HEALTH CARE STORIES

[florida80]

Their Attitude Stinks

Pharmacy | Right | November 14, 2014


(An order comes to my pharmacy for a well-known antibiotic. This antibiotic is known to smell exactly like rotten eggs, so most of us just hold our breath while we count it and try not to think about it too much. We dispense it to a woman who is picking it up for her teenage son. Everything is normal and she leaves with the prescription, but about 10 minutes later she comes stomping back into the pharmacy, pretty much shoves the person that I am currently helping out of the way, and throws the bottle of medication on the counter.)

Customer: “I want to speak to your manager right now! You guys gave me rotten medication!”

Me: “Really? Let me look at the expiration date on your bottle. Normally we don’t keep anything that has one less than a year away.”

(I look at the bottle and see that the pharmacist wrote a date of over a year away, and I go over to our stock bottle and check and the numbers correspond with each other.)

Me: “Hmm. Well, ma’am, it doesn’t look like this medication is expired but I will have the phar—”

Customer: “You are just lying! I mean, come on and open that bottle! It smells totally rotten! I can’t believe that you would ever give someone bad medication! My son is very very ill!”

Me: “Oh, that’s just because the active chemical that is in this medication has a bad smell. Trust me, I wish there was something that we could do about it back here, too. Most of us hold our breath while we count it.”

Customer: “Stop ****** lying to me. You just don’t want to admit you did something wrong! I will have your job for this, b****!

(At this point the pharmacist who has been listening the whole time walks over.)

Pharmacist: “Ma’am, while I don’t like the fact that you are calling my staff names like that I will let you know two things. One is, certain chemicals have a bad smell. It’s just a fact of life. So, while I know that smell is unpleasant, it’s just one of those side effects that come with being able to take medications that will help your sick son. I assure you it’s supposed to smell that bad. If it didn’t, it wouldn’t work right. Two, since you don’t seem to want to listen to my employees and call them awful names, this will be the last time that you or any members of your family can shop or fill any type of medication here. Maybe in the future you can learn how to treat people the way you want to be treated.”

(The woman proceeded to turn bright red with embarrassment and tried to apologize, but my boss wouldn’t hear it. That was almost two years ago and he still will not allow her or her family to fill their prescriptions at his pharmacy.)

[florida80]

Allergic Overreaction

Pharmacy | Right | October 27, 2014


(I work at a large chemist’s shop in North Yorkshire. I am about halfway through my shift when a woman comes running into the shop and up to the register. She is scratching herself really fast and making weird faces.)

Me: “Good morning, ma’am. How can I help you?”

Customer: “ALLERGIC REACTION!”

Me: “I’m sorry…?”

Customer: “ALLERGIC REACTION!”

Me: “Okay… what about it?”

Customer: “ARE YOU STUPID OR WHAT? I NEED MEDICINE! ALLERGIC REACTION!”

(I was quite alarmed by this point and other customers in the shop were starting to stare.)

Me: “Right, what caused your reaction? Is it animal related, or—”

Customer: *scratching like mad* “I DON’T KNOW! ALLERGIC REACTION!”

Me: “Yes, but to give you the correct medication we need to know what caused your reaction. What—”

Customer: “I DON’T F****** KNOW WHAT CAUSED IT! ALLERGIC REACTION! GIVE ME SOMETHING TO MAKE IT STOP ITCHING!”

Me: “But, ma’am…”

(The customer was now running around the store pulling items from the shelves before throwing them to the ground.)

Customer: “WHERE IS THE F****** ALLERGIC REACTION MEDICINE? I NEED IT NOW!”

(The manager, hearing the commotion, runs out from the back room.)

Manager: “What seems to be the problem?”

Customer: “I NEED MEDICATION FOR AN ALLERGIC REACTION AND THIS F****** S*** WON’T GIVE ME IT!”

Manager: “What caused your reaction, ma’am?”

Customer: “I. DON’T. F******. KNOW!”

Manager: “In that case we can’t help you. Have a nice day, ma’am.”

Customer: “F*** YOU! WHEN I DIE I’M GONNA COME GET YOU FIRED!”

(The customer runs out of the store screaming ‘ALLERGIC REACTION!’)

[florida80]

No Follicular Coupon Is A Folly

Pharmacy | Right | October 21, 2014


(A man comes up to the pharmacy registers to purchase a bottle of hair growth product. These items come with coupons attached to the box so customers receive instant savings.)

Customer: “I’d like to purchase this, and I have a coupon for it.”

Me: “Excellent. I’ll ring this up for you.”

Customer: “I also have two coupons from previous boxes that I forgot to use before but I don’t have them with me. You can just take the ten dollars off my purchase now, though.”

Me: “I’m sorry, sir, but unfortunately I can only use one coupon per purchase of this item as it says here at the bottom of the coupon.”

Customer: “Well, I didn’t get to use them before so I would like to use them now.”

Me: “So you would like me to give you a discount for coupons that you do not currently have with you today?”

Customer: “Yes. I don’t see what the problem is.”

Me: “I’m sorry, sir, but that’s not the way it works.”

Customer: “Well what do you expect me to do with the coupons, then?”

Me: “Give them to your friends or relatives?”

Customer: “They won’t use them. They have hair!”

[florida80]

Hopefully His First Name Isn’t John

Pharmacy | Right | October 13, 2014


(I work in a well-known national chain pharmacy. The particular store that I work in provides medicine to at least half of our well-sized county, so we stay rather busy and have a lot of customers. This exchange happens far more often than it really should:)

Customer: “I’m here to pick up a prescription.”

Me: “All right, what’s the name?”

Customer: “Johnson.” *or some other common last name*

Me: “Okay, and the first name?”

Customer: “There’s more than one?!”

Me: “…”

[florida80]

A Thought For Your Pennies

Pharmacy | Right | September 24, 2014


(I’m a pharmacy tech working the drive thru. An older customer pulls up, and we go through getting her prescriptions.)

Me: “Okay, your total will be $67.29.”

Customer: “Okay.”

(I go and grab her prescriptions from our waiting bin and come back to finish the transaction.)

Customer: “Was that $68?”

Me: “$67.29.”

Customer: “$67.34?”

Me: *now trying to not laugh* “$67.29”

Customer: “Oh, 29.”

(I looked back at my pharmacist and he’s trying to not crack up while in view of the customer. I finish the transaction and close the window.)

Pharmacist: “Where on earth did she get 34 from?!”

[florida80]

Countering Those At The Counter

Pharmacy | Right | September 21, 2014


(I’m in line at the pharmacy. It’s been a long day, and I just want to pick up my prescription and go home. The customer in front of me has a basket full of groceries.)

Customer: “I need to pick up my medicine! And I want to pay for my groceries here. I only have six things.”

Pharmacist: “Sure, let me get those for you.”

(The customer puts way more than six grocery items on the counter. I am beyond irritated at this point since she’s making me wait. As the pharmacist scans the groceries, however, I decide not to let it get to me. The wait isn’t that much longer, and I’m next in line anyway.)

Pharmacist: “… and there you go. You’re all set. Have a nice evening!”

Customer: “You too.”

(The customer turns to go and notices me standing in line behind her.)

Customer: *to me* “Excuse me.”

Me: “Oh, it’s no problem—”

Customer: “I SAID, EXCUSE ME. THE SIGN SAYS YOU’RE SUPPOSED TO WAIT FOR THE PHARMACIST, NOT CROWD AROUND THE PEOPLE AT THE COUNTER. YOU ARE IN MY WAY!”

(She grabs her stuff and storms off in a huff, leaving both me and the pharmacist speechless.)

[florida80]

The High Point Of My Night

Pharmacy, Retail | Right | September 9, 2014


(I work as a cashier and am finally at the end of a long, frustrating split-shift. About 10 minutes to closing a group of guys in their early 20s come in and head straight for the confection aisle. They seem to be having a hard time deciding, and become panicked when my supervisor makes the closing announcement. They shove their candy, chips, and pop into the arms of one guy, and push him toward the cash. They leave the store, leaving their friend to pay. He places the items very slowly on the counter, blinking with confusion a number of times, swaying a little on his feet. I ring his items through.)

Me: “That’s $14.59. How will you be paying?”

Customer: “Uh… debit?”

(He slowly pulls out his wallet and fumbles for his card. He finally places it in the debit machine, and then stares at it, unmoving. The machine times-out, so I reset it. He manages, with some difficulty to make it through the rest of the transaction. When I place his bag in front of him, he looks confused.)

Customer: “Is this mine?”

Me: “Yes, it is.”

Customer: “These are the things I bought?”

Me: “Uh… yes. Are you all right?”

Customer: “Huh? Oh, yeah, don’t mind me, I’m just really fried.”

(He pulls a 2 dollar coin out of his pocket and puts it on the counter.)

Customer: “Don’t tell; my parents know the owner.”

(He left, marveling at the automatic doors as he did. He has been back to the store a number of times, in the same state, and makes my day whenever he shows up.)

[florida80]

Not Good For Your Blood Pressure

Pharmacy | Right | August 31, 2014


(The pharmacy that I work at has a very standard closing time of 7:00 pm. We’ve had this for years, much longer than I’ve worked there. If a customer comes in around 6:58 or so they usually purchase their items quickly and leave. This customer comes in at 6:59.)

Customer: “Whoo! Made it in the knick of time!”

Me: “You certainly did! You picking up a prescription today?”

Customer: “Yes, it’s [Name].”

(The transaction goes smoothly and he heads for the door. It’s 7:01 pm and he turns and goes to the blood pressure machine which usually takes a couple minutes to finish the measurement. My boss tells me to turn the lights off because we’re technically closed.)

Customer: “Hey! Can you turn the lights back on? I can’t see my reading!”

Me: “The display is LED; you don’t need the lights on, sir.”

[florida80]

Those Who Can’t Be The Easter Bunny, Teach

Pharmacy | Related | August 13, 2014


(I am checking out a woman and her young daughter while I overhear their conversation.)

Daughter: “Mom, can I be a teacher when I grow up?”

Mother: “You can be whatever you want when you grow up sweetie.”

Daughter: “Can I be the Easter Bunny?”

Mother: “No… you can’t be the Easter Bunny.”

[florida80]

A Spoonful Of Violence Helps The Medicine Go Down

Pharmacy | Right | July 15, 2014


(I am on quite a few prescription medicines, one of which costs $170. I am picking up four refills.)

Pharmacy Clerk: “This one is $1.17. The second is $7.79. And the third is…”

(He trails off and takes a few steps back from the counter separating us.)

Pharmacy Clerk: “Uh… do you know how much this costs?”

Me: “If it’s the [Brand Name Medicine], then it will be about $170.”

(He looks relieved and returns to the register.)

Pharmacy Clerk: “Sorry. On my first week on the job, a customer assaulted me after hearing the price of his medicine.”

[florida80]

You Are Eavesdropping On I

Pharmacy | Related | July 11, 2014


(I’m out with my parents, running some errands. During one stop, my dad picks up a prescription while my mom and I wait in the car, since it’ll be quick. She cracks the windows, though, since it’s warm. Two women exit the store.)

Woman #1 (https://www.vietbf.com/forum/usertag.php?do=list&action=hash&hash=1) : “Now, this is just between you and I…”

(She continues talking unaware as Mom sighs dramatically.)

Mom: “People misuse ‘I’ and ‘me’ so often. It’s so annoying!”

Me: “So is eavesdropping…”

[florida80]

Looking For A Needle In A Haystack Of Stupid

Pharmacy | Working | May 25, 2014


(I’m in the pharmacy picking up my prescription for insulin.)

Pharmacy Tech: “We are currently out of the insulin pens, so we’ve substituted a bottle of insulin that you can use until we get the pens back in stock in a few days.”

Me: “That’s fine, but I don’t have any syringes at home any more so I’ll need to buy some.”

Pharmacy Tech: “You’ll need to get a doctor to send us a prescription for the syringes.”

Me: “So, you are saying you don’t have the insulin pens. So you are giving me a bottle of insulin, but you won’t give me the syringes to use them?”

Pharmacy Tech: “We can’t give you syringes without a doctor’s prescription.”

Me: “Can I please talk to the pharmacist?”

Pharmacy Tech: “She’s very busy right now, and she’s going to tell you the same thing.”

Me: “I will wait.”

(The pharmacy tech huffs, and I go sit down in the waiting area. About 10 minutes later, after I’ve seen the pharmacist give several consultations, I walk up to the consultation window.)

Pharmacist: *very pleasantly* “Hi. Do you need a consultation?”

Me: “Actually, the lady at the register said that you were substituting a bottle of insulin instead of the pens because you are out.”

Pharmacist: “Oh, you need to know how to use the syringes?”

Me: “No, I know how to do that, but I don’t have any syringes.”

Pharmacist: “Oh, no problem. We’ll give you some since we are out of the pens.”

Me: “The lady at the register is refusing to give them to me without a prescription.”

(The pharmacist looks towards the registers and glares.)

Pharmacist: “She’s been doing that all day. I don’t know why I have to keep explaining it to her. At least she goes home in half an hour.”

(The pharmacist rang me up and I was on my way with syringes. I never saw the pharmacy tech there again.)

[florida80]

Not As Easy As ABC, 123

Pharmacy | Right | May 5, 2014


Patient: “I’m picking up some meds. My name is [Name].”

Me: “I have three prescriptions here for you today. Is that correct?”

Patient: “I think so. Can you show them to me?”

Me: “Sure”

(I pull out three bottles from the bag and show all three to the patient.)

Patient: “Okay, where’s the third one?”

Me: “I just showed you all three. What are you talking about?”

(I hold each one up and count as I go along. I get to three and he still looks confused.)

Patient: “I thought you said I had three… I don’t see the third one!”

Me: “I just showed you three bottles! What are you talking about?! Do you know how to count?!”

Patient: “Oh… okay. I’ll take your word for it but I still don’t think there’s three here”

[florida80]

Not A Hire Level Of Professionalism

Pharmacy | Working | May 2, 2014


(I get a call on the first of April, one day after a job interview.)

Caller: “HEY! HEY! Guess what!”

Me: “Who is this?”

Caller: “It’s [Name] from [Company] from yesterday! You’re hired! All the other applicants were total f****** idiots! That’s why we want you!”

Me: “Uhm, thanks? That’s—”

Caller: “You know what I did? Do you want to hear it?”

Me: “What did you do?”

Caller: “I called all the other applicants and told them they’re hired! And when they got all excited I screamed ‘April Fools!’ Haha, I would have loved to see their faces. The first guy told me he’d sue me! Isn’t that funny?”

Me: “So… is this a joke? Or am I hired?”

Caller: “You’re actually hired. As I said, all the others were total f****** idiots! Welcome to [Company]!”

(I’m not sure if I’m going to take this job…)

[florida80]

Likes To Party Hard

Pharmacy, Retail | Right | May 1, 2014


(I am the cashier at a convenience store that also has a pharmacy on the back. It is a slow day and my pharmacy coworker asks me to watch his station for a minute. A mustached, gallon-hat wearing cowboy (boots and all) comes up to me and asks in a very deep voice:)

Cowboy: “Do you carry generic Viagra?”

Me: *stunned* “I’m sorry. If you could just wait for a minute?”

(Thankfully my coworker heard him and took over. I went back to my station and then the same customer appeared. His purchases? Generic Viagra, a tequila bottle, and a 25-pack of lollipops…)

[florida80]

Please Keep Customer Interaction To A Condominimum, Part 2

Pharmacy | Right | April 29, 2014


(It is a Friday late afternoon. I am mechanically ringing up sales adding “have a nice weekend” to my normal “here’s your receipt” spiel. I realized after saying this to a male customer that he is buying several high-quantity boxes of condoms. I also remember he had a work shirt on with his name sewn on it. I stepped into the pharmacy and talk to my coworkers.)

Me: “Oh, my God!”

Coworker: “What is it?”

Me: “I just told a customer to have a good weekend, before noticing he was buying nothing but condoms! He obviously has plans to do so!”

(About thirty minutes later the phone rings, and the pharmacist picks it up.)

Coworker: “[My Name], you have a phone call.”

(I answer.)

Caller: “Hi, I’m [Customer With Named Shirt]. I’m calling because I want to go out with you this weekend!”

(Um, that would be ‘NO,’ creepy condom dude!)

[florida80]

Seeing Eye Dog

Pharmacy | Right | March 19, 2014


(I am serving on the counter of a small pharmacy on a busy Saturday. A middle aged lady approaches my desk.)

Customer: “Hi. Can I get something for infected eyes, please?”

Me: “Of course. When did the problems with your eyes begin?”

Customer: “Oh, it’s not for me. It’s for my dog. His eyes looked really sore this morning!”

Me: *slightly alarmed* “We don’t sell medicines for pets here, unfortunately. You would have to go a vet to get something for your dog.”

Customer: “No, it’s fine. I give him human medicines all the time!”

Me: “I’m sorry, but I can’t sell you anything for your dog. I’m not allowed to do that, and what’s more, I wouldn’t want to cause him any harm.”

Customer: “But… his eyes are the same size as human eyes!”

[florida80]

Your Ears Must Deceive You

Pharmacy | Working | January 25, 2014


(It’s eight in the morning on a Saturday, at a very small shop that’s located by a big shopping centre. There’s literally nobody in the car park or in the shops of this place. The only people in the area are the pharmacist and the cashier.)

Me: “Could I get my ears pierced, please?”

Pharmacist: “Sorry. We’re too busy on weekends to pierce ears.”

(There’s a moment of awkward silence as I look around the empty, silent shop.)

Me: “You’re too busy?”

Pharmacist: “Yes. We only pierce ears on weekdays because weekends are too busy.”

(I’m lost for words for a moment, as I stand alone in the customer area where not even all the aisles have their lighting on.)

Me: “Could you make an exception?”

Pharmacist: “What if ten people with prescriptions were to suddenly arrive? Then what would we do? There’s only two of us behind the counter.”

(I end up leaving pretty soon after without getting anything, as the pharmacist continued to insist that ten people with prescriptions would materialise from the empty car-park.)

[florida80]

A Gross Grocery Error

Great Stuff, Ignoring & Inattentive, New Jersey, Pharmacy, USA | Right | January 2, 2014


(The customer in front of me is dropping off a prescription. She’s on her phone.)

Customer: “…and then can you pick up [Child] from school, or do you want me— Hang on, I’m at the front of the line.” *to pharmacist* “Here’s my prescription, ID, insurance data. Need anything else?”

Pharmacist: “Just give me a minute to read through this.”

Customer: *on phone* “So, anyway, about the groceries. Why is taking—”

Pharmacist: “Excuse me?”

Customer: “Oh, hang on.” *to pharmacist* “Sorry, I know it’s rude to talk on the phone, but—”

Pharmacist: “No, no. Your prescription. It says ‘cheese, yogurt, chunky peanut butter.'”

(There is a pause.)

Customer: *on phone* “I think I know why it’s taking you so long at the grocery store.”

[florida80]

Doesn’t Have A Glue

Pharmacy | Right | December 29, 2013


(We have bottles of hand sanitizer at the pick-up and drop off counters for customers to use if they please.)

Me: “Hi. Can I help you?”

Customer: “WHAT DID I JUST PUT ON MY HANDS?”

Me: “Er, what?”

Customer: *waving hands frantically* “What’s in that bottle? It’s not glue is it? My hands aren’t going to stick to my cart when I touch it?”

Me: “No, ma’am. It’s just hand sanitizer.”

Customer: “Oh, okay. Thanks! Have a good day!”

(The customer leaves without getting anything from the dispensary.)

Me: *to coworker* “Why the h*** would we have glue in squirt bottles?”

[florida80]

Can’t Pin Him Down To A Number, Part 2

Pharmacy | Right | December 10, 2013


(It’s Friday afternoon, and I am a customer waiting for my prescriptions in the waiting area of my pharmacy. The customer ahead of me, a gruff older man, is getting upset with the cashier over a problem with the card reader.)

Customer: “I’m telling you, it’s not my card. It’s your machine!”

Cashier: “Sir, you have to enter your PIN correctly—”

Customer: “I KNOW how to enter my PIN! Your machines are wrong! This doesn’t happen to me anywhere else.”

Cashier: “I don’t know what to tell you, sir. My machine has been functioning properly all day. Your transaction failed after you entered your PIN. Would you like to try it again?”

Customer: “If I try it again, you better MAKE it work right! [Financial Institution] is going to freeze my card if I keep trying. I’m going away for the weekend so I NEED my card to work!”

Cashier: “Well, I can’t put in your PIN for you, sir. So I can’t guarantee you it will work.”

Customer: “This has happened the last two times I’ve been in here! I’ve been a customer here for 30 years and you’re saying it’s MY fault? Your machines are wrong! And now my card is going to be frozen until Monday!”

Cashier: “I don’t know what else to tell you, sir. Let me get my manager.”

(The cashier pages the manager, who arrives promptly.)

Manager: “I understand there’s some trouble with your card, sir?”

Customer: “The machine is messing up. It’s NOT my PIN. My card is going to be frozen and I’m going away this weekend!”

Manager: “I understand, sir. If you have time to wait, I’ll call [Financial Institution, which is also responsible for card reader] and try to find out what’s going on.”

(My manager dials the phone and explains the situation to tech support.)

Manager: *on phone* “Uh-huh. I see.”

Customer: “Ask them if my card is frozen!”

Manager: *on phone* “So there’s no problem with our system? Alright. Thank you.”

Customer: “Oh, wait. My PIN on this card is five digits. I only entered four

[florida80]

Intelligence Is Not The Flavor Of The Month

Pharmacy | Working | December 3, 2013


(In the UK, you get your prescriptions for free if you’re age 16, 17, or 18, and in full-time education, which I am. Your age in years and months is written on your collection form. Mine reads 16 years and 9 months.)

Me: “Hello. I need to pick up a prescription. Could you show me what I need to sign?”

Pharmacist: *glances at the form* “Are you working?”

Me: “No.”

Pharmacist: “Are you in full-time education?”

Me: “Yes.”

Pharmacist: “Are any of these applicable?”

(The pharmacist points to war veterans benefits and low income benefits, as well as two others that definitely don’t apply.)

Me: “Uh. No.”

Pharmacist: “Well, I’m afraid you’re going to have to pay for this medicine. It’ll be £7.88.”

Me: “What? It’s always been free in the past! I haven’t got any money on me.”

Pharmacist: “It’s £7.88, I’m afraid. If you want, I can hold it for you and you can pick it up later when you’ve got some money. We close at 5:45.”

Me: “Alright, I guess I could do that. I’ve never had to pay before. Are you sure that’s right?”

Pharmacist: “Have you? You should’ve been charged. Anyway, you have to pay now.”

(I leave, knowing I won’t be able to return home and back in time. I call my dad and ask him to collect it for me. He does so and gets it to me when he gets home from work.)

Dad: “Want to know why they wouldn’t give it to you?”

Me: “Why?”

Dad: “The other pharmacist was serving me. She read over your prescription and asked the woman who’d served you why she’d charged you, as your prescription form clearly said you’re 16. She looked mortified. Turns out, she’d misread the ‘9’ in your 9 months as ’19’!”

(Good to know these are the people handling our medicine!)

[florida80]

A Bitter Pill To Swallow

Pharmacy | Working | November 23, 2013


Me: “Hi, I’m here to pick up my prescription.”

Pharmacist: “What’s the name?”

Me: “[Name], that’s [N-A-M-E].”

Pharmacist: “[N-A-M-E]?”

Me: “Yes.”

Pharmacist: “We don’t have a prescription under that name.”

Me: “Could you look again? It should have been sent over from [School] this morning.”

Pharmacist: *without checking* “We don’t have it.”

Me: “Could you check your computers to see if you got the order?”

Pharmacist: *checks computer* “Oh! Yeah, we got the order. [Medicine] has been backordered for weeks, so no one has it.”

Me: “I see. So, you just didn’t fill the order?”

Pharmacist: “Yeah. We couldn’t.”

Me: “And you didn’t call the number in my file or my doctor to let them know the medication wasn’t available?”

Pharmacist: “We can’t just call EVERY person who orders this! That would take forever!”

Me: “So it’s better that EVERY person who needed that medication should come all the way down here just to hear that their prescription can’t be filled?”

Pharmacist: “Yeah.”

Me: *furious*

[florida80]

Cause For Pregnant Pause, Part 5

Pharmacy | Right | November 19, 2013


(I’m a pharmacist, and one day at work, a young woman comes up to the counter to pick up a script. I notice she is wearing one of those insertable birth control rings around her wrist.)

Me: “Ma’am, you know that’s not how those work, right?”

Customer: “Huh?”

Me: “Your birth control ring. Those are meant to be worn… you know… internally.”

Customer: “Oh, shoot, really? I… I didn’t know that. Excuse me.”

(She walks away and returns with a pregnancy test, clearly worried and very embarrassed.)

Customer: “I guess I’ll be needing this, too.”

[florida80]

The Pharmacist Calls The Shots

Pharmacy | Working | November 7, 2013


(I have numerous health problems, and have to take 10 different prescription medications. Because of the risk of drug interactions, I don’t take as much as a vitamin without running it past a pharmacist. I’m in the pharmacy to buy an over-the-counter drug allergy tablet.)

Me: “Before I get that, I’d like to speak to the pharmacist please.”

Assistant: “The pharmacist is very busy. What’s the problem?”

Me: “I take several prescription drugs. I’d like to make sure this tablet’s not going to cause a bad interaction.”

Assistant: *rolling eyes* “I shouldn’t think it would.”

Me: “I would like to speak to the pharmacist, please.”

Assistant: “The pharmacist is very busy. I’m sure I can answer your questions.”

Me: “I’m concerned about drug interactions and I WOULD LIKE TO SPEAK TO THE PHARMACIST, PLEASE.”

