Hail and farewell

April 7, 2010

As the years went by, it became evident just how much of a stamp the first person to get hold of you professionally will put on your career.

Not that my preceptor and I were friends. It was his job to mold into something resembling a pharmacist the lump of clay that showed up in the summer of 1989 at the front door of his store, and there were times when I'm sure he thought I would be more than his creative skills would be able to handle.

The first thing I did as a pharmacy intern was to spill a bottle of Capoten (captopril) on the floor. The second thing I did as an intern was to clean it up while hearing all about how much a bottle of Capoten cost.

I did a lot of the things he did the way he did them, at times using almost exactly the same words he'd use, without even realizing it until the moment had passed.

As the years went by, it became evident just how much of a stamp the first person to get hold of you professionally will put on your career, whether you like it or not.

"Always remember, it doesn't matter to that lady at the counter how many prescriptions you do. To her, the 30 Inderal (propranolol) tablets we give her are going to be the most important thing we do all day."

He also taught me the concept of the "monkey-wrench moment," those times when someone comes to the counter who really needs your help and you give it to them, no matter how much time it takes and no matter how much of a monkey wrench it throws into the rest of your day.

As a new intern, I resented the monkey-wrench moments; they could mean hours of catch-up work afterward. However, by the time I left to practice on my own, I started to see that the monkey-wrench moments were actually what made my job a profession.

I had to leave for work as soon as I got the news of my preceptor's death. When I got there I noted all the things a pharmacy didn't have when I started as an intern. Point-of-sale technology, Windows software, a fax machine. I saw dozens of new drugs that probably weren't even in the pipeline the day I made Capoten the latest in floor coverings. Then I saw the look on the face of a woman at the end of the counter. Amid all the things that had changed about pharmacy, that look, I knew, was eternal.

"I just got these prescriptions, and I don't understand why I need to take both of them," she said as she slid them across the counter and into my hand. "I'm not sure what I should do." There was actual fear in her voice.

I asked her what exactly had landed her in the emergency room, and I listened. I told her that one drug would treat her short-term symptoms and the other would treat the underlying condition over time. Then I told her again when she didn't seem to understand. It was a monkey-wrench moment, and she got all the time she needed. Amid all the chaos that is a modern pharmacy, with the fax machine whirring, the customer in the background asking my technician where the shoelaces were, and all the prescriptions that were being cranked out for a $1.50 dispensing fee, a little bit of my preceptor flowed from me into that woman that day. And the profession lived on.

David Stanley is a practicing community pharmacist in California. He can be reached at drugmonkeyrph@gmail.com
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