Pill-hounds are not only the ones who hate pharmacists: practically everybody hates them. In turn, pharmacists hate everyone back and, for that brief moment when they are in charge of your medical treatment, they will jack you around out of pure spite.

A pharmacist shuffling papers behind his altar-like counter won't look up when you arrive. He won't even grunt before he's good and ready to peer down at you and acknowledge your existence. Then he will make you talk out loud about your medical problems. Sometimes, he will challenge your prescription. Hmmmmm, you got the clap, dontcha? Prozac, eh? Don't look depressed to me. Isn't it a little early for you to be refilling this codeine? In fact, I'm not sure you should have any more codeine. He will make you grovel. That's what he lives for.

How did the pharmacist become so odious? Does pharmacy inherently attract people who naturally seethe with inner malice while maintaining a stony facade? Are they born this way or does something happen to them? Unfortunately, there is no evidence that pharmacists have a genetic problem. Like sadistic prison guards, they are largely creations of their surroundings. Something about the job ruins them.

THE BIG SCAM
The sadistic process of twisting a pharmacist's psyche begins in college. Pharmacy school is rough--you can't get through it without advanced calculus, chemistry and super dedication. Pharmacy school lasts at least five years. And it costs a lot.

No one would endure pharmacy school for the chance to count pills, let alone to be hated by customers and held in contempt by doctors. So, to make students cram pharmacokinetics (which they will never use on the job), the schools tell big, outright lies. They promise that their graduates will be liked, and will hold an esteemed position in medicine, in society even. Students are told again and again about the high degree of trust placed upon pharmacists by patients and doctors. They see pictures of kindly people in smooth coats holding up test-tubes and being beamed at by old ladies. They are shown photocopies of a folklorish survey indicating how certain professions are trusted. Pharmacists, they see, are only a notch or two below Supreme Court Justice--and far above a doctor.

This is the opposite of reality, of course, which just makes the hoax crueler. When you see a pharmacy student, what you are looking at is someone who just wants to be liked and valued by their community, slaving away for respectability and honor they will never get.

THE SUCKER PUNCH
The reality of pharmacy is that it is a service industry, not much different than a dry cleaners. Pharmacists are not pillars of the community, they are pill-counters and stock boys. And respect? Please.

Instead of being part of a benevolent triangle of medical care, the pharmacist finds himself at the butt end of an abusive process nobody likes. It probably doesn't take more than one day on the job to show a newly minted pharmacist that he or she has been tricked, and it's little wonder pharmacists are five times as likely to kill themselves than the average person, or that only psychiatrists (narrowly) finish before pharmacists in the sad race for most suicidal profession.

Think about it: customers arrive at the pharmacy because they have been hurt or are sick. They have already made the trek to the doctor's office, lost a day of work, been kept waiting and charged a hundred bucks to spend three minutes with a doctor who hands them a piece of paper. Now they have taken the bus to the drugstore and are about to be appalled by the money they are going to shell out to this grump behind a counter so high it makes them feel like a three-year-old. They are not happy to be there. They are, in fact, quite unhappy. And nothing the pharmacist does is going to make them happy. But--too bad--the pharmacist isn't all that content himself. He's been swindled so badly he's never going to trust anyone again.

The collision between sick, ripped-off patient and tired, ripped-off pharmacist is as predictable, and mean, as a cockfight. The customer grumbles at the pharmacist, asks some ridiculous question--or any question at all--and the pharmacist sneers and usually doesn't respond. The phone is ringing. The people standing in line start clearing their throats. The pharmacist shoots a few withering looks, then doles out the pills. Slowly. Sufficiently abased, the customer begins to limp home. The pharmacist waits for more abuse. Since old people take the most medicine, the majority of his customers are old people--cranky old people who complain about prices and ask the same stupid questions a thousand times a day. This is just more gravel in the pharmacist's shoes.

There are no test-tubes in sight. No mortar and pestles, no hand-in-hand work with the doctor. In fact, there are no real prescriptions anymore. A clerk in a pizza joint has a more complex job than a pharmacist. Doctors prescribe ready-made medicines, often by brand name. Doctors decide if a generic can be substituted. The pharmacist just gets the right bottle of pills and starts counting. Substitute birdseed for the pills, and a competent pigeon could do your pharmacist's job. There is simply no pharmacy going on in a pharmacy. All those nights of midnight oil, learning absorption rates of alkenes into mucous membrane mean nothing now. That was just the price for a pill-selling license. And pharmacy school didn't breathe a word of this.

