Groundhog Day… Again

Fintan Moore reflects on 20 years of writing for Irish Pharmacist

By Fintan Moore

They say that time flies by when you’re having fun, but it passes pretty quickly when you’re working too. The days might occasionally drag a bit but you can blink and realise that a few years have gone by in what seems like no time at all. At any rate, that was how it felt to me when the Editor let me know that I’ve now been writing a monthly column for 20 years. As the saying goes ‘the past is a different country’, and 1999 certainly had its differences to today — pharmacies were still regulated in terms of where they could open, the only School of Pharmacy was in TCD, and the morning after ‘pill’ was an off-label dose of two Ovran 30 tablets. Things have certainly changed in some ways. On the other hand, I took a look back at what was exercising my mind two decades ago and some things haven’t changed much at all.

1999: Celtic tiger

There’s no town like a boomtown. Everybody making loadsamoney and buying bigger houses and faster cars. Sitting in the sun outside a coffee shop drinking espresso, or else in the shade in a wine bar sampling a crisp Chardonnay or an earthy Merlot. Every window has a ‘help wanted’ sign, but every week you walk by more beggars and step over more sleeping bags. The average Joe is mortgaged to the neck to buy a shoebox, and spends three hours a day commuting, watching other lemmings scream abuse at each other for stealing five yards of road in a traffic jam. The newspapers keep talking-up the party and there’s no sign of the good times stopping rolling. Yeah, London in 1999 was a lot like Dublin today. 1999: Packaging Design

Do the people who design the packaging for drugs ever consider the ‘nuts and bolts’ of the dispensing stage in a drug’s journey from factory to patient? One company’s antibiotic liquid is protected by a paper seal beneath the cap. The seal is gummed so tightly that after you tear it, you have to scrape the remnants off the mouth of the bottle with a blade (a fingernail would work, but hygiene forbids that).

1999: Thoughts Inspired by Baz Luhrmann’s ‘Sunscreen’

Remember the compliments you receive. Forget the insults, but if someone is unreasonably and aggressively obnoxious, cheer yourself up by looking at their patient history – they will almost invariably have a record of insomnia, stomach ulcers or heart disease.

Do not fill Valium 10mg containers with Warfarin 3mg tablets and leave them in your drug safe for syringeraiders. The ethical pharmacist wouldn’t even think of this.

Computers do NOT respond to physical or verbal abuse. Accept the fact that ‘upgrades’ aren’t and ‘help-desks’ don’t. Computer terms like ‘help-desk’ and ‘telephone support’ belong to the same lexicon as ‘military intelligence’ and ‘political integrity’.

2000: ‘Natural’ Remedies

It’s hard to keep a straight face at times when people ask if you can order some totally obscure product that even health-food shops can’t source. Did you know that you can buy ‘Beaver Fat Capsules’ to protect you from the effects of ageing? Apparently, because of the high levels of bark in the beaver’s diet, its body fat is particularly rich in beneficial tannins and antioxidants. Actually, I just made that up, but there are people who would swallow it, and would pay handsomely to do so. I think over-regulation of the ‘natural medicine’ market would be wrong, but the leeway that has existed for charlatans to exploit the unwary has been crying out for attention. Especially if you put the words ‘weight loss’ on anything, you will find people to use it, as long as they don’t have to walk to the shop to buy it, and can eat a bar of chocolate to survive the drive home.

2000: Translation Service Sales rep: ‘There are three free with 12 on that.’ Translation: ‘… but only one will actually arrive in the order.’ Sales rep: ‘That order will be out before the end of the week.’ Translation: ‘… but I didn’t say which week.’ Sales rep: ‘Payment will be made by direct debit.’ Translation: ‘So you can’t compensate for lousy service, slow credit note handling and delayed delivery of owed (but already invoiced) stock by not paying us on time.’

Pharmacist: ‘Oh, Mrs Murphy! Those tablets we owe you are coming in this afternoon’s delivery. We should have them by four o’clock. I know I said ‘today’ — I really meant this afternoon. Sorry about that. Alright so, see you later. Bye now.’ Translation: ‘Crap! I knew there was something I’d forgotten to order!’

2000: Premonition of Doom

I may have found the Payments Board to be efficient, but there are reasons for concern. The DPS fee is too low, especially with both broken bulk and container fee axed. The drug list is too restrictive. If we will ultimately be required to validate DPS and medical cards, we had better be paid to do it. Some pharmacy computer boffins have warned against moves towards online validation of prescriptions. Is drug budgeting in the pipeline?

2000: Pharmacy top-Ten chart

No. 10 ‘Lyclear, Right Now’ by Fatboy Slim. No. 9 ‘Je Nicorette Rien’ by Shirley Bassey. No. 8 ‘Ibuleve I Can Fly’ by Boyz 2 Men. No. 7 ‘Pharma Chameleon’ by Culture Club. No. 6 ‘I Should Be So Losec’ by Kylie Minogue. No. 5 ‘Livial Next Door to Alice’ by Dr Hook. No. 4 ‘You’ve Lost That Loving Feldene’ by The Righteous Brothers. No. 3 ‘You Are Olbas On My Mind’ by John Denver. No. 2 ‘Mirena On the Wall’ by Suzanne Vega. No. 1 ‘A Noriday in Paradise’ by Phil Collins.

2000: Pharmaglut

How would the powers-that-be decide that there was an over-supply of graduates? What benchmark do you use to measure supply and demand? Let’s assume further that TCD is still producing 70 graduates annually and that another college, say UCC, has a brand-new School of Pharmacy now producing 50. So, in the year 2010, having somehow assessed that there is definitely a glut of pharmacists — where do you cut the number of graduates? Henry Kissinger once said ‘university politics are so vicious precisely because the stakes are so small’. I can’t picture either institution meekly accepting a cut in student numbers and related funding so we could expect any Minister for Education to long-finger the hard decision and maintain the status quo.

1999: Patient Tales

My favourite story goes back a couple of years to the weekend of an American Football match in Croke Park between the US Army team and the US Navy team. As usual on these weekends, there were hundreds of American servicemen out on the rip. One of our Methadone patients arrived with the most hung over, bloodshot eyes that I’ve ever seen — try to picture a rabbit with hay fever in headlights. He proceeded to tell us that he was having a gargle in some pub the night before and he’d bumped into a bunch of US Army fans. So he asked them:

‘Did youse know that dere’s a big population of Vietnamese here in Dublin? Yeah, dey all came over in boats after the war and dey stayed. An’ do ya know wha? Dey should get together and form an American Football team… and then dey could wipe yer backside all over again.’

He was clearly living proof of the adage that there’s a god who looks after fools and drunks.

1999: Condom Buyers

Worse again is Mr Remarkable. This guy just can’t buy condoms without making some asinine remark about the fact. If he buys a 12-pack, it’s ‘Stocking up for a long weekend – you know yourself.’ Wink wink.

If he buys an 18-pack, it’s ‘Off on holidays. Ibiza Uncovered, here we come.’ A mere three-pack is only ever ‘just in case I get lucky. Friday night — you never know.’ Look mate, just buy the condoms. People buying toothpaste don’t have to say: ‘Just keeping the teeth white’, or ‘dental hygiene — can’t be too careful, you know yourself.’

The more things change, the more they stay the same. If I’m still writing in 2039, I wonder what will be different!