Assistant: “Well, it’s just Lipitor or something, isn’t it? That’s no problem.”

(Instead of answering, I place on the counter the bag I carry my meds in; I bring it to new pharmacies so there’s no possibility of mistaken dosages or anything forgotten. I open the bag and begin to take out my various medications, including the injectible, and the ones plastered with warning labels. The assistant’s eyes get bigger with each new box.)

Assistant: “…I’ll just go get the pharmacist.”

Me: “You do that.”

[florida80]

Drive Flu

Pharmacy | Right | October 30, 2013


(I work at a pharmacy that has a drive-thru. We do flu shots and they are in high demand. We have never administered a flu shot at the drive-thru. A customer drives up to the window in her mini-van.)

Me “Good afternoon! What can I help you with today?”

Customer: “I would like to get the flu shot. Can you hurry because I have things to do.”

Me: “I’m very sorry, but you will have to come inside for us to administer the shot. It won’t take more than five minutes.”

Customer: “No! I don’t want to get out of my car. I’m in a hurry; I’m the customer and you have to do what I say, so you have to do it from here!”

Me: “I’m sorry, but it’s against the rules to do it at the drive-thru. I don’t think it would be very sanitary and I wouldn’t even be able to reach you from this window. You will need to come in. I promise it won’t take long.”

(The customer puts her car into gear, so I figure she is coming inside so I close the window and walk away. As I walk away I hear a blaring car horn so I go back to the window.)

Customer: “You have no right to deny me the shot! Are you trying to kill me? What if I get the flu and die? It would be your fault and you will go to jail for MURDER!”

Me: “I’m not denying you the shot, ma’am. Like I said you will have to come inside; it’s the rules. Please move so I can help the other customers.”

Customer: “NO, B****! I WANT THE SHOT RIGHT NOW AND I’M NOT COMING INSIDE! I’M NOT MOVING MY CAR UNTIL YOU HELP ME! WHAT IS WRONG WITH YOU? YOU ARE WASTING MY TIME! I HAVE THINGS TO DO! I AM THE CUSTOMER AND YOU HAVE TO HELP ME! GIVE IT TO ME NOW YOU LAZY B****!”

Me: “No, you need to come inside. We can not administer a shot at a drive-thru window. We have never done it that way. If you come inside I will be able to help you and it will only take minutes. Please move your car so I can help other customers.”

Customer: “NO! I’M NOT MOVING AND YOU BETTER NOT HELP ANYONE ELSE! I WAS HERE FIRST AND I DEMAND YOU GIVE ME THE SHOT FROM HERE! IF YOU DON’T GIVE ME THE SHOT I’M GOING TO HAVE YOU FIRED AND I WILL MAKE SURE YOU NEVER GET ANOTHER JOB IN THIS CITY!”

Me: “For the last time, NO! If you don’t move your car, I’m going to call the police.”

(I start helping the other customers. The customer continues to yell, flips me off and hits the gas. That’s when I hear a loud crash. I look to see that she had put her car in reverse by accident and slammed into the car behind her!)

[florida80]

No ID, No Idea, Part 13

Pharmacy | Right | October 3, 2013


(I have recently been hired at a pharmacy a few towns over from mine. It’s my second day as cashier, when a teen girl comes to my register. I’m 22 and wearing a name tag.)

Customer: “Hi, I’d like a pack of [Brand] cigarettes, please.”

Me: “No problem. I just need to see your ID.”

Customer: “Oh, well it’s at my house and I don’t have time to run back and get it. Can’t you let me go this time?”

Me: “Sorry, it’s not worth my job.”

Customer: “But you know me!”

Me: “I can’t say that I do.”

Customer: “Dude, [My Name], we go to high school together.”

Me: “Oh, really? What high school do you go to?”

Customer: “[Local High School]. We totally have English together.”

Me: “Yeah, no. First of all I went to [Rival High School]. Second, I was in AP English, the scores of which I used to go to [University], which I just graduated from. So, no, I don’t know you. Show me ID or move along.”

Customer: “You suck.”

(She left and asked the next few visibly older customers to buy her cigarettes. No one bought them, and one even threatened to call the cops if she didn’t leave!)

[florida80]

Let’s Hope This Negative Becomes A Positive

Pharmacy | Working | October 3, 2013


(My sister and her husband are having trouble conceiving. It’s been four long and emotional years for all of us. She forgot to buy pregnancy tests last time she was out, so I offer to get some on my way over to her house. I hand over my items to the cashier.)

Cashier: *picking up pregnancy test with a gleeful smile* “Oooh! Is this a good thing or a bad thing?”

Me: “…what?”

Cashier: “Are you hoping you are or hoping you aren’t?”

Me: “That is a pretty personal question.”

Cashier: “Yeah, but I’m stuck here all day with nothing to do. So I’m thinking you cheated on your boyfriend and hope you aren’t carrying some random guy’s kid!” *huge grin* “Am I right?”

Me: “They’re not for me, but that’s really none of your business.”

Cashier: *offended and hostile* “Y’know, it’s people like YOU who make the world a terrible place! Try being friendly instead of such a b****!”

Me: “Just finish ringing me up, please.”

Cashier: “I HOPE YOUR B****** KID HAS A.D.D.!”

[florida80]

Doing A Real Job On Doing A Real Job

Pharmacy | Working | October 3, 2013


(I have just gotten off of a split shift, during my second seven-day work week. My children have joined me for the last part of my second shift to help me out and we are heading home. It’s just after 8:30 pm, and I’ve been at it since 6 am. We go to the pharmacy next to my store to buy some ibuprofen, and I go up to the pharmacy desk to pay since the main cash has a huge lineup of people buying toilet paper and snack foods. After waiting about two minutes the pharmacy technician, who’s been looking at me and sighing deeply, finally comes to serve me.)

Employee: “Are you here to pick up a prescription?”

Me: “No, I’d just like to pay for these.”

Employee: *as she’s scanning my pills* “Okay, well this cash is only for prescription medication purchases. You should really have gone to the main cash.”

(I’ve often seen customers paying for everything from band aids to makeup at this cash without buying prescriptions, as long as they had some sort of medication with them from the pharmacy area where I picked up my pills.)

Me: “Oh, I’m sorry about that. I just assumed that you pay for medicine at the pharmacy counter. I’ll keep that in mind for next time.”

Employee: “Yeah, well we’re really busy you know, and this takes me away from doing all my work. Now it’s going to take me even longer to finish up and get out of here tonight.”

Me: “Again, I’m sorry. I didn’t realize. I work in retail myself, I know how frustrating it is when you’re busy and you have to stop to help a customer or coworker. It can be—”

Employee: “And you know, just because it doesn’t look like we’re doing anything, it doesn’t mean we’re not busy. We have a lot to do here and this is really annoying! You know, people are just leaving us with their prescriptions all the time.”

Me: “Well, that is your job but still I can understand—”

Employee: “When customers like you waste our time like this it’s really annoying. It’s going to take us even longer to finish up now.”

(The pharmacist finally hands me my change. My children are clinging to me nervously and the customers around me are all shuffling around awkwardly, trying not to look our way. I’ve had enough.)

Me: “Look, I’ve literally been working since 6am. I worked seven days in the last week, I have one day off this week, and I’ll be working from home, and then I work another seven days. I am exhausted, and I regularly have to stop what I’m doing to help my customers, coworkers and employees even when they really could have managed without me. I regularly have to work late or start early due to these interruptions, and my job is 90% physical work on the floor doing heavy lifting and going up and down ladders in a dusty stockroom. You are preaching to the choir here lady. And I’ll tell you, I have never spoken to a customer the way you just spoke to me, or made them feel guilty about coming in to shop and making me do my JOB! Thank you and good night

[florida80]

Cold And Uncaring

Pharmacy | Working | September 12, 2013


(Our pharmacy has recently switched to a new manufacturer of Lorazepam, which requires refrigeration. I overhear a conversation between a patient’s caregiver, and the pharmacist.)

Caregiver: “So I was told this stuff has to be kept cold? Is it still good if it wasn’t?”

Pharmacist: “No, you’re going to have to get it replaced. If it’s been left in room temperature for more than a few hours, I cannot recommend you giving it to your patient.”

Caregiver: “Well nobody told me it had to be kept cold! I want a free replacement.”

Pharmacist: “We put ‘REFRIGERATE’ on every label; don’t you read your patient’s labels?”

Caregiver: “I don’t have time to read all the labels.”

Pharmacist: “Then how do you know you’re giving the drugs properly to the patient?”

Caregiver: “…”

Pharmacist: “That’ll be $30 for a new bottle.”

[florida80]

Drugs Can Make You See Things

Pharmacy | Right | September 2, 2013


(I am at the pharmacy picking up my prescription. I am standing in line behind a very elderly lady.)

Pharmacist: “Hello, ma’am. What can I do for you?”

Elderly Lady: “I am picking up my prescription. It’s under Mrs. [last name].”

(I overhear the elderly lady, and realize that she has the same last name as I do. This is not a totally uncommon name, but it doesn’t happen too often.)

Pharmacist: “Okay! Here we go I think it’s… huh…”

(The pharmacist looks confused as she picks up some pills.)

Pharmacist: “Can you tell me your first name please? I don’t think I grabbed the right one.”

Elderly Lady: “Sure, it’s [first name].”

(By a crazy coincidence, this is my first name too! At this point the pharmacist widens her eyes in shock as she stares at the pill box in her hand. She starts to stammer.)

Pharmacist: “But… um… I don’t… uhh… how?”

Me: “Um, I think those might be mine. I have the same first name and last name. Those are my birth control pills.”

Pharmacist: “Oh thank GOD! I thought I was in the twilight zone!”

Elderly Lady: “Oh dear! No wonder! No I don’t want THOSE!”

[florida80]

Stupidity Is Its Own Reward, Part 2

Pharmacy | Right | August 23, 2013


(I’m about to ring a customer up. I’m supposed to ask if they have our rewards card, and if they say no, I offer them to sign up for it, as it’s free of charge and relatively quick to do.)

Me: “Good evening, ma’am. Do you have a rewards card?”

Customer: “No. What’s the benefit of it?”

Me: “The rewards card allows you to get the sale prices of whatever’s on sale for the week, and with certain sale items and over the counter medications. You build up rewards points, which you can use to save money later on.”

Customer: “Okay. Do I need anything for it?”

Me: “All we need is some basic info, just for identification purposes. Would you like to sign up? It’s free of charge.”

Customer: *says nothing, fumbles around her purse*

Me: “Ma’am? Would you like to sign up for the card?”

(The customer takes out her credit card and swipes it, paying for the purchase.)

Me: “Okay.”

(I hand her the receipt and her bags.)

Me: “Have a good night.”

Customer: “So, do I get the rewards now?”

Me: *screaming internally*

[florida80]

Misconceiving The Point

Pharmacy | Working | August 21, 2013


(I am a 20-year-old female, but I guess I look younger. This occurs the first time I am buying condoms. I feel a little awkward, since it is my only item, and I’ve never bought them before.)

Cashier: *holding up the box of condoms* “Will this be all?”

Me: “Yep.”

Cashier: “I don’t think I can sell these to you.”

Me: “W-why?”

Cashier: “I think you’re too young to be having sex.”

Me: “That’s absurd! I’m 20 years old!”

Cashier: “Yeah, okay. Prove it! Let me see your driver’s license.”

(I start to go through my purse, when an old lady in line behind me speaks up towards the cashier.)

Old Lady: “Hey, you pimply a**-hole! Just let the girl buy her stuff. She’s trying to buy contraception to have safe sex instead of risking an STD or a pregnancy. Even if she was younger than 20, and I believe she is telling the truth, you should still sell them to her to prevent another teenage pregnancy! On top of it, we are on a college campus! How many young teenagers do you see around here? Most of the people who shop here are 17 or older! Just give her the d*** condoms!”

(The cashier wordlessly scans my items and bags them, and takes my cash.)

Me: “Have a nice day, jack-a**! Oh, and I’m paying for her stuff, too

[florida80]

Make His Life A Living Bell

Pharmacy | Romantic | August 13, 2013


(I am a cashier at a small town pharmacy. An older customer walks in making a jingling sound, and I see that he has bells tied to his shoelaces. It is August, and he appears anything but jolly, so I am perplexed by the bells.)

Me: “Sir, if you don’t mind my asking: why the bells?”

Customer: “My wife is going deaf, and she gets mad when I ‘sneak up on her.’ This was her solution.”

[florida80]

In Need Of Valium

Pharmacy | Related | August 7, 2013


(I am eight years old. My mom and I are shopping, and we pass the drug store.)

Mom: “I need to go there.”

Me: “Mommy, no, I’m tired! I wanna go home; let’s go home!”

Mom: “No. It’ll be quick.”

(Mom pulls me into the drug store.)

Me: “Why do we have to go here? It’s a bad place!”

Mom: “Oh, really? Why do you say that.”

Me: “Yeah, it’s called a drug store, and I heard that drugs are bad! On TV!”

Mom: “Uh huh.”

Me: *to other customers* “DRUGGIES! You’re bad people! Drugs are BAD—”

(My mom hustles me out of there and never takes me back!)

[florida80]

You Really Don’t Want That On An Open Wound

Pharmacy | Right | July 17, 2013


(I’m currently doing inventory at the local pharmacy where I work. An older customer comes up to me with her friend, in a panic.)

Customer: “Can you help me?! I need some ‘Polysperm’!”

(I assume she means ‘Polysporin’, the topical ointment that treats infections.)

Me: “Did you mean ‘Polysporin’?”

Customer: “Oh, no! I DEFINITELY need some ‘Polysperm’!”

Me: “I’m sorry; I haven’t heard of that product. May I ask what you are using it for?”

Customer: “Oh, I scraped my elbow, and want to put that ‘Polysperm’ on it!”

Me: “Okay, let me show you where it’s stocked.”

(I point to the display of ‘Polysporin’.)

Customer: *to her friend* “Young kids these days! They don’t know anything!”

[florida80]

An Impatient Patient

Pharmacy | Right | July 11, 2013


(It is a Sunday, so not many pharmacies are open. I’ve come in with my friend, who is rather unwell. The staff know my husband and I quite well, as we’re in there for our regular medication. Additionally, I have multiple piercings, a rather large tattoo on my nape of my neck, and teal green hair.)

Pharmacist: “Won’t be long; please take a seat.”

(We do, and I give the tech I know well a smile and a nod in greeting. Another customer enters.)

Customer: “How long will it be for my medication?”

Pharmacist: “About 20 minutes. We have a few people in front of you.”

Customer: “Fine. I wouldn’t come here if you weren’t the only pharmacy open on a bloody Sunday; you’re always slow!”

(The pharmacist brushes it off and goes to make up medications.)

Customer: “I’m only having to wait this long because of stupid drug freaks.”

(My friend turns to say something, but I put my hand on her arm and shake my head.)

Customer: “Yeah, I mean you, green freak! What, come in for your methadone early, and they won’t give it to you?”

(I’ve deliberately turned my back on him at this point.)

Customer: “F****** druggies! We pay for you to get f****** high.”

Pharmacy Tech: “Sir, can you watch your language please?”

Customer: “No I f****** won’t! That stupid b**** is the reason I have to wait so f****** long! She’s strung out, look at the f****** circles under her eyes; they’re all bloodshot!”

Pharmacy Tech: “I’ll have you know that young lady there is a full-time carer for her husband, who is disabled. And all this whilst being disabled herself. She looks like she hasn’t slept in a week because she probably hasn’t; between caring for him, volunteering with [national advice organization], and helping out her friend here who is rather unwell. And I don’t personally care if my taxes are being used to help her out; I wish there were more people like her out there!”

Customer: “I… I… I demand to see a pharmacist!”

Pharmacist: “Sir, I am not going to reprimand my tech for handling that much better than I would have. Do not insult my customers. Here is your prescription back; please fill it somewhere else.”

(The customer stomps out.)

Me: “I’m really sorry I caused that.”

Pharmacist: “Eh, don’t worry; he’s always an a** when he comes in here. Besides, he has an exemption certificate, which means our taxes are paying for his meds too

[florida80]

A Leftist Agenda

Pharmacy | Right | June 29, 2013


(I am filling out a form to refill my medication. A fellow customer, here for a flu shot, sits down next to me. Note that I’m left-handed.)

Customer: “Woah! How are you doing that with your left hand?”

Me: “I’m left-handed.”

Customer: “Don’t you people like, flip around letters?”

Me: “No, can’t say I do. I think you’re thinking of dyslexia, which some left-handed people have.”

Customer: “Huh…”

(The customer notices that I’m writing with a gel pen.)

Customer: “Wait… you people can’t use gel pens! How do you write with that?”

Me: “Carefully.”

Customer: “What would happen if you used your right hand? Would it, like, work?”

Me: “Well, for most of us, no. My left hand is like your right hand, and my right hand is like your left hand. You could probably use your left hand if you had to, but it’s not ideal. The same goes for me with my right hand.”

Customer: “That’s so weird! I’ve never seen anything like this!”

[florida80]

Diabetes Meets Rabies

Pharmacy | Right | June 27, 2013


(A customer is picking up some diabetic test-strips, and I am ringing him up.)

Me: “How are you doing today, sir?”

Customer: “I’m alright; how about yourself?”

Me: “I’m doing great, thanks. Did you have any questions for the pharmacist?”

(The customer gestures at the test strips, jokingly.)

Customer: “Yeah, do I really have to poke myself for these to work?”

Me: “Yep, I’m afraid so.”

Customer: “Can’t I just poke you instead?”

Me: *laughing* “Sorry, I’m afraid it doesn’t work that way, sir.”

(The customer gestures at my multiple facial piercings.)

Customer: “You look like the type that would enjoy that, though.”

Me: “Your doctor might have a problem with that, though.”

(When a customer picks up a prescription, they’re required by law to sign, stating that they’ve received it. Our pharmacy does this through an electronic prompt. The customer looks at it.)

Customer: “What’s this?”

Me: “It’s just a way to say that you’ve gotten your prescription. That way there’s no confusion later. It’s as much for your protection as ours really.”

Customer: “Well what happens if I don’t sign it?”

Me: “Then unfortunately, we’re not allowed to give you your prescriptions.”

Customer: “WELL I GUESS I’M NOT GETTING ANYTHING TODAY!”

(The customer THROWS the electronic pen across the counter, hitting me in the face. He turns, and practically skips away. The pharmacist and I aren’t sure if he is joking, but by the end of the day he still hasn’t come back!)

[florida80]

The Opposite Of Disappearing Ink

Pharmacy | Right | June 21, 2013


Me: “I’m sorry, sir, but it looks like this prescription is expired.”

Customer: “What do you mean?”

Me: “The law says we can’t take prescriptions this old.”

Customer: “But you said it’s expired. Where does it say that?”

Me: “It doesn’t, but see the date? That’s several months old. We couldn’t fill it now if we tried.”

Customer: “You’re telling me if I’d brought this in exactly as it is just a few months ago, you’d have been able to take it?”

Me: “Theoretically, yes.”

Customer: “So why won’t you take it now? Nothing’s changed!”

Me: “Except today’s date, sir. The prescription expired a few weeks after it was written. You can even see the disclaimer written at the bottom.”

Customer: “So why doesn’t it notify me when it expires? It ought to say ‘expired’ on it!”

Me: “Um… the paper isn’t going to magically print the word ‘expired’ if you wait too long to bring it in.”

Customer: “Well, it should!”

[florida80]

This Cashier’s Number Is Up

Pharmacy | Working | June 9, 2013


(I am 20 years old at this time. Valentine’s Day is approaching, so I go out to the store to buy some fake wine and chocolates for my boyfriend.)

Cashier: “Oooh, a date for Valentine’s Day?”

Me: “Yep! We’re going out to dinner, and I thought I’d buy this stuff for dessert.”

Cashier: “Nice! Can I see some ID for the wine?”

Me: “Oh, that’s grape juice. It doesn’t have alcohol.”

Cashier: “No, I need to see your ID for the wine. I can’t sell it to you if you’re under 21.”

Me: “No, it’s sparkling grape juice. I’m 20 and I’ve bought it before. It doesn’t have any alcohol in it.”

Cashier: “I suppose I can let it slide for a pretty girl like you.”

Me: “Excuse me? First off, that would be illegal if this was real wine, and second, I just mentioned I have a boyfriend. It’s fake wine. Please just let me buy this and leave.”

Cashier: “No need to be like that. I’ll sell it to you.”

Me: “Thank you! What’s my total?”

Cashier: “Your phone number.”

Me: “What?”

Cashier: “I’ll give this to you for your phone number! I can take you out someplace really nice to eat, and then we can go back to my place if you know what I mean. I get free condoms for working here!”

Me: “Here’s $10. This should cover my purchases. I’m going to leave and pretend you didn’t just ask me to have sex with you in exchange for dinner and my groceries.”

[florida80]

Needs To Take A Chill Pill, Part 2

Pharmacy | Right | June 4, 2013


Me: “Thank you for calling [Pharmacy], how can I—”

Customer: “So I just requested a refill, and I want to know when it will be ready.”

Me: “Okay, what is your name?”

(The customer gives her name. I see that no refill was requested. The medication is out of refills, and needs approval from the doctor.)

Me: “I am very sorry, but we must not have gotten your refill request. I see that there are no refills available. I am going to have to fax the doctor.”

Customer: “I did that. I went to their site and asked the doctor to do that. It should have just given my request to you, and it should be ready by now.”

Me: “So, which website did you go to? Was it ours, or your doctor’s site?”

Customer: “His, duh! How can you be that stupid? I requested it, and you see that request, and then you just fill out the paper to give me refills. All the doctor does is sign it. It should take like all of five minutes to get that done. So when the h*** is my prescription going to be ready?!”

Me: “Ma’am, I am sorry. We are in no way connected to your doctor’s office. They have their own software, and we have ours. We cannot in any way see what you have requested with your doctor’s office. We have to wait until he contacts us, and sometimes that can take up to three days for a response. Now if you are out of this medica—”

Customer: “This is unacceptable! I know how these computer things work. You can look up any person’s prescriptions anywhere and anytime, no matter what pharmacy they are at! Now fill my f****** prescription!”

Me: “Ma’am, there is no way I can do that. That would be in direct violation of federal law. There is a privacy act that means that we cannot share medical information with anyone else without your direct consent. Would you like it if I could access your medical record right now and see things like what you went to the ER for?”

(Note: this customer is a notorious drug seeker, and is well known at ERs and Urgent Cares throughout the area. She also knows that we know.)

Customer: “…uh, no.”

Me: “That’s why we can’t see anything your doctor may have on you, or what requests you may have made to him. It’s to protect your privacy. Now since this isn’t a narcotic, I can ask the pharmacist if we can advance you some of your medication until we hear back from the doctor.”

Customer: “Uh yeah, okay. That will be fine then.”

(My pharmacist later pulls me to the side and tells me that I did a great job with a difficult customer, and with keeping my cool. Come Christmas time, I got a few extra bucks in my bonus!)

[florida80]

Doing More Pharm Than Good

Pharmacy | Working | May 31, 2013


(My daughter has a seizure disorder. We are a low income family, and we get low cost insurance through the state for her. However, because of this disorder, she has separate insurance through the state; the pharmacy knows this.)

Tech: “Um, okay, so we tried to run your daughter’s medication and it won’t go through. We have to contact [regular] insurance to see why it won’t go through.”

Me: “Wait, no… you have to run it through [other] insurance. I called this in like three days ago, and you are now just calling me?! That is medication she takes for her seizures. I am out too, and I can’t have her miss a dose.”

Tech: “We did and it didn’t work. You can pay cash for it. That’s $54.99.”

Me: “Look, I am low income. I can’t afford something that expensive. Are you sure you ran it through the right insurance?”

Tech: “Uh, yeah. It’s not my fault you let your insurance lapse or something. You need to call [regular] insurance and take care of it on your end or else pay cash.”

(I call my daughter’s regular insurance, who confirms my side of things. They call the pharmacy and get them to approve the medication. I call back, but request to speak with a pharmacist directly.)

Me: “So, did it work this time?”

Pharmacist: “Yeah, it did. I’m sorry [tech] was acting that way. She just didn’t want to run it on the other insurance because it takes a few more steps to make.”

Me: “Yeah, I know. I’ve heard this song and dance every month for the last three months and nothing has changed. Look, my kid was totally out of her seizure meds! She could have had a seizure because of your lack of calling me about it in a timely manner and making jump through hoops I don’t need to.”

Pharmacist: “Well, I’m really busy, and I can’t watch everything they do all the time.”

Me: “Wow, you just inspired me to take my business elsewhere and call corporate to complain.”

(Within two hours, my daughter’s prescriptions we transferred to another pharmacy where they DO take the time to run it correctly and call me if/when there is a problem. I recently went back into that store to return something and there was an entirely new staff in the pharmacy. I hope these ones do actually care!)

[florida80]

One Good Deed Job-Leads To Another

Pharmacy | Working | May 28, 2013


(I am working late at night in a 24-hour pharmacy. There are only three customers in the store: a scruffy but clean young couple and another gentleman. The woman in the young couple is very heavily pregnant, and her partner is picking up the range of baby hats we carry and holding them up against her stomach, then looking at the prices and sadly putting them back. They pick up a packet of the cheapest pain medication we carry and bring it to the counter.)

Female Customer: “I’m sorry, but can you please ask the pharmacist if these are safe for me to take?”

Me: “Of course!”

(While we’re waiting for the pharmacist to come out, they tell me they’re expecting their daughter any day now. The pharmacist has been watching the young couple since they came in.)

Pharmacist: “These are fine, but can I ask why you need them?”

