My Car Exploded. No....seriously. *Boom*

So I haven't posted in months. I suppose one or more "clever" person(s) has noticed how fitting that is to my blog name.

Anyway....MY FREAKIN CAR EXPLODED!

So I'm at Sam's buying bulk Mike-sustaining supplies. This includes bulk chimichanga packages, bulk pot sticker packages, 30-packs of bottled water, bulk packages of Kashi Go-Bars, and #90 Adderall 20mg....which is kind of like a bulk purchase.

So anyway, I'm checking out and a few dozen employees start running in and out of the store in a panic. Over the intercom they announce, "if you are parked in the side parking lot, you need to move your vehicle....NOW!"

Being that I was parked in said lot, I kinda put a little bounce in my step and "rode" the back of the cart to the door where the old receipt checking guy was doing his incredibly easy and pointless job.


As he's magic markering my receipt he says to some other employee, "Hey, Bob, will you tell the owner of a Red Buick in the side lot to come to the parking lot IMMEDIATELY."

Odd, I thought....I was driving a red Buick.
So I continue using the shopping buggy as a scooter and scoot myself to the parking lot where....you guessed it...my worthless deathtrap of a Buick was engulfed in flames and a dozen or so Sam's monkeys were dancing around my car with fire extinguishers. It was like trying to extinguish Dante's Inferno with a squirt gun.
And not a cool super soaker

....oh no. One of those dinky plastic jobs you buy at Kroger for 85 cents in the checkout isle.....
.

In time they realized that their futile attempts at making my car less on fire were...well...futile. Eventually the fire department shows up. For some reason they decided the best course of action was to beat my car with a giant ice pick looking thing (no, seriously). After realizing that you can't beat a fire to death, they whipped out the water hoses and finally took the fire out. By this point, I swear to God, no less than 400 people were standing in a circle around the car. I almost expected a guy with a hotdog on a stick to show up in a few seconds all pissed off that they extinguished his barbecue. You'd be amazed at the amount of smoke a 1998 Buick Regal LS can produce.

Then this idiot old guy notices all of the parking spaces available and actually parked his car three spaces away from my charred hunk of metal with a dozen firemen running around it, blasting it with water. He gets out all proud of his space, then while walking to the enterance, glances right and *realizes* in a sort of shock the commotion that has magically appeared in front of him. He then gets in his car and moves it away. It was damn hilarious.

So afterwards, when it's out, I approach the car. A firemen goes, "I'd hate to be the poor son of a bitch that owns this piece of ****!" as I'm standing two inches behind him. I pat him on the back and say, " 'at's me, buddy." The look on his face was priceless. I think he may have actually thought I was mad at him.

I tried to talk to them about the entire process of why a car decides to spontaneously explode. Their best answer was, "It's been happening a lot around here lately. This is the fourth one in two weeks. It just seems to happen." I asked to see the security tape, but for some reason the Walton's only pay for "lookin'" cameras, not "recordin" cameras as a Sam's employee so eloquently pointed out. Being as though I only had liability on that piece of crap, I'm up ****'s creek without a mechanism for fighting it's current. I'm personally hoping more cars explode and some ******* arsonist is lighting them up. Then I might get some cash from someone.

That won't happen though. I'm sure my car randomly exploded. It's so absurd and ridiculous that it is just one of those things that *would* happen to me.

Here are some cell phone pictures I took:



I guess I have to get a job now. My evil plan of waiting as long as humanly possible thanks to diligent budgeting has been royally f'd over. Oh well. Maybe it's the universe's way of telling me to stop doing nothing with my life. A nice exploding car....that's one hell of a way to get a point across....

Oh, yeah, the last few months of my life....uh...I graduated finally...I should probably take the Naplex eventually...

Rotation X: Acute Care II.....the post that goes nowhere....

So rotation number ten was in Uniontown, PA....a medium sized town roughly 40 minutes from Pittsburgh....and 40 minutes from Mo'town. It was much more like Pittsburgh than WV culturally. The first day I'm there this pharmacist walks by us around lunch and goes, "Jeet jet? Some good pizza dahn'n the cafeteria, n'at." Haha. They speak Yinzer. The Pittsburgh accent is absolutely confounding to outsiders. It's barely English. I was with two other students and the one from around Beckley (Southern West Virginia) asked me what the hell that person just said. I told her he just wanted to tell us they make good pizza down in the cafeteria....she says back to me, "Nah, he said something about an airplane....I think." Good times.

