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1
"Have you noticed how many more prescriptions we've been filling lately?" Louise asked. Her question surprised me. Although she's only worked here since August, my new staff pharmacist rarely wants input from me.
"It's seasonal," I explained. "We'll be even busier as more and more winter visitors arrive."
"I've never seen so many women with the same three scripts," she said. "An antibiotic, a blood clotting agent, and a pain pill. And always on Wednesdays and Fridays."
I looked at Louise Rettenberg, trying to gauge whether she was concerned about her ability to work in a busy store. She's a recent pharmacy school graduate, but until now I'd considered her to be self-assured and efficient.
"They come from the clinic on E. Arizona Street," I said.
She looked puzzled. "I know that."
"Abortions," I added-and waited.
"Oh!" She tugged on the neat dark braid that reached just below the collar of her white lab jacket, a nervous gesture I'd seen before.
"Does it bother you?" I asked bluntly.
"Only because most of the women seem so young."
I suppressed a smile. Louise is at least thirty years younger than me. But she was right, and my amusement died quickly as I remembered how frightened and teary-eyed many of these patients look. Some have boyfriends or husbands along; others are with their mothers. But too many seem to be alone, and they're the ones I worry about.
"Don't get me wrong," she added. "I can handle it."
She sounded upset and I hurried to reassure her. "I wasn't doubting your professionalism. Since I'm the pharmacy manager, though, I need to know about potential problems."
Although I'm the pharmacy manager, Louise has never confided in me during the two months we've worked together. She seems to talk more to our young technician, Karen, but the only personal conversation I ever overheard centered on Karen's latest boyfriend.
Louise, Karen, and me—Ruth Kantor Morris. More than half of today's pharmacy graduates are women, but our all-female pharmacy is unusual enough to invite comments from customers and other pharmacists.
Louise was right; we were busy. People seemed to arrive in Scottsdale hourly from the east and midwest. I had even noticed a few Canadian license plates in the parking lot. Although most Arizonans call these seasonal arrivals "snowbirds," I prefer the polite term, "winter visitors." After all, many of them are my customers here at the Food Go pharmacy.
Compared to the weather they're escaping from, our October days are warm. After surviving another Arizona summer, however, I feel chilly in the early mornings and evenings. That's why I arrived at the pharmacy a little while ago carrying my white cotton cardigan—too warm to wear now, but I'm on the night shift. I'll need the sweater when I leave work this evening. Now, I put on my professional jacket and started to help Louise clear the backlog of prescriptions. We had no time to talk.
Louise's shift ended about an hour later. Karen, our technician, was off today, so I'd be working alone until closing. I tried to move fast to keep up with the flow, but as quickly as I filled prescriptions, they kept coming in. At one point, at least four people were at the window. Others took the opportunity to shop while they waited, which was one advantage of a supermarket pharmacy.
"Is my prescription ready?" A thin, thirtyish woman with dark eyes that darted from side to side and never looked directly at me was next.
I took her name and looked through the "will call" stack. Nothing. The Rx's we were keeping "on hold" for a doctor's telephoned okay also yielded nothing. The only other place to look, the stack waiting for incoming inventory, was another miss. I rubbed my forehead, wondering what I'd overlooked and checked the computer.
"Nothing here for you," I told the customer.
"Has to be. Didn't my doctor call you?"
"No. I'm sorry." I looked at the screen. The computer showed that we filled a script for Toradol, the non-narcotic pain reliever, for this patient on the 10th of October and refilled it on the 12th. Today was the 14th of the month.
"Toradol, that's right," she said when I gave her the details. "That's the one I want."
"I'm sorry," I repeated. "You got it already."
"How can you tell?"
That was an odd question, but I showed her the original written prescription with the stickers that the computer generates when we fill each script. By this time, five or six other people had lined up behind her. I would never catch up.
"Somebody else got my medicine," she announced to the crowd. "I never did."
"Would you like me to call your doctor?"
"Never mind. I'll take care of it myself." She turned again to the people behind her. "I didn't even see the doctor until today."