Female Customer: “Oh, I have a horrible cough that’s making my back ache even worse. I can’t get to sleep.”

(The pharmacist goes through a list of cough medicines safe for her to take, before the young man shakes his head with tears in his eyes.)

Male Customer: “I’m sorry, I’ve just lost my job and we really can’t afford any of those. Sorry for wasting your time.”

Pharmacist: “That’s okay, but this packet is damaged, and legally I can’t let you take it. Seeing as it was the last one, let me and [my name] go look in the back for some more.”

(The pharmacist takes me out the back, where he puts three packets of name brand painkillers, four bottles of name brand cough syrup, a wheat bag for her back, a tin of formula, a packet of newborn nappies and a few of the hats the couple was looking at into a box. He hands me the box and tells me to take it out to them. I do and they both burst into tears, thanking us over and over again. They leave with huge smiles on their faces.)

Female Customer: “Thank you again!”

Other Customer: “I’m sorry, I couldn’t help but over hear. Did you say you just lost your job at [local company]?”

Male Customer: “Yes, I was an IT tech.”

Other Customer: “I own [other computer store in the area], and I’m looking for a new tech. Can you start tomorrow?”

(There were tears all round that night. A week later, the young woman brought in her beautiful daughter and a giant batch of cupcakes for the pharmacy staff. Best night at work ever!)

[florida80]

Probably Needs Some Valium Too

Pharmacy | Right | May 17, 2013


(A customer comes into the drive thru.)

Me: “Hello, how are you, ma’am?”

Customer: “I want my Nexium.”

(She provides her information, but I see that nothing has been filled.)

Me: “I’m sorry, ma’am; I don’t see that we have anything ready for you.”

Customer: “This always f****** happens! I’ve been trying to get my f****** Nexium for a month! I dropped it off here a month ago!”

Me: “You dropped it off at this location?”

(I ask this, as there are many branches of our chain within a 10 mile radius of each other.)

Customer: “Yes, I only fill here!”

Me: “Ma’am, there is no Nexium in your profile.”

Customer: “Yes their f****** is! This always f****** happens!”

(My coworker takes over, trying to calm her down. My manager has had enough of her mouth, and he goes to tell her off.)

Manager: “Ma’am! You have never filled here! It is not here! We have nothing for you!”

(The customer continues to curse up a storm. Another customer stares at the drive thru window, looking between it and me.)

Customer #2 (https://www.vietbf.com/forum/usertag.php?do=list&action=hash&hash=2) : “That b**** be crazy.”

Me: “I agree, sir.”

(I suddenly hear the drive thru window slam, and the car speed away.)

Me: “Sorry you had to hear all that, sir.”

Customer #2 (https://www.vietbf.com/forum/usertag.php?do=list&action=hash&hash=2) : “Nah it’s cool. Hey if something happens, I heard everything!”

[florida80]

It’s Apparent He’s A Parent

Pharmacy | Working | May 13, 2013


(My first child is sick and has been up all night crying with a fever. Before the store even opens, I am in the parking lot staring through the store window at the medicine I need with my sick, screaming baby. I can see and hear two employees nearby watching and making fun of me.)

Rude Employee #1 (https://www.vietbf.com/forum/usertag.php?do=list&action=hash&hash=1) : “Oh my god, do you see that? That crack w**** is here with her crack baby so early in the morning! I thought those kinds of people only came out at night.”

Rude Employee #2 (https://www.vietbf.com/forum/usertag.php?do=list&action=hash&hash=2) : “I guess you can never tell. I wonder what’s so important that she has to bring her screaming brat with her before we even open?”

(I ignore them as I wait patiently, but after another ten minutes my patience is wearing thin. I am about to tell them off when another employee walks up to the front doors and opens them.)

Nice Employee: “Ma’am, I know the store isn’t open for another twenty minutes, but I wanted to check on you.”

Me: “Oh, I’m sorry. My baby has had a fever all night and just won’t sleep! I only need something to help her fever so she’ll stop crying.”

Nice Employee: “I see. Would you come with me, please?”

(He opens the door for me and lets me into the store.)

Nice Employee: “Get what you need and I’ll meet you on register one to ring you out.”

Rude Employee #1 (https://www.vietbf.com/forum/usertag.php?do=list&action=hash&hash=1) : “Hey! Don’t let that crack w**** in here. Her baby’s not sick! She’s just scamming you so she can shoplift!”

(Fortunately, the nice employee ignores them and helps me find what I need and walks me to the front of the store)

Nice Employee: “I’m sorry we let you wait out there so long. If I had known I would have gotten to you sooner. Unfortunately the registers are still not open, so I can’t ring you in, but I can let you go home with the medicine.”

Me: “But I have to pay for it. Let me at least leave some money here. You’ve been so nice; you can keep the extra as a tip.”

Nice Employee: “Ma’am, that’s very sweet of you, but I must insist you take your medicine and your sweet little girl home. As a single father, I have been in your shoes before, so I would like to pay for your baby’s medicine.”

Me: “Thank you. This is the nicest thing anyone has ever done for me. Thank you so much!”

(I always go back to that store just because of that one nice employee. He totally makes up for the rude ones.)

[florida80]

Makes A Difference When Cashiers Are Minus A Few Brain Cells

Pharmacy | Working | May 8, 2013


(I’m buying a common cold medicine that is OTC, but you have to be 18 to buy. At the time, I’m 19.)

Cashier: “I need to see your ID.”

(I hand it to her.)

Cashier: “Oh, I’m sorry. I can’t sell this to you.”

Me: “What? Why not? ”

Cashier: “Well, I have to be able to verify you’re over 18.”

Me: “Is there a problem with my ID?”

Cashier: “You were born in 1989.”

Me: “Yes, and it’s 2008, so I’m 19.”

Cashier: “But you could be lying because I don’t know how to figure out how old you are if you were born in 1989. It’s too hard to subtract!”

[florida80]

Don’t Ask What He Puts In His Granola

Pharmacy | Right | May 3, 2013


(A customer comes in, and looks confused for several minutes.)

Me: “Sir, can I help you find something?”

Customer: “Where is the yogurt?”

Me: “All of our dairy products are in the cooler.”

Customer: “No, yogurt. You know, yogurt that you put under your arms.”

Me: “…you mean deodorant?”

Customer: “Yes, yogurt!”

Me: “…aisle four.”

[florida80]

Herd Behavior, Part 2

Pharmacy | Romantic | April 26, 2013


(I’m a 25-year-old Brony. I use a Brony lanyard with several Pony buttons on it to wear my name tag, and a wallet that has a short leather Rainbow Dash tail sticking out of my back pocket. I also have looks that some consider girly, and am often confused for a girl. I am serving a male customer who appears to be around my age.)

Customer: “Hi… I’m here to pick up my Dad’s prescriptions.”

Me: “Certainly, I just need the name and date of birth.”

Customer: “So, when do you get off?”

Me: “Uh… why?”

Customer: “Well, I was wondering if you might want to go out for drinks a little later.”

Me: “Whoa, buddy, stop right there. I’m probably not your type, anyway, since I’m a guy.”

Customer: “Oh, yeah, I can tell. I like your wallet by the way.”

Me: “Thanks. I’m a Brony, but, uh… I don’t really swing that way, man. I have a girlfriend; she actually gave me the bracelet as a gift.”

(I take out my wallet, and show him the picture of us in the front.)

Customer: “Oh! That’s a cute picture. That’s too bad.”

Me: “No big deal, though. I’m actually kind of flattered; you’re the first guy to hit on me thinking I’m a guy. Usually it’s some pervert that thinks I’m a girl. It’s usually one of those ‘anything that moves and has boobs’ types.”

Customer: “Hah! No way! Have a good one. Gimme a brohoof, and tell your girlfriend she’s lucky.”

(We brohoof, and he leaves. Thank Celestia for people who can take ‘no’ for an answer!)

[florida80]

Coworkers-In-Arms

Pharmacy | Working | April 22, 2013


(When we get truck, they normally try and schedule it so at least one male is working to help, since the boxes are stacked up very high and often quite heavy. On this particular day however it’s me and the store manager who is notoriously lazy. I’m only five feet tall and he’s well over six feet.)

Store Manager: “[My name], I need you to start sorting the totes.”

Me: “I’m going to need some help.”

Store Manager: “There’s no reason you can’t do it!”

Me: “So, you think I should be able to scale the ladder, lift a bulky 35 pound tote and make my way safely back down?”

Store Manager: “Yes, why is that so hard?”

Me: “It’s not safe.”

Store Manager: “I don’t care how you do it. Just get it done!”

(He stalks off while I try and figure out how to do this. One of our pharmacy techs cuts through the backroom and sees me; I’m visibly upset at this point.)

Pharmacy Tech: “Hey, what are you doing?”

Me: “[Store manager] left me alone to try and get all these totes down.”

Pharmacy Tech: “Right, like that’s totally safe.”

Me: “He doesn’t care. I’m just trying to figure out the best way to do it to avoid not only hurting myself, but breaking anything.”

Pharmacy Tech: “Yeah, hang on…”

(He goes back into the pharmacy before reappearing and shucking his vest.)

Pharmacy Tech: “We’re slow, and like h*** I’m letting you do this by yourself. The pharmacist told me to go ahead and help you.”

Me: “Won’t you get in trouble?”

Pharmacy Tech: “I’d like to see him try and get me in trouble.”

(The tech helps me get the down so I can more easily sort the totes. After we’ve finished, the store manager shows back up.)

Store Manager: “I can’t believe you’ve only gotten this much done!”

Me: “Well, maybe if you were actually halfway competent you would have realized that you were supposed to be helping me! I’m one person, what exactly have you been doing all this time? Sit around on your butt texting in the office, most likely!”

Store Manager: “You can’t talk to me that way! I’m your boss!”

Me: “Not anymore!”

(I threw my name tag at him and walked out. Several other members of management called to try and get me to come back, but I refused. I found a job at another pharmacy and shortly later, my pharmacy tech buddy joined me there!)

[florida80]

Prescribing Perspective

Pharmacy | Right | April 16, 2013


Me: “How may I help you, ma’am?”

Customer #1 (https://www.vietbf.com/forum/usertag.php?do=list&action=hash&hash=1) : “I’m picking up a script for [name].”

(I proceed to look it up. However, the system alerts me that we do not have anything ready.)

Me: “I don’t see that we have anything ready for you, ma’am.”

Customer #1 (https://www.vietbf.com/forum/usertag.php?do=list&action=hash&hash=1) : “What do you mean, you don’t have anything! They called two days ago!”

Me: “I apologize, ma’am. If a prescription sits on our shelf for too long, we have to put it back on our stock shelf.”

Customer #1 (https://www.vietbf.com/forum/usertag.php?do=list&action=hash&hash=1) : “It’s only been a week! That’s just stupid! Give me back my script! I’ll go to [rival store]! Only one week! Absurd!”

(I escort her to my co-worker, so that I may help the other customers in line.)

Customer #2 (https://www.vietbf.com/forum/usertag.php?do=list&action=hash&hash=2) : “Oh, honey, I think I may have done the same thing and waited too long; can you check?”

Me: “Certainly, sir.”

(I check, and indeed his was placed back to stock as well.)

Me: “Yes, sir, I’m afraid so.”

(Customer #2 (https://www.vietbf.com/forum/usertag.php?do=list&action=hash&hash=2) speaks loud enough for everyone to hear.)

Customer #2 (https://www.vietbf.com/forum/usertag.php?do=list&action=hash&hash=2) : “Oh, shoot. IT’S PURELY MY FAULT FOR FORGETTING, EVEN AFTER Y’ALL WERE SO NICE TO CALL ME TWICE. Thank you, sugar; I’ll go talk to [co-worker].”

[florida80]

Prescription Affliction

Pharmacy | Right | March 27, 2013


(I am a pharmacy technician. The pharmacist receives a call.)

Caller: “This is Lisa; I am calling from Dr. [Name]’s office. I need to call in a prescription for a patient.”

Pharmacist: “Sure, what is the patient’s name?”

Caller: “It is [Patient].”

Pharmacist: “And the prescription?”

Caller: “It’s [narcotic], 90 pills, three times a day.”

Pharmacist: “Okay, thanks.”

(The pharmacist hangs up and turns to me, frowning.)

Pharmacist: “Do you know anything about this?”

Me: “What? No, why?”

(The pharmacist shows me the called-in prescription.)

Me: “Oh! Lisa was fired months ago. You had better call the police.”

(When Lisa came in to pick up the narcotic prescription for her boyfriend, the police were there to arrest her. The doctor she used to work for is my father; she was trying to use his license number to get pills from a dozen nearby pharmacies.)

[florida80]

You Got Dad’s Back

Health & Body, Jerk, Pharmacy | Right | March 26, 2013


(I am eight years old. My mother, father, and I are all in the chemist to get some medication. My father has a rare spinal condition which is causing him to wobble when he walks, even with a frame. We’re waiting at the counter and hear a customer behind us make a remark under their breath; deliberately loud enough for us to hear.)

Customer: “Drunk at nine am; you should be ashamed.”

(We try to ignore it.)

Customer: “This is disgusting; you should be so embarrassed.”

(I don’t like this person being rude to my father.)

Me: “Watch your tone lady. If you’d bother to be polite and ask if my father is okay, you’d know he has a special illness that makes him this way. He’s not drunk; he’s my father, and I love him. Now apologize for being so mean about him.”

(She went red, stammered, and went down an aisle. The pharmacist gave me a lollipop.)

[florida80]

He Came First

Pharmacy | Right | March 19, 2013


(Two customers enter at the same time. One is a woman, and the other is a man in his 70s. I get their scripts ready. As the woman is done first, I send her up to the tills while I finish with the man. Since there is another customer at the tills, I end up putting the man through before the woman is served.)

Woman: “I was here first! How come he is served before me? What does he have that I don’t?

(The man responds without a second thought.)

Man: “Raw sex appeal.”

(If I was allowed to discount scripts, I would have given him his for free.)

[florida80]

High School Dropouts Work On The Pharm

Pharmacy | Learning | March 12, 2013


(I work as a pharmacy tech at a chain pharmacy. I am also currently in pharmacy school and will be a pharmacist one day.)

Customer: “You should be ashamed of yourself!”

Me: “I’m sorry. Can I help you with something?”

Customer: “No! I refuse to be helped by a high school dropout! You should be ashamed of yourself for working where children can see you! You are going to make them think that it is okay to not have an education!”

Me: “Ma’am, I am not a high school dropout. I have a high school diploma and I am currently in pharmacy school working towards a Doctor of Pharmacy. I am going to be a pharmacist one day.”

Customer: “Stop lying! I have never heard of a pharmacist before. You are a high school dropout!”

Manager: “Can I help you?”

Customer: “Yes! Your employee is lying to me! She says she is going to be a pharmacist! That job doesn’t exist!”

(The manager looks at our pharmacist who is near tears from laughing so hard.)

Manager: “Ma’am, see the man over there? He’s the one who filled your prescription. He is a pharmacist.”

Customer: “No he isn’t! He just counts pills! You don’t need school for that!”

[florida80]

You Can’t Make This Advice Up

Pharmacy | Working | March 11, 2013


(I am buying some make-up for myself. I have oily skin and very mild acne, so my dermatologist has recommended using powder foundations. I’m a student working part-time so I can’t afford the high range stuff, but I still buy reliable branded products.)

Cashier: “Are you wearing this now?” *screws up her nose at my powder*

Me: “Um yeah, I always get that one.”

Cashier: “Well, you should get [famous brand] matte foundation instead. We’ve got it for like $80. I bought some myself.”

Me: “Oh thanks, but I can’t really afford it! I like this powder because I just want some light coverage for blemishes and it looks quite natural. And it’s on special for $38, which sounds good to me!”

Cashier: “Ugh, but you’re so pale, and I can see you’ve got some gross little pimples by your chin! This stuff is way better. See?”

(The cashier points at her own face. True, she doesn’t seem to have any acne showing, but she hasn’t blended it to her neck and consequently looks like she is wearing a mask. On top of this, she seems to have applied several layers of the stuff and a load of bronzer, so the makeup resembles orange cake mix, set off nicely with false eyelashes and bright blue eyeshadow.)

Me: “Oh, yeah it is quite nice… but I think I’ll stick with my powder.”

Cashier: “Whatever…” *rolls eyes* “You’ll find the cheap tanning sprays over in the corner!”

[florida80]

Mistaken Shaken Medication

Pharmacy | Right | February 17, 2013


(I am counseling a customer who is receiving a prescription for her child’s strep throat. As she’s signing for the prescription, I give her directions on the medication.)

Me: “It needs to be shaken well.”

(All of a sudden, she starts shaking the electronic pen that is attached to the signature pad. After a moment she stops.)

Customer: “You meant shake the medicine, didn’t you

[florida80]

They’re Obviously Married To That Idea

Pharmacy | Working | February 17, 2013


(I am a college student and picking up my inhaler from a local pharmacy. I’ve just gotten a new prescription insurance card and need to have the information changed. Since I’m under my parents’ insurance, the card is in my father’s name.)

Me: “I’d like to pick up my prescription and update my insurance.”

(I hand the pharmacy tech the insurance card.)

Tech: “This is under a guy’s name. You’re a girl.”

Me: “Yes, that’s my father’s name. I’m included under his insurance.”

Tech: “So, you’re under your husband’s insurance. Let me see if I can update that.”

Me: “Father, not husband.”

Tech: “What’s your husband’s date of birth?”

Me: “That’s my father, not my husband, and it’s [date].”

Tech: “Wow! You look young to be married to someone that old.”

Me: “For the third time, I am under my father’s insurance. I’m not married.”

Tech: “Oh. Okay. Well, I need to show this to the pharmacist on duty.”

(She walks over to the pharmacist, who is still within my earshot.)

Tech: “Hey, this girl is under her husband’s insurance and I need help updating her info…”

Me: *facepalm*

[florida80]

A Mother’s Duty

Pharmacy | Right | February 12, 2013


Me: “Thank you for calling the pharmacy. How may I help you?

Customer: “Hi, my fiancè’s mother is incompetent, and I am going to be helping out with her medicines.”

(When she says ‘incompetent,’ I am thinking she might want to transfer the woman’s meds to our pharmacy, has a question about her drugs, or something of the sort.)

Me: “Okay, what can I help you with?”

Customer: “Since she is incompetent, I think she is going to need some kind of diaper or underwear. So, what do y’all sell there?”

[florida80]

This Story Just Drugs On And On And On

Pharmacy | Right | February 9, 2013


(I work at a pharmacy, both as a tech and at the till when necessary. It is a Sunday, so the pharmacy is not heavily staffed. The sole customer waiting is a man, late 20s to early 30s, wearing a pink button-up shirt.)

Me: “Hello, sir. How can I help you?”

Pink Guy: “Six for [Name].”

(I search the current container and find five prescriptions. It’s not uncommon for a prescription to be put in adjacent containers if the proper one is too full, which this one likely was. I search the other containers but don’t find anything.)

Me: “One sec, I have to check the computer.”

(I check the computer. I do verify he has six prescriptions to pick up.)

Me: “Sorry about that. Can I verify the date of birth, please?”

Pink Guy: “What is this? You want my date of birth now?”

Me: “Yes sir, to verify the prescription.”

Pink Guy: “You guys never asked for that before.”

(I am roughly two years’ tenure in the pharmacy, and that has been a part of policy since day one.)

Me: “If I could just verify the date of birth to make sure there isn’t another person with the same name?”

Pink Guy: “It’s not very likely you’d have two people with the same exact name. I suppose you want me to verify my social security number in case someone has both my name and my birthday?”

(We actually do have two people with the same name and birthday.)

Me: “Not necessarily. I would go by address or phone number first.”

Pink Guy: “I’m not comfortable giving you my date of birth.”

Me: “I already have a date of birth here. I just need you to verify at least the month and the day.”

Pink Guy: *crossing his arms* “Fine. But just know that you’ve never asked me for this before and I’ve been coming here for years. It’s [birthday].”

Me: “Thank you, sir.” *check each of the prescriptions* “Okay. And I have all six prescriptions.”

Pink Guy: “Six?”

Me: “Yes, sir, six prescriptions.”

Pink Guy: “Not seven?”

Me: “Was there more?”

Pink Guy: “There should be one more.”

Me: “Okay, let me check the computer.”

(I go back to the computer, and re-enter him just to refresh the data. I verify each prescription that I have and make sure he doesn’t have another one that he usually refilled; none pop out.)

Me: “I only have six prescriptions for you, sir.”

Pink Guy: *with an inflection implying I’m a moron* “And there aren’t any for my wife?”

Me: “Oh, I see. It’s under another name.” *without asking him, I query by address, and find his wife. I see that she does have a pending prescription, but there’s a catch* “Did you call it in today?”

Pink Guy: “Yeah, I called it in this morning. It said it’d be ready tomorrow but I figured you guys would have it ready by now.”

Me: *explaining casually* “Well, not exactly. You see, when you call it in it actually gets picked up by an outside pharmacy and they fill it and ship it to us next-day. You did it through the automated system, right?”

Pink Guy: “Well, yeah. I’ve done it before and you guys had it ready.”

Me: “Well… I’m not sure about that time, but I do know the automated system tells you when the pickup is and then asks if you want it earlier; if you select that you want it earlier it sends it to us. Maybe that just didn’t go through this time.”

Pink Guy: “No, I just assumed you’d have it ready by now.”

(Well, at least he’s honest.)

Me: “Well, I’m sorry but we don’t. But I can pull it and we can fill it here. The pharmacist is out to lunch, but when he gets back in about ten minutes he’ll fill it right away. Do you have some shopping you could do or would you like to wait in the waiting area?”

(The pharmacist is behind the counter, but I’m not going to bother him unless I absolutely have to.)

Pink Guy: “No! I don’t have time for all of this crap! If you guys aren’t ready I’ll just waste my time and gas and get it tomorrow! I’m in a hurry!”

Me: “I’m sorry about that, sir.”

(I start scanning and bagging the prescriptions. He reaches across the counter at me to tear the bag away from me.)

Me: “Excuse me, just a sec, sir. I need you to verify the information on the screen.”

Pink Guy: “I thought you already verified everything. That’s why I gave you my date of birth!”

Me: “I need you to verify everything on the screen. Make sure all of the information is correct and hit ‘next’ in the lower-right of the screen.”

(Without looking at the screen, he hits the ‘back’ button at the lower-left.)

Me: *re-initializing the verification phase* “It’s the ‘next’ button on the lower-right, sir.”

(Second time’s the charm. He still doesn’t look at the screen.)

Me: “And if you could sign to verify you’ve picked up the prescriptions.”

Pink Guy: *mutters a signing-my-life-away cliche* “There. Are we done?” *extends his hand, expectantly*

[florida80]

Me: “Not quite. Your total comes to $20.”

Pink Guy: “Are you kidding me!? You make me go through all that and then you expect me to fork over $20? I have insurance! It covers everything! You must not have run it through, you idiots. Go check your little computer and you’ll see. I have never had to pay anything for my meds!”

(I go to the computer and refresh his information.)

Me: “It shows here we ran it through [Insurance]. They paid [amount] toward the prescription, leaving you with a co-pay of $20. The last time you got it, on [date], they paid [amount minus $20] and therefore you had a $40 co-pay. And you’ve had a $40 co-pay the last 3 times you picked this medication up.”

Pink Guy: “This is ridiculous! Whatever.” *pulls out his checkbook* “Can I get $100 cash-back?”

Me: “No, sir, the limit is $50. And, I’m sorry, but I don’t have enough in my till.”

Pink Guy: “Well… can’t you get more?”

Me: “I could, but it’d be faster for you if you just got a bottle of water and get cash-back up at the front.”

Pink Guy: *standing up defiantly* “I’m not making two transactions. I’ll wait.”

Me: “Okay. Your total is $70, and the date is [date].”

Pink Guy: “You said it was $20 before!”

Me: “Right. $20, plus $50 cash-back is $70.”

(He proceeds to write his check.)

Pink Guy: “Can I have my cash-back?”

Me: “I need to run the check first.”

(With a great show of impatience and contempt he tears the check out and hands it to me. It’s policy to verify the check by hand before running it through the feeder. Before even turning it my direction, I see he hasn’t signed it.)

Me: “Could you please sign the check?”

(He clicks his pen and makes a very dramatic and flourish display of signing the check.)

Me: “Thank you.” *I start to validate the check, the date is wrong by a few days* “I’m going to change it to today’s date and initial it, okay?”

Pink Guy: “Fine, whatever.”

(I check everything, saving the amount for last since I know it’s cash-back and I want to verify they match properly. But… there’s a problem.

Me: “Sir, I’m afraid I’ll need you to write a new check.”

Pink Guy: “What the he-why!?”

Me: “Because. You wrote the amount for $120, but the limit for cash-back is $50, and that’s how much I asked for.”

Pink Guy: “Well here!” *takes the check from me, scribbles all over it, and writes the new amounts in as tiny as he can above the errata* “There. You need my driver’s license?”

[florida80]

Me: “No, sir, I need you to write a new check. This one is illegible and I can’t accept it into my till.”

Pink Guy: “Screw you! Fine, forget the cash-back. I’ll just pay with my card.”

(He pulls the card out, and swipes it. But it’s too fast, I have to hit a button first.)

Me: “Okay, your card is ready to swipe.”

Pink Guy: “I already swiped it.”

Me: “I wasn’t ready in time, sorry. I have to hit a button for it to take. It’s ready now, though.”

Pink Guy: “The machine said it was ready!”

Me: “That’s the default screen. It always says that. I know it’s irritating. I wish they’d change it.”

(He swipes his card again, and poises with his pen. I expect him to start with the card transaction, but notice he’s still standing there after a second.)

