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What was pharmacy practice like before it went corporate? Here's a snapshot from Drug Topics contributor Truman Lastinger.
By Truman Lastinger,RPh
Truman Lastinger is a walking history of pharmacy practice. He spent 58 years in retail pharmacy, 50 of them as an RPh, and did more to bring healthcare services to his rural Georgia community than he is likely to admit. He has, however, recorded many of his memories of causes championed and patients helped in a new book, titled “Farming to Pharmacy: Memories of a Sharecropper’s Son.” Below, he tells us how it all began.
Being born in 1937 to a sharecropper did not lend itself to getting a college education. Sharecropping existed with, and then replaced, slavery after the Civil War. The only thing the sharecropper had was a mule and a little furniture. His family literally existed at the whim of the landowner.
At 15 years of age I got tired of working on farms and went to town, Moultrie, Ga., to see if I could find a job. Most local folks called this “working for the public.”
I went almost all the way around the courthouse square, going into every office and store. There was six drugstores around that square, and they served about 25,000 people. All the stores seemed to be doing a good business, and everyone had a lunch hour.
I got hired in the fourth drugstore I went into. They needed a soda jerk, so the owner told me to see his wife. She asked me to write down my name and the name of the store. When she saw she could read my writing, she told him to hire me.
After a week or so in the soda fountain, the boss told me to come into the back of the store and put me to pouring up and labeling wets, and measuring and labeling drys.
It was here that I discovered some peculiar names for drugs. Acetylated salicylic acid (aspirin), phenylazodiamino pyridine (pyridium), acetylated para amino phenol (APAP, which became Tylenol), were some that caught my eye, and I was hooked on pharmacy.
Off to pharmacy school
My boss told me to apply for pharmacy school. When I told him that I couldn’t afford it, he said that he would pay my tuition if I would come back and work for him. I was excited and applied. I was accepted in The University of Georgia, Auburn University in Alabama and Southern College of Pharmacy in Atlanta. I told my girlfriend that I was going to pharmacy school.
Then my boss had a heart attack and drowned at Daytona Beach. Suddenly I was back where I started. My girlfriend insisted that I could work my way through school and said she would help.
We got married and went to Atlanta, where I entered Southern College of Pharmacy. This school was the best choice, because I could find a job in Atlanta. It took us eight hard years and overcoming many obstacles, but we finally made it.
My first drugstore
We moved back to South Georgia and finally opened our own drugstore. I remembered how things were done in Moultrie, and practiced the way they did.
I, and many of my pharmacy neighbors, served as primary healthcare providers to the county. We treated people with small problems with OTC meds and meds we made up.
We made eyedrops, lozenges, douche powders, toothpaste, and poultices. Sulfur and cream of tarter lozenges for skin problems. I mixed insulins, administered B-12 injections, and gave allergy shots. Quite often a doctor would call me and ask me to go to the store and administer a tetanus shot, and to let him know if the patient needed stitches.
I went to the school board and explained that many of our families could not afford the $4 to $5 dollars a doctor charged when their children had a problem that was not good for other children in the school. The school board agreed to accept my written excuses, ensuring that a child would not have to be absent without cause.
The health department administered inoculations and began to pass out certain medications. One of these was birth-control drugs. I went to the health department and volunteered my time to oversee the distribution of oral medications, and wound up running a birth-control clinic once a week. At these clinics I would counsel and dispense birth-control drugs. When the patients came back the next month I would discuss side effects with them. Some of them would have to be taken off the pills and put on other means of birth control, due to their reactions.
The University of Georgia Pharmacy School put on a drug-testing continuing education program. I attended, because we had begun having some drugs show up in our county. I brought the equipment back and told the police department and the sheriff’s department that I could quickly give them testing results for suspected drugs. This would give them cause to charge someone until the state crime lab provided the official results. Both departments used this service until drug tests became available to them.
During the Sixties there was a nationwide effort to inoculate the entire nation’s population with the oral polio vaccine. Our county participated. Each pharmacist was in charge of a district in the county. My district was a small town south of Cairo, where I administered the vaccine to residents of that community. One of the families I attended was a family with 18 living children. This family was the largest family that I had ever seen. Overall, this program was very successful in the eradication polio in the United States.
We had a large assortment of trusses that we fitted for people with hernias. With a good fit, a person could continue working without having to undergo the surgical procedures that were very invasive at the time. We sold pessaries on prescriptions quite often and had them in different sizes. We even had sets of rectal dilators that were prescribed in some instances.
One day an 86-year-old lady came in with a prescription for some pain pills. She sat on our little sofa while I filled her prescription. I noticed that she was crying, so I sat down beside her and asked if I could help her in any way.
She said she had just come from her doctor, who told her that she had terminal cancer and should go home and get her affairs in order. He told her that the cancer was too far gone to treat and that she had anywhere from six to 12 weeks to live. She looked at me and said, “Mr. Truman, old folks want to live too. Why won’t they try to help me?” I explained that most of the treatment available for cancer was very debilitating and quite often at her age would cause more misery that the cancer would.
I told her that in my opinion cancer cells were bullies in the system and being large, affected the nearby cells, taking away the nutrients the good cells needed. I told her that I felt most cancer patients’ pain was caused by hunger pangs, which are very painful. Many patients did not know they had cancer until surgery, after which they were sewn up and sent home, and wound up in great pain. Being told you have cancer is very stressful and causes depression, which affects the appetite.
I told her that if she would like me to, I would design a diet for her that would ensure the proper amount of calories her body needed to remain strong. She said she would like that, so I wrote down a diet and told her to write down everything she ingested and to come to the store once a week so I could weigh her and monitor her diet. I told her that I felt that she would not experience the pain most people did and would possibly live longer than the doctor said.
This lady was very diligent and came every week. She maintained her weight and remained pain-free. She lived a little over two years after her doctor told her she had up to 12 weeks to live, and she died peacefully in her sleep at home. Her 56-year-old son came by the store a little later and told me that his mother had asked him to come in and apologize for her crying in the store that day.