areas with soap and water, and to get them very dry with a blow dryer. 

"Galveston is humid," I told her. "Fungus cannot grow where it is dry." 

"Okay, Doctor Jim, I have a blow dryer."			

"When it's dry, spread on a small amount of this." I handed her a tube of terbinafine cream. That is my go-to antifungal because it is the only fungicide. 

She checked the price. "Oh, I have some of that at home."  

What the ... ? Why do they do that when they don't want to buy what you advise? They don't say, "That is too expensive." They lie. I tried to get her to take clotrimazole cream at half the price, but she had some of that at home too. 

Who says the pharmacist's role has changed over the years? Haven't we always helped patients with their dead sea creatures?