Pink Guy: “Well?”

(I look at my screen, and realize it hasn’t taken the card still. I clear it and prime it again.)

Me: “Try it again, please?”

Pink Guy: “No! You’ll charge me twice!”

Me: “It won’t charge you twice. I promise. It only charges when you approve the amount and sign.”

Pink Guy: “If it charges me twice I’ll get you fired.”

Me: “I promise. It won’t charge you twice.”

(He poises with the card and practically stares me down as if judging the worth of my soul as he slides the card through. It’s then I notice the magnet strip is in his fingers.)

Me: “May I see your card, sir?”

Pink Guy: *apparently giving up, he responds less angrily than I expected* “Take it.”

(I take the card and swipe it through the correct way, setting it on the counter. Once again he poises with the pen, waiting for the prompt, and again, I notice it’s taking him a tad longer than other people. I look at the screen just as he comments.)

Pink Guy: “It’s still not doing anything.”

(I pick up his card, and take in a breath. It’s a ditch effort, but I enter the card number manually. No dice. I hand his card back.)

Me: “I’m sorry sir, your card won’t go through. Do you have another method of payment?” (It has been rejected.)

Pink Guy: “What the h***!” *literally throws the card at me, hitting my chest, and I catch it* “That’s a new f****** card! Of course it’ll take! Your computer is stupid!”

Me: “I’m sorry, sir.”

[florida80]

(He leaves, and I continue the day setting any emotions aside to deal with for later. I put his credit card in with one of the scripts and make a note of it for whoever has to handle it. Later that week, the pharmacist, who had been sitting behind the counter that whole time, talks to me during a slow hour.)

Pharmacist: “Hey, [My Name], you remember Mr. [Pink Guy] from the other day?”

Me: “Yeah, what about him?”

Pharmacist: “His wife came by the next day. I did the transaction. She picked up all seven scripts. She didn’t say anything about the price. Paid with a perfect check, and got the $50 cash-back.”

Me: “So, she didn’t give you any trouble?”

Pharmacist: “No, not at all.”

Me: “Well, good. At least that whole thing happened on a slow day.”

Pharmacist: “Yeah. Anyway, here.” *takes a Barnes & Noble gift card from his smock pocket and sets it on the counter* “Consider this an apology from Mr. [Pink Guy].”

(The gift card was for $75.)

[florida80]

Needs To Take A Chill Pill

Pharmacy | Right | January 29, 2013


(I’m at a chain company pharmacy/mini-stores getting a bottle of water. As I pass by the pharmacy, I witness an exchange between a very burly, muscular customer and a short, skinny female clerk.)

Customer: “I need to refill my prescription.”

Clerk: “Well, I’m sorry, but according to our systems, you have no refills left. You’ll need to contact your doctor and get a new prescription.”

Customer: “What?! I want my pills. Give me my pills!”

(The exchange continues for a while, with the customer getting more and more agitated. The clerk appears to be frightened and close to tears. The commotion is drawing the attention of the people around.)

Customer: “You dumb b****, are you f***ing stupid? Give me my pills or there will be a problem.”

(At this point, I step between him and the clerk behind the counter.)

Me: “Look buddy, she already said that she’s not giving you pills and told you what to do. So you better just listen to her, leave, and stop making an a** of yourself.”

(For a moment he looks like he is going to hit me, then just stomps away swearing under his breath.)

Me: *to the clerk* “I’m sorry you had to deal with that.”

Clerk: “It’s alright. Thank you for that. Here, that water is on me, okay?”

[florida80]

Paging Charlotte On Aisle 5

Pharmacy | Right | January 16, 2013


(I am at the cashier, ringing up a long line of people. I notice when customers walk in, they suddenly skirt around the theft detectors. A lady approaches the counter.)

Lady: “There is a big spider in the entrance!”

(Note: I don’t want to leave the counter because of the enormous line.)

Me: “Okay, cool.”

Lady: “You have to kill it. You work here.”

Me: “It’s not hurting anyone.”

(The lady’s husband chimes in.)

Husband: “Kill it, she’s right!”

(Everyone in the line seems to agree with the lady and her husband.)

Me: “Okay, I’ll just move it outside.”

Husband: “No, kill it!”

Me: “No, it wont do any harm out there in the parking lot.”

(I move the spider outside.)

Lady: “I can’t take it anymore!”

Me: “Can’t take what?”

(Suddenly, the lady grabs a basket made for carrying products outside and finds the spider. She starts violently smashing the red basket on the spider.)

Lady: “Why is it not dying?!”

(It turns out the basket has little legs on the bottom, preventing it from making contact with the spider. She eventually figures this out and kills it, but not before it charges her one last time and causes her to flip out

[florida80]

Paging Insecurity

Pharmacy | Right | January 16, 2013


(I am a customer in this pharmacy store late at night. As I walk up to the counter, a male customer is loudly complaining to a male cashier about ‘the gays.’ Being a lesbian, I’m gathering up the courage to say something when the following happens.)

Male Customer: “The gays keep trying to turn everyone!”

Male Cashier: “It must be rough.”

Male Customer: “How do you mean?”

Male Cashier: “I have a handful of gay friends, and no matter how much time I’ve spent with them, I’ve never wanted to have sex with other dudes. I’m just saying it must be rough to have such a tenuous hold on your sexuality that you’re always worried about being turned by the slightest contact. I feel for you.”

(It takes a moment, but the male customer realizes what the male cashier is saying.)

Male Customer: “…Hey, f*** you, buddy!”

Male Cashier: “You want to f*** me? Oh god, it’s happening now! There must be a gay in the store! Run!”

Customer: *screaming* “Go to h***!”

(The customer then runs out of the store. As I put my stuff up on the counter, the manager runs up from one of the aisles.)

Manager: “What the h*** was that?”

Cashier: “Oh, I’m probably just getting a customer complaint in the morning. Totally worth it… I’ll explain later.” *to me* “Sorry about all that. How are you tonight?”

Me: “If I was straight, I would totally be giving you my number right now.”

[florida80]

Antisocial Behavior Is Its Own Reward

Pharmacy | Working | January 9, 2013


(About three months prior, we hired some new help since we were severely understaffed at our pharmacy. Two of the workers are doing very well. One, on the other hand, is not. Today, it’s a bit busier than normal, and unfortunately the not-so-good worker is the only one I have to back me up on the register. Note: In October we switched our rewards cards.)

Coworker: “Do you have [Rewards Card]?”

Customer: “Yes, it’s right here.” *pulls out our current rewards card*

Coworker: “Sorry, but we have a new one now that we switched to.”

Customer: “I was told this is the new one.”

Coworker: “Yeah, but we have a newer new card.”

Customer: “Well, what’s going to happen to my points?”

Coworker: “I can switch you, but I don’t know what’s going to happen.”

Customer: “Well, this is stupid! Why do you keep changing it up?!”

(By this point, I finish cashing out my own customer and speak up.)

Me: *to the customer* “Ma’am, I can assure you, the card you’re holding is our current rewards card. I have no idea why he’s lying to you.” *to my coworker* “For God’s sake, don’t do that.”

(My coworker shuts up for the rest of the transaction. After all the customers are cashed out and gone, I confront him.)

Me: “You cannot do that to the customers! What the h*** are you thinking?”

Coworker: “Man, I been doing that, and I’m gonna keep doing it! It’s what keeps me sane here!”

[florida80]

Kids Will Send Any Parent To The Funny Pharm

Pharmacy | Right | January 1, 2013


(I am taking a refill order over the phone.)

Me: “Thank you for calling [pharmacy]. How can I help you?”

Customer: “I need to refill a couple of prescriptions. This one I have the number for.”

(She proceeds to give me the number, and while I am running the prescription through her insurance I hear some kids playing in the background.)

Me: “Okay, so that one went through just fine. What is the next one?”

Customer: “I don’t have the number, but can you look it up for me? It’s my birth control.”

(I look in the customer’s file and sure enough it’s there. But while I am running it, the playing in the background has turned into a serious screaming and fighting match.)

Customer: *embarrassed* “And this is why I am refilling the birth control. Can’t you tell?”

[florida80]

Their Problems Will Only Multiply From Here

Pharmacy | Working | December 10, 2012


(I am training a new girl. One basic of our job involves 3rd-4th grade level math. We are both in our twenties.)

Me: “Okay. They are taking two, four times a day. How long will it last?”

New Girl: “Uh…”

Me: “What’s 2 times 4?”

New Girl: “…12?”

[florida80]

Super-flu-ous Advice

Pharmacy | Right | December 10, 2012


(It’s currently flu season, and we are offering flu shots.)

Me: “Alright, sir. We got you all set. Have you gotten your flu shot yet?”

Customer: “Ah, no. I don’t get a flu shot. I don’t get the flu, sweetie.”

Me: “Wow, you must be lucky.”

Customer: “You want to know my secret, dear?”

Me: “What’s your secret, sir?”

Customer: *leans in close* “You see now, chickens, cows, pigs: they get the flu. So, if you don’t eat them, you don’t get the flu! You remember that now!”

Me: “Um, okay, sir. I will. Have a nice day.”

[florida80]

A Paucity Of Verbosity

Pharmacy | Working | November 25, 2012


(I need to get some prescription medication, and decide to use the opportunity to get some exfoliating cream, which helps remove dead skin.)

Me: “Hi, this is a prescription I need filled. Can you also tell me where you keep the exfoliating creams?”

Cashier: “…The what?”

Me: “Exfoliating creams?”

Cashier: *slowly* “Ex-fooo-liating creams…” *turns to her manager* “What’s exfoliating creams?”

Manager: *to me* “They’re right this way.”

Cashier: “Sorry, I haven’t learnt big words yet!”

[florida80]

Might We Prescribe A New Job

Pharmacy | Working | November 22, 2012


(I’ve just come from the emergency department of the hospital, with instructions to fill two prescriptions immediately. I’m obviously sick and having difficulty breathing. It’s about 9:30 PM, which is 30 minutes before closing.)

Me: “I have a severe corn allergy, so can you please double-check the ingredients on those before filling them?”

Pharmacist: “No.”

Me: “…Pardon? ”

Pharmacist: “Almost all medications are made with corn starch, you know. I don’t think I can fill them.”

Me: “My understanding is that very few prescriptions meds have corn in the them. Can you check them please?”

Pharmacist: “No. I don’t have the ingredients.”

Me: “Aren’t they on the bottle?”

Pharmacist: “No.”

Me: “Can you look them up somewhere? Online or in a compendium?”

Pharmacist: “No.”

Me: “I really need these medications immediately.”

Pharmacist: *sighs* I guess I could leave them for someone tomorrow, and they could call the company.”

Me: “I need them tonight. I’m not sure what to do.”

Pharmacist: “I’m sure you’ll be fine. There’s only a little bit of corn starch in a pill.”

My Husband: “NO! Didn’t you hear her? She’s ALLERGIC!”

Pharmacist: “Well, there’s nothing I can do tonight. I guess I can keep these until tomorrow and someone else will deal with it.” *wanders off*

(I called another pharmacy in the same chain, and they were able to check the ingredients immediately. We retrieved my prescriptions from the unhelpful pharmacist, and my husband made a complaint the next day. It turned out he was a temp and was fired

[florida80]

This Is Why We’re In A Recession, Part 16

Pharmacy | Right | November 13, 2012


Customer: “Excuse me, miss? I’d like a $20 iTunes card, but there are none here.”

Me: “Oh, yes. Unfortunately we haven’t received that shipment yet. But we do have the $10 cards.”

Customer: *frustrated* “But I want a $20 card.”

Me: “Well, ma’am, you could always buy two $10 cards instead.”

Customer: *yelling* “That doesn’t equal 20 dollars!” *storms out of the store*

[florida80]

Discretion Is The Better Part Of Disclosure

Pharmacy | Working | October 10, 2012


Coworker: “Hello, how may I help you?”

Customer: “I need… um…”

(The customer is clearly too embarrassed to speak, so she pulls out a piece of paper and writes what she wants down.)

Coworker: *reads the paper and looks over at me* “HEY, [my name], WHERE DO WE KEEP THE THRUSH CREAM?”

Me: *facepalm*

[florida80]

Contraception Misperceptions

Pharmacy | Right | October 5, 2012


(I am a pharmacist working at 24-hour pharmacy. This takes place on a late Sunday evening.)

Female Caller: “Hello, um… I… um… you know the morning after pill?”

Me: “Yes, certainly. What would you like to know about it?”

Female Caller: “Is there an anti-morning after pill?”

Me: “Sorry? An anti-morning after pill?”

Female Caller: “Yes. You see, this guy, he came around today, and he brought some flowers and everything, so now I’m kind of regretting taking that pill. So is there an anti-morning after pill I could take?”

Me: “No, I’m sorry, there isn’t such a thing.”

Female Caller: “Oh, that is a shame. Do you think they will make one?”

Me: “No, I’m sorry, but I really don’t think they will.”

Female Caller: “Really? Oh, that is a bummer.” *hangs up

[florida80]

Not Quite Registering

Pharmacy | Working | August 25, 2012


(A customer pays with a fifty dollar bill. Spotting it, the pharmacist on duty grabs his wallet and asks the cashier to give him the fifty for two twenties and a ten.)

Coworker: “I can’t do that!”

Me: “Why not? He’s giving you $50 for $50.”

Coworker: “But my till will be wrong!”

Me: “How? You take out the fifty, and put in two twenties and the ten. The totals are still the same.”

Coworker: “But I won’t have the fifty, and the register will KNOW!”

[florida80]

Good Things Come In Small Dosages

Pharmacy | Right | August 15, 2012


(My coworker at the pharmacy has been working with a customer who seems to be having the worst day. Unfortunately, my coworker is the victim of the customer’s mood, and he has reduced the poor girl to tears. Behind this customer is a young father in his mid-20s and his three sons, aged probably six, two, and less than a year old. The young father is clearly upset with the behavior of the customer in front of him, but, probably for the sake of his children, is keeping his mouth shut. Out of nowhere, his six-year-old son speaks up.)

Six-year-old Son: “‘Scuse me, sir? I think you’ll probably get what you need easier in life if you’re nice to people. You’re making the pretty lady sad and she didn’t do anything wrong.”

Customer: *clearly shocked* “Didn’t your father here teach you to mind your own business, son?!”

(The young father is actually grinning proudly, and reaches over to high-five his son.)

Father: “Actually, I taught him not to raise his voice at good, honest people.”

Customer: *clearly embarrassed, pays and leaves quickly*

Six-year-old Son: *to my coworker* “Can I give you a hug? If anyone gives you trouble, call me!”

(My coworker was very impressed by the brave little boy’s actions, while his father proudly teared up. I doubt the family will ever have to pay at our pharmacy again, and my coworker has a new best friend!)

[florida80]

There’s No Business Like My Business

Pharmacy | Right | August 9, 2012


(I work at a well-known retail pharmacy. One night while I’m still new on the job, I’m manning one of the cash registers.)

Woman: “Hi, where is your baking soda?”

Me: “Um, I can’t guarantee that we have baking soda, but if we do, it would be in Aisle 3.”

Woman: *goes off to look for it*

(15 minutes later, the customer comes through my line with her baking soda.)

Me: “Oh, I see you found it! I’m glad we carry it.”

Woman: “If you hadn’t, I would have been very frustrated, and I would never have come here again!”

(I think she’s joking and laugh a bit.)

Me: “Well, I’m certainly glad you found it!”

Woman: *completely serious* “I did that to [other retail store] when they didn’t have lettuce, and they went out of business within a week!”

Me: *pause* “Um… I’m REALLY glad you found the baking soda, then.”

[florida80]

A Knight In Patrolling Armor

Pharmacy | Right | August 2, 2012


Me: “So, your total is going to be of 30 thousand colones (60 USD). Here you go, and have a nice day.”

Customer: “Oh, you’re so nice. Thank you, too. I was wondering if you could do something else for me?”

Me: “Sure, what is it?”

Customer: “I was told at my church that they needed more members, and I was asked to bring a few. Would you mind to come?”

Me: “Well, I apologize, but I wouldn’t like to.”

Customer: *gets defensive* “Why? Don’t tell me you think we’re all cultists that don’t care about God!”

Me: “I’m sure you’re not, but I don’t want to go.”

Customer: “Why the h*** not, then? I already told you we’re nice people, so why don’t you go?!”

Me: “Ma’am, if I offended you I apologize, however I don’t want to go. It’s not because you’re nice people or not; it’s because I’m an atheist.”

Customer: “So, you don’t believe in God, is that it? Well, f*** you! You’re going to Hell! What are you going to tell me next, that you’re a f***ing queer?”

Me: “In fact, I am a homosexual, but—”

Customer: “That’s all I needed to know! Being gay is a sin!”

Me: “Ma’am, I’m going to have to ask you to leave.”

Customer: “F*** no! You’re kicking me out because I’m a Christian! That’s illegal, and it’s bulls***!”

(At this point, a man behind her speaks up. Note that he is a police officer in full uniform.)

Officer: “No, he’s kicking you because you already paid and you’re disturbing the peace. So, I’m going to give you my recommendation: Leave now, or I’ll arrest you.”

Customer: *suddenly pales and leaves without saying a word*

Me: “Thank you very much, Officer. Now, how may I help you?”

Officer: “Actually I didn’t need anything. I was just patrolling when I heard the conflict. However, now that you mention it…” *he blushes a little* “…I need to ask, would you go out in a date with me?”

Me: “…Of course!”

(The officer and I have now dating for nearly half a year.)

[florida80]

Never Say No To La Novia

Pharmacy | Right | July 10, 2012


(I am watching my girlfriend’s two-year-old sister near the counter while she does her shopping. Her sister is learning to talk in Spanish, so I’m quizzing her with colors. While we’re playing, a seven-year-old girl approaches us and asks to play because she takes Spanish at school. Everything is fine until the girl’s mother comes.)

Mother: “Leona, what are you doing? You know not to bother people.”

Me: “Oh, she’s not, ma’am. She just asked to play with me and my girlfriend’s sister.”

Mother: “Girlfriend?” *thinks for a few moments* “Oh, a close friend! Sorry, I was thinking you meant a girl you were dating.”

Me: “I did. I am dating a girl. This little girl is her sister and your daughter was just playing with us. She wasn’t bothering us.”

Mother: “What?! Leona, you were playing with a homo?!? Come over here, right now!”

(In tears, the girl slowly approaches her mother, who yells at her about how she knows better than to interact with “h***-bound sinners” like me. She then chides me for “sinning” around such a small child, referring to my girlfriend’s sister. While I’m speechless, a man comes up, who I assume is the girl’s father.)

Father: *to the mother* “I got the rest of the stuff. What are you yelling about?”

Mother: *to her daughter* “Tell Daddy what you did!”

(In hysterics, the girl tells her father what happened, ending her telling by clinging to his leg and apologizing over and over. I’m feeling dreadful and very guilty and am near tears myself. But to my surprise, this happens.)

Father: *to the mother* “Are you serious?! What is wrong with you?! I don’t even know why I came out with you! Just go wait in the car! Sheesh!”

(The mother, now apparently embarrassed, exits the store. The father calms his daughter down and apologizes to her and me before leaving. Right after they leave, my girlfriend comes up, having seen the whole thing.)

My Girlfriend: “I actually know that family. The father moved in next door to me two weeks ago. That girl’s parents are divorced and her parents have joint custody of her, but today is her birthday and she wanted to be with both of them together. They said yes to make her happy, but I don’t think that’ll happen again.”

(A few weeks later, my girlfriend tells me the father got full custody of his daughter. Now, she and my girlfriend’s sister play together on a daily basis, and I occasionally help her with her Spanish homework.)

[florida80]

No Scan, No Scam

Pharmacy | Right | July 10, 2012


(I work in a store in a small town where most of the customers are elderly and sweet. If a price doesn’t come up, I will generally trust a customer if they say they know the exact price.)

Me: “Oh, there’s no bar code on this.”

Customer: “Well, it was $39.99, but I guess that doesn’t help you.”

Me: “Well, I can enter it manually. You’re sure it was $39.99?”

Customer: “Actually, it was…$19.99.”

Me: “Sir, do you really want me to call for a price check and make you and all the people behind you wait ten minutes for someone to come up here?”

Customer: *defeated* “…It was $39.99.”

[florida80]

Not Ever Working

Pharmacy | Working | July 9, 2012


(The pharmacy I work at has just lost several techs at once, so we’ve hired a few new people. One of these new coworkers isn’t working out at all.)

Pharmacist: “Hey, could you help out in the front for a minute? I think [coworker who isn’t working out] could use a hand.”

Me: “Sure. Hi, [regular customer], what can I do for you?”

Regular Customer: “Oh good, I’m trying to get a refill.”

New Coworker: *to Regular Customer* “I keep telling you, you don’t have any!”

Me: *to Regular Customer* “Let me just check on it for you.”

New Coworker: *to me* “Why? I already told him he didn’t have one.”

Me: “Actually, he has enough refills for the rest of the year. What are you looking at?”

New Coworker: “No, you’re wrong. I know what I saw!”

Regular Customer: “I knew I had some..I was starting to think I was going to have to call my doctor. Thank you so much, [my name]!”

New Coworker: *to Regular Customer* “You need to leave right now. GET OUT!”

Me: *to New Coworker* “Whoa, what do you think you’re doing? You do not have ANY authority to kick a patron out.”

New Coworker: “He’s being unruly.”

Me: “What? No, he’s not. You’re just being rude.”

New Coworker: “No, you’re just trying to make me look stupid. I know exactly what I saw.”

(I examine my new coworker’s computer screen.)

Me: “You were looking at the wrong person.”

New Coworker: “No, I wasn’t!”

Me: “Sorry, but the name on your screen is a woman’s. [Regular Customer] is a man. It happens.”

New Coworker: “You changed it!”

Regular Customer: “Are you kidding me? Listen kid, you were wrong. It’s not that big of a deal. It happens. Just man up already.”

New Coworker: “You, shut up! I’m not talking to you, old man!”

(The pharmacist has been listening to the entire conversation. He decides he’s had enough.)

Pharmacist: *to New Coworker* “Get over here, right now!”

New Coworker: *rudely* “I’m BUSY! I’m trying to work, but—”

Pharmacist: “Get your stuff. You’re fired.”

New Coworker: “You can’t fire me!”

(At this point, the store manager also comes over.)

Store Manager: “I can. Get your stuff. You are not longer employed here.”

New Coworker: “YOU CAN’T FIRE ME! I DIDN’T DO ANYTHING WRONG! YOU PEOPLE ARE JUST TRYING TO MAKE ME LOOK STUPID!”

Regular Customer: “No one has to try and make you look stupid, son. You’re doing a fine job of that all by yourself.”

(My coworker carried on and screamed obscenities. We ended up having to call the police to remove him from the store

[florida80]

Unfiltered








Plz Change Abbrev, Stat

Pharmacy | Right | July 9, 2012


(If a customer gets regular medication from a pharmacy, they can have a Medicine Use Review (MUR). It’s basically talking through their meds with a pharmacist. I answer this call from a sweet elderly caller.)

Me: “Hello, pharmacy.”

Customer: “Um hello, someone just delivered my medicine. The bag has a sticker on it that says “Patient eligible for MUR.” What it is MUR?”

Me: “It stands for “Medicine Use Review,” which involves discussing your medicines with the pharmacist. However, those labels are meant for our reference, so I apologise that it’s been put on your bag by mistake. Sorry if it caused confusion.”

Customer: “Oh, that’s alright, dear. I just thought MUR might be short for murder!”

Me: “Er no, ma’am! Don’t worry, no one is going to murder you!”

Customer: “Oh, good! Thank you very much

[florida80]

Feeling Man-strual

Pharmacy | Right | June 24, 2012


(I am working the prescription counter when a big, burly 6-foot or so tall man comes to the counter. Note: I am a female.)

Me: “Hello, how can I help you?”

Customer: “Um, I think…” *trails off*

Me: “I’m sorry, sir…could you say that again?”

Customer: *leans in close* “I think I got my first period.”

Me: *speechless*

Customer: “I’m bleeding down there, and I’m really hurting in my stomach.”

Me: “Sir, men don’t get those. You need to go to the hospital.”

Customer: “I knew you girls would be insensitive! I’m leaving!”

(I didn’t see him again. I still hope he got to a hospital!)

[florida80]

Employees Are Sharper Than You Think

Pharmacy | Right | June 20, 2012


(Pharmacy law in Utah says that it’s up to the pharmacist’s discretion if they want to sell insulin needles/syringes without a prescription. Our store has the policy that the patient either has to have a prescription for the syringes or for an injectable medication on file.)

Customer: “I need to get some syringes.”

Me: “Okay, I need your name so I can look up the prescription.”

Customer: “Actually, they’re not for me. They’re for my mom.”

Me: “Okay, what’s her name?”

Customer: “Well, not my mom. My best friend’s mom who’s like a mom to me.”

Me: “What’s her name?”

Customer: “Actually, it’s for her dog.”

Me: “What’s the dog’s name?”

Customer: “I…don’t know.”

Me: “Then I’m not selling you any syringes.”

Customer: *walks away in defeat*

[florida80]

Contextual Innuendos

Pharmacy | Right | June 19, 2012


(I’m at work on a Saturday with a clerk and a pharmacist. I notice the clerk speaking with an elderly woman out front but don’t think much of it. A few minutes later, the clerk comes back with a strange expression on her face and tells me I have to go help the woman.)

Me: “What can I help you with?”

Customer: “I’m looking for a vibrator.”

Me: “A…vibrator?”

Customer: “Yes. I had one, but I used it too much and it wore out.”

Me: “I don’t think we have anything like that. Where did you buy the first one?”

Customer: “At another pharmacy, but I want one with a long handle so it can reach better.”

