Fragmented update

My thinking is a little fragmented today, so here’s an update on 8 aspects of my life in one or two sentences each:

In my rush to get home this weekend, I forgot my webcam, so I won’t have any video updates this break.

I’m a little disappointed that my investigative report on Blackboard didn’t generate the response that I would have liked it to.  Maybe all those outages frustrated me a lot more than everyone else.

I was given an old book of the writings of Kahlil Gibran by my aunt Mary Ellen for Christmas, and I am really excited about reading them!  She didn’t know I read The Prophet over the summer, so how’s that for an amazing coincidence?

I knew the new Classic Crime CD The Silver Cord would be good, but it turned out to be more than I expected!  I’m really enjoying listening to it (thanks Isaac).

I am going to Kylee B. and Tim S.’s wedding tomorrow in Washington, IN with Amanda.  It will be good to reconnect with a bunch of my old alumni friends.

I’m psyched about meeting up with my high school friend Brandon P. on Tuesday.  I’ve got a feeling it will be the highlight of break.

The pharmacy where I used to work has asked my grandma twice this week to have me call them when I get into town.  I’m avoiding calling them for a while, because I know they’ll put me to work on a holiday.

Looking ahead, this break, spring break, and most of February 2010 are the last breaks I will have for a very long time.  I need to be putting them to better use.

of golf and holes

Troy, this one’s for you…  Thanks for the text today bro!

Yeah, I know it’s been a long time, but you have to trust me that it is for the better.  Anything I would have said prior to today would have just been venting out of frustration.  Of late, it seems that I am just playing the role of the Vicodin police.  Which, whatever, is kind of my job, but I’ve been letting my frustrations slip into my real life.  Take this article I saw on Purdue’s homepage.  (Just so you know if you’re not familiar, only the biggest news stories from Purdue get posted on the front page.)  Let me quote the first line of the story:

Golfers who play well are more likely to see the hole as larger than their poor-playing counterparts, according to a Purdue University researcher.

This for some reason absolutely infuriated me last week.  I haven’t even read the entire article because it is completely uninteresting and would only make me more mad.  I had to stop reading after a quote from this psychologist chick Jessica Witt,

We know a relationship exists between performance and perception, but we are uncertain how they affect each other. For example, do golfers see the hole as bigger so they putt better? Or if they putt better, does that mean they see the hole as bigger? I believe it is a cyclical relationship, but more studies are needed to clarify if one affects the other.

WHO THE HELL CARES?  Why is this news?  Am I alone in thinking that no more studies need to be done on this?  Is this how my tax dollars are spent?  I am stunned that the National Institutes of Health funded this garbage, when I know these funds could be used for research that actually matters.  While writing about this story, I stumbled upon a graphic which was to be included in the University News Service story to help clarify this incredibly difficult concept of the cyclical relationship between performance and perception, but was edited from the final publication at the last minute.  This is a Ternary Complex exclusive:

So I’ve got this idea that Jessica Witt is so self-righteous that she Googles herself on a weekly basis, so my guess is here in a few days I’m going to get a nasty e-mail from her or one of her MUF (Masters in Ultimate Frisbee) students telling me to take this down.

You see what I mean?  I warned you I become mean-spirited when I get frustrated.  Maybe I’m not as calmed down as I thought I was.  Either way, YouTube has become my safeplace.  I love spending hours on there just seeing where the related videos take me.  People can be so creative and goofy.  I love it!

The thing about work which frustrates me is that I spent all this year learning about how to best serve, educate, and manage a proverbial entity called “the patient.”  All the profs say, “when treating your patients…” or “be sure to educate your patient that…”  And we as students naturally tend to envision our grandmas as this proverbial “patient.”  I scoured over my notes for hours on end every single day of the year trying to learn as much as I possibly could to be the most help to this “patient.”  But then I talk to these drug-seekers like the lady who called the pharmacy today on three separate occasions to ask three different people when Medicaid would pay for her “Vico-dans” next, or the opiate-addicts who I’m supposed to feel good about because I’m replacing their heroin use with Suboxone addiction, and my idealism is chipped away little by little.

I race home to the quietude of YouTube or my book.  I listen to Steve P.’s sermons and get so excited about the fall that I start dancing.  I long for the day that I get regular again (yes, I’m talking about my bowels here).

There’s a recurring theme that Dostoevsky keeps bringing up about life, which I discovered several months ago on my own.  I’ll be able to write about his interpretation of it a bit later, but I want to quickly introduce my ideas on it to you now.  It’s the idea that in order to find anything important to you in life, you have to lose it first by knowingly giving it up – that you have to fall to the lowest of lows before you can start your climb to redemption.  I remember well my lowest day.  It was Saturday, January 26, 2008.  I’m nearing my 6 month mark of a rocky, but gradual climb.  I have much to be thankful for, and little to be frustrated about, even though it takes a reminder every once in a while.  I’m really growing in my faith, and am very excited about the new push at Northview for “Living a Life on Loan” in service to those in my community.