The rotation was made easy because I was with a person whose love for clinical pharmacy matched my love for pharmacology/medicinal chemistry. Between the two of us, there literally was about 3 things all month the preceptor asked we couldn't come up with the answer to off the top of our heads. I'm pretty sure we left her with an incredible impression of WVU students. The words, "Wow, most students don't know that" came out of her many times during the month. I suppose that should be expected......she tells me she usually gets mostly Pitt students .

I also missed an entire week of the rotation because my lungs hate me. I feel bad for the poor dermatology (I think resident) guy that saw me in student health when I came in. He was so lost. I presented with a history of asthma , afebrile lung infection x 3 days, and marked SOB. His first idea was to give me Biaxin and send me off. Uh, no. The correct answer is give me a nebulizer treatment and some damned steroids. I spoke up and asked for steroids...he went and got the attending family medicine doc...she agreed with me. 20 minutes later I'm breathing a-ok and I got a script for sweet, sweet prednisone.

I don't know what it is, but the vapor from nebulizer treatments tastes really good. I know I'm probably crazy on that one. Actually, I think it's a remnant from my childhood. Remember when the fire department would come around to your elementary school and stick your class in that playhouse thing and pump in that fake smoke....then you had to get on your hands and knees and crawl out. The nebulizer tasted like that shit. Mmmmm.

Due to said steroids, I opted to get some greasy-ass food to defray potential "stomach ouchies". Yes, that's the technical term. I figured I'd get some fast food for the first time in ages. Like as in high school. I was disappointed in my $3 worth of food prepared in 35 seconds by a guy making $5.15/hour. WTF has happened to Wendy's? Their shit used to be delicious. Now the fries taste like cardboard and the best part of their hamburgers are the buns. Jesus. My phlegm was saltier and less soggy than their fries. I think that when Dave died, his company died with him. I miss that son of a bitch. His warm, portley smile on those damned commercials made me feel happy. Just like the guy that pimps those delivery diabetes testing supplies who used to be on the Quaker Oats commercials. I swear to God, every time he's on one of those diabetes commercials, I get this urge for some damned oatmeal. God damn Quakers and their subliminal mind games.

What the hell else do I miss?

Hmm......that Supermarket Sweep gameshow. Shit was hilarious.....and robot dancing. That shit needs to make a comeback. When was the last time WVU has a good mass riot/couch fire? 2005 after the Elite 8 in basketball? That's bullshit. That's the one thing I miss I can actually change. Fuck it, I'm going to go light something on fire right now.

Rotation IX: Acute Care with Omniscience Personified.

So I really didn't know too much about this specific professor, Dr. P. The only thing I know about him is that he is very adamant his students know that when you have a cold, you burn roughly 7 calories per sneeze.

It turns out that he knows everything.

No, seriously, like, everything. It's creepy. Other faculty members I've been around, I really don't sense anything remotely close to omniscient....this guy, no, he actually may have memorized the entire contents of PubMed.

I was at first clued in on his stature as a clinical pharmacist when he was nominated to sit on the Pharmacy academy on the National Academies of Practice during the first week of my rotation. If you don't know what that is, it's kind of a big deal. Any time you are going to be added to a list of 28 or so elite people and the name Koda-Kimble is on the list, well, in pharmacy, you are hot shit.

So anyway, I got to work with this dude for a month. Suffice it to say, I am and remain blown away with the sheer amount of crap that he knows. He raises the bar too damn high. I can't ever even theoretically strive to one day become as good of a clinical pharmacist as this dude. It's not a good idea to put people who have only done this stuff for a few years with this dude. It's like me trying to learn basketball from Michael Jordan. Sure, watching him dunk is cool, but it won't help my slow, white ass...it just makes me feel useless.

Anyway, the rotation went well. I got to see first hand how little medical students know about drugs...again. I asked them about it. Turns out they only get 6 weeks of the stuff total in school. Yikes. From what I've seen, medical training seems to be more like a series of apprenticeships rather than actual school. They just learn about the drugs on rotations as they need to. Whereas pharmacy school is just a series of useless classes that involve things like memorizing telephone numbers of the local poison control centers and knowing what the transtheoretical theory of change is (My WVU peeps know what I'm talking about...)

Back on track...