(At this point I’m biting the inside of my cheek in an effort not to laugh.)

Me: “What kind of vibrator are you looking for, exactly?”

Customer: “You know! One of those that rub your feet!”

Me: “OH! Sorry, we don’t have anything like that.”

[florida80]

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Not Lacking For Laxatives

Pharmacy | Right | June 17, 2012


Me: “**** Pharmacy, how can I help you?”

Customer: “Yeah, I gotta question for you: I drank a whole thing of prune juice like water, and now I’m s***ing my brains out.”

Me: “Okay, and what did you need to know?”

Customer: “Is your generic of ducolax the same thing?”

Me: “Yes. Same thing.”

Customer: “Okay, good, because I’m gonna need a plug soon or something!”

[florida80]

Getting Burned Can Be A Pain In The Butt

Pharmacy | Right | June 15, 2012


(It is a very windy day during summer, and a power line has blown over in the field behind our store.)

Me: “Hello, [pharmacy] how may I help you?”

Customer: “I need to see if you have [hemorrhoid cream] in stock.”

Me: “Alright, let me check…”

(At this point, I put him on hold to check our stock when a fireman walks in. He tells us they are evacuating all the buildings in the area, and that we have 5 minutes to get out. I go back to pick up the phone so the customer isn’t on hold forever.)

Me: “Sir, we do have it in stock. However, I can’t help you right now. I’m being told to evacuate the building.”

Customer: “Does it have aloe vera in it?”

Me: “I don’t know. As I said, I need to hang up. Please call back tomorrow.”

Customer: “Can you see if you can order it for me?”

Me: “Sir, there is a field fire right behind the pharmacy and I really can’t answer your questions right now. I was told by the fire department to evacuate. Please, call back another time.”

Customer: “Well, fine then. I’ll just get it somewhere else!” *hangs up*

[florida80]

Unfiltered








Out Of Brain Cells

Pharmacy | Working | May 22, 2012


(At the pharmacy where I work, I do a lot of training of new employees. This day’s trainee is particularly slow on the uptake.)

Me: *to new employee* “Now, when the customer pays in cash and just hands you a bill, you should repeat back to them how much they gave you. For example, when a customer gives you a $20 bill, you say, ‘Out of $20,’ as you make change.”

(This is a technique to help avoid after-the-fact disputes about the denomination of the bills customers hand over.)

New Employee: “Got it.”

(The customer walks up and pays cash, handing him a $20. The new employee says nothing.)

Me: *to new employee* “What are you forgetting?”

New Employee: “Um…”

Me: “Say the amount they gave you.”

New Employee: “Oh, right…”

(The next three customers all pay cash, and as they each fork over a crisp clean $20 bill, the new employee performs flawlessly, verifying that it is indeed “Out of $20” with each transaction. I think he’s finally gotten it down until the fourth customer.)

New Employee: “That will be [price].”

Customer #4 (https://www.vietbf.com/forum/usertag.php?do=list&action=hash&hash=4) : *hands over credit card*

New Employee: “Out of $20!”

Me: *facepalm*

[florida80]

Time To Start Screening Customers

Pharmacy | Right | May 19, 2012


(A customer slams a bottle of sunblock on the counter.)

Customer: “This is worthless! I can’t believe you sell this!”

Me: “I’m sorry to hear that, sir.” *examines the empty bottle* “But this is the highest protection factor we have.”

Customer: “Well, it’s crap! I want a refund!”

Me: “Sorry, I can’t refund an empty bottle; it’s store policy.”

Customer: “Well, what do you expect?! I have two large windows!”

[florida80]

A Game Of Kat And Birdie

Pharmacy | Right | April 5, 2012


(I work at a pharmacy and we are very busy, causing a few customers having to wait. The last woman in line finally steps up.)

Me: “I apologize for your wait. How can I help you?”

Customer: “Does your name tag say your name is Kat?”

Me: “Yes, ma’am, how can I help you?”

Customer: “Did you have some crazy new age parents or something? Why would they name you after an animal? That’s just dumb! You should have a good sturdy name, like mine!”

Me: “I’m sorry, ma’am, but what can I help you with?”

Customer: “I need a refill.”

Me: “Of course. Can I get your date of birth?”

Customer: *gives me her date of birth* “And the prescription is under Birdie.”

Me: “Okay, it’s put in and will be ready in 15 minutes.”

Customer: “Thank you. I’m sorry you have such a foolish name.”

Pharmacist: “Did that woman just tell you your name was foolish and complain about people with “animal” names?”

Me: “Yeah.”

Pharmacist: “But her name was Birdie…”

[florida80]

Less Is More, More Or Less, Part 3

Drug Store, Pharmacy | Right | March 30, 2012


(Our store regularly runs a promotion on the various vitamin brands for ‘BOGO’, buy 1, get 1 free. A customer comes up to the register with a bottle of a brand on the BOGO promotion. I am also an avid couponer and I regularly take in coupons for items we carry that I won’t use so that I can give them to customers.)

Me: “Sir, I see you’re buying a [brand] item. This week we currently have this whole line at Buy One, Get One Free. If you do get another one, I also have a coupon I can give you which is good for $2 off two items. So instead of getting one for $9.99 you can get 2 for eight bucks and change.”

Customer: *quite angrily* “What the h*** is wrong with you people? I just want my vitamins. Why are you always trying to push me to buy extra stuff and give you more money!?”

Me: “I’m…sir, I apologize. I probably wasn’t clear you’ll get twice as many vitamins and spend two dollars less—”

Customer: “Oh f*** this. You’re all scam artists!” *storms off without paying*

Me: *stares in disbelief*

Next Customer:“So…can I use that coupon?”

[florida80]

No Pain, No Vain

Pharmacy | Right | March 29, 2012


(A customer comes in to return a home leg waxing kit.)

Me: “Can I ask why you are unsatisfied with this product?”

Customer: “It hurts!”

Me: “Yes, because waxing involves ripping the hair out by the roots.”

Customer: “Well, it shouldn’t hurt!”

[florida80]

You Better Belize It

Pharmacy | Right | March 19, 2012


(I live in Belize. A lot of tourists think they can get away with anything in my country. One day, a foreigner walks into the store.)

Customer: “Can I get some Diazepam?”

Me: “Do you have a prescription?”

Customer: *tries to look bewildered* “Do I need one?”

Me: “Yes, especially since it’s a controlled substance.”

Customer: “It is?” *scoffs* “Well I didn’t know that. Some Xanax, then.”

Me: “That is a controlled substance too. Valium, Xanax, alprazolam, lorazepam, diazepam…they’re all controlled.”

Customer: “Well, then!” *hurriedly walks out of the store*

[florida80]

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Why You Always Bring Your Own Dinnerware

Pharmacy | Right | March 3, 2012


(An elderly lady approaches the counter.)

Me: “Can I help you?”

Customer: “Yes, I need some dish bags.”

(Unaware of what dish bags are, I assume she means dish rags.)

Me: “I’m not sure what that is and if we carry it. I would look in the cleaning section.”

Customer: “Well, my doctor said I could get it here.”

Me: “Okay, well I would check that aisle.”

(The customer leaves and returns after a couple minutes.)

Customer: “I didn’t find them!”

Me: “Can you tell me again what it is you need?”

Customer: “Dish bags.”

Me: “And you say your doctor told you to get them here?”

Customer: “Yes!”

Me: “Well, I’m sorry. I’ve never heard of dish bags and I don’t believe I’ve seen anything like that here.”

Customer: “Well, this is ridiculous! What am I going to do?”

Me: “I’m sorry, ma’am, would you like me to ask our pharmacist about them?”

Customer: “Yes!”

(I go get the pharmacist to assist me.)

Pharmacist: “So, what is a dish bag used for?”

Customer: “Jeeze! You clean your lady parts with it!”

[florida80]

Perhaps There’s Insufficient Blood To Your Brain

Pharmacy | Right | February 24, 2012


(We have a free self-use blood pressure machine in our pharmacy.)

Customer: “When are you going to fix your blood pressure machine?”

Pharmacist: “Excuse me?”

Customer: “Your blood pressure machine is broken. Every time I come in here, it doesn’t work! You should really take care of it. Lots of old people need to check their blood pressure, you know!”

Me: “Are you sure? I just filled the paper roll the other day. It was working fine.”

Customer: “No, it’s not! I’ve been trying to use it for days. It’s not working. You should really take care of it!”

(I take a look at the machine and try to troubleshoot the problem. I sit in the seat, roll up my sleeve, put it in the cuff, and push the big green “Start” button. The cuff inflates normally.)

Customer: “You mean you’re suppose to push that button?!”

[florida80]

Weekend Roundup: Don’t Mess With Employees

Fast Food, Gun Store, Pharmacy, Tech Support | Right | February 19, 2012


Introducing Weekend Roundups: each week, we’ll be featuring some of our favorite stories from the Not Always Right archives.

Don’t Mess With Employees! This week, we feature five stories that teach misbehaving customers the consequences of messing with employees.
1.In Real Hot Sauce Now:
A young teenage employee decides her dignity is worth more than £3.71 and dealing with a cowardly manager.

2.A Good Ol’ Fashioned A** Whoopin’:
A customer tries to rough up an employee, but ends up getting roughed up by the manager instead.

3.Hard Drugs And Harder Pharmacists:
Teenage robber, meet Doug. Doug is our new pharmacy tech. Doug is also built like a fridge.

4.Who’s Got The Power Now:
Tech support is happy to support your technology. Supporting your potty mouth, not so much.

5.Your Prank Got Spanked:
A prank caller picks the wrong, well-armed store to call.

[florida80]

A Dose By Any Other Name

Pharmacy | Right | February 3, 2012


Customer: “Hey, I want some Tylenol.”

Me: “For children or for adults?”

Customer: “For adults.”

Me: “At the moment, we only have the generic kind available. You know, paracetamol, also known as acetaminophen?”

Customer: “No! I don’t want any acetaminophen! Give me the other one!”

Me: “Ma’am, they are the same thing, just different names for the same ingredient.”

Customer: “Well, I just want the first one you named. Just don’t give me the other one.”

[florida80]

Harvested From The Great Nyquil Tree

Pharmacy | Right | January 25, 2012


Patient: “Hi, my 6-month-old grandson has some congestion in his nose and a fever. I gave him some NyQuil yesterday and that seemed to help. Is there anything you would recommend?”

Me: “For the congestion, you can use these saline drops, they’re–”

Patient: “No! I don’t wanna use that medicated stuff.”

Me: “All right. Well, for the fever you can try this Tylenol. Do you know the wei–”

Patient: “No! I don’t want to use that! It has acetaminophen in it! That’s not safe for babies.”

Me: “Actually, acetaminophen is quite safe for infants.”

Patient: “You’re a pharmacist. You would say that!”

Me: “Well, the only other option is the Advil.”

Patient: “That has acetaminophen too!”

Me: “No, that has ibuprofen. Which is also saf–”

Patient: “No, it isn’t!”

Me: “Are you aware that NyQuil has acetaminophen in it?”

Patient: “You lie! NyQuil has NyQuil in it! Isn’t there anything more natural I can give?!”

Me: “No.”

Patient: “You’re useless!” *storms off

[florida80]

It’s The Small Victories

Pharmacy | Right | January 21, 2012


(I’ve been working for a quite a while, so my voice is scratchy. Near the end of my shift, an old man comes to the counter.)

Customer: “Hm. You’re losing your voice there, eh?”

Me: “Haha. A little bit, I suppose.”

Customer: “Well, that’s the end of the world for a woman.”

Me: “Ha ha…” *confused as to where he’s going with this*

Customer: “HAHAHA, YOU CAN’T YELL AT ME!” *does a victory dance*

[florida80]

The Horrors Of Mispronunciation, Part 5

Pharmacy | Right | January 2, 2012


Customer: “Do you have any fecal heart monitors?”

Me: “Uh…what?”

Customer: “You know, to hear the baby while it’s still in the womb?”

Me: “That would be a fetal heart monitor. Right this way…”

[florida80]

Photo-synthesise A Cure

Pharmacy | Related | December 17, 2011


(A mother has her sick three-year-old with her. She needs help finding medicine.)

Me: “What symptoms are you trying to treat?”

Mother: “Well, her nose…and, um, her eyes, uh…Hang on.”

(The customer digs in her purse and pulls out a photo.)

Mother: “Here’s a picture of what my daughter normally looks like, and look at her now. She’s really sick. What do you recommend

[florida80]

A Real Pain In The Rear

Pharmacy | Right | December 14, 2011


(An elderly gentleman approaches me at the counter.)

Me: “How may I help you, sir?”

Customer: “My butt hurts! I need medicine!”

Me: “All right, do you have a prescription? Or, can you tell me what exactly is wrong so that I can recommend you something that doesn’t need one?”

Customer: “I don’t know what’s wrong. But my butt hurts!”

Me: “Please go see a doctor then, sir. Without knowing what causes your pain, there’s little I can do.”

Customer: “But I don’t want to wait at the doctor’s together with all the sick people! I’ll catch a disease or something!”

Me: “That’s understandable. Maybe you could go early in the morning when fewer people are there?”

Customer: “No! I don’t want to! I want you to tell me what’s wrong! Look at my butt!”

Me: “Sorry, sir, but we don’t do that–”

(The man doesn’t listen. In front of me and three other customers, he drops his pants and underwear, turns around and sticks out his butt in my direction.)

Me: “Sir, please pull up your pants again! I can’t tell what’s wrong and you will have to leave if you don’t stop that!”

Customer: “Nonsense! If you can’t tell what’s wrong from over there, come closer and get a better look!”

(My boss then comes to look at what’s going on and ends up kicking the guy out.)

Customer: *on the way out the door* “Why will no one look at my butt?!”

[florida80]

A Warm And Full(filling) Night In

Pharmacy | Right | December 9, 2011


(A man in his mid-30’s approaches the register. I notice that he looks a little grumpy about something.)

Me: “Hello!”

Customer: “Hi.”

(It is at this point that I notice that he only has two items to ring up: a 20oz bottle of soda and an enema.)

Me: “How are you today?”

Customer: “I’m holding an enema, what do you think?!”

Me: *speechless*

(I ring him up silently. Poor guy, I hope he feels better!)

[florida80]

D Is For Definitely Shiny

Extra Stupid, Holidays, New Jersey, Pharmacy, Retail, USA | Right | November 16, 2011


(A customer walks to my register with a Halloween decoration in tow. It’s a cheap cardboard statue of a cartoon-looking black cat covered in a shiny plastic material.)

Customer: “So, why is this 3D?”

Me: “Excuse me?”

(I peer at the tag. It says “3D Cat.”)

Me: “Oh, that’s because it’s 3D.”

Customer: “No, I mean why is it ‘D’? Is it because it’s shiny?”

(A multitude of thoughts are racing through my head at this point. I debate the prospect of explaining to her what 3D actually means. In the end, I decide it’s easier to just agree with her.)

Me: “Exactly! It’s really sparkly and that’s why it’s called a 3D cat. Would you like to purchase it?”

Customer: “Oh, definitely!”

[florida80]

What’s Your Poison

Pharmacy | Right | November 15, 2011


(I’m a pharmacist in a rural area. A shop assistant calls me out from the dispensary to talk to a customer, who is a slightly intoxicated middle aged woman.)

Customer: “This medicine made my partner sick! Violently sick!”

Me: “Let me see. Has he had any alcohol?”

Customer: “No.”

Me: “Are you sure? Not even a little?”

Customer: “He doesn’t drink. Maybe only a little, but he wasn’t drunk.”

Me: “It clearly says on the label that you must not drink any alcohol while being treated with this medicine.”

Customer: “But he didn’t drink much at all. A beer shouldn’t matter, should it?”

Me: “It contains enough alcohol to–”

Customer: “But, like, you can even drive if you only drink a beer!”

Me: “That has nothing to do with–”

Customer: “I think he’d better not take this medicine. It made him violently sick!”

Me: “I think he should–”

Customer: “Thanks, I’ll tell him what you said. This medicine is a poison!” *turns around and walks out*

[florida80]

Have You Tried Dihydrogen Monoxide, Part 3

Pharmacy | Right | November 9, 2011


(I am standing in line at the pharmacy counter and a man rudely cuts in front of me, stating that he has been waiting in line, just in another part of the store. He assures me he’ll be quick, but I don’t buy his excuse. The following exchange occurs between him and the pharmacist.)

Customer: “I need to speak to a pharmacist immediately.”

Pharmacist: “Do you have a question about your medication?”

Customer: “Yes, it says on the bottle to take with water. I don’t drink water. Water makes you fat.”

Pharmacist: “Um, water is essential for your body, especially with those pills.”

Customer: “What about water retention? Will I just pee it out, then?”

Pharmacist: “Yeah, your body will eventually eliminate it. You should drink water, though. Your body needs plenty of water to work well, and you really don’t want to be dehydrated while on this drug.”

Customer: “Okay, I’ll try it. Oh, and one more question. What about alcohol? Can I still have my alcohol?”

[florida80]

Have You Tried Dihydrogen Monoxide, Part 3

Pharmacy | Right | November 9, 2011


(I am standing in line at the pharmacy counter and a man rudely cuts in front of me, stating that he has been waiting in line, just in another part of the store. He assures me he’ll be quick, but I don’t buy his excuse. The following exchange occurs between him and the pharmacist.)

Customer: “I need to speak to a pharmacist immediately.”

Pharmacist: “Do you have a question about your medication?”

Customer: “Yes, it says on the bottle to take with water. I don’t drink water. Water makes you fat.”

Pharmacist: “Um, water is essential for your body, especially with those pills.”

Customer: “What about water retention? Will I just pee it out, then?”

Pharmacist: “Yeah, your body will eventually eliminate it. You should drink water, though. Your body needs plenty of water to work well, and you really don’t want to be dehydrated while on this drug.”

Customer: “Okay, I’ll try it. Oh, and one more question. What about alcohol? Can I still have my alcohol?”

[florida80]

Take Two Werewolves And Call Me In The Morning

Pharmacy | Right | November 8, 2011


(I have just given a customer his prescription and am explaining to him the directions.)

Me: “So, just take two of these with water at night.”

Customer: “Okay, thanks. Wait, I work at night…should I take these in the day time?”

Me: “Yes, just take them before bed.”

Customer: “Okay, so they aren’t activated by the moon or anything?”

Me: “No.”

Customer: *slight disbelief* “Hmm, okay…” *turns around and leaves*

[florida80]

I’ll Take An Album Cover For 7000

Pharmacy | Right | November 4, 2011


(I work in the OTC section of a well-known pharmacy chain. I’m stocking the shelves in an aisle when a customer approaches me.)

Customer: “Excuse me. I’ve looked all over here. Where are your hemorrhoid wipes?”

Me: “Oh, those are actually down on Aisle 20.”

Customer: “Really? Why are they over there and not in this aisle with the rest of the anal care?”

Me: “I’m sorry, what?”

Customer: “Anal care!” *points at the aisle’s sign*

(The sign she was pointing at? “Analgesics”.)

[florida80]

Like There’s No Tomorrow

Pharmacy | Right | October 24, 2011


(A customer has called to ask if we carry an over the counter soap in our store.)

Me: “Hello, ma’am? I just checked and we do carry [brand] soap. However, we are all out of stock right now, but we could order some for you and it would come in tomorrow.”

Customer: “You don’t carry [brand]?”

Me: “We do carry it. We just don’t have it in right now.”

Customer: “Well, why not?”

Me: “Because other customers have purchased it. But we can order some for tomorrow.”

Customer: “Well, how long will that take?”

Me: “It’ll come in tomorrow.”

Customer: “So, how many days will that be?”

[florida80]

They’re Right Next To The Abacus Tablets

Pharmacy | Right | October 10, 2011


(I’m working behind the counter one morning when an older customer and her son approach.)

Customer: “I’ve been really itchy lately. I need something for the itch. My son used algebra tablets last time.”

Me: “Well you could use an allergy tablet, but you can’t if you have high blood pressure.”

Customer: “I have high blood pressure but this itching is terrible. Can you show me the algebra tablets?”

Me: “I can’t recommend the allergy tablets, then. It could interact with your medicine.”

Customer: “I know, but my son had algebra tablets last time and they helped with the itching.”

Me: “Yes, the allergy tablets would interact though. So I can’t recommend those.”

Customer: “Which of these algebra tablets would you recommend?”

Me: *gives up* “The pink box.

[florida80]

Have You Tried Dihydrogen Monoxide, Part 3

Pharmacy | Right | November 9, 2011


(I am standing in line at the pharmacy counter and a man rudely cuts in front of me, stating that he has been waiting in line, just in another part of the store. He assures me he’ll be quick, but I don’t buy his excuse. The following exchange occurs between him and the pharmacist.)

Customer: “I need to speak to a pharmacist immediately.”

Pharmacist: “Do you have a question about your medication?”

Customer: “Yes, it says on the bottle to take with water. I don’t drink water. Water makes you fat.”

Pharmacist: “Um, water is essential for your body, especially with those pills.”

Customer: “What about water retention? Will I just pee it out, then?”

Pharmacist: “Yeah, your body will eventually eliminate it. You should drink water, though. Your body needs plenty of water to work well, and you really don’t want to be dehydrated while on this drug.”

Customer: “Okay, I’ll try it. Oh, and one more question. What about alcohol? Can I still have my alcohol?”

[florida80]

Take Two Werewolves And Call Me In The Morning

Pharmacy | Right | November 8, 2011


(I have just given a customer his prescription and am explaining to him the directions.)

Me: “So, just take two of these with water at night.”

Customer: “Okay, thanks. Wait, I work at night…should I take these in the day time?”

Me: “Yes, just take them before bed.”

Customer: “Okay, so they aren’t activated by the moon or anything?”

Me: “No.”

Customer: *slight disbelief* “Hmm, okay…” *turns around and leaves

[florida80]

I’ll Take An Album Cover For 7000

Pharmacy | Right | November 4, 2011


(I work in the OTC section of a well-known pharmacy chain. I’m stocking the shelves in an aisle when a customer approaches me.)

Customer: “Excuse me. I’ve looked all over here. Where are your hemorrhoid wipes?”

Me: “Oh, those are actually down on Aisle 20.”

Customer: “Really? Why are they over there and not in this aisle with the rest of the anal care?”

Me: “I’m sorry, what?”

Customer: “Anal care!” *points at the aisle’s sign*

(The sign she was pointing at? “Analgesics”.)

[florida80]

Like There’s No Tomorrow

Pharmacy | Right | October 24, 2011


(A customer has called to ask if we carry an over the counter soap in our store.)

Me: “Hello, ma’am? I just checked and we do carry [brand] soap. However, we are all out of stock right now, but we could order some for you and it would come in tomorrow.”

Customer: “You don’t carry [brand]?”

Me: “We do carry it. We just don’t have it in right now.”

Customer: “Well, why not?”

Me: “Because other customers have purchased it. But we can order some for tomorrow.”

Customer: “Well, how long will that take?”

Me: “It’ll come in tomorrow.”

Customer: “So, how many days will that be?”

[florida80]

They’re Right Next To The Abacus Tablets

Pharmacy | Right | October 10, 2011


(I’m working behind the counter one morning when an older customer and her son approach.)

Customer: “I’ve been really itchy lately. I need something for the itch. My son used algebra tablets last time.”

Me: “Well you could use an allergy tablet, but you can’t if you have high blood pressure.”

Customer: “I have high blood pressure but this itching is terrible. Can you show me the algebra tablets?”

Me: “I can’t recommend the allergy tablets, then. It could interact with your medicine.”

Customer: “I know, but my son had algebra tablets last time and they helped with the itching.”

Me: “Yes, the allergy tablets would interact though. So I can’t recommend those.”

Customer: “Which of these algebra tablets would you recommend?”

Me: *gives up* “The pink box.”

[florida80]

One’s Green And The Other Makes You Green

Pharmacy | Right | October 10, 2011


Customer: “Hi, I’m calling to see if you have cholera pills in stock.”

Me: “I beg your pardon? Cholera is a contagious disease.”

Customer: “No, it’s not! I’m looking for cholera pills!”

Me: “Um, do you mean the natural supplement Chlorella?”

Customer: “That’s what I said! Cholera! It’s spelled C-H-L-O-R-E-L-L-A. Cholera. I am looking for a large bottle if you have it.”

Me: *gives up* “Yeah, sure. We happen to have a few bottles of cholera in stock.”

Customer: “I’ll be there in five minutes!”

[florida80]

Run Artificial Stupidity Program

Pharmacy | Right | September 27, 2011


(Our pharmacy phone system is down, so all pharmacy calls are going through the main line, which is answered by me. These calls include people trying to reach the automated prescription line.)

Me: “Thanks for calling [store], where we offer flu shots every day. This is [name]. How may I help you?”

Customer: “You’re not a machine.”

Me: “No. If you were trying to reach the automated line, the phones are down. I can connect you to the pharmacist.”

Customer: “I want the automated system. People are dumb!”

[florida80]

Not So Modest Aspirations

Pharmacy | Right | August 25, 2011


(I’m speaking with a three year old girl as I serve her mother.)

Me: “Do you like the pharmacy? Do you think you will be a pharmacist when you grow up?”

Girl: “No! I will be a dancer!”

Me: “Oh, a dancer! That’s nice! Like in a dance group?”

Girl: “No! On the pole!”

[florida80]

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Cost-Benefit Analysis

Auto Shop, Pharmacy | Right | August 25, 2011


(A customer comes in to pick up his Viagra prescription. I’m trying not to be awkward and ring him up as if it’s any other order.)

Me: “Hi, how may I help you?”

Customer: “My name is [name]. I need to pick up my prescription.”

Me: “That will be just a moment.”