Coming soon (if I get to it):  a review of Lafayette Civic Theater Under the Stars and another video!

misoprostol

I had the most bizarre conversation with a customer last night, and I can’t seem to get it out of my head.  Friday nights in a 24-hour store, after all the other pharmacies have closed, are when the crazies come out.  OK, so this guy comes up to me and says his wife/girlfriend needs a medication.  He can’t pronounce the name of it, so he hands me his cell phone and has the woman on the other end say it for me.  I take the phone and say, “OK, I’m ready.”  She says only one word, “misoprostol,” I hand the phone back to him, and he shuts his phone without even saying goodbye to her.

Misoprostol, a prostaglandin E1 analogue, is used to prevent gastric ulcers, most commonly caused by high usage of non-steroidal anti-inflammatory drugs (NSAIDS) such as diclofenac, oxaprozin and meloxicam by stimulating the secretion of gastric mucus which acts as a protective lining.  Another use is for induction of labor because its oxytocic effect is stronger than that of Pitocin, commonly used in hospitals today.  It can, however, also be used with or without another drug (mifepristone a.k.a. RU-486) to induce an abortion.

Thinking that she is requesting a refill, I ask him for her name.  He gives it to me, but I am unable to find her in our system.  I ask him for her date of birth so I can look her up in our central database — still nothing.  Meanwhile, he’s asking me how much it’s going to cost, but I’m still trying to locate her profile.  Finally I ask if she’s had any prescriptions filled at CVS before, and he says:

No.

Where did she have it filled last time?

She’s never had it before.  I was on your website and it said I could pick it up at any pharmacy or order it online.

Well, that’s true, but I’ll need a prescription.

I don’t have one of those.  It said online I could come and pick it up.

…With a prescription.

Is there anything else like it I could get?

No.

Well how do I get a prescription?

She will need to see a physician, and he or she can write one for her.

And then he walks away.  It was so bizarre.  Now, I’m just assuming that she was trying to induce an elective termination, but still, to not understand that a prescription is needed when you go to the pharmacy or even how to get a prescription was enough to leave me speechless for a minute or two.

character revealing moments

All right.  I’m back.  Thanks for all the comments and e-mails; I appreciate them a lot!  Las Vegas was tons of fun with my roommates.  I’m so glad Nathan and Casey will be around for another year with me this fall.

So I’m creating a new term called ‘character revealing moments.’  These are times and situations in which my behaviors and reactions give me insight into the type of person I really am.  I feel that at my age of 22, my character is pretty much set.  I may not know myself completely, but I’m not going to change.  It’s funny for me to watch little kids grow up.  When is it that they develop their personality?  Or is it innate, and not even developed at all?  Either way, I am still learning who I am through certain situations I face.  For example, how kindhearted am I really?  I find out through how willing I am to help patients at work.  Do I just do the minimum for them, or do I take things to the next step and offer an alternative solution to help them?  Am I compassionate throughout the week, or do I take shortcuts on Friday afternoons?

I’ve always hated those ‘Choose Your Own Adventure’ books.  I could never decide which path to take, so I only chose after I had read both possible passages.  Life’s not like that at all, and neither are these character revealing moments.

Now notice I call them character revealing, and not character defining or character developing. There’s an important distinction there.

Troy left for his internship in Texas today.  He’ll be working at a church, and from what I understand, will be closely following a youth minister and learning that trade.  Honestly, it seems to me sometimes that he has so many spiritual gifts:  encouragement, exhortation, evangelism, faith, giving, hospitality, intercession, knowledge, leadership, and mercy — and I maybe have two:  music and some other gift that I have to cheat on the test to get.  He’s hands down had the most positive influence on me of everyone I’ve met at Purdue and I can’t wait to see him when he gets back — I know he’ll have some great stories.

I’ve got an idea for this summer, but it will take some courage.  I’ll tell you about it if I decide to pass through this character revealing moment.

the past few days

No matter what I write about, Hannah will make fun of me.  I think that’s how she shows her love.

So I went up to Lafayette yesterday for Troy’s birthday, and I always seem to forget how much of a ghosttown that place becomes in the off-season.  But it was a great time, and I wouldn’t have missed it.  Robbie finished Hard to be Humble and he really liked it, which is still cool to hear.  My art lives on!

Quote of the week goes to Ann from work.

Me: So are you and your fiancé cohabitating?
Ann: Do you mean are we living in sin?  Yes.

Got my first paycheck today from doing what Curtis calls “dealin’ and healin’,” which is, by the way, the coolest way of describing my work.

