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The dreaded old patient

·4454 words·21 mins

I’ve seen a lot of things come through my workplace.  Crackheads, addicts, people with guns, seekers, screaming children, teenage mothers, people who should be in a care home rather than on the street, etc.

However you know what really makes my asshole pucker when I see them walk through the glass doors? You know what makes me want to run and hide the moment they come into my sight?

Old people, with a baggie full of medication.

I know right then and there that if I get suckered into talking with them, there goes about 45 min of my day and the remainder of my patience.  Why do the elderly have to be so stupid and so difficult to deal with.

You tell a crackhead that they can’t have their vicodin, and although they may pitch a fit and threaten you, eventually they get the hint and leave.  Tell an old person they got their lisinopril filled 2 days ago, and they just stare at you expecting god-knows-what to magically appear in front of them.

Here are some signs and symptoms of oldfartitis:

Females: Usually they will give you the infamous blank stare (AKA: Cow Eyes) and expect you to know exactly what they are thinking.  After about 45 seconds of silence and her staring at you, she will finally throw some random curveball at you like requesting refunds for drugs she picked up at another pharmacy.  No matter how long you explain to her about Medicare Part D deductibles or how she received 30 atenolol just 2 days prior, it will appear that you are just talking to yourself.  The same “Cow Eyes” just stare at you devoid of any sort of knowledge or common sense.  Its quite frustrating.  Eventually, you’ll use every technique in the english language to say “Okay, you’re done, you can go now” without outright booting her.  She’ll pick up her baggie, walk out, and in 30 mins will call you and ASK YOU THE SAME FUCKING QUESTIONS YOU JUST WENT OVER WITH HER!!!  Im surprised she doesn’t trip over her cordless phone (and you’re surprised you don’t hang yourself with your phone cord)

Males: Everything is your fucking fault.  You are the reason why Hitler killed those jews, why Jag got canceled from channel 12 and why Hometown Buffet and Cracker Barrel was closed last Saturday so they can repaint.  In their mind, you have screwed the pooch big time, and the only solution is to sit there and express their confusion via yelling at you.  No cow-eyes for them, they just blab their frustration with why they cannot pee and why they have not pooped today right over that counter all over your little white coat.  You can show them the video tapes of them coming into your store 2 days ago and picking up their pills and they will STILL yell at you and call you a liar and demand their refills.  They squack about their $1 copays each time every time, and you wonder how Mrs Cow Eyes can live with Mr Poopy Pants.

Both of them share one thing: The inability to grasp and understand simple concepts.  I’m not talking about people who are on 10 different medications here, I’m talking about 2 pills both taken at bedtime.  At what point do you draw the line and say “Hey, listen.  No offense, but I don’t think you are mentally capable of taking this lisinopril once daily.  Let me put corks on the end of your forks and give you the rounded scissors so you don’t harm yourself”.  These patients are super high maintenance, and to be honest I’d rather deal with the scummiest crackhead off the street who can understand what I’m saying.

Its sad that I have to rag on the aging population, however they are pissing away all of my Medicare money that I pay into and will never see, so since I’m footing the bill for their lives I can rag on them all I want.

Comments #

Comment by on 2008-05-01 01:16:42 -0700 #

You hit the nail right on the head! Well said!!!

Comment by CPhT on 2008-05-01 05:02:40 -0700 #

I can agree, to a point. I spent 45 fucking minutes of my life yesterday talking to an old woman who insisted I go pull her hard copy for her Digitek that was recalled, and she decided that since she was so smart, she’d read it a hundred fucking times and then she decided she’d try to write on it. I snatched that back off her, printed her a copy of her label again, and handed it to her and told her to talk to her doctor. Not even 5 minutes later, she came back and demanded my pharmacist who was ALSO on the phone with an old person about Digitek, and she wasted 25 minutes of HER life. Total time wasted: 1 hour, 5 minutes. I’d also talked to her for 25 minutes on the phone. That increases our wasted time to 1 hour, 30 minutes. I also told her to bring in her pills so we could switch them out, and she didn’t bother. She had the nerve to tell me I didn’t tell her to, so I walked away. I couldn’t deal with her any longer. I can understand her worry. But seriously, we know what we’re doing. There’s a reason we aren’t working at McDonald’s or something. Trust us.

