Scene: a typical grocery store with a pharmacy counter. It’s dinner-time so the store is fairly peaceful. There’s people walking around but it’s not a hectic atmosphere. Center stage is the pharmacy counter and to the left is the entrance to the grocery store. As the curtain rises, patient enters the store and walks toward the pharmacy counter. Pharmacist looks up through his window & waves to patient.
Patient (at the counter now): Hi, I’m here to pick up a prescription for Cashelle. C-A-S-H-E-L-L-E.
Tech (at the computer): Let me look that up. [pause] It looks like we haven’t filled it yet. Can you give us a few minutes? Then we can have it ready for you.
Abigail: Ok. Sure.
[Advance clock by 15 minutes. Abigail is now sitting in the waiting area. Pharmacist now waves at her to come forward]
Abigail (approaching the counter): Hi.
Tech: We filled that prescription for you. Can you verify your street address?
Abigail: 1234 Any Street.
Tech: Thank you. Your total comes to —- amount.
Pharmacist (leaning over from his computer to the counter): Hey, how are things going for you?
Abigail (ignoring tech): Lots of ups and downs. I’m just trying to hang in there. It’s been rough recently.
Abigail: You know that I was on that muscle relaxant metaxalone, right? (pharmacist nods) Well, I have this connective tissue disorder called Ehlers-Danlos syndrome that affects the collagen in your body. And the muscle relaxant seemed to help with a lot of the symptoms. Except that it made me really nauseous. Like I stopped eating. And that became its own problem. So they switched me to another muscle relaxant. I picked that up yesterday but I haven’t started taking it yet. My first dose is tonight.
Pharmacist (to tech): Can you look up what that prescription is for? (Tech clicks away on her computer while pharmacist looks on.) Oh yes.
Abigail: Does that look familiar?
Pharmacist: Yes, definitely. I can see what they’re thinking. I mean, I can’t really tell you what to expect because, well, you know, you never react in a way that people expect. But keep coming in and we can figure this out, okay?
Abigail: Okay. Do you see this often? I mean, people with connective tissue disorders & muscle relaxants?
Pharmacist: Well, not really. I mean, that condition is pretty rare, right? But now that I know, I’ll keep an eye out for it.
Abigail: Oh, right.
Tech (who has been ignored the whole time lifts her eyebrows and pharmacist steps away): That will be $—-.
Abigail: Oh sure. Sorry. Here’s my card.
[They complete the transaction and the tech steps away from the window. Abigail goes to pick up all her stuff and leave. When she looks up again, she realizes that the pharmacist has come back and is now leaning over the counter with this confidential look on his face.]
Pharmacist: Ummm, what did you say the name of that condition is?
Abigail: Ehlers-Danlos syndrome. Do you want me to write it out?
Pharmacist: No. Can you spell the first part? Is it I-L-…?
Abigail (shaking her head): No, no, it’s E-H-L-E-R-S. It’s named after someone.
Pharmacist: Oh, okay. They always are. Can you tell me a little bit more about this condition & how it affects you?
Abigail: Well, it’s a connective tissue disorder that affects the collagen in your body. Usually, people discover that they have it because they’re very hypermobile, like double-jointed and stuff. In the United States, it’s typically considered benign, but in Europe they’re realizing that it also affects things like your digestive tract & your neurological system because they’re composed of connective tissue as well.
Pharmacist: Oh, so this is a collagen deficiency?
Abigail: Yes, you got it. It’s rare, and they don’t know a whole lot about it, but it seems that people with that condition tend to respond to muscle relaxants especially when they don’t respond to much else. Physicians have started noticing patterns like treatment-resistant depression. It’s genetic dominant, and we think it runs in my family. Perhaps my uncle Eddie had it.
Pharmacist (gears in his head churning): I see. Well, thanks for sharing all this information. I’ll definitely keep my eye out for you. And come back if you’re having trouble. We can get to the bottom of this.
Abigail: Thanks so much.
Pharmacist: Sorry I can’t do more.
Abigail: No, this is amazing. It’s so hard for me to keep track of all these things myself. There’s so many different medications, and tons of stuff for me to keep track of. All I want to do is feel better and not have to deal with this. Plus, I studied history in college. It’s not like I’m prepared for all of this. It’s helpful just to know that I have someone else on my side, someone who’s an expert who’s looking out for me.
Pharmacist (smiling): History! Okay, well, I can definitely do that. We want that for our customers. Thank you again.
[As curtain is closing, you see Abigail picking up all her stuff (again) and leaving while pharmacist walks back to his computer muttering "history!"]
That’s pretty much how the scene played out between me and my pharmacist yesterday. Ken has always been really thoughtful and caring and approachable, so I feel like there’s plenty of reason to go back (besides the fact that I keep getting prescribed meds.) It’s certainly been helpful to be able to talk to him about what has been going on over the past few months and to try to sort through things and discern the difference between side effects and symptoms and try to ascertain that fine line between suggestions and warnings on the drug information sheet.
I’ve had my fair share of bad interactions with pharmacists, pharmacists who think counseling means pointing to the information sheet and saying, “Read this.” Mostly, it’s been pharmacists who have a huge backlog of work or are used to fielding complaints on insurance or the location of the bathroom. Retail has got to be a tough environment. (I bet they feel a lot like librarians in this sense.) Over the years, I’ve had pharmacists who have recognized me from previous visits and know my name & what I’m taking. But Ken’s been the first pharmacist who’s consistently sat down with me to talk about my case and how I’m doing, why I’m taking these various meds and what is actually going on in my life medically. I know he’s lucky because his grocery store chain emphasizes care & smiles foremost and the particular location that he’s at is rarely swamped with people (or at least I never shop at those times.) I know he gets excited to actually put his pharmacist degree to good use.
But even more, I feel like I matter to him. Not just because I’m a paying customer and I come in multiple times a week. (Hello, having brain fog means not being able to coordinate that all my meds have refills at the same time!) Not just because I make all of his schooling relevant. But because I’m a person, and he cares about me and wants me to be well. And so, finally, I have someone here on my side and who’s willing to be on “the team”. And that’s why Drs. Samuel, Leo, & Mark have all heard about Ken.