Thanks for the blog response Lisa (or should I say Sharpay?  YAY!  I am coming to watch you!).  I concede the argument to you and your thorough rebuttal.  Mike is equally to blame.

Headed to Vegas Saturday morning for a week with the old roommates.  So that probably means you won’t see an update from me until the 24th at the earliest.  Sorry this post was so fragmented.  I’m off to catch up on some sleep.

the doctor isn’t in yet

So the last time I tried to update, this site was undergoing maintenance, so I wasn’t able to post.  In the words of Gopher, “Sorry, America.”  I am anxiously awaiting the new Dorm Life episode that will be posted at midnight tonight!  Prediction: Mystery Hot Girl will be involved!!!  Danny B is awesome, but my new and permanent favorite character is Courtney, played by Nora Kirkpatrick.  If you need further evidence as to why she is the best on this show, please watch this video.  She reminds me of my old neighbor Bonnie Herald Glass for some reason…

Anyway, my body keeps reminding me how old it’s getting.  For example, I just ate a bunch of junk food, and my stomach is not happy with me.  I think it’s giving me the cold shoulder.  I’ll eat some vegetables in a bit to get back on its good side.  I was talking to Troy the other night about how old I am getting.  I’ll be 23 in a few months.  I remember Mark E. complaining to me about how old he felt when he turned 23 and I was 20, and at the time I told him that that was not old, and told myself that I would never complain about getting old when I really wasn’t.  But I can’t help myself now.  But I’m really excited for this week because Troy is coming to Indy to celebrate his 25th and it should be a great time!  He’s telling everyone that it’s his 21st so people will pay more attention to him…  He’ll never tell you about the 4 years he took off school to volunteer for the Peace Corps (and that they waived the baccalaureate requirement for him).  Anyway, I miss that kid so much, so it will be good to see him and the rest of his buds.  I’m thinking about going up to Lafayette the weekend after Memorial Day to go to Northview and maybe hang out.  We’ll see…

So yesterday was the first time a real patient called me “doctor.”  It was probably the coolest thing ever.  In school we mock-call ourselves doctors when we’re doing counseling simulations, but yesterday was the real thing.  He said, “Thank you, doctor,” after I’d helped him out.  I corrected him and told him that I still have two years of school left, but the truth is that at work people come to me seeking my advice all the time, and they take it.  It makes me wish I had a really cool last name like Pepper or Dre…

the law

So the big debate at work this morning was over this section of the Indiana Code (IC 25-26-13-25(c)):

Except as provided in subsection (d), a prescription for any drug, the label of which bears either the legend, “Caution: Federal law prohibits dispensing without prescription” or “Rx Only”, may not be refilled without written, electronically transmitted, or oral authorization of a licensed practitioner.

According to my law prof, this means that pharmacists can authorize refills on OTC meds without authorization from the original prescriber.  And the man would know, because he literally WROTE a lot of Indiana’s law as it pertains to pharmacy.

The reason why this is an issue at all is because AB called me on Monday asking for a refill on her daughter’s MiraLax, a newly over-the-counter laxative.  I informed her that her physician had called us and specifically voided the 5 refills on this medication.  She did not believe that her doctor would ever do such a thing, and didn’t appreciate being told what she could and could not pick up.  She ended up so furious that she called the pharmacy supervisor Tomi (I didn’t even have to give her his number because she already had it — it sounds like she’s a routine critic).  Tomi later called me to talk about this, and I suggested we invoke the law cited above.  He said that was a great idea, but the pharmacists on duty weren’t about to authorize a refill without a doctor’s authority, even though the law specifically says they can!  So we had to call the doctor’s office Tuesday morning for authorization.

I brought in a copy of this law this morning, and the two pharmacists had a less than enthusiastic idea about this authority the law has granted them.  One said that she only knew of “older” pharmacists who did this, but only because they had little care for the law (sic) and would have done it just to get the customer out of the store.  The other called this one of the “gray areas” of pharmacy.

I was kind of surprised by these responses.  I would have thought that pharmacists on the whole would be more receptive to more autonomy than they’re used to.  Instead, it’s sort of frustrating to me to see pharmacists shuffling back into their familiar corner of just rubber stamping whatever physicians tell them.  We have the education enough to decide whether a patient needs a laxative or not, and we should be able to bill it through Medicaid without fear of the dreaded audit.

I fear that the only noisemakers in the advancement of prescriptive rights for pharmacists are the vibrant young pharmacists and those in the university setting.  Even our biggest professional organization, the American Pharmacist’s Association (APhA), is not in favor of HR 5780, a bill proposed in the House which would allow for the billing of Medicare Part B by clinical pharmacists for practitioner services.  But I have hope that I’ll see significant and exciting advances in this area during my career, and it starts with pharmacists taking charge of the law which is already written for them!