Comment by Shalom (R.Ph.) on 2008-05-01 07:04:00 -0700 #

Arrgh, thanks for reminding me.
Some years ago, when I was filling in on the day shift of a 24-hour R*te A*d, I got a call from an old person. She wanted to know how to take her medication. I told her, the Fosamax she took first thing in the morning with a full glass of water, and the other one (I forget, probably Lopressor) she took twice a day with food. She said, wait a minute, let me get a pen and write this down. After a minute or two, she comes back and asks me to repeat it. I tell her, the Fosamax she took first thing in the morning with a full glass of water, and the other one she took twice a day with food. Fine, she hangs up.
About an hour later, she calls again. She wanted to know how to take her medication. I told her, the Fosamax she took first thing in the morning with a full glass of water, and the other one she took twice a day with food. She said, wait a minute, let me get a pen and write this down. After a minute or two, she comes back and asks me to repeat it. I tell her, the Fosamax she took first thing in the morning with a full glass of water, and the other one she took twice a day with food, etc. Word for word identical to the first conversation, you could’ve copy/pasted it (in fact I just did). Not only couldn’t she remember what I’d told her the first time, she couldn’t even remember that she’d called me in the first place.
Altogether she called me four times that afternoon, and I parroted the information a total of eight times, because each and every time she went for a pen to write it down, and then had me repeat it once she’d got it. The last time, I told her to stick the paper on the fridge, so the next time she called I could tell her to go look there. Didn’t help, I heard from the night-shift guy that she’d called back two more times that night.
She did apologise once, around the third call, saying “I’m sorry, ich hab a ch’leir’ya in kop” (literally “I have a cholera in the head”, and how she knew I spoke Yiddish I’ll never know). Somehow I’ve been blessed with patience for old people, and I can’t understand why or how.

Comment by one_angry_tech on 2008-05-01 07:50:29 -0700 #

I’ve learned don’t argue with them, yes sir no sir yes ma’am no ma’am, try not to stare in their eyes, and don’t bother asking if they would like to call their refill in a day ahead.. because they really don’t give a shit that you’re busy and it would help us out when we don’t have the time to count 10 prescriptions within a 5 minute period.
Case in point: I asked an older lady (politely, of course) if she ever tried calling her refill in ahead, so she doesn’t have to wait?
Her Answer: NO!
That took care of that.
And kudos to Shalom.. cuz I would have lost it after the second time!

Comment by AZ RPh on 2008-05-01 08:51:48 -0700 #

Bravo!! Your post typified my daily personal hell for the last 5 years. …after half a decade working pharmacies in an ‘active living’ retirement community, I finally transferred to a nice, middle-class, low-maintenance bedroom community. My sanity is slowly returning.

Comment by Paul on 2008-05-01 11:13:51 -0700 #

You must really hate old people. Just wondering, what are you gonna do when you become old?

Comment by The Ole’ Apothecary on 2008-05-01 15:08:22 -0700 #

Alzheimer’s, otherwise known as ch’leir’ya in kop, may be rearing its head here. Some people say “Old Timers” instead of Alzheimer’s which may not be far from the truth.

Comment by Biggest Fan on 2008-05-01 19:20:53 -0700 #

Man am I dreading getting old! Going to fight it every single itty bitty step of the way! Already saving for my face lift, boob lift, botox and whatever else I think I need when I get older! Hopefully my doc colleagues will give me big-time discounts!
TAP – I will be the old woman (let’s say 74-ish or so) coming to your counter with the low (LOW) top, LOTS of cleavage, highlighted hair – trying to be 31 again. I will flirt with you, batting my eyes (assuming the botox didn’t backfire) to get you to fill my aricept a few days early. I will lean over the table, trying to convince you to throw in a couple more darvocets. I imagine myself being a rather techy-old lady, so I will text in my refill requests (probably 2 weeks to early). I will park my hybrid right up front so you see me coming (and you can hide if you want). I will probably insist you have designer Depends just for me, and I will give you a big wink when I set them on the counter to pay. I will have constant questions about my husband’s viagra – and I will give WAY too much information during that conversation. And if he’s with me in the store, I will make sure someone sees me grab his backside (or frontside…). I can see myself having the latest gen ipod and having wireless little earbuds that don’t disturb my highlighted, once-a-week hairdo. I will be bouncy-bouncy with my tunes in the store and may even be blowing bubbles (if the denture stuff is really good and sticky by then). Can’t see myself having diabetes – especially since I’ll still be registering for marathons – only speedwalking them by then……..but just in a sports bra (okay, maybe TWO sports bras – depending on that boob job). I’m sure to have osteoarthritis – especially in the knees with all the running. So, I’ll need some Icy-Hot or something similar…and I’ll ask you for a demo on how to apply it.
Yeah – getting old…geez! Can’t wait!!!