(I get the man’s prescription and proceed to ring him up for it.)

Me: “Your total today comes out to [price].”

Customer: “What?!”

Me: *I repeat the price*

Customer: *mumbles* “Still cheaper than a hooker, I guess.” *pays and leaves*

[florida80]

Sleepless Sleep Aids

Pharmacy | Right | August 24, 2011


(A woman comes to the counter.)

Me: “Hello, how can I help you?”

Customer: “I see you’ve got [sleep aid]. Does it come in a non-drowsy version

[florida80]

Two Halves Make A Hole In Your Brain

Pharmacy | Right | August 22, 2011


Me: “Thank you for calling the pharmacy, how can I help you?”

Customer: “I’d like you to check how much my prescriptions are. My name is [name].”

Me: “You have two prescriptions waiting for you. Each one is $2.50.”

Customer: “So, how much does each one cost?”

Me: “$2.50 each.”

Customer: “So, one is $2.50. How much is the other one?”

Me: “Each of your two prescriptions is $2.50.”

Customer: “So, if I give you $5, how much will my change be?”

Me: “Nothing.”

Customer: *hangs up*

[florida80]

Recipe For Disaster

Pharmacy | Right | July 14, 2011


(A customer comes up to the pharmacy counter. Keep in mind, Sudafed (pseudoephedrine) is controlled in all 50 states as it is used to make methamphetamine.)

Customer: “I need some Sudafed.”

Me: “Did you want Sudafed or [store brand]?”

Customer: “What’s the difference?”

Me: “The active ingredient is the same but sometimes they change the inactive ingredients. It still works the same though. Plus, [store brand] is about 5 bucks cheaper.”

Customer: “The recipe said I need Sudafed.”

Me: “…”

Customer: *realizing what she said* “Um, s***. Never mind, I got to go.”

[florida80]

Zombies Need Lawyers Too

Pharmacy | Right | June 17, 2011


Me: “Ma’am, unfortunately we are waiting on your prescriber to contact the pharmacy because parts of your prescription were unclear.”

Customer: “Are you telling me my prescription is not ready?”

Me: “Yes, it is not ready.”

Customer: “Well, if I die, I’m suing you!”

[florida80]

The Purchase Was A Pre-Medicated Decision

Pharmacy | Right | May 23, 2011


(I am closing the pharmacy curtain. A customer comes up to the counter.)

Customer: “I need to pick up my prescription for my pain medication. I’m in a lot of pain.”

Me: “Okay. Just for future reference, the pharmacy closes at 9pm.”

Customer: “I know. I was too busy getting an iPhone to get here while you were open.”

[florida80]

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This Medicine Doesn’t Really Hit The Spot

Pharmacy | Right | April 10, 2011


Me: “Thank you for calling [pharmacy]. What can I help you with?

Caller: “I just bought some [acne medication]. I was wondering if you could, uh… use it on herpes?”

Me: “On herpes? [Acne medication] is a treatment for acne only.”

Caller: “So can I put it on my junk or not?”

[florida80]

This Customer Has Trouble Written All Over Him

Pharmacy | Right | April 3, 2011


Customer: “I’d like to buy some syringes.”

Me: “Can I see some ID?”

Customer: “They’re not for me, they’re for my dad. He’s a diabetic and needs them for his insulin.”

Me: “Okay. I still need to see some ID. Do you know his date of birth?”

Customer: “I’ll never forget his date of birth. I had it tattooed on my arm the day he died.”

(The customer proceeds to show everyone in the pharmacy the tattoo of his deceased father’s DOB–the same father that he is trying to buy syringes for.)

[florida80]

So Mummy Can Have Birds Without The Bees

Pharmacy | Right | January 30, 2011


(I am a customer in line at a pharmacy. A mother and her two youngs boys is ahead of me. One of the young boys is sitting on the floor pointing at random medicines.)

Boy: “Mummy, what’s that for?”

Mother: “That’s for an itchy head.”

Boy: “Mummy, what’s that for?”

Mother: “That’s for when you can’t sleep.”

(The boy then points at the pregnancy tests.)

Boy: “Mummy, what’s that for?”

Mother: “That’s to see if you have a baby growing inside of you!”

(The boy then stands up and gets back in line with his mother.)

Mother, to me and the pharmacist: “Thank god he didn’t point at the condoms!”

[florida80]

Two Pillows On The Couch, Once Daily

Pharmacy | Right | January 26, 2011


(I need to make a new profile for the customer’s wife on our computer system, so the customer calls his wife.)

Customer, to wife: “Hello? What’s your card number? It’s for the prescription.”

(The customer relays the card number to me. I ask for her birthday.)

Customer, to wife: “When’s your birthday? No, of course I remember. It’s December 7th!”

(I hear his wife cry out loudly over the phone.)

Customer, to wife: “What? It’s September 22nd?!”

(The customer ends the conversation and hangs up the phone.)

Me: “Are you going to be alright when you go back?”

Customer, to me: “You should warn me next time you have to ask for her birthday.”

[florida80]

Identity Theft Is Childs Play

Pharmacy | Right | January 14, 2011


(I am a customer in line. There is a woman with a 4 year old finishing up their purchase.)

Me: “Here’s your change.”

4-Year-Old: “Mommy, can I do the scribbles?”

Customer: “No, honey. I paid with cash, not my credit card

[florida80]

Looking Down The Barrel Of A Smoking Gum

Pharmacy | Right | January 3, 2011


(I hear this conversation in my checkout line.)

Customer #1 (https://www.vietbf.com/forum/usertag.php?do=list&action=hash&hash=1) : “Oh my God, I love that nicotine gum! It makes my mouth feel all numb.”

Customer #2 (https://www.vietbf.com/forum/usertag.php?do=list&action=hash&hash=2) : “You know that stuff’s going to get you addicted to cigarettes, right?”

Customer #1 (https://www.vietbf.com/forum/usertag.php?do=list&action=hash&hash=1) : “Nah! That stuff gets you un-addicted to them and I don’t smoke. I’m fine!”

[florida80]

Children Get Sick Periodically

Pharmacy | Right | November 19, 2010


(A woman walks into the store with her young daughter. Her daughter looks feverish and is sniffling.)

Customer: “Oh look honey, they have candy bars. Go get yourself one while mommy shops for her things.”

(The little girl walks up to the counter and takes a candy bar.)

Me: “Are you feeling okay, little girl?”

Daughter: “My mommy says as long as she gets her tampons, I’ll feel better.”

(The girl suddenly vomits all over the candy bars and on the counter.)

Daughter: “QUICK MOMMY! GET YOUR TAMPONS!”

[florida80]

Ear-Waxing Lyrical About Bad Service

Pharmacy | Right | November 1, 2010


Customer: “I’ve come to pick up my prescription.”

Me: “Oh I’m really sorry, due to extenuating circumstances we don’t have a pharmacist at the moment so legally I can’t give out any prescriptions. But if you wait 5 minutes, a replacement pharmacist will be here and then you can take it.”

Customer: “But I need it. Give it to me!”

Me: “I understand your problem but I would be breaking the law if I gave it to you.”

Customer: “I work in the pharmaceutical industry and I know for a fact you are lying! Give it to me now!”

(The pharmacist arrives and I explain the problem.)

Pharmacist: “I’m really sorry for the inconvenience but my colleague was right, there was nothing she could do. But now that I’m here, you can take your prescription.”

Customer: “You’re colleague is a cruel, moral-less b**** with the intelligence of a moron. She has endangered my life! I shall take this to court and win!” *storms out*

Me: *to pharmacist* “What was in her prescription?”

Pharmacist: “Drops for excessive ear wax.”

[florida80]

Retired & Extremely Dangerous

Pharmacy | Right | October 18, 2010


Me: “Thank you for call [Pharmacy], may I help you?”

Elderly Female Customer: “I would like to get these two of my medications refilled and I want to pick them up tomorrow afternoon.”

Me: “Okay ma’am, that will be fine. Is there anything else I can do for you?”

Elderly Female Customer: “Honey, you can come to my house and do me anytime.”

Me: “I, uh, oh, uh…”

Elderly Female Customer: “

[florida80]

Discount Discounted

Pharmacy | Right | September 29, 2010


Me: “And do you have a free rewards card with us, ma’am?”

Customer: “A what? I don’t know. Maybe. I don’t know.”

Me: “If you think you have one, I can look it up by your phone number?

Customer: “My what?”

Me: *louder* “Your phone number, ma’am.”

Customer: “I don’t have one of those! I don’t think I have one! I don’t have a phone number! I don’t have one!”

Me: “Okay, ma’am, that’s fine. Your total today is $26.74, and just to let you know, you could have saved $5.90 if you had the rewards card.”

Customer: “A discount? My phone number is ***-****.”

[florida80]

Will Power On Aisle 2

Pharmacy | Right | September 28, 2010


Teenage girl: “Do you guys sell that contraceptive abstinence?”

Me: “Abstinence?”

Teenage girl: “Yeah! Abstinence! I read that it’s the only 100% way to not get pregnant!”

Me: “That’s right. But, abstinence is to not have sex. Like abstain from.”

Teenage girl: “Well, that just sucks!”

[florida80]

Misunderstood ‘Total Coverage’

Pharmacy | Right | September 17, 2010


Me: “Our records show you’ve never had a prescription filled here before, so I’ll need an ID and your insurance.”

Customer: “Here’s my ID. I don’t have my insurance on me, but it’s through [car insurance company].”

Me: “Sir, I think that’s your car insurance. Do you have health insurance?”

Customer: “You mean there’s more than one kind?”

[florida80]

Feeling Pooped

Pharmacy | Right | September 12, 2010


(A couple approaches the counter.)

Me: “Can I help?”

Customer: “Yes, can you give me advice about his stool?”

Me: “I’m sorry, I can’t give medical advice. Perhaps you’d like to speak to our pharmacist, or consult your doctor?”

Customer: “No, I’m sure they’re very busy. I just want someone to tell me if it’s normal.”

Me: “The law says I can’t give advice. Let me get the pharmacist.”

Customer: “No, really, I have some here.” *whips out a clear bag of poo on the counter* “See, it’s all gritty. That’s not normal, is it? Do you have pills for that?”

Me: “Ma’am, you might want to take that to your doctor. We can’t accept biological waste.”

Customer: *to her husband* “See, Joe, I told you it was wrong. That’s why I save them.”

[florida80]

Rectify The Situation

Pharmacy | Right | August 12, 2010


Customer: “Hi there, do you sell rectums?”

Me: “I’m sorry, what?”

Customer: “Rectums. I need a rectum. do you sell them?”

Me: “Why do you need it?”

Customer: “I have some tablets here and it says ‘insert via rectum’ and as I don’t have one, I thought I better buy one.”

Me: “I think I better call the pharmacist in.”

(I call the pharmacist in who explains to the man exactly what a rectum is. He leaves red faced.)

[florida80]

Don’t Hold Your Breath For This One

Pharmacy | Right | July 16, 2010


(I am counseling a patient on using an inhaler.)

Me: “Do you know how to use an inhaler, sir?”

Patient: “Nope, never used one.”

Me: “Okay, you’ll want to begin inhaling, and then depress the inhaler as you are breathing in. Then, hold your breath for as long as possible to allow the medication to be absorbed into your lungs.”

Patient: “Oh, sort of like smoking pot…”

[florida80]

Hollywood, M.D.

Pharmacy | Right | July 1, 2010


(A customer comes to the counter with a bleeding hand.)

Customer: “Have you got a first aid kit back there? I caught my hand and it’s bleeding.”

Me: “Of course. I’ll go get it.”

(I come back with the kit and take out some antibiotic ointment and some bandages.)

Customer: “Oh, I shouldn’t need the bandages.”

Me: “Are you sure? It’s bleeding quite a lot.”

Customer: “Well, that ointment will just fix it, won’t it?”

Me: “Pardon?”

Customer: “That stuff you’ve got in your hand, that’ll just heal it up right?”

Me: “This helps it heal faster and prevents it from getting infected, but it doesn’t heal it immediately.”

Customer: “Don’t you have the stuff that just fixes it right away?”

Me: “I don’t believe they have anything that does that, ma’am.”

Customer: “They do, I saw it before!”

Me: “Where did you see it?”

Customer: “I saw it on some movie. I don’t want that stuff there. I want the stuff I saw in the movie. Just get that stuff and fix this already, will you

[florida80]

Medication Frustration

British Columbia, Canada, Health & Body, Pharmacy | Right | June 28, 2010


Customer: “I’m picking up a prescription for [Name].”

Me: “Okay. Just a second.”

(I check the drawer for the prescription and can’t find it.)

Me: “When did you order it?”

Customer: “Well, I saw the doctor on Monday.”

Me: “So you came in on Monday?”

Customer: “No, I went to the doctor’s on Monday.”

Me: “Okay, so when did you drop your prescription off?”

Customer: “What do you mean? I went to the doctor.”

Me: “And did he give you a piece of paper that said what drugs you needed?”

Customer: “Yeah.”

Me: “That’s a prescription. You need to bring it here so that we know what you need.”

Customer: “But I saw the doctor on Monday! Why didn’t he do it?”

Me: “That’s not his job. That’s what pharmacists are for.”

Customer: “So what, he’s a doctor but he’s not a pharmacist? Look, I saw him on Monday so he probably just did it then. You’re just not looking hard enough. Look for the things done on Monday!”

[florida80]

The Truth Is A Bitter Pill To Swallow

British Columbia, Canada, Health & Body, Pharmacy | Right | June 25, 2010


Customer: “Why isn’t my prescription ready yet?”

Me: “We’re trying to get in contact with your doctor because of a problem with the prescription. Your profile says you’re allergic to penicillin. Is that correct?”

Customer: “Oh yeah, that stuff is really bad for me!”

Me: “The medication your doctor prescribed has penicillin in it, so we’re trying to get a hold of him to find out what he wants you to take.”

Customer: “Oh, well, he wants me to take the penicillin. That’s what he wrote down, right?”

Me: “Yes, but you said you were allergic to it.”

Customer: “But he’s a doctor, so he knows what’s best. If that’s what he wrote, then just give me that.”

Me: “Well, we’ll check with him first to make sure that it’s safe for you.”

Customer: “Of course it’s safe for me or the doctor wouldn’t have prescribed it! He probably just cured my allergies. Check my old prescriptions; I bet he prescribed me something to cure my allergy!”

[florida80]

High School Dropouts Work On The Pharm

Boston, Massachusetts, Pharmacy, USA | Right | June 12, 2010


(I work as a pharmacy tech at a chain pharmacy. I am also currently in pharmacy school and will be a pharmacist one day.)

Customer: “You should be ashamed of yourself!”

Me: “I’m sorry. Can I help you with something?”

Customer: “No! I refuse to be helped by a high school dropout! You should be ashamed of yourself for working where children can see you! You are going to make them think that it is okay to not have an education!”

Me: “Ma’am, I am not a high school dropout. I have a high school diploma and I am currently in pharmacy school working towards a Doctor of Pharmacy. I am going to be a pharmacist one day.”

Customer: “Stop lying! I have never heard of a pharmacist before. You are a high school dropout!”

Manager: “Can I help you?”

Customer: “Yes! Your employee is lying to me! She says she is going to be a pharmacist! That job doesn’t exist!”

(The manager looks at our pharmacist who is near tears from laughing so hard.)

Manager: “Ma’am, see the man over there? He’s the one who filled your prescription. He is a pharmacist.”

Customer: “No he isn’t! He just counts pills! You don’t need school for that!”

[florida80]

Health Care(less)

Health & Body, Money, Pharmacy, South Carolina, USA | Right | May 19, 2010


Me: “That will be $43.78, ma’am.”

Customer: “Oh, no, it won’t.”

Me: “I’m sorry, did you have insurance? You weren’t in the system. Do you have your card on you?”

Customer: “No, I don’t have insurance. Obama said health care is free.”

Me: “I don’t think that’s how it works, ma’am.”

[florida80]

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There’s No Pills Like Home, Part 2

Health & Body, New Jersey, Pharmacy, USA | Right | April 19, 2010


(My phone number is one number off a nearby pharmacy. We get a lot of misdials. My father happens to actually be a pharmacist but he doesn’t work there.)

Me: “Hello?”

Caller: “Hello? You just say Hello? How dare you be so rude! You should say “thank you for calling”!”

Me: “Oh, you must be looking for [pharmacy]. You have the wrong number.”

Caller: “Liar! How would you know what store I’m looking for? You’re just trying not to get in trouble. Give me your manager.”

Me: “Ma’am, I don’t have a manager. You’ve called a private residence. The number for the pharmacy is close to our number, so we get a lot of wrong calls.”

Caller: “This is outrageous! Give me your manager! I will not be treated this way!”

(At this point the caller was rambling and being rude so I hung up the phone. She called back, and my father answered it.)

Father: “Hello?”

Caller: “Is this the manager? Thank god! I want to know if [drug] can be taken with food! And you should fire that girl that answered before, she was very rude to me! I want to file a complaint!”

Father: “Ma’am, this is not the grocery store pharmacy. You just told off my 14-year old daughter. I happen to be a pharmacist. That drug does not need to be taken with food. However, you should see a doctor about your ears, as you clearly can’t hear a word anyone says.”

[florida80]

Seriously Bad Hair Day

Australia, Melbourne, Pharmacy, Time, Victoria | Right | March 11, 2010


(It’s 10 pm. We are in the final motions of locking up: registers closed and lights off. I’m just locking the door.)

Customer: *runs up in a panic* “Oh, no! You are closed? It’s an emergency! I really need to buy one thing!”

Me: “Sorry, we’re closed. Maybe you could come back in the morning.”

Customer: “No! I can’t wait that long-this is an emergency! Please help me!”

Me: “Okay, I suppose I can help you quickly for an emergency. Do you need antibiotics or paracetamol or something?”

Customer: “I need a packet of hair pins!”

[florida80]

How To Seize The Moment

Crazy Requests, Health & Body, Ohio, Pharmacy, USA | Right | March 8, 2010


(An elderly woman is having a seizure and obviously 911 has been called to the scene.)

Customer: “Excuse me, but when can I get my prescription?”

Me: “Ma’am, this woman is having a seizure and needs medical attention right away.”

Customer: “But I was here before her!”

[florida80]

This One’s A No-Brainer

Australia, New South Wales, Pharmacy, Sydney | Right | February 13, 2010


Customer: “My mother is taking some medication and it is making her sick. Can you stop giving it to her?”

Me: “I’ll have to ask the pharmacist for you. What medication is it?”

Customer: “It’s a little white pill.”

Me: “You don’t know the name of it, sir? We do have many white pills in the pharmacy.”

Customer: “I think it’s for her heart… or her brain.”

[florida80]

Noah Already Had Two Customers On The Ark

Extra Stupid, Pharmacy, Weather | Right | October 26, 2009


(Much of our area is suffering from massive flooding. A man walks into our chain pharmacy, completely drenched from the chest down.)

Me: “Wow, what happened to you?”

Customer: “I tried to go to your other location and it was closed!”

Me: “That location is flooded, sir. There’s about four feet of water surrounding it.”

Customer: “I know! I had to wade all the way up to the door before I found out it was closed! How do you think I got so wet?”

[florida80]

Not A Case Of If, But When…

Alcohol, Party, Pharmacy, Police, Teenagers | Right | August 20, 2009


(While waiting in line, I overhear a conversation between a teenager and a police officer, both of whom are also waiting. The boy has red plastic cups and ping pong balls in hand.)

Officer: “Can I ask what those are for?”

Teenage Customer: “No, no questions.”

Officer: “Where’s the party?”

Teenage Customer: “No parties.”

(The kid checks out, and as he’s walking out the door yells “SODA PONG!” and flicks his wrist.)

Officer: *to me* “Yeah, I’ll get the call in a couple of hours

[florida80]

Hard Drugs And Harder Pharmacists

Criminal & Illegal, Great Stuff, New Jersey, Pharmacy, Physical, USA | Right | July 31, 2009


(A teen approaches my cash register very slowly.)

Me: “Can I help you?”

Customer: “Give me all the f****** medicine!”

(The teen pulls out an airsoft pistol with orange tip still glued to the front.)

Me: “The pharmacy is in the back of the store.”

Customer: “Oh… okay.”

(He holsters the airsoft gun in his belt and darts down the aisles to the back of the store. My manager comes out of the back room because of the commotion.)

Manager: “Who was that?”

Me: “Some kid looking for drugs. He went back to the pharmacy.”

Manager: “Why didn’t you call the police?”

(The teen runs screaming from the back of the store, out of the front door, followed closely by the pharmacy technician, a 35-year-old boxer built like a fridge.)

Me: “Doug started working today.”

[florida80]

There’s No Pills Like Home

Extra Stupid, Great Stuff, Pharmacy | Right | July 17, 2009


(A patient called in to inquire about the medication she has just picked up.)

Me: *on the phone* “Pharmacy.”

Patient: “Hi, I just picked up this medication, and I think I may have a problem.”

Me: “Is there something incorrect with how it was filled?”

Patient: “No, it’s just that the cream here says to apply locally, and I’m going out of town tonight. I was wondering if I could still use it.”

Me: “Um… yes. Yes, you can.”

Patient: “Oh, okay, good… Oh… Oh, God. I just realized… Oh, my God, just forget I asked! How stupid of me

[florida80]

On The Bright Side, There Are Worse Orifices

Extra Stupid, Health & Body, Pharmacy | Healthy Right | July 15, 2009


Me: “[Pharmacy], how can I help you?”

Customer: “Yeah, your medicine is defective.”

Me: “Sir, why don’t I get your information so I can take a look at your profile.”

Customer: *gives his name and date of birth*

Me: “I see that the last prescriptions you filled were antibiotic and drops for your ear infection. Are your symptoms still bothering you?”

Customer: “Yes, and how the h*** do you expect me to fit this giant pill in my ear?”

Me: “Sir, that’s an antibiotic tablet. It’s meant to be taken orally.”

[florida80]

TMI Mom Tries To Help

Pharmacy | Right | July 6, 2009


(A forty-something year old woman comes to the counter with her purchases. Amongst them is a box of condoms, which have security stickers on them. Before I scan the item, I swipe it a few times over the scanner to deactivate it.)

Customer: “Is it not scanning?”

Me: “No, I’m just deactivating the security sticker. I don’t want you to set off the alarm on the way out. Especially over condoms!”

Customer: “Oh I’m not embarrassed! They’re not for me, they’re for my son. I can’t even get an erection!”

[florida80]

Script Stupidity

Extra Stupid, Health & Body, Pharmacy | Right | May 28, 2009


Customer: *holds up two bottles* “What’s the difference between these two medicines?”

Me: “The one on the left is a capsule; the one on the right is a tablet.”

Customer: “I mean, which one would be better?”

Me: “They’re exactly the same medicine, just in different forms. Most people buy whichever one is easier for them to swallow.”

Customer: “That’s just stupid! How can you swallow a bottle?”

[florida80]

Where There’s A Pill, There’s A Way

Pharmacy | Right | May 21, 2009


(A customer comes in with a prescription for a narcotic pain reliever. He says that he was at the hospital with his wife and the hospital stole his pills, which is why he needs to get this prescription filled, even though his last prescription was just filled a few days ago.)

Me: “OK, sir, I talked to your doctor and he says I can fill your prescription.”

Customer: “Great, can I wait? I have no pills left and I really need it.”

Me: “It’ll be about 10 minutes.”

(10 minutes later.)

Me: “OK sir, your prescription is ready.”

Customer: “Hey, are those pills the same as this?” *holds up pill*

Me: “I thought you didn’t have any pills left, sir.”

Customer: “Well…I bought this off the street, to be honest with you.”

Me: “Oh…good.”

[florida80]

Super Absorbent For Those Mentally Heavy Days

Food & Drink, Great Stuff, Health & Body, Pharmacy | Right | April 23, 2009


(An elderly man calls up to the store.)

Me: “Thank you for calling [Pharmacy]. This is [My Name]. How can I help you?”

Customer: “Yes, my granddaughter came to visit me, and she bought me a birthday gift. It’s on the kitchen table, but I’m not sure what it is.”

Me: “Okay, well, what can you tell me about the product?”

Customer: “Well, the box says ‘K-O-T-E-X’. Can you tell me what that is, honey? What it’s used for? I just can’t figure it out.”

Me: Well, sir… that’s a feminine hygiene product.”

Customer: “Feminine hygiene? What’s the product for? I just can’t figure it out.”

Me: “Sir… it’s for women on their period.”

Customer: “Why would my granddaughter buy me Kotex?”

Me: “I don’t know, sir. Maybe you should ask her that.”

Customer: “So can I still use them to stir my Kool-Aid with? Because that’s what I’ve been using them for.”

[florida80]

Yeah, Definitely Contraindicated

Drugs, Great Stuff, Health & Body, Pharmacy | Right | April 21, 2009


(A patient walks up to the pick-up window looking like he just came from the emergency room.)

Me: “Hello, sir, how can I help you?”

Customer: “I wanna drop this off…” *hands me an ER prescription*

Me: “Sir, this is the pick-up window. You need to drop off the prescription at the drop off window.”

Customer: “Where’s that?”

Me: “The counter at the entrance to the room with the big sign that says “Drop Off Window’.”

Customer: “Where?”

Me: “You know, you already waited in line so I’ll just take the prescription here. Have you ever had any medication here before?”

Customer: “I don’t know; have I?”

Me: “I’ll take that as a no. Do you have any allergies to medication?”

Customer: “Well, when I mix heroin and battery acid, I get a rash.”

Me: “…I’ll make a note on that.”

[florida80]

Bilingual Secret Shame

Pharmacy | Right | April 20, 2009


Customer: “Excuse me, what are diaper couches?”