Patient care is an interesting thing with me. Personally, I hate following patients and using guidelines to solve problems. It's just boring. Really boring. I guess I did a good enough of a job, they never threw back one of my recommendations as incredibly stupid or not the best course of action. If you use chemical classifications to describe drugs, it will confuse the common med rotatee like you wouldn't believe. Calling an ED drug a phosphodiesterase-5 inhibitor will make them step back, pull out a PDA, look it up, then come back pretending like they knew what you were talking about the entire time. It actually quite humorous to watch.

My evaluation took the a slight deviation from normal. I was mildly chastised for not working hard enough and not caring...but with this guy, he realized I belong in Industry or in a lab somewhere and didn't hold it against me. He actually took over an hour to completely evaluate me...20 minutes of which was to try to convince me to go to graduate school and "use my talents." Eh...that's another 6 years. I'm thinking no. Especially because they hire PharmDs in industry, anyway. Why get another degree if my current degree should get me where I need to go?

Oh....and he also said I talk too fast and look like I'm about to fall asleep far too much. Par for the course.

According to the Princeton Review - It's official - West Virginia U is, again, the #1 party school in the nation.

I'm like a damn prophet.

Last year WVU was underrated at #3 behind U Texas at Austin and Penn State at College Park. They clearly did not research that properly at all. I mean, C'mon, we set damned couches on fire after sporting events and Morgantown accounts for roughly 1% of all alcohol sales in the US (at least that's the rumor...) UT and PSU can't carry our beer bongs, let alone challenge us for the throne. I've been in both. They are both weak. Well, relatively weak, anyway.

To the press write up:
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MORGANTOWN, W.Va. (AP) — For the first time in 10 years, West Virginia University is back where students say it belongs, ranking as the nation's No. 1 party school in the annual survey by The Princeton Review.

To the historic disappointment of school administrators who have worked hard to curb underage drinking and other rowdy behavior, WVU has been among the top 20 party schools seven times in the 15 years students across the nation have been surveyed.

Not since 1997, however, have the Mountaineers taken the top spot. Last year, WVU was No. 3, bested by the University of Texas at Austin and Penn State — both of which remain in the top 10 this year.

WVU also ranks No. 1 in the category of Their Students (Almost) Never Study.

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To everybody that contributed, good job!

Holy crap...E.S. Posthumus is releasing another album!

For the longest time I thought that the Brothers Vonlichten of ES Posthumus wouldn't make another album because their unbelievably brilliant music (like, the best shit put out by anybody in the entire US right now brilliant) didn't seem to catch on with the mainstream (not that it surprised me or anything...music without English lyrics backed by movements and intricate instrumentation is usually...well...a death sentence...)

....and paying all of the people to play cello, violin, and the rest of the ungodly huge assortment of instruments they use probably wouldn't be worth whoever pays for production of their album to make another one.

But, alas, it appears that they have been going hog wild in the background making more music. This appeared on their website:

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According to ancient legend, the tiny island of Numa was completely destroyed by natural disaster in the Southern Indian Ocean. Its inhabitants had been highly civilized and advanced seafarers. They traded with peoples from every corner of the Earth and developed a language that incorporated all known tongues from that era.

On our next release, "Cartographer", we imagine what this language sounded like and combine it with compositions that are uniquely those of ES Posthumus.

"Cartographer"
ES Posthumus
featuring Luna Sans
---------------------------------------------------------------
Fuckin' eh! The little music sample they gave on the site sounded like an evolved version of an earlier song they did named "Nara" (known to the casual person as "The Theme Song to CBS' Cold Case) That shit makes my damn month. I have no idea when it's coming out, but apparently the gears are a' turning.

I'm pumped. I thought that I'd never hear this type of music ever again. Thank Jebus!

Rotation VIII: Multiples of Five.

I. Rotation VIII.
II. Guide to getting narcotics.

-------------------------------------

I. Rotation VIII: Community Pharmacy

So my 8th rotation was labeled as "Advanced Practice Community." This is essentially a euphemism for "spend 4 weeks counting by 5s". It wasn't really all that bad. It was a little independent chain. The dude owns five stores in the North Central WV region. The store I was at was doing 300 scripts a day - absolute insanity for an independent. From my old Kroger days, I really envy the guy, too. He has the power to hang up, tell off, or ignore anybody he wants to without the possibility of some retard district manager coming along later and giving the offender a gift card for being an asshole.

