Single, poor, and desperate

January 15, 2011

Pharmacists save the medical system millions of dollars every day by being the last resort for the poor people who have nowhere else to turn.

I could imagine how these 4 spent their happy days in Galveston. She had a husband at home who took them to the wide sandy beaches on the weekends. Saturday night, they hired a baby-sitter and Mom and Dad went out on their weekly date. Dinner and a movie. Maybe some music and dancing at a club. A romantic moonlit walk on the seawall ... or maybe not. Maybe none of it was true.

Because this was a single mother. And she was at the drugstore, looking for, hoping for, desperate for some help.

"They haven't felt good for about a month." The mom gave me a guilty look and avoided my eyes. "They cough a lot."

On closer inspection, the smallest one, maybe 3 years old, looked ill. Her eyes were dark and there was a smear of dried mucus under her nose.

"Ma'am, this is important." I reached toward the little girl and looked at her mother for permission. She nodded and I placed my hand on the child's forehead. "I'm not a doctor," I said. "But I'm a dad, and this child is burning up. You need to get her to a doctor right now."

This was crushing news. Her shoulders slumped and her mouth worked before she said, "I don't have the money."

"No insurance?"

She wore a Popeye's Fried Chicken uniform. "I'm not in management yet."

"Medicaid?"

"I make too much. I'll be in management soon. Can't you help me?" She waved her hand at all the products on the shelves.

Here I was, in a familiar position, at the bottom of the funnel where all the leftovers from an only-good-if-you-have-money (or no money) medical system empties out. Poor people have so little standing in the United States that they are ignored. Most medical professionals never even see them; why would they think about them?

For thousands of poor people, you are the primary care provider. They come to you with a $20 bill, perhaps out of the grocery money, and hope that you will help them with everything from lice to traumatic injuries. You've seen it all. Rashes and coughs and blood all over the floor. They don't come to the pharmacist because they want to. They come to you because they have to. They know that you are accessible and they know that you are free.

You and I and a couple hundred thousand of our brothers and sisters save the medical system millions of dollars every day.

- Really? Come on now, Plagakis. Millions?

Really, Mildred! Imagine the cost to our system if you sent every single poor person in need to the ER.

- Come on, JP. Every one?

Okay, okay. Most just need an OTC to help with the pain or the sniffles. Some do need to see a doctor and ... whoops! They all go to the ER because they are smart rats and they know that the ER will take them for free. It's the law.

The pharmacist is a safety net. Not just for the patient, but for the entire medical system. I am very sincere when I claim that we save the system millions of dollars every day. I'd just like the system to recognize us for that.

A guy came in seeking my help. He was the type of tough guy who always thinks he has a right to give another man's woman a come-hither look. He got into a fight a couple Fridays ago and came to me around 9:30 PM. He showed me the knuckles on his left hand. They looked like raw cube steak.

"What the hell did you do?"

"I looked at a girl wrong."

"What are these two white things in there, your bones?"

"Help me get them out," he said, "They're the other guy's teeth."

I poured some Betadine on the hand and sent the guy to the ER. Forgive me. The medical system will have to pay for this one.