Me: “I’m sorry?”

Customer: “Diaper couches.”

Me: “Ma’am, I’m not sure what you mean.”

Customer: *points to the boxes of diapers* “That box! It says ‘diaper couches’.”

Me: *suddenly understanding* “Ma’am, that box says diapers, and then it says ‘couches’. That’s the French word for diapers.”

Customer: *looks around, then whispers* “Don’t tell anyone!” *leaves*

[florida80]

Rip Van Winkle To The Extreme

Crazy Requests, Pharmacy | Right | April 2, 2009


Customer: “Hi, I have a rather simple question to ask you.”

Me: “Sure thing. What can I help you with?”

Customer: “Hypothetically speaking, if I wanted to make someone sleep for a really long time, what would I use?”

Me: “Um, just how long are you talking?”

Customer: “Well, I was thinking somewhere around forever.”

Me: “…”

[florida80]

Ăn Để Chết - Chu Thập







“Ăn để chết” là tựa đề của một bài báo trong nước về điều thường được gọi là “văn hóa ẩm thực” tại Việt Nam thời xã hội chủ nghĩa.




Ngoài tựa đề ra, bài viết chẳng có gì mới mẻ. Chuyện ăn uống của người Việt Nam trong nước hiện nay là một đề tài không bao giờ cạn.


Thoạt đọc qua tựa đề, tôi không thể không liên tưởng đến bữa ăn cuối cùng của các tử tội trước khi bị đem đi hành quyết. Mà suy cho cùng, dường như cái lối ăn uống của nhiều người Việt Nam trong nước hiện nay chẳng khác bao nhiêu với bữa ăn cuối cùng của các tử tội.

Bài viết nói đến trường hợp của một bệnh nhân tại quận Đống Đa, Hà nội: “Bệnh nhân 54 tuổi này đã rời xa các bàn nhậu từ khoảng gần một năm nay vì bệnh tiểu đường. Trước đây, trong các cuộc nhậu của bạn bè, gần như ông không bao giờ vắng mặt. Bác sĩ trưởng khoa Tim mạch tại Bệnh viện Hữu Nghị Hà Nội cho biết ông đã gặp nhiều người (nói không ngoa) chết vì ăn, chết vì uống.




Ông bác sĩ này kể lại: “Một bệnh nhân mới 45 tuổi, khi còn nghèo khó thì làm việc cật lực, chí thú kiếm tiền và tiết kiệm. Đến khi có nhiều tiền, anh quay ra ăn uống nhậu nhẹt vô biên, ngày nào cũng nhậu, có ngày nhậu mấy cuộc. Ở tuổi 45, anh chết vì xơ gan sau một thời gian dài phải “đeo ba lô ngược” (bụng quá phệ).


Cũng theo bài viết, có nhiều bệnh nhân ăn uống vô độ, chỉ cao khoảng 1m63, nhưng nặng đến gần một tạ. Gia đình bệnh nhân này lại có tiền sử mấy đời cao huyết áp. Khi được bác sĩ khuyên cần phải giảm cân bằng cách giảm ăn, tăng vận động, bệnh nhân từ chối hợp tác vì nhịn ăn là chuyện không thể.


Bác sĩ trưởng khoa Tim mạch, bệnh viện Hữu Nghị Hà Nội nhận định: “Nếu cứ như vậy thì anh ta không phải ăn để sống, mà là ăn để chết. Tôi thấy xã hội chúng ta giờ trọng chuyện ăn uống quá. Làm việc gì cũng phải có tiệc chiêu đãi toàn món ngon, bổ béo”.


Bác sĩ này cũng cho biết: đa số những người “ăn để chết” đều là những người giàu có và các bệnh phổ biến hơn cả vẫn là tim mạch, huyết áp, gan, thận, tiểu đường.



Dĩ nhiên, nếu có những người giàu “ăn để chết” thì cũng không thiếu người nghèo bị buộc phải ăn thực phẩm rẻ tiền, không hợp vệ sinh, không an toàn do đó cũng bị mang bản án “ăn để chết”. Tựu trung, người giàu chết vì béo phì, còn người nghèo chết vì thiếu vệ sinh.


Phải nói chẳng có nơi nào trên thế giới, người ta ăn nhậu tưng bừng như ở Việt Nam. Sáng sớm, mới mở mắt đã thấy có người gánh hàng đi ngang trước nhà. Tối đến, khuya lơ khuya lắc, không chỉ các nhà hàng sang trọng, mà các hàng quán rẻ tiền cửa vẫn mở. Tiệc vui, người ta ăn nhậu đã đành, mà ma chay, người ta cũng nâng ly “dzô” tới bến

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Không biết có phải vì điếc mà người ta không sợ súng chăng? Người Pháp thường nói “bụng đói không có tai”. Đây là kinh nghiệm của cá nhân tôi.






Sau năm 1975, cái bụng đói của tôi hầu như không còn tai nữa. Cà phê được pha chế cỡ nào, tôi cũng nốc. Thuốc lá có tẩm thuốc độc cỡ nào tôi cũng rít. Rượu thì khỏi nói. Biết người ta bỏ thêm thuốc rầy Mitox vào để tăng nồng độ rượu, tôi cũng chẳng chê. Còn thịt mỡ có thèm “nhỏ rãi” cũng chẳng có mà ăn, hơi đâu mà quan tâm đến “Cholesterol”, tức mỡ trong máu. Cũng nhờ “được” sống trong thiên đàng xã hội chủ nghĩa mà hầu như thịt gì tôi cũng nếm. Đúng là hễ con gì cựa quậy, nhúc nhích là xơi được ráo!


Người Việt Nam nào đã từng sống dưới chế độ cộng sản có lẽ cũng đều đã trải qua những cảnh phải tranh đấu với thiên nhiên để sống còn chẳng khác gì Bear Gryllss trong chương trình truyền hình “Man vs Wild” (người chống chọi với thiên nhiên).


Ngày nay, sau gần nửa đời người sống ở xứ người, ý thức hơn về những đòi hỏi của phép vệ sinh, nhất là vệ sinh trong ẩm thực, học được đôi chút về nếp sống văn minh, tôi không thể hiểu được tại sao mình đã có thời ăn uống bừa bãi như thế trong 5 năm sống dưới chế độ cộng sản.


Tôi hiểu được phần nào phản ứng, cách suy nghĩ và ngay cả phán đoán gay gắt của ông Joel Brinkley, giáo sư chuyên ngành báo chí thuộc trường đại học Stanford, Hoa kỳ, về cách ăn uống hiện nay của người Việt Nam trong nước. Theo ông giáo sư đã từng đoạt giải Pulitzer này, sở dĩ người Việt Nam “hung hăng, hiếu chiến” là vì ăn nhiều thịt.





Giáo sư Brinkley đã đưa ra nhận xét trên đây sau một chuyến du lịch 10 ngày xuyên qua nhiều nơi tại Việt Nam. Viết trên báo The Chicago Tribune, ông Brinkley cho rằng du khách đến Việt Nam hầu như chẳng còn thấy bóng dáng thú nuôi hay động vật hoang dã nữa bởi vì đa số đều đã bị người Việt Nam hiện nay săn tìm để xơi tái.


Ông viện dẫn những cuộc chiến của Việt Nam Cộng Sản với Trung Quốc và Campuchia để kết luận rằng vì thường xuyên ăn thịt cho nên người Việt Nam hung hăng hơn nhiều so với người dân các nước lân bang.



Dĩ nhiên, bài viết của ông giáo sư của trường đại học danh tiếng Stanford trên đây đã tạo ra một làn sóng phản đối mạnh mẽ từ người Việt khắp nơi trên thế giới, khiến báo The Chicago Tribune phải chính thức lên tiếng xin lỗi.


Không phải quơ đũa cá nắm, nhưng bất cứ người Việt hải ngoại nào về thăm Việt Nam một lần cũng đều nhận thấy người Việt Nam sống dưới chế độ cộng sản hiện nay “khác” với người Việt Nam trước năm 1975.






Khác nhiều thứ lắm. Khác nhất là cách ăn uống. Như ông bác sĩ ở Bệnh viện Hữu Nghị Hà Nội trên đây đã nói, nhiều người Việt Nam trong nước hiện nay “ăn để chết”. Nghe như một nghịch lý. Nhưng thực tế là như vậy. Không chết dần chết mòn trong thân xác, thì cũng chết từ từ trong nhân cách.

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Người Tây Phương có lý để nói rằng “we are what we eat” (tạm dịch: ăn cái gì thì người như vậy). Tính khí của người ăn chay trường chắc chắn khác với kẻ nhậu nhẹt quanh năm ngày tháng. Người ăn uống điều độ hẳn cũng có tư cách khác với kẻ ăn uống bừa bãi, vô độ.


Người Việt Nam chúng ta thường nói: “miếng ăn là miếng tồi tàn”. Kỳ thực, tự nó, miếng ăn là điều tốt. Miếng ăn nuôi thân xác, tạo sự gặp gỡ, giúp thể hiện tình liên đới và chia sẻ. Có tồi tàn chăng là trong tư cách của con người mà thôi. Chỉ biết tới cái bụng của mình, chỉ biết ăn cho sướng cái lỗ miệng mà chẳng màng đến sức khỏe, bệnh tật và những hệ lụy đối với người thân và xã hội, ăn như thế đúng là ăn để chết và chết tồi tàn.





Trong một bài viết về cái ăn, tiến sĩ Nguyễn Hưng Quốc cho rằng dân tộc Việt Nam bị “ám ảnh” bởi cái ăn. Chuyện gì cũng quy về cái ăn. Từ nào cũng có thể được ghép với chữ ăn. Thật ra, ông bà ta không hẳn theo triết lý hiện sinh, nhưng đã có lý để xem cái ăn như chuyện quan trọng nhất trong đời người, cho nên mới xếp việc “học ăn” lên đầu của mọi thứ học. Cứ như “học ăn” được thì chuyện gì cũng học được hết!



Chúa Nhật vừa qua, trong giờ Thánh lễ, tôi đã bị “thu hút” bởi cái miệng của một bé gái khoảng một tuổi, ngồi với cha mẹ ở băng ghế phía trước. Trong các nhà thờ Úc, người ta thường thiết kế một chỗ đặc biệt ở phía cuối dành riêng cho thơ nhi đi cùng cha mẹ. Ngồi trong một “lồng kiếng” như thế, trẻ con tha hồ la hét. Nhưng cũng có nhiều bậc cha mẹ phá lệ, mang trẻ thơ đến ngồi hòa đồng trong đám đông. Gặp lúc muốn nghe bài giảng của vị linh mục thì trẻ thơ, dù có dễ thương cách mấy, cũng làm cho mình khó chịu.



Nhưng khi vị linh mục giảng mà mình có chăm chú cách mấy cũng chẳng hiểu gì thì trẻ thơ, dù có quậy phá cỡ nào, cũng vẫn là “thiên thần” cứu nguy khỏi cơn…ngủ gục. Vị thiên thần ở trước mặt tôi quả đã mang lại cho tôi nhiều giây phút “thoải mái” trong giờ lễ. Cô bé có cái miệng thật xinh. Có lúc cô nói bi bô. Có lúc cô quay xuống cười với vợ chồng tôi. Nhưng động tác chính của cô vẫn là cầm bất cứ món gì cũng cho vào miệng, không riêng miệng mình mà còn nhét vô miệng cha mẹ nữa một cách thật dễ thương.


Tan lễ, khi bàn đến cái miệng của cô bé thiên thần trong nhà thờ, nhà tôi nhắc lại hai điểm nổi bật trong tư tưởng của cha đẻ phân tâm học Sigmund Freud (1856-1939). Theo ông, đời người có hai giai đoạn: giai đoạn tuổi thơ tập trung vào cái miệng; cái gì cũng đưa vào miệng. Giai đoạn trưởng thành lại xoay quanh tính dục; bản năng tính dục chi phối mọi sinh hoạt của con người; động lực đàng sau mọi hoạt động của con người luôn là tính dục.


Vai trò của tính dục trong cuộc sống con người, theo quan niệm của Freud, có thể còn trong vòng tranh cãi. Nhưng về vai trò của cái miệng ở tuổi thơ và ngay cả trong tuổi trưởng thành, thì quả thật tôi thấy khó chối cãi được. Trong thân thể con người, miệng không phải là cơ phận quan trọng nhất sao? Và trong các chức năng của miệng, ăn không phải là sinh hoạt chính sao?


Đâu phải chỉ có người Việt Nam mới xem “chuyện ăn” là điều quan trọng nhất trong cuộc sống con người. Tôi nghĩ đến câu chuyện ông bà nguyên tổ loài người Adam và Eva bị cám dỗ trong vườn địa đàng. Cơn cám dỗ đầu tiên của hai ông bà này, dù có giải thích như thế nào đi nữa, vẫn xoay quanh chuyện ăn. Điều này cho thấy cám dỗ lớn nhất trong đời người có lẽ vẫn là chuyện ăn uống.


Cũng trong Kinh Thánh, tôi đọc được rằng cơn cám dỗ đầu tiên mà Chúa Giêsu phải trải qua sau 40 đêm ngày chay tịnh cũng chính là về cái ăn. Ma quỉ dụ dỗ Ngài: hãy biến những hòn đá trước mặt thành bánh mà ăn!


Tôi không biết Chúa Giêsu có phải là một người thích ăn uống nhậu nhẹt không. Nhưng rất nhiều những sinh hoạt chính của Ngài được ghi lại trong Kinh Thánh lại liên quan đến chuyện ăn uống. Hẳn Ngài cũng đã nhiều lần ngồi vào bàn nhậu để chén thù chén tạc với phường thu thuế cho nên những kẻ chống đối Ngài rêu rao rằng Ngài là một tên “bợm nhậu”. Chắc chắn Chúa Giêsu phải xem chuyện ăn uống là điều quan trọng trong cuộc sống con người cho nên trong rất nhiều bài giảng, Ngài thường xử dụng hình ảnh của bữa tiệc hay tiệc cưới. Rõ ràng nhất là trước khi chết, nghi thức mà Ngài muốn trối lại cho các môn đệ để cử hành và tưởng nhớ đến Ngài cũng chính là một bữa tiệc (thường gọi là Tiệc Ly).


Ngày nay, mỗi lần gặp nhau trong các thánh lễ Chúa Nhật, các tín hữu Kitô cũng lập lại nghi thức “ăn uống” ấy. Đỉnh điểm của đời sống tôn giáo của họ là một bữa ăn. Họ lập lại bữa ăn ấy không chỉ để tưởng niệm Đấng Cứu Độ, mà còn để tự nhắc nhở rằng cuộc sống tự nó phải là một bàn ăn trong đó mọi người đều được mời gọi ngồi bên nhau và chia sẻ cho nhau. Cuộc sống vẫn mãi mãi là một trường dạy “học ăn”.



Trong lúc trà dư tửu hậu, khi chia sẻ với bạn bè thân quen, tôi thường nói rằng, với tôi, trong các thứ học thì học làm người là điều khó nhất. Người, theo một định nghĩa mà tôi vẫn cho là xác đáng nhất, là “một con vật có lý trí”. Xét dưới nhiều phương diện, con người chẳng khác con thú bao nhiêu.


Có khác chăng là bởi con người có lý trí và luôn phải hành động theo lý trí. Vứt cái lý trí đi thì con người sẽ hành động chẳng khác gì thú vật. Cụ thể là chuyện ăn uống. Hãy thử tưởng tượng: khi ta tạm nghỉ chơi với lý trí để được tự do ăn uống như súc vật, chuyện gì xảy ra nếu không phải là: con người chỉ còn biết “ăn để chết”.





Có lẽ vì học làm người là chuyện khó nhất trong cuộc sống và trong học làm người thì ăn lại là chuyện phải học suốt cả một đời, cho nên trong tôn giáo nào cũng có chuyện ăn chay. “Ăn chay” chính là “học ăn”. Ăn như thế nào để “ăn không phải để chết” mà là để sống và sống sung mãn trong nhân cách vậy.

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MacGyver Becomes a Dad

Great Stuff, Medication, Parents/Guardians, Pharmacy | Right | March 26, 2009


(A man is picking up a prescription for his infant child.)

Customer: “How much did you say the prescription was?”

Me: “$49.99.”

Customer: “What’s the difference between this and what I can get over the counter?”

Me: “There’s no cough medicine you can give your eight-month-old, sir, other than this.”

Customer: “Well, what’s in it?”

(He picks up the prescription papers and starts rustling through them.)

Customer: “If I can buy everything that’s in it over the counter, I’ll just make it myself.”

Me: “…excuse me?”

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Perhaps Multiple Choice Might Be Easier

Pharmacy | Right | February 20, 2009


Customer: “I’m after some cold and flu medication.”

Me: “Sure, do you take any other medication?”

Customer: “Um… no… I don’t thi-… wait, yes, but it’s… actually no, no, I don’t.”

Me: “Okay then, and are you allergic to anything?”

Customer: “God, this is too hard!” *storms out*

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Surely, One Missed Anatomy Class Can’t Hurt…

Pharmacy | Right | February 19, 2009


(A woman walks in with her daughter one afternoon.)

Me: “Hello, how can I help you?”

Customer: “There’s something wrong with my daughter.”

Me: “Oh?”

Customer: “Her eyes keep closing on their own!”

Me: “…ma’am, that’s called blinking.”

[florida80]

An Inconvenient List of Truths

Hospital, Pharmacy | Right | February 5, 2009


Me: “Hello?”

Caller: “Yeah, I need you guys to fill a prescription for me.”

Me: “I’m sorry, sir, but we are a hospital pharmacy. We only prepare medications for patients of the hospital.”

Caller: “Well, that’s simply discrimination. You ought to fill for everyone.”

Me: “You see, sir, we’re very different from a retail store. We issue individual, bubble-packed pills in one-day supplies to the nurses to give to their patients. We don’t have bottles, and we don’t do 30-day supplies like a store does. We don’t have a cash register, or any kind of means to ring up customers. We’re also located in an employees-only area of the hospital, near the morgue. You can’t really get to us that easily.”

Caller: “Well, those are all excuses.” *hangs up*

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That’s Commitment

Pharmacy, Retail, Time | Right | January 15, 2009


Me: “Thank you for calling your local 24-hour pharmacy. How may I help you?”

Customer: “Yeah, what time do you close?”

Me: “Sir, we never close. We’re open 24 hours.”

Customer: “Well, that’s just ridiculous. How can you put up with that?”

Me: “Sir?”

Customer: “So if I show up at four in the morning with a prescription, you’d be there?”

Me: “Yes, sir, we’d be open.”

Customer: “And what time do you open?”

Me: “Sir… we never close; we are always open. Think of it like a 24-hour diner; there’s always someone here to help you.”

Customer: “Oh, man, that must stink! When do you get time to go home and sleep?!”

Me: “Er… we have cots in the back

[florida80]

Insert Butt Crack Here

Great Stuff, Health & Body, Pharmacy | Right | October 31, 2008


Customer: “Hi, I’m having a problem with my suppositories. They’re not working at all!”

Me: “Okay, let me get the pharmacist for you so he can help you.”

(The customer decides to just yell the same question over two counters to the pharmacist in front of at least 10 other people.)

Pharmacist: “Ma’am, would you like to come over to our consultation are so we can talk about this privately?”

Customer: “No, I just want to know why my suppositories aren’t working!”

Pharmacist: “Well, okay. Are they melting before you insert them?”

Customer: “No, nothing like that!”

Pharmacist: “Are they breaking up into pieces before you use them?”

Customer: “No, no, nothing like that! They’re all in one piece and the same shape and all that stuff! I know how to follow the d*** directions!”

Pharmacist: “Are parts of the foil wrapper sticking to it at all?”

Customer: “What wrapper?!”

(Note: the suppository wrappers are aluminum foil with sharp edges. Ouch.)

[florida80]

After This, She’s Gonna Need An Antidepressant

Crazy Requests, Extra Stupid, Money, Pharmacy | Right | October 26, 2008


Customer: “Hi, can I have some of those allergy medications that are behind the counter? The 24 hour kind.”

Me: “Sure thing…”

(I grab one, because law mandates that the computers only allow me to check out one 24 hour medication for a certain period of time).

Customer: “Oh, I wanted four. Can I have four, please?”

Me: “Sorry, I can only give you one. There’s a law that makes me check your ID on the computer. It won’t let me check out more than one for you, at least not in the 24 hour dose.”

Customer: “Well, can you at least try? If you’d TRY once in a while, you never know what you can do!”

Me: “All right, then…”

(I scan one and sure enough, the second won’t go through.)

Me: “Yup, it won’t let me check out the second one. Your total’s gonna be about 20 bucks.”

Customer: “Okay, now try the third one.”

Me: “What?”

Customer: “If the second one didn’t work, maybe the third one will.”

Me: “Ma’am, all four of these are exactly the same. If the second one didn’t work, what makes you think if I rang up another box of the exact same thing would work?”

Customer: “JUST DO IT!”

Me: “Okay… yeah… it’s not working.”

Customer: “Okay, now try the fourth one.”

(Suffice it to say it doesn’t work; after she buys her one box, she comes back about fifteen minutes later.)

Customer: “HOW DARE YOU SELL ME THIS EXPIRED MEDICATION!”

Me: “Err… what? I can guarantee you it’s not. I checked it before I gave it to you.”

Customer: “Oh yeah? Then what’s this? It says FEB 20!”

Me: “Yes… February… of 2020. Not February 20th.”

Customer: “Uh… well, I’m older than you and I probably make way more than you anyway, so I’m right. I’m 42 and I make $[amount] an hour!”

Me: “I’ll agree with you, you’re much older than I am. I’m only 26. But, ma’am, you are talking to a pharmacist. I make twice that. Oh, wait… I’m in overtime now… three times that. Actually, in the time it took me to help you, I just made one hour’s worth of your wage. Is there anything else I can do for you today?”

[florida80]

Even Managers Have A Stupid Quota

Bosses & Owners, Crazy Requests, Health & Body, Money, Pharmacy, Refund | Right | October 8, 2008


(A young, angry-looking woman is standing at the pharmacy counter with a small pile of white sticks.)

Me: “How can I help you?”

Customer: “Yeah, these pregnancy tests are all faulty. I want a refund.”

Me: “Okay. So, what happened? Were they broken or missing pieces?”

Customer: “No, they keep saying positive. I’m not pregnant.”

Me: “Um… okay. So, if you’re not pregnant, then why get the tests?”

Customer: “Get your manager!”

Me: *gets manager*

Manager: “What’s the problem?”

(I wander off at this point, called into the vitamins section. When I come back, security is taking the woman out of the store.)

Me: “What the…?”

Manager: “Twit. She just wanted her money back. I hope she has twins that cause a LOT of pain and are ugly. REAL ugly… and poop a lot!”

[florida80]

Speak For Yourself

Great Stuff, Jerk, Pharmacy, USA | Right | August 28, 2008


Customer: “Excuse me!”

Me: “How can I help you, sir?”

Customer: “My wife sent me in here to pick up some chestnut brown and I can’t find it.”

Me: “Okay, is that makeup or hair color?”

Customer: “I don’t know; she just said chestnut brown.”

Me: “Do you happen to remember the brand name?”

Customer: “No! She just said chestnut brown. Weren’t you listening?”

Me: “Well, it sounds like hair dye to me. Let’s have a look.”

(We both go to the hair coloring aisle and I start to look through every shade in every brand. The man does not help at all; it takes me ten minutes.)

Me: “Here you go, sir. This is Garnier hair color, chestnut brown.”

Customer: “Are you sure that’s it? I don’t want to go home and have to come back.”

Me: “You could call your wife and ask her.”

Customer: “She’s not at home. Oh, wait, hold on.”

(He pulls a piece of paper from his pocket and begins to read it.)

Customer: “Yep, Garnier chestnut brown. That’s it!”

Me: “Sir, no offense, but you could have saved us a lot of time by reading that note in the first place.”

Customer: “That’s the problem with this country. Nobody wants to work anymore!”

Me: “Yeah, that’s our problem.”

[florida80]

He Shoots, He Misses

Pharmacy | Right | August 13, 2008


(I used to work at a drug store. From time to time, the pharmacy portion of the store wouldn’t open because there wasn’t a pharmacist to do so. A customer reads the closed sign…)

Customer: “What’s the meaning of this?!”

Me: “I’m sorry, sir. The pharmacy is closed today because we don’t have a pharmacist.”

Customer: “People are SICK! They need their MEDICATION!”

Me: “I wish there was something I could do, sir, but–”

Customer: “You know what this is? Do you?! Two words! TWO WORDS! UN-ACCEPTABLE!”

[florida80]

Thirteen Bucks Can Buy A Lot Of Beans

Great Stuff, Health & Body, Money, Pharmacy | Right | August 4, 2008


Customer: “I hear there’s this stuff you can put on your food that won’t give you gas.”

Me: “Oh, yeah… it’s called Beano. Put a couple of drops on your food and the enzymes in it prevent the food from giving you gas.”

Customer: “So, you have it?”

Me: “Yep. I’ll show you.”

(We walk over to the shelf where Beano is kept. I show him the little 3 or 4 oz. bottle; a little goes a long way with that stuff.)

Me: “This is it.”

Customer: “How much?”

Me: “$12.99.”

Customer: “For THAT little bottle? S***, I’ll just fart!”

[florida80]

The Inadvertent Thief

Criminal & Illegal, Extra Stupid, Great Stuff, Health & Body, Pharmacy | Right | June 26, 2008


Lady: “Do you sell aloe vera gel?”

Me: “No, I’m afraid we don’t, but you might be able to get it at [Store] down the street.”

Lady: “Oh, great, thanks.”

(She leaves and ten minutes later returns wielding a tube, looking irritated.)