The joint was also a professional compounding center. Interestingly, his best sellers were this methimazole topical cream for cats with hyperthyroidism and a nifedipine/hydrocortisone/lidocaine suppository for hemorrhoids.

Whenever I wanted, they let me hide in the back and work on the retarded assignments the school of pharmacy forces them to make us complete. They also didn't mind that I took hour long lunches. I probably only ACTUALLY spend 2 hours a day counting and 6 hours doing busy work or just kinda spacing out. It was quite nice, actually.

But, man, it all makes me remember why I hated retail. All you are anymore is an insurance billing technician and narcotics diversion officer without any actual power. I'm being 100% serious - I think pharmacists should have the right and authority to arrest anybody on the spot who is forging a script. In fact, give us all guns, too. Then nobody sure as hell would rob us anymore. I want to be sitting there, counting pills, with one of those over-the-clothes gun strap things over my labcoat.



I want a .50 caliber Desert Eagle, too. Check out what this thing does to a watermelon (about halfway through video):

Hell yeah. I want THAT on my side when Mr. Oxyhead comes in to rob me.

So back to the point, the druggies were running strong in the particular area I was in. The second week I was there somebody called us up and asked for brand Oxycontin 80s. And what makes it worse is that you know the type as soon as you pick up the phone, too. Every other word is sir this, sir that, please this, thank you that. They are the only nice patients you have. Hell, I wish only druggies came in...at least my day would be pleasant. On the other hand, it pisses you off that they think you are being fooled by their facade.

Anyway, after I said "no," she asked if I had any of the "blue round ones with the W in the middle of a box on one side and 03 then 52 on the other side...I think it's Watson brand" (Note: it's actually an "M" and Mallinckrodt brand...but I give her points for effort) Impressed by her opiod-addiction-fueled knowledge, I actually went to see if we had them for shits and giggles. I go look at the ones we have..and they weren't the Mallinckrodt brand. So I get back on the phone and I say "All we have are green ones with 33 on one side and 93 on the other."

And what does the woman say?

"Oh, no, the Teva ones really don't do me that much good, thanks, I'll call elsewhere!"

I mean, c'mon, she can tell me what freakin' brand it is by the imprint. WTF?

All in all it was a good rotation for what it was. The folks there were friendly as hell and made me feel at home. They even bought me a going-away cake when I left. Awww...how sweet.

My preceptor didn't really like the ratings thing on the evaluation form, so just gave me 4.5/5 on everything. So...yeah.....no comments page this time around. He told me I should get a PhD in pharmacology.....which is honestly the best idea, based upon my talents, I've heard so far.

...and this bring me to another thing that bugs me....

...why the hell do people think that the "next step" for pharmacy graduates is a residency? I swear to God, the next person who looks at me and asks if I want to do a residency I will douse in gasoline and set on fire. (Note to FBI: Not really.)

Ok, ok. I understand that if you want to pursue some sort of specialized clinical pharmacotherapy career path, it's definitely what you want to do. However, what this fails to realize is that clinical pharmacy is the most boring thing on the damned planet.

There is a reason why I got straight Cs in therapeutics in the actual school part of pharmacy school....it is basically the equivalent of memorizing an encyclopedia. The only real interesting part of pharmacy school is pharmacology and biochemistry. It's cool shit. You know how shit works and you can brainstorm how doing shit to said shit will make other shit happen. It's pretty sweet.

But anyway, I just don't understand why "residency" is considered the "next step". If I had to sit in a hospital and deal with applying guidelines to patients, I'd probably kill myself.

The next step is PhD in pharmacology or medicial chemistry for me. That's the real science right there. If I had the personal motivation, didn't care about money, had a desire to actually help humanity, etc, etc, I'd probably do it.

Ah, oh well.

------------


II. The Pharmacists' Guide to Scoring Narcotics

I feel as though this should be available to the public. I figure the more druggies know, the less I have to deal with actually noticing their obvious BS and, thus, annoying me by making me do something about it.

1) Do not address a pharmacist as sir/ma'am.
Why? Because retail pharmacists don't get praise or a general happy/nice attitude from ANYBODY before we actually bend over and let you ram us in our collective asses via making us do your bitch work (call the Dr, call the insurance, diagnose your allergic rhinitis, etc).