Comment by BlueTech on 2008-05-01 23:41:22 -0700 #

(Names have been changed to protect the senile)
I was new to the pharmacy when I helped little old Mrs. Schwartz. She’s terror with permed hair, and she stomped up to the counter grumbling about life in general: “These copays are too high ($1.05), the air is too dirty, the sun is too sunny, all you young’ins are skateboarding on my sidewalks, etc etc etc” and then she sees me. I try to wear the biggest customer service smile I can muster (I have since forgotten what a smile is), and said “What can I get for you today?” She said “I need my diabeetus medicine” (Just like Wilfred Brimley, I swear to God).
So, as I was ringing her out, she opened her wallet, and there happened to be a picture of two dogs. She noticed me looking and said, “You see these here dogs o’ mine?” “Yes, they’re cute” I replied, hoping to brighten her day.
She looked me square in the eye and said in a stone-cold tone, “They’re dead.” Flat out.
I was frozen. What the hell was I supposed to say?! She went on to say “They died of diabeetus (There’s Wilfred again), and I’ll probably die of diabeetus too.” I gave her the change, her receipt, and backed away.
I’ve seen her in from time to time, but not once have I rung her out, taken her script at the drop-off, or ever said another word to her.
Those dogs aren’t dead. They’re hiding.

Comment by Anon on 2008-05-02 11:59:06 -0700 #

This blog entry made my day.
Lately I’ve been dealing with one elderly couple who are on 15-16 different rxs between the two of them. They complain constantly that we didn’t refill the right one (we did), we shorted the quantity (we didn’t) or that we gave them broken/ineffective medication (nope on that one too). Of course, they never call in all the refills at once, but every couple of days, so we deal with this every week.

Comment by on 2008-05-02 22:00:38 -0700 #

First off, I would like to thank you Mr.Angry Pharmacist. I love you. Dude what kinda life is this. Why didn’t anyone warn me. I was all happy and excited to start working as a pharmacist. And suddenly bamm really hits me in the face. WHAT THE F*###K IS THIS?? this is not what i signed up for man. I heard about your site through a tech and came home after a horrible day of slavery…and just wanted to tell you that you give me hope. Even though I suffer every second of every day, there is still some contentment in thinking that I’m not alone. I know understand that there is a sea full of people just like me out there.
Just to add to the old people story…when I check voice mail every now and then I hear “hello…helloo….is anyone there….can anyone hear me…helloo…helloo…who is this….can you hear me” times three…dude I hope i don’t turn into one of them one day. What the hell??
They’re all kookoo man…at least 85% of them. I haven’t been working that long, but I’ve had people taking my picture and threatening to sue me cause I won’t dispense their klonopin early!! I hope you freaking choke on the damn pills…so you don’t have to come and bug me about it!! Can someone let the entire world know that pills are not M &M’S…
Whats your name? Whose the manager? I want your license number? I wanna take out a bat & hit you over the head but do I tell you…no…so keep your damn questions to yourself. Go ask someone who cares. Dude I don’t mind helping people…thats why i went to school and did all this..with a passion…now in less than one month of working the passion has turned to hate and anger. what a waste. And when ever I get a bloody glucometer…I just say contact the manufacture. One less to worry about!! I don’t know how much longer I can keep doing this!!

