Footnote To Pharmacy

About halfway into my somnambulance as a pharmacist I discovered some choices within the choice I had made. I found my satisfaction in that special relationship with customers/patients. It is unique to see the same people at regular intervals over a period of years, knowing what keeps them alive, literally, and yet not quite knowing them personally. I got to know many of them in ways unrelated to their medications.

At the same time the definition of what a pharmacist does had changed from dispenser to consultant. We were allowed to have ancillary help who could also count to 30 while we would discuss the use, cautions and management associated with the meds. This was the human interchange that lifted me out of the confined space and woke up my senses.

I had grown weary staring down apothecary jars or trying to coax the mystery out of elixirs. I experienced the person standing on the other side of the counter, the troubles, anxieties, ways of coping and, at times, their full dimension.  It was enough that I offered my listening ear.

This was my portal out of that petty space. I discovered poetry by the late seventies gradually finding my voice which grew organically out of my life as a merchant/pharmacist along with all the other cargo I carried.

I started writing what would pass for poetry. I attended a workshop around 1976 run by a respected poet with well-established writers. After a year at it I left and was told that I had yet to write a poem. The leader, Alvarro Cardona-Hine, insisted that a poem cannot be willed, that it comes intuitively, unbidden. I feel strongly both ways. The idea can be deliberate but the lines come from a confrontation with my unknowing and the transformation slips in from out of the language itself.

Nowadays most poetry I come across seems like carefully ruined prose, a chopped up paragraph with a jagged right hand margin. This is not necessarily a bad thing. I have no use for categories; they remind me too much of Pharmacy.

The word poetry or poetic is used today to describe something beautiful or a piece of writing with elevated language. For a poet, the last thing he wants is to write poetically. Too precious, too limp from overuse.

In 1980, about the time when I started doing poetry readings, I had also bought my own pharmacy and more importantly I met Peggy. Everything that has happened since, I credit to her muse, her spirit, her love. If transformation is the operative word I had much to transform.

As for pharmacy or any other work situation one might feel trapped in, I offer this advice: infinite possibilities, maybe everything, is contained in anything.

White Paper

When I sat down to write the previous two blogs about Pencils and Pharmacy the single image I had in mind got lost in the shuffle. It was the 4 ¼ X 5 ½ inch white paper called an Rx or prescription; perhaps the last such hand-written note still in use in our daily life. Shopping lists are as ephemeral as poems written on napkins. Restaurant receipts, even dry cleaner stubs, are print-outs but prescriptions remain in much the same form as they did a century ago. They are actually legal documents, required by law to be retained from three to ten years.

So why are Rxs seemingly scribbled as if the doctor was breaking in a new pen? Is the writing deliberately careless or carefully unintelligible as if to preserve its arcane roots? It says to the patient, don’t ask questions, just do as you’re told. Even today an Rx preserves scraps of abbreviated Latin and a residue of its esoteric history. Most pharmacists can spot a forgery. The neat penmanship a dead giveaway; it lacks the authority and disdain for clarity of a true prescriber.

A prescription is a hot potato fraught with potential ambiguities. For example, Q.D. (one daily) can be read as Q.I.D (4 times a day) if the pen slides or a spec of lint lands and makes the dot between the Q and the D more than a dot. A grain (gr.) which is a measure from the apothecary system is easily confused with gram (gm.) from the metric system. The more I think about all this I seem to be getting a brain ache and I suddenly remember why I retired.

Some doctors have a habit of embroidering their Rx with redundant Latin phraseology such as misce et fiat which means mix and make where there is nothing to be either mixed or made, but simply counted. Liquid preparations still bear the old q.s. to indicate quantity. These are initials for quantum sufficit a medieval way of saying how many ounces. The signifier, Rx, is short for recipe, which means, take. The symbol is also claimed by astrologers and Greek scholars.

A patient hands me the white paper as I stand on a raised platform, as if a pedestal. From that angle, stationed between globes of colored water, I become a descendent of the brother/sister hood of shamans and alchemists. Instead of stirring a potion of plucked feathers, bark and berry I have merely to read the Rx and pluck the product off the shelf.

Every doctor seems to have his/her sui generis way of prescribing. Some have chicken scratching only a mother could love. Others have their own shorthand meaningless to any but the pharmacist in their building. My first prescription was written as P.B. I had no idea what that was. As I looked at it quizzically the patient said to me, Don’t you have any Phenobarbital? This was an abbreviation not recognized in academia. (It could just as well have meant, Pentobarbital). I received my initiation in the real world.

Whatever romance of the sorcerer is attached to a prescription written with a flourish there is an accompanying danger of misreading the name, strength or directions. It happened to me a few times though without grave consequences, I’d like to believe… or is that why some regular customers didn’t return? The pharmacist’s lot is not a happy lot, happy lot.

In this computer age more prescriptions are being transmitted electronically. At Kaiser-Permanenteas well as other medical facilities, all medical records including lab results and prescriptions are entered in their data base to be shared by every doctor and checked for contra-indications or duplications.

Soon every Rx will look the same; Ariel or New Times Roman. Much safer but much less collectible as an artifact of squiggly lines. A reasonable trade-off, I think. A time may come when archeologists in pith helmets will sift through ruins of ancient cities pulling out these curious odd white papers in scribbled glyphs.