We are like your spouse/friends/family. We KNOW that whenever you are nice to us, you just want something. I swear to God, whenever I answer the phone and the first thing that comes out of your mouth is "Hello, good sir, how are you this morning!" I know you are one of two things. A guy trying to sell me something or a drug addict looking for Xodol 10/300.

This is what you do. After I give you the stock phone intro, just say, "Hey, you guys got any Xodol in stock?"

Simple.

2) Do not wear anything that says the words thug, g-unit, sean jean, or is the logo of some hippy band from the 1960s. A tshirt from an 80s hair band is questionable. Also, be sure to shower.

Why? Personally, I don't discriminate, but from my limited experience, your average retail pharmacist is one prejudiced ass motherfucker. Usually with reason. If you look like a shady character, you'll be put under a microscope.

This is what you do. Go to Target and buy one of those decent looking suits they have that costs like $70. Wear it to pick up your Vicodin. In fact, treat PICKING up you drugs like a kid on his first job interview. Uncharacteristically wear a suit, show up a few minutes late, only answer when spoken to, and act like you've never done it before.

3) I know it's hard....but don't call your narcs in early.

Why? It makes you a marked man. If you call a script for a narc in any more than 1 day early, we make a note of it and we NEVER EVER FORGET.

This is what you do. Suck it up. Call the day it's due. Triple bonus points if you actually wait an extra day or two.

4) Don't tell me you dropped your pills down the sink.

Why? Because this is easily the most commonly used bullshit excuse in the history of opiate addiction. By my count, around 25% of all hydrocodone preparations produced wind up in the sewer system of every town in the US. In fact, it wouldn't surprise me to find out that hydrocodone has some sort of static-electrical attraction to running water or something.

This is what you do. DON'T LIE TO US. Every excuse you come up with sounds absolutely retarded. No matter how brilliant you think your excuse is, we've heard it before. Do you honestly think we believe that you are going to allow the drug you've been trying to get filled early every day for the last 3 weeks to "accidentally" be consumed by your Poodle? Please. We all know you have that shit locked up in a damned fire-proof safe in your bedroom. I'm sure your birth certificates and social security cards are probably on an idle table next to a fireplace, too.

5) When getting your script for a narc filled, do not stare at me like I'm Natalie fucking Portman walking around topless.

Why? Because you are making it bloody obvious you are doing something shady. Sometimes I like looking right at them for a few seconds, then go over and pick up the phone. Their eyes get as big as a damned basketball. I did that once and the dude got up and ran out of the store.

This is what you do. DON'T STARE AT ME. For one thing, this isn't Subway. You don't have permission to watch me, anyway. And secondly, again, you are just creeping me out. LEarn to use your ears or something. Christ...seriously, anything, just don't stare at me intently for 5 minutes straight.

6) If you have a prescription for an antibiotic and a painkiller, for the love of God, don't tell me you "only need the painkiller."

Why? Because we aren't a bunch of fucking morons. If anybody is given a script for an antibiotic + pain med, it is 100% of the time more important that you get the antibiotic before you get the pain med. And, again, WE JUST KNOW YOU ARE TRYING TO PULL ONE OVER ON US. It's like a freaking innate instinct. We are the most omnipotent, omniscient, omnimalevolent sons of bitches you will ever know.

So what do you do? Jesus, just pay for the damned amoxicillin.

7) Don't tell me to not bill a narc to your insurance because it's too early to go through.

Why? Because, again, we aren't fucking stupid. Why in God's holy name would anybody waive the chance for an insurance company to pay a large portion of the medication cost? We're gonna run it through your insurance anyway just to see what happens.

This is what you do. Go somewhere else. Duh.

8) Don't ask for brand name anything.

Why? Because, once again, we aren't fucking stupid. We know you are going to sell whatever goes out of our store with a brand name on it. We also know that there is about a 0.00001% chance that there is a legitimate medical problem that prohibits you from just taking the generic product. It's called an AB rating.

This is what you do. DON'T ASK FOR BRAND. Instead, educate your customer about the wonders of bioequivalancy and FDA Orange Book ratings. Tell them they can get equally as high at a fraction of the cost. If they still think they feel a difference, educate them on the potential of placebo effect.



That's all I got for now. Till next time.

Why WVU is the greatest party school EVER.

Ah, sweet memories. I was down the street when this went down. You could hear the riots from a few miles away, I'm told.