Paradigm lost

March 15, 2013

JP cuts his hand - and loses all his illusions.

JP at Large

Talk about not working. Pharmacists and technicians know all about working. We do not know about not working, loafing around, malingering, shirking, or playing hooky when we are supposed to be working.

We come in at eight and we never stop until four or seven or ten. We perform two or three tasks at a time, and we supervise two or more technicians who are doing three or four tasks at a time. 

We never stop. We race to get to the bathroom, sometimes almost too late. We eat on the run, and for many of us a meal is a bag of Fun-Size Snickers bars and a Big-Grab of Doritos washed down with a Diet Coke. 

When we explain how we work to our family and friends, they believe we are telling stories. You are a pharmacist. It can’t possibly be that bad. That’s what they say.

Can you imagine the shock to my system when I realized, after decades, that pharmacists are the only medical professionals who consistently work like this? Every day we make a mad dash to the finish line, never looking to the right or to the left, and we still get criticized because we don’t go fast enough. 

Moment of truth

I cut my hand badly a couple of years ago. There was a gaping wound.

At the trauma center I stood for nearly half an hour, waiting to be checked in - and I was the first in the line. There were three nurses in a glass-walled room. Two were sitting on a desk, socializing. The third, sitting at a computer terminal, stopped often to swivel her chair around and laugh when the conversation took a humorous turn.

This is not right, I thought. I was standing there with my hand wrapped in a kitchen towel drenched in Betadine. How can they get away with this?

I immediately made the connection between what they were doing and what pharmacists do. I asked myself, Are pharmacists just stupid, or are these nurses robbing the hospital? 

If I were to engage with two technicians in a half hour of lighthearted banter that caused all work to stop, my ass would be grass. Not to mention that I would feel really uncomfortable. I am always looking for the next thing to do at work, and I suspect that you are too.

The messenger

The ER doctor appeared to be an old hippie. Ponytail, salt-and-pepper beard, plaid shirt under his white jacket, jeans, and sneakers. He listened to me while another nurse cleaned the wound. I admit that I had an attitude when I asked him how those three nurses got away with wasting time like that, especially with me standing there, dripping blood on the floor.

“Hey, man,” he said politely. “No reason to be upset. We’re all just chopping wood and carrying water. The nurses, me, you, everybody. We have to eat and provide clothes and shelter for our families. It’s Maslov’s Hierarchy of Needs. It doesn’t hurt if you take a few minutes to be human with your co-workers. What counts is that you chop enough wood and carry enough water.” 

He was getting ready to stick me with lidocaine. My hand hurt and I was feeling snotty. “What is this?” I opened my arms. “Little House on the Prairie?” Chopping wood and carrying water was one thing, but pharmacy practice? It couldn’t possibly be reduced to such a simplistic metaphor. Could it?

While we waited for the lidocaine to kick in, the doctor said, “What do you do for a living?” I told him. He smiled a tolerant, old-hippie grin and said, “Don’t try to tell me that you’re getting above the bottom tiers in Maslov’s Hierarchy.” He gave me a conspiratorial look. “We’re the same. We come to work, chop wood, and carry water, collect our paychecks, and do it again, hour after hour, day after day.”

The light dawned

I stared at him vacantly. In just 10 minutes, the ground of my being as an important medical professional was shattered.

Well, not quite. What was shattered was my preconception, born all the way back in pharmacy school, that I was supposed to practice pharmacy in a self-driven and dignified way.

In reality, that was some kind of load of malarkey, and I finally got it. Rules and policies determine how I work. And I chop wood and carry water, week after week, month after month, year after year.

Jim Plagakisis a community pharmacist in Galveston, Texas. Contact him at jpgakis@hotmail.com.