Comment by nobody on 2008-05-03 06:10:47 -0700 #

I won’t be growing senile. I’m gonna fly down to the Golden Triangle (Thailand, specifically) when I can no longer walk or function mentally. Of course, in my case, it will be the body that goes first (some bodily injuries never go away), so I’ll still be aware enough to take off before geriatrics can trap me in its web of coma. I don’t believe in the limbo, even though it makes companies billions of dollars in health care services. I see it here and hear about it in other cities, how waiting rooms and ERS are clogged with geriatric issues.
Where is the integrity? If you are frustrated daily because you deal with Mrs. Cow Eyes and Mr. Poopy Pants, TAP, imagine the suffering they go through as walking corpses. That shit ain’t gonna be me!

Comment by RxRoo on 2008-05-03 08:35:28 -0700 #

Speaking of choking on pills, I had an old lady come in and tell me she almost choked to death on her calcium that morning. I recommended one of the calcium petite tabs but if she couldn’t see them (as in open the box and refuse to pay for it) she didn’t want those. Then I recommended the chewable Viactive type. She proceeded to scream at me “HAVE YOU TASTED THOSE!?!” I said I had and they weren’t that bad and suggested she try a different flavor. She said they all were awful. Okay… how about Tums? The smooth dissolve ones are semi-tolerable. That provoked another tirade of are you kidding?!? You’re just getting worse…So her decision? She bought a pill crusher to crush the pills and take them that way (which I’m sure will taste lovely). The only thing that sweetens the story was the phone call I got the next day where she asked if she could crush the entire bottle at once so she didn’t have to do it every day. I responded with it would be pretty tough to figure out each dose if you crushed the entire bottle. So I was able to convince her NOT to crush the whole bottle but she then said she takes 3 tabs of the 600 at a time. I tried to tell her why she shouldn’t take that much at a time but it was completely lost…I just shook my head as I hung up the phone. Ah the wonders of Old People…there’s just so many stories….

Comment by Red in Jersey on 2008-05-04 09:05:20 -0700 #

I’ve been doing this crap for over 30 years. It took a long time but I’ve finally learned not to let these shit heads get to me. I do enjoy reading these rants, though, because they’re all true. When people ask if my kids go to pharmacy school I tell them that’s grounds for child abuse. Anyway, I was reminded of the old lady who called one day. She said that she tried to explain to the woman on the phone that she only wanted half of her prescription filled, but the woman wasn’t listening. I explained to the lady that she wasn’t talking to a person; she was talking to our automated computer. Then she said: oh, are you a computer? It took all my will power not to say yes I am. I almost can’t wait for the day when I lose my marbles (it’s not far off, actually) so I can enjoy some payback on some young yet-to-be disillusioned pharmacist. “What’s taking you so long? Back in my day…”
To TAP: I think it would be interesting if you had a F*@K YOU blog that people could comment on. How’s this for starters: FU, you ignorant bitch! I guess I must have missed the class that taught us to read the doctor’s name on a hospital blank when his signature looks like a straight line. Never mind that it’s Friday night and the rx is a week old. Go ahead and call the manager; see if I give a shit! The next time you see a doctor why don’t you get a prescription for some brains?
Gee, that felt good.

Comment by Kacey on 2008-05-05 12:20:38 -0700 #

I could just cry reading this post. It sounds like being old is a worse crime than being a crack head. I have had my turn at taking care of elderly people, who came to the hospital with a big bag of medicine, so we could write down the drug and dosage on their admission. Wait until you need (or your doctor thinks you need) fourteen different drugs to stay alive. Since I am a nurse, I can take care of our medical needs, but it isn’t easy to keep track of which company is the best to provide coverage for the least amount of our pension money. Or, rather, which company is going to screw us out of everything we saved when we were younger and didn’t need heart or arthritis drugs. I really hope your parents don’t read your blog — it really hurts to find that you have lived a long useful life and now the next generation wants to send you out on the ocean in a burning raft. By the way, you are not paying for our medicine — we had to pay into Social Security all our lives, but the government frittered it away in the general fund instead of investing the money. If people are coming into your store with confusion about their drugs, tell their doctors to give them written instructions along with their prescriptions. You forget that the public does not have the benefit of your medical knowledge — they are not stupid— you are just educated. Part of that education is supposed to be used to teach your customers what they need to know about their drugs. God! When I look through your eyes, I hate being old! You know — those same old folks wiped your butt when you were little and didn’t complain that you couldn’t do it yourself.

