So as promised a couple of weeks ago here is my little xmas story. It was originally intended as an article for the Irish Pharmacist but for various reasons it will not be appearing there.
The Ghost of Pharmacy Future
This tale is set in a small community pharmacy on christmas eve a few years into the future. SWMBO Harney, Prof Dumb Dumb and Ambrosia Creamy & Nice have wrought their havoc on the world of Irish pharmacy.
Bob Crachett sat at his dispensing counter at the back of his pharmacy. Just like he had done since he first opened it so many years ago. When he started he sat there because things were slow to begin and he did not have much to do. Now the pharmacy was busier he sat to ease the burden on this old bones. It was after 7PM on chistmas eve and he was looking forward to going home time. The long hours were a pain but it was one of the few ways that he could make the pharmacy profitable now. His hips were really giving him grief. “They both need replacing,” his consultant had told him. “I’m putting you on the waiting list for a double replacement.” That was six months ago and he made it a point once a month to ring up and see how far up the list he had gone. It was never very far. He cursed the day that he gave up his private health insurance. But the effects of the cuts was so severe that something had to go. He held off as long as possible but choices had to be made. Add to that the cost of a locum when he would be out of commission and as much as he wanted and needed the hip replacement he dreaded the day that he would be told that he was top of the list.
Pain killers would have helped. He could not take NSAIDs because of his ulcer so his pain management consultant has prescribed oxycodone. But he was reluctant to take it. Ever since the crackdown by the regulator on pharmacists with supposed addiction problems it was more trouble than it was worth. The compulsory blood and urine tests, the out of hours visits to his home made him feel like an olympic athlete or a criminal. Once they became aware that he had been prescribed them he was singled out for special treatment. How many times did the inspectors need to count every tablet in his safe and pour over every entry in the CD register. Once a week it seemed.
Their first call to the consultant was met with a polite confirmation. The next calls left an uneasy feeling with the pain management team. He could feel it with the questions that he was asked when he called for further prescriptions. No smoke without fire.
It made him feel like running out on the street and screaming. But he remembered last year when his old employer Mr Scrooge did that. It took him three months to convince the regulator that he was of sound mind and could operate a pharmacy. All the while his Marley & Scrooge Pharmacy was closed. It nearly ruined him.
Just then he looked up to see Mrs Crachett arriving. She had come down to give him a lift home as driving was beyond him at present. “Come on, close up,” she said. “There’s nobody about and there is only half an hour to go. It is christmas eve after all. I got a lovely four pound chicken in Lidl, it will make a great christmas dinner for us all.”
“I’d love to,” he replied. “But 8PM is my contracted closing time and you know how much the HSE would love an excuse to pull my contract. Remember what happened to poor Joe. He closed half an hour early to attend the removal of his uncle and the following morning he had the letter terminating his contract.” The HSE wanted 600 pharmacies to close and had managed about 100 until pharmacists got wise to their tactics. Now the underground grapevine passed on descriptions of the HSE spies and their car registrations. A few select patients had to be handled carefully as well because of their fondness of ringing up and complaining about the slightest thing.
8PM came and Bob heaved himself down from his stool. He winced as his legs took his weight. Mrs Crachett watched and decided that tonight she would slip some oxycodone into his cocoa. Bob needed a rest and she had done it before. She had picked up a few compounding tricks from all those early years at his side at the dispensing bench. She was also a good cook and he never noticed. All he might say is that the pain seemed a bit lighter tonight. The pharmacy was locked up and both of them gave a silent thank you that christmas fell on a weekend this year and they could legitimately close for three whole days.
They arrived home and Bob lowered himself into the armchair. The fire was lit and they has cheese sandwiches for tea. Bob thought to himself. “It’s not fair to rest of the family that I should be in bad form tomorrow because of the pain. I’ll take some oxycodone in the morning.” As he was preparing for bed he thought “I might as well have a good sleep first.” So he took a double dose of oxycodone before retiring. He finished his cocoa and pulled the covers over himself.
Some time during the night in the middle of a pleasant dream his breathing became more laboured. Then it became shallower and shallower and gently stopped. Bob stayed in his dream world where he met his old pals and they talked about pharmacy past all day.
Later at the inquest the PSI addiction unit reported on all their inspections. The coroner noted the high levels of oxycodone and Bob’s supposedly depressed state and deemed his death to be a suicide. Because of this all the insurance companies refused to pay on any of the policies.