"That's strange," I countered. "Right here, in the doctor's own handwriting, it says October 10th."
I saw some of the other customers trying not to laugh, but a waiting teenager seemed lost in her own thoughts, and the older woman with her looked grim. Before walking away, the woman threw one parting dart at me. "Well, I don't care what you say. You made a mistake."
This was a serious accusation, and I glanced quickly at my other customers to see their reactions. I intercepted a few sympathetic looks, and the next woman in line even reminded me that it takes all kinds. I smiled at her, but thought it would be unprofessional to agree.
Working as quickly as I safely could, I finally got to the last of the line of waiting customers and saw that no new ones had approached. Maybe I'd have some breathing space to do some paperwork tonight.
The last people in line were the teenager I'd noticed before and her dour companion. The younger woman handed me prescriptions for an antibiotic, a blood clotting agent, and a pain pill. I felt a surge of sympathy, knowing she'd probably just had an abortion.
Although the young woman wasn't alone, she was the kind of patient I worried about. She was wearing jeans and a pink T-shirt that advertised a popular amusement park. A typical teen at first glance, but her eyes were bloodshot with dark smudges below, and she seemed to be making an effort to hold herself together. She was thin enough to appear emaciated, and her face was pale. I looked at the first script again. Her name was Amy Brookman. She was sixteen.
"It'll take about ten minutes," I said.
"Okay."
"Can you make it faster?" the older woman demanded. Her voice was deep, but I couldn't tell whether it was an emotional huskiness or her natural tone. She was about sixty, with well-shaped features and short white hair. I thought she looked too old to have a teenage daughter. Neatly dressed in a black and white herringbone suit and crisp white blouse, she seemed to have just stepped out of one of the office buildings across the street from Food Go. I wondered if Amy had been left to face the surgery alone while mother went to work. That was unfair, I reminded myself. Not everyone could afford to lose a day's salary.
Usually, I hate it when people try to rush me. They can't really think I take my time deliberately. Amy, however, looked as if she couldn't stand up much longer, so I buried my annoyance.
"I'll do my best," I answered mildly and moved over to the computer. While the labels for the three scripts were printing, I pulled the bottles from the shelves and counted out the dosages. She was getting the usual—10 Doxycycline, the antibiotic, to be taken one capsule twice a day. Then, her 20 Vicodin pain pills for the cramps. I used the generic here to save her money. And, finally, the 12 Methergine to control the bleeding.
Taking the labels from the printer, I checked each vial before labeling them. Amy and the older woman hadn't moved or spoken to each other. I reached across the pharmacy window and showed each vial, in turn, to Amy before bagging them. "The blue capsules, the Doxycyclines, are the antibiotic. You have to take one capsule twice a day for five days. Be sure to take them all." I paused a moment and added in my most professional tone, "That's very important."
She wasn't meeting my eyes, and I wondered how much patient counseling was getting through. At least her mother seemed to be listening.
"The purple ones are to stop the bleeding," I continued. "Take one tablet four times a day for three days. Be sure to take them until they're all gone, too."
Now she looked at me. I could see the sudden realization that I knew what her medications were for.
"The last ones, the white tablets are for pain," I said, keeping my voice as detached as possible. "Take one every four hours if you need them. That will help with the cramps."
"Did you understand, dear?" The husky voice was solicitous, and I was glad to see the girl's mother was supportive. Sometimes when a teenager is involved, the mothers humiliate their daughters by berating them right in front of me and any other customers who might be listening. And when boyfriends or husbands accompany the young women, their attitudes range from tenderness to abusiveness.
"Yes, Auntie."
Well, I had guessed wrong. As they left the pharmacy area, I wondered momentarily where her mother was. I would never know the girl's story, but she seemed so fragile that my heart went out to her. Both telephones in the pharmacy began to ring just then, and I forgot all about Amy. By the time I took care of the call-ins, more customers were at the window. The next prescription I filled was for Clomid, a fertility pill, but I was too busy to reflect on life's ironies.
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