Comment by Pharm Guy on 2008-05-05 20:30:25 -0700 #

I thought it was great! One day, this old lady calls in. She was happy to talk to me. I was so understanding and nice. She called in one other time and got this really rude guy. He talked too fast. He asked too many questions. He kept asking for her prescription number. When she told him she didn’t have it, he asked again. She got so frustrated that she hung up on him! Yeah, turns out it was the automated refill system.

Comment by KDUBZ on 2008-05-16 23:08:15 -0700 #

As much as it may help to think about playing the old card when I reach that age, I really hope I die before I get old. Bitching about 1.09 copays is a little ridiculous, and I would like to think of my time in retirement as just a little too precious to waste arguing over nickels and dimes.

Comment by cathy on 2008-05-21 23:04:46 -0700 #

Isn’t it just wonderful TAP that one day you will be one of those old farts. Oh surely, you think not. But, little man, it WILL happen.
Its just wonderful that you would rather service someone with a gun on you, or a crack head, than the elderly of our society. I assume you have parents? Maybe you even have grandparents? Do you show them this type disrespect? If so, they must be very proud of you.
Trust me when I tell you we have earned our way in society. We are the one’s who worked our ass off, so you could go to school to get a good education, and become so much smarter than we are.
Sometimes I find some humor in what you write and you are a very talented writer. It is a damn shame you have to use that ability, to just spread venom and hate.
You are an attention whore! You will trash anyone to get a few minutes of fame here on your little blog. Maybe it’s just time to grow the hell up?

Comment by on 2008-06-03 07:03:12 -0700 #

that is funniest shit I have ever read! Every time a patient like this comes in now all the pharmacists say “throw poop”!!

Comment by whatever. on 2009-03-14 21:00:53 -0700 #

“It is a damn shame you have to use that ability, to just spread venom and hate.”
Who’s spreading venom and hate here? You’ve obviously never worked in a pharmacy before, or else you’d realize that TAP speaks the truth; old people ARE just as high maintenance as he claims. The crackheads who come through the pharmacy, while they’ll lie through their teeth and probably yell a bit, do eventually get the idea and leave. But try talking with an elderly person, 75+ years old, about their medications. Just try it. When there are 38 different things going on that need your immediate attention, and you have to spend 15 minutes with Mrs. Smith, explaining to her exactly how to take her lisinopril every day, you’ll realize quickly just how right TAP is.
I’m not saying that the elderly are mean, or don’t deserve the time of the pharmacist; this post isn’t meant to be taken that way. Some of our nicest patients are over 80, and it pains me to write this while thinking of them. All this post is doing is expressing how frustrating they can be (but usually are) to deal with.

Comment by PinoRPh on 2009-08-21 18:18:07 -0700 #

An old lady yelled at me today for not having all of her rxs ready. After all the yelling, she said “CAN… YOU… UNDERSTAND… ENGLISH…?” I’m Filipino by the way. And I smiled and stared at her blankly… Then later on, I said “DID… YOUR… DOCTOR… CHANGE… YOUR… DOSE?” And she got more flustered… Hahaha! Got you back, yeah!

The signature pad then did not take her signature for her credit transaction, and called her back (after throwing the pen down on the counter and stomping out)… She came back, signed again, and threw the pen down a second time… This time I asked her (with a smile, of course) if she wanted her receipt… She stomps back and takes her receipt.

I feel bad for those RPhs who cannot speak English clearly. I am very fluent (no accent whatsoever), and I got that comment because I look the way I do…

I wonder if there’s a law out there that will prevent customer discriminating against us “different-looking” peeps…

Comment by Clare Palmer on 2013-02-22 13:29:37 -0800 #

You are so uneducated on Fibromyalgia. Unbelievable. I didn’t know I had FM until it was diagnosed, until then I thought I was cracking up. You would only have to spend a week with me and you’d realise it’s very real…. And for your information, FM is now considered a Neurological disorder, where the brain signals tell you there is pain even when there is no visible injury. No one can fake that. No one.