Monday, September 12, 2011

Healthcare encapsulated

She was petite, in blue dress pants and a conservative blouse with a small gym bag over her shoulder. I probably wouldn’t even have noticed her when I arrived at the pharmacy counter and stood the customary respectful distance behind her, except her conversation with the pharmacist was taking a long time. A really long time.

I tried not to listen, but her voice was taking on a panicked tone, and the more she talked, the more high-pitched and quavery – and loud – she got.

“I’ll have the money in my account on Friday when I get paid,” she told the pharmacist. “But I ran out of my medication yesterday.” She choked back whatever was welling up in her throat.

The pharmacist apologized in a tone so low I couldn’t hear what she was saying, even though she was facing me. I could tell she was deeply troubled by having to withhold medication from a patient. But I assume there are strict laws against dispensing prescriptions on store credit.

The pharmacist had already rung up a few extra items for the woman, and they were in a bag on the counter. The woman opened the bag and looked at the other things she’d intended to buy with her medication.

“How much would the total be if I didn’t buy this?” she asked as she handed back a bottle of Sprite Zero and a package of cookies. The tiny sparkle of hope in her voice belied what she, the pharmacist and probably everyone else in earshot already knew: a few dollars wouldn’t make a difference.

“That brings it down to $735,” the pharmacist said.

The woman’s shoulders slumped. She handed the pharmacist two more products from the bag as I busied myself examining the display of sharps containers and daily pill organizers on the wall next to me.


The bag was empty. And even though her back was to me, I could see the woman was trying to survive this conversation with every ounce of dignity she could muster.

There was a long, heavy pause. Then something occurred to her.

“Can I just pay for a few day’s worth? Even one day’s worth?” The hope in her voice made me silently root for a good answer from the pharmacist as I discovered you can even buy pill organizers that lock so they won’t open in your purse.

The pharmacist took a breath so deep I could hear it from my position six feet away with my head turned away from her.

“I’m sorry. That’s not how the prescription was written.”

I hadn’t realized the woman had been holding her bagged prescriptions in her hands during the entire conversation. She could have grabbed them and run, which is obviously a terrible decision. But it seemed like a viable option even to me as we all stood there.

She clutched the bag to her chest for a moment – holding whatever drugs she obviously needed as close to her body as they were going to get today – and then slowly set them on the counter and pushed them back to the pharmacist.

“I’ll be back on Friday,” she said in a resigned voice. “My paycheck usually gets deposited in my account first thing in the morning, so I’ll be here before work. You open at 7, right?”

I stepped way back and started examining the boxes of alcohol wipes that the doctor uses on your skin before giving you an injection. My attempt to give her some space worked, at least for me; I didn’t see her walk away.

But when I walked up to the pharmacist, who looked slightly ashen, I saw the woman’s empty drugstore bag on the counter. And her Sprite Zero, her cookies and her two boxes of vitamins still sitting next to the register.


don said...

Archaic patent laws ensure that American pay more for drugs than anyone else. So much for life in the "free" world.

Chaely said...

This could have been me. $30 a pill for my prescription and that was when I was buying my own insurance for $205/mo out of pocket. Now I don't have insurance at all & managing a chronic pain condition with no meds has been a heavy burden to carry. Having to resort to other ways of managing pain and coming up with the meds when I can has turned me into a common criminal, but it's easier than socializing health care, right?

John said...

I complained how much my meds are until I overheard how much drugs are with no insurance. PS: My pharmacist has led me to believe that the patient CAN adjust quantities downward. Perhaps not in IL.

Anonymous said...

Unless the meds were for Schedule II drugs, the pharmacist could have GIVEN her the pills to last until Friday, then on Friday he could have filled the prescription, subtracting the number of meds he had already given.

Practicing pharmacy for 23 years, I've done this a number of times. Board regulations always allow the pharmacist to use judgement in doing what is best is the patient.

My suggestion for this patient would be to find another drug store.

Amanda said...

Oh that poor woman!!

I really hope that corporation gets their tax break so their CEO can get that raise he's been aiming for.

Daniel said...

wow. this brought tears to my eyes. i've read it over and over.

Anonymous said...

You should have bought her damn sprite and cookies. I would have.

2PAX said...

On hearing stories like this, I realise how well off I am living in a country who's people require the government to provide medical care, and who willingly give government the power to negotiate with drug companies on the price of many drugs, and then let me buy them at a guaranteed price. We have a health system that has equal or better outcomes than the USA at about half the cost. Where do I live? Australia

William Dameron said...

Well written and touching. The juxtaposition of the trivial items mixed with the necessary was powerful.

Rick Aiello said...

Wow... I just happened to drop in and saw this. It makes me angry. And grateful I have the insurance to pay for my medicine. For now.