Neither did the school teach any of the practical skills the pharmacist genuinely needs. They didn't teach how to run a cash register, or catch shoplifters, or even how to identify pills. Pharmacy students can draw the molecular structure of almost any drug but cannot visually ID or even name the top twenty pills they will sell. Then there's pill-counting--the most obvious part of pharmacy drudgery. Just how much organic chemistry is necessary to count pills? This is even more humiliating since the number of pills in a bottle is one of the few things a pharmacist/pigeon can screw up. It's also something the old bag snapping about high prices can and will check.

Of course, as the years grind by under the fluorescent lights behind the silly counter, the pharmacist eventually learns all this. But it's all on-the-job, hard-gained knowledge. And in learning it, hearts are broken. All the bad land sold in Florida cannot have caused the pain a single pharmacist feels by the time you see him there among the pills.

PILL COUNTERS VERSUS DOCTORS
Pharmacists are not taught to read doctor handwriting, which is unfortunate because all the jokes about this subject are true: most doctors really do have shitty handwriting and the inability to read it can lead to serious mistakes. People have been killed by script fuck-ups and pharmacists commonly mis-dispense drugs due to errors in reading the prescription. Then they get sued and kicked out of the business forever. The doctor, of course, is unaffected.

So this is a very real problem. But calling the doctor's office for clarification of a prescription just makes the pharmacist a pest. The receptionist treats him like an irritant. The doctor treats him like an idiot. Should the pharmacist have any other "problems" with a prescription, he comes dangerously close to questioning the doctor's wisdom--and may incur the doctor's wrath. And doctors are often angry, angry people with a lot of resentments of their own about the way their educations turned out and the way society views them. So the brittle ego of a pharmacist will not allow him to risk calling a doctor every time he thinks there's something wrong with a script. Mostly, the pharmacist just lives with the fear and uncertainty, which only adds to his or her time-bomb-like personality.

MINOR SUPERPOWERS OF THE PHARMACIST
Before about 1970, refills were the province of the patient and pharmacist. A doctor merely prescribed a medication and a regimen. It was up to the patient to comply. One prescription was essentially good for life. Although it is severely restricted compared to a couple decades ago, pharmacists still retain vestiges of the right to refill a prescription without contacting a doctor.

These days this happens almost exclusively when little old hunchbacked ladies come in to get more heart pills and the pharmacist goes ahead and refills the damn thing, knowing she's gonna be on that drug for the rest of her life. If a doctor discovers this, they may get insulted and retaliate against the pharmacist. This may result in loss of license or worse. So generally, pharmacists demand refill instructions from the doctors--simply out of fear.

In some states, a pharmacist may still have the right to prescribe certain medications to the public at large. In practice, this is almost never done because of the severity of punishment should some authority be brought down to investigate.

Just to torment pharmacists some more and stamp out whatever tiny scraps of mercy remained in their souls, 60 Minutes once sent a team of middle-aged, well-dressed and well-spoken women with out-of-town IDs to pharmacies around Washington, DC, and had them beg the pharmacist to give them just a few days' supply of Valium since they had forgotten theirs back home. Lo and behold, some pharmacists went so far as to dispense a little of the (at the time) number-one-selling drug to a person who, from all outward appearances, was not only a typical patient for Valium but verging on hysteria. A believable story and supporting identification clinched it.

The women managed to collect a stock of Valium which they dramatically poured into a little pile in front of the camera. Then the 60 Minutes hack commentators declared with shock their outrage that such a "haul" was possible. Gee, why didn't they send in scrungy men with three-day beards and no coherent story to get the pills? I have some experience in this area and can promise you the results would have been very different.

MORE SIGNIFICANT SUPERPOWERS OF THE PHARMACIST, AND WHAT THIS ALL MEANS TO YOU, THE PILL-HOUND
Pharmacists in many states have the power to self-prescribe. In practice, this means they can maybe hand out antibiotics to family and friends. Also, the drudgery of the job makes catching--or choosing to ignore--fake scripts practically the only "fun" thing about it (other "fun" things are diverting drugs, selling stolen drugs and dealing controlled substances illegally). This all would make pharmacists good people to hang out with, were they not so fucked up and fearful. If you can find a nice one, you might want to think about cultivating their friendship. Then again, because law enforcement sometimes pays attention to pharmacists, enlisting their help in the war on drugs, the police may be the only source of feelgood a pharmacist has. So maybe you should stay further away from them than you already do.

In any case, you should try to understand your pharmacist. When you have to go see him, be patient and try to appear sympathetic. Then, when they finally come, be grateful for your well-counted pills. And be very, very grateful that you are not the one who dispensed them.

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