Me: “Hello again, did you manage to find it okay?”

Lady: “No! You told me they had aloe vera gel! All they had is the cream! I don’t want the cream!”

Me: “Um… you didn’t want the cream but you bought it anyway?”

Lady: “No, of course I didn’t BUY–”

(She suddenly stopped and looked at the tube in her hand. Her expression turned to horror and she legged it back out the door. My coworkers and I laughed for a good ten minutes at that one.)

[florida80]

Up Munchkins

Extra Stupid, Great Stuff, Pharmacy | Right | May 23, 2008


(I live in a town where 65% of the people are 65 years old and older. When we were redoing the design of the store, they placed a large white walkway from the front door to the pharmacy.)

Customer: “Hi, I would like to pick up my prescription.”

Me: “I’m sorry, ma’am, but this is the front of the store. Your prescription is in the back of the store, in the pharmacy.”

Customer: “How do I get there?”

Me: “Follow the white brick road.”

[florida80]

Teenage Boys And Smutty Mags? You Don’t Say!

Crazy Requests, Great Stuff, Parents/Guardians, Pharmacy, Religion, Rude & Risque | Right | May 19, 2008


Angry Old Woman: “Excuse me! I am very upset because you sold my young grandson p*rnography!”

Me: “I’m sorry, ma’am, but we don’t sell p*rnography.”

Angry Old Woman: “Get me the manager, now!”

Manager: “What seems to be the problem, ma’am?”

Angry Old Woman: “Your pervert cashier sold my grandson p*rnography!”

Manager: “Are you sure about that? We don’t sell anything like that here.”

Angry Old Woman: “Do you think I’m stupid? I saw it with my own eyes! It had naked women and he told me he bought it here with no problem!”

Manager: “Could you show me on the shelf what it was?”

(She goes over to the magazines, and points at Maxim.)

Angry Old Woman: “It was this one! See? Right here! Where any child could see!”

Manager: “Ma’am, this magazine is not p*rnography. Granted, the women are scantily clad in a few pictures but they aren’t naked and there is no age restriction on its sale.”

Angry Old Woman: “I know p*rnography when I see it, and this is very offensive. How could you sell it to young children?”

Manager: “Well, actually our store policy dictates that we won’t sell this to a young child even though it is still legal. How old is your grandson?”

Angry Old Woman: “He’s only sixteen!”

Manager: *rolls eyes* “I don’t want to offend your moral beliefs, Ma’am, but if your sixteen year old grandson wants to look at women in bikinis there is no force on earth that is going to stop it. Seriously.”

Angry Old Woman: “The power of Jesus can stop it! The power of Christ should compel you to remove this magazine from your shelves!”

Manager: “Right… Real quick, ma’am, before I get back to work, can I ask you a question? Does your grandson have Internet access?”

Angry Old Woman: “What does that have to do with anything?”

Manager: “A lot, and I think that the power of Christ should compel you to learn how to look up his browser history. Have a good day.”

[florida80]

How About Some Ritalin While You’re At It

Pharmacy | Right | May 7, 2008


(Our insurance transmitter was experiencing problems, so we were unable to transmit to any insurance companies when filling prescriptions. I explained this to one customer, who decided to sit and wait for a while to see if the transmitter would come back up. Meanwhile another customer came in with a prescription.)

New Customer: “Hi, I’d like this filled please.”

Me: *explains transmitter problem*

New Customer: “Oh that’s okay, I don’t have insurance.”

Me: “No problem, we’ll have it ready in just a few minutes.”

Original Customer: “Wait! I was ahead of her! Why isn’t mine ready!?”

Me: “We are still waiting for the insurance transmitter to come back up, sir.”

Original Customer: “Well how did you fill hers!”

New Customer: “I pay cash, I don’t have prescription coverage.”

Original Customer: “Well I pay cash too!”

Me: “You want to just get it at retail price, and not use insurance?”

Original Customer: “Yes! I have cash! I’ll pay for it, just fill it now!”

(Five minutes later…)

Me: “Okay, sir, we’ve got you ready. The total comes to $35.99.”

Original Customer: “WHAT! My co-pay is only $3.00!”

Me: “Sir, you said you wanted to go ahead and pay cash price since the insurance transmitter is still down.”

Original Customer: “I do have cash! See?” *shows wallet with cash in it* “Why is it $35?! You people don’t know anything! I’m taking my business elsewhere!”

Me: *facepalm*

[florida80]

We Can Also Give It Lots Of Benadryl

Great Stuff, Ignoring & Inattentive, Pharmacy, USA | Right | April 28, 2008


(Our new drugstore is assigned a phone number that had previously belonged to the animal shelter. We ALWAYS answer the phone with our store name and hours, but people don’t always listen. This becomes annoying, but one of my coworkers likes to have fun with it.)

Caller: “Uh, yeah. I have this raccoon in my backyard.”

Coworker: “Hmm… that’s nice.”

Caller: “Yeah, well it seems to be acting strangely… like it’s crazy.”

Coworker: “What do you want me to do about it?”

Caller: “Well, you should do your job and come out and get rid of it! Isn’t that why I pay my taxes?”

Coworker: “Okay, then. Give me your address.”

Caller: *gives out address*

Coworker: “All right, after I close the drugstore I’ll be over with my shotgun around midnight. There will be a loud noise, so warn your neighbors. Since I don’t work for your taxes, just tape a $20 bill inside your mailbox, more if you want a fancy burial. Have a nice day!” *click*

[florida80]

Back In My Day, Pills Fell Like Mana From The Heavens

Crazy Requests, Great Stuff, Health & Body, Pharmacy | Right | March 13, 2008


(I was cashiering the closing shift on a Sunday night. The pharmacy closes earlier than the rest of the store on weekends. A customer comes in at 9:30pm.)

Customer: “Oh sh*t! The pharmacy is closed?!”

Me: “Yes, they close at 6pm on weekends. They will open again at 8am tomorrow morning.”

Customer: “But I need a prescription filled.”

Me: “I’m sorry, sir, but the pharmacist will not be here until 8am tomorrow morning.”

Customer: “Can’t you do it?”

Me: “No…”

Customer: “Why not?!”

Me: “I’m not a pharmacist.”

Customer: “Don’t be a smart a**!”

Me: “I’m sorry, sir. Only a pharmacist can fill your prescription.”

Customer: “What is this world coming to?!” *storms out*

[florida80]

Unfiltered Story #179127 (https://www.vietbf.com/forum/usertag.php?do=list&action=hash&hash=179127)

Australia, Pharmacy | Unfiltered | December 9, 2019


(In the pharmacy I worked at they had a sign that said medications are up to 80% off of the regular retail price. A customer comes to my till to pay for his purchases.)

Me: You’re total is (total).

Customer: Where is my discount?

Me: What discount sir?

Customer: The 80% off that it says on that sign!

Me: Oh the discount is already added. What we sell you is already up to 80% off the regular retail price.

Customer: No, it says it’s 80% off, I want my discount.

Me: The discount is already included, it’s off the regular retail price not our current sale price.

(Customer continues to get angrier. He yells at me and won’t let me explain how it works and how it clearly states on the sign what it means. He then starts to blame me personally about the false adversiting in the store even though I have no say as it is a chain store. Eventually he leaves, leaving me to take a break to compose myself.)

[florida80]

Getting The Tattoo Was Too Painful To Remember

Extra Stupid, Pharmacy, USA, Washington | Right | November 27, 2019


(A man covered in tattoos walks up to the pharmacy window to pick up a prescription for his son.)

Cashier: “What is the person’s name?”

Customer: “[Child].”

Cashier: “What is [Child]’s birthday?”

Customer: “Um, is it [date]?”

Me: “No.”

(While the customer is trying to remember his child’s birthday, the cashier notices that a large tattoo on the customer’s arm is the child’s name… and birthday.)

Cashier: “Is [Child]’s birthday [date]?”

Customer: *wide-eyed* “Yes! How did you know?”

Cashier: *speechless*

(I would have thought that if you spent a couple of hours under a tattoo needle, you’d remember what was imprinted into your skin, but I guess I was wrong.)

[florida80]

One Ring To Rue Them All

Bad Behavior, Doctor/Physician, Pharmacy, USA | Healthy | November 13, 2019


My mom has an accident at work and spills boiling water directly on her hand, badly burning several of her fingers, one of which happens to be the finger she wears her wedding ring on. Her boss drives her to a nearby pharmacy clinic where she is seen by the on-call doctor.

At this point, her fingers have swelled a lot, locking her wedding ring on her finger and causing painful constriction. It’s clear that the ring needs to be removed. My mother is assuming they will cut the ring off of her finger, which she is sad about, but at this point, she’s much more concerned about relieving the intense pain she is in. The doctor comes into the room and quickly examines her hand, saying, “What a beautiful ring! It would be such a shame to damage it by cutting it off!”

He then proceeds to forcibly yank the ring off of her finger past the swelling, putting my mother in even more pain and tearing open the blisters that have started to form.

She has since healed and is relieved to be able to wear her ring again and not need to pay to have it fixed, but she isn’t sure it was worth all of the pain and the extra time it took to recover due to the blisters being torn

[florida80]

Mitochondria are the 'canary in the coal mine' for cellular stress

Finding by Salk researchers helps explain how some cancers resist chemotherapy

Salk Institute


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IMAGE: Pictured are mitochondria (red), cell nuclei (blue) and mtDNA (white dots). view more 

Credit: Salk Institute/Waitt Advanced Biophotonics Center

LA JOLLA--(December 13, 2019) Mitochondria, tiny structures present in most cells, are known for their energy-generating machinery. Now, Salk researchers have discovered a new function of mitochondria: they set off molecular alarms when cells are exposed to stress or chemicals that can damage DNA, such as chemotherapy. The results, published online in Nature Metabolism on December 9, 2019, could lead to new cancer treatments that prevent tumors from becoming resistant to chemotherapy.

"Mitochondria are acting as a first line of defense in sensing DNA stress. The mitochondria tell the rest of the cell, 'Hey, I'm under attack, you better protect yourself,'" says Gerald Shadel, a professor in Salk's Molecular and Cell Biology Laboratory and the Audrey Geisel Chair in Biomedical Science.

Most of the DNA that a cell needs to function is found inside the cell's nucleus, packaged in chromosomes and inherited from both parents. But mitochondria each contain their own small circles of DNA (called mitochondrial DNA or mtDNA), passed only from a mother to her offspring. And most cells contain hundreds--or even thousands--of mitochondria.

Shadel's lab group previously showed that cells respond to improperly packaged mtDNA similarly to how they would react to an invading virus--by releasing it from mitochondria and launching an immune response that beefs up the cell's defenses.

In the new study, Shadel and his colleagues set out to look in more detail at what molecular pathways are activated by the release of damaged mtDNA into the cell's interior. They homed in on a subset of genes known as interferon-stimulated genes, or ISGs, that are typically activated by the presence of viruses. But in this case, the team realized, the genes were a particular subset of ISGs turned on by viruses. And this same subset of ISGs is often found to be activated in cancer cells that have developed resistance to chemotherapy with DNA-damaging agents like doxyrubicin.

To destroy cancer, doxyrubicin targets the nuclear DNA. But the new study found that the drug also causes the damage and release of mtDNA, which in turn activates ISGs. This subset of ISGs, the group discovered, helps protect nuclear DNA from damage--and, thus, causes increased resistance to the chemotherapy drug. When Shadel and his colleagues induced mitochondrial stress in melanoma cancer cells, the cells became more resistant to doxyrubicin when grown in culture dishes and even in mice, as higher levels of the ISGs were protecting the cell's DNA.

"Perhaps the fact that mitochondrial DNA is present in so many copies in each cell, and has fewer of its own DNA repair pathways, makes it a very effective sensor of DNA stress," says Shadel.

Most of the time, he points out, it's probably a good thing that the mtDNA is more prone to damage--it acts like a canary in a coal mine to protect healthy cells. But in cancer cells, it means that doxyrubicin--by damaging mtDNA first and setting off molecular alarm bells--can be less effective at damaging the nuclear DNA of cancer cells.

"It says to me that if you can prevent damage to mitochondrial DNA or its release during cancer treatment, you might prevent this form of chemotherapy resistance," Shadel says.

His group is planning future studies on exactly how mtDNA is damaged and released and which DNA repair pathways are activated by the ISGs in the cell's nucleus to ward off damage

[florida80]

Dartmouth study finds conscious visual perception occurs outside the visual system


Dartmouth College


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IMAGE: One of the stimuli from the fMRI experiments illustrates the remarkable difference between the perceived (illusory) path versus the real (physical) path of the Gabor patch. Click here ((https://www.cavlab.net/Demos/CBDemo/) for... view more 

Credit: Figure by Sirui Liu and Patrick Cavanagh.

A Dartmouth study finds that the conscious perception of visual location occurs in the frontal lobes of the brain, rather than in the visual system in the back of the brain. The findings are published in Current Biology.

The results are significant given the ongoing debate among neuroscientists on what consciousness is and where it happens in the brain.

"Our study provides clear evidence that the visual system is not representing what we see but is representing the physical world," said lead author, Sirui Liu, a graduate student of psychological and brain sciences at Dartmouth. "What we see emerges later in the processing hierarchy, in the frontal areas of the brain that are not usually associated with visual processing."

To examine how the perception of position occurs in the brain, participants were presented with visual stimuli and asked to complete a series of behavioral tasks while in a functional magnetic resonance imaging (fMRI) scanner. For one of the tasks, participants were asked to stare at a fixed black dot on the left side of the computer screen inside the scanner while a dot that flickered between black and white, known as a Gabor patch, moved in the periphery. Participants were asked to identify the direction the patch was moving. (Click here (https:/​/​www.​cavlab.​n et/​Demos/​CBDemo/​) to view or download the video of the stimulus used in the experiment). The patch appears to move across the screen at a 45 degree angle, when in fact it is moving up and down in a vertical motion. Here, the perceived path is strikingly different from the actual physical path that lands on the retina. This creates a "double-drift" illusion. The direction of the drift was randomized across the trials, where it drifted either towards the left, right or remained static.

Using fMRI data and multivariate pattern analysis, a method for studying neural activation patterns, the team investigated where the perceived path, tilted left or right from vertical, appears in the brain. They wanted to determine where conscious perception emerges and how the brain codes this. On average, participants reported that the perceived motion path was different from the actual path by 45 degrees or more. The researchers found that while the visual system collects the data, the switch between coding the physical path and coding the perceived path (illusory path) takes place outside of the visual cortex all the way in the frontal areas, which are higher-order brain regions.

"Our data firmly support that frontal areas are critical to the emergence of conscious perception," explained study co-author and co-principal investigator, Patrick Cavanagh, a research professor of psychological and brain sciences at Dartmouth, and senior research fellow and adjunct professor of psychology at Glendon College. "While previous research has long established the frontal lobes are responsible for functions such as decision-making and thinking, our findings suggest that this area of the brain is also the end step for perceiving where objects are. So, that's kind of radical," he added

[florida80]

Following the lizard lung labyrinth

Savannah monitor lizards have a unique airflow pattern that is a hybrid of bird and mammal flow patterns

University of Utah


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IMAGE: Different types of airflow patterns in animal lungs. Mammals (top left) have a tidal airflow pattern where air moves to-and-fro through a branching network of bronchi. Birds (top right) have... view more 

Credit: Robert Cieri

Take a deep breath in. Slowly let it out.

You have just participated in one of the most profound evolutionary revolutions on Earth--breathing air on land. It's unclear how the first vertebrates thrived after crawling out of the sea nearly 400 million years ago, but the lungs hold an important clue.

Birds, reptiles, mammals and birds have evolved diverse lung structures through which air flows in complicated ways. Birds and mammals are on extreme ends of the airflow spectrum. Mammals inhale oxygen-rich air that funnels into smaller branches, ending in tiny sacs where oxygen enters and carbon dioxide leaves the bloodstream. When mammals exhale, the depleted air follows the same route out of the body, exhibiting a so-called tidal flow pattern.

In contrast, bird breath travels tidally through part of the respiratory system, but in a one-way loop throughout most of the lung. Thanks to a unique design with aerodynamic valves, air always moves toward the head through many tiny tubes in birds--during both inhalation and exhalation. Scientists thought this pattern of flow is hyper efficient and evolved to support flight until University of Utah biologist Colleen Farmer's research group discovered that alligators and iguanas also have a unidirectional air flow pattern.

In their latest study, U biologists have discovered that Savannah monitor lizards have lung structures that are a kind of a hybrid system of bird and mammal lungs. The researchers took CT scans of the entire lung labyrinth and used two different supercomputers to simulate airflow patterns at the highest resolution. The software used computational fluid dynamics similar to those used to forecast weather, calculating millions of equations every tenth of a second. The findings show that vertebrate lung evolution is complicated and we have yet to understand the full picture.

"We don't know why animals have different types of lung air flow," said lead author Robert Cieri, a postdoc at the University of the Sunshine Coast who did the research while a graduate student in Farmer's lab. "Why do humans have the lungs we have verses the lungs of a bird? That's not a simple question. By answering that, maybe we can find out more about our own history."

The paper published on Dec. 13 in The Anatomical Record.

A unique airflow pattern

The Savannah monitor lizard has long fascinated scientists because they have one of the most complicated lung systems of any reptile. In 2014, Cieri and colleagues analyzed one section of the lung that had primarily one-way airflow. This new study uses more powerful techniques to paint a completer and more complicated picture. Savannah monitor lizard lungs are structured around a long branchial tube that runs through to the back of the lung and opens into a big sac. Many smaller tubes branch off from the main one and distribute air into tiny chambers. These chambers have holes in their walls, allowing air to flow also from chamber to chamber. This complicated layout results in an airflow pattern that changes over the course of a breath cycle. It's a unique pattern that is part bird, part mammal.

When the animal exhales, nearly all of the air flows towards the front of the lung and out of the trachea in a net unidirectional flow. At the beginning of inhalation, air enters through the trachea and flows towards the back of the lung. As the inhale continues, the air begins to distribute throughout the different side chambers and starts to loop back around towards the front of the lung. As these loops become more dominant, the late stages of inhalation look similar to exhalation because most of the air is flowing unilaterally back from the central chamber. The complicated structure has no flaps or valves that determine airflow, like the heart pumps blood. Pure aerodynamics guide the complicated physics.

"This study is important in demonstrating it is possible to numerically analyze patterns of airflow in these extremely complicated lungs. This quantitative ability opens up new avenues to study the basic mechanisms of how aerodynamic valve work, and gives us better tools to piece together the evolutionary history of these patterns of flow and the structures that underpin them," said senior author Farmer.

Supercomputers tell a complicated story

The physics is so complicated that Cieri needed two supercomputers from the Center for High Performance Computing at the U and the National Science Foundation Blue Waters to run the computer fluid dynamics simulation. After creating the CT scans, he modified existing software to predict the velocity and pressure based on the lung structure. He divided the structures into millions of tiny "boxes." Each box has the physical parameters of that section of the lung. The simulation uses equations to predict what the pressure and velocity will be in the next box, and so on.

"There are millions of these elements. Each one is influencing another one every ten-thousandth of a second in every direction. That's why we needed the computer power--the simulation is brute force balancing two equations at each step to figure out the next piece," said Cieri.

The evolution of lungs is one crucial clue to understanding the pressures that led to where we are now. Along with learning more about lung evolution, Cieri believes we can learn something from the physics of the structure.

"We have this amazing wealth of really cool fluid dynamics out there in the animal world that we want to know more ab

[florida80]

Salmon lose diversity in managed rivers, reducing resilience to environmental change

Natural resilience is more important than ever in the face of unprecedented climate change

NOAA Fisheries West Coast Region


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IMAGE: Chinook salmon smolts are facing increasingly warm waterways in order to reach the ocean. view more 

Credit: Photo: Rachel Johnson, NOAA Fisheries/University of California, Davis

The manipulation of rivers in California is jeopardizing the resilience of native Chinook salmon. It compresses their migration timing to the point that they crowd their habitats. They may miss the best window for entering the ocean and growing into adults, new research shows.

The good news is that even small steps to improve their access to habitat and restore natural flows could boost their survival.

The curtailment of high winter river flows by dams means that they no longer provide the cue for the smallest fish to begin their migration to the ocean. The loss of wetlands in the Sacramento-San Joaquin Delta leaves little of the refuge habitat they need to grow along the way. Meanwhile later-migrating fish suffer from rising summer temperatures that reduce their survival even though they migrate at a larger size.

Fish that begin their migration in mid-spring are the ones that survive best and dominate adult salmon returns to rivers such as the Stanislaus. These results were cited in a study published this week in Global Change Biology. Flow alteration and habitat loss have in effect homogenized the survival opportunities of salmon in this highly managed river system, researchers wrote.

That diminishes what is called the "portfolio effect," where a diversity of salmon migration strategies help the fish cope with changing environmental conditions. This is similar to how diversified investments help buffer your financial portfolio against jolts in the stock market. Chinook salmon in California evolved diverse migration timing to handle the wide variation in climate, ocean, and river conditions in the Central Valley region. This is also important as climate change and rapidly changing, "whiplash weather" patterns further alter the picture.

"You never know what's going to be a winning strategy in the future," said Anna Sturrock of the University of California, Davis, and lead author of the research that also included scientists from several other agencies and universities. "Keeping options on the table is the best strategy, but that is not what we see happening."

The research also found that the lower flows released from dams tend to reduce fish production. This is likely due to reduced access to floodplain habitats and lower food production in rivers.

Biologists analyzed two decades of salmon migration data and tracked seven generations of Chinook salmon in the Stanislaus River using chemical signals in their ear bones, called otoliths. Otoliths grow in proportion with the salmon and reflect the chemistry of the surrounding water. Researchers can use them to trace the way fish travel to the sea and gauge their size when they move among habitats.

The use of otoliths made it possible to track very young juvenile salmon called fry that are too small to fit with the electronic tags typically used for such research. This alternative approach revealed that large numbers of migrating fry can survive to adulthood--if they can find freshwater rearing habitat where they can grow along the way.

"That tells us there is this other life history strategy that may be really important," said Rachel Johnson, a research fisheries biologist at NOAA Fisheries' Southwest Fisheries Science Center and senior author of the research. "Tracking the smaller fish through their otoliths provides important new insights into Chinook salmon dynamics that have otherwise been missing from the picture."

The trouble is, less than 3 percent of wetland habitat remains in the Sacramento-San Joaquin Delta. This leaves the small, early migrating fry without the much needed feeding and rearing refuge they need to grow and thrive on their seaward journey.

The authors say that even minor steps to restore some of the natural fluctuations in river flow could benefit salmon by helping maintain some of their valuable diversity. Fry migrate early in such great numbers that even small improvements in their survival rates through the Delta could yield many more fish to help boost adult returns.

"As the climate gets more unpredictable, we need to think about incorporating bet-hedging into river management rather than manipulating the environment in ways that limit options for fish," Sturrock said. "The more options that are left on--or added to--the table the better chance that some fish will be in the right place at the right time."

[florida80]

New assay assesses multiple cellular pathways at once


Baylor College of Medicine


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IMAGE: Synthetic assembly cloning for inserting multiple luciferase reporters into a single vector. Nature Communications/The Venken lab view more 

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A novel technological approach developed by researchers at Baylor College of Medicine expands from two to six the number of molecular pathways that can be studied simultaneously in a cell sample with the dual luciferase assay, a type of testing method commonly used across biomedical fields.

Published in the journal Nature Communications, the report shows that multiplexed hextuple luciferase assaying, meaning a testing method that can effectively probe six different pathways. It can also be used to monitor the effects of experimental treatments on multiple molecular targets acting within these pathways. The new assay is sensitive, saves time and expense when compared to traditional approaches, reduces experimental error and can be adapted to any research field where the dual luciferase assay is already implemented, and beyond.

"One of the interests of our lab is to have a better understanding of the processes involved in cancer. Cancer usually originates through changes on many different genes and pathways, not just one, and currently most cell-based screening assays conduct single measurements," said corresponding author Dr. Koen Venken, assistant professor of biochemistry and molecular biology, and pharmacology and chemical biology at Baylor.

To get a more detailed picture of the cellular processes that differentiate normal versus cancer cells, researchers resort to conduct several independent screening assays at the expense of time and additional cost.

"Our goal in this study was to measure multiple cellular pathways at once in a single biological sample, which would also minimize experimental errors resulting from conducting multiple separate assays using different samples," said Venken, a McNair Scholar and member of the Dan L Duncan Comprehensive Cancer Center at Baylor.

Dr. Alejandro Sarrion-Perdigones, first author of the paper, focused on developing a multiplexed method - a method for simultaneously detecting many signals from complex systems, such as living cells. He developed a sensitive assay using luciferases, enzymes that produce bioluminescence. The assay includes six luciferases, each one emitting bioluminescence that can be distinguished from the others. Each luciferase was engineered to reveal the activity of a particular pathway by emitting bioluminescence.

"To engineer and deliver the luciferase system to cells, we used a 'molecular Lego' approach," said co-author Dr. Lyra Chang, post-doctoral researchers at the Center for Drug Discovery at Baylor. "This consists of connecting the DNA fragments encoding all the biological and technological information necessary to express each luciferase gene together sequentially forming a single DNA chain called vector. This single vector enters the cells where each luciferase enzyme is produced separately."

Treating the cells with a single multi-luciferase gene vector instead of using six individual vectors, decreased variability between biological replicates and provided an additional level of experimental control, Chang explained. This approach allowed for simultaneous readout of the activity of five different pathways, compared to just one using traditional approaches, providing a much deeper understanding of cellular pathways of interest.

"In addition to applications in cancer research, as we have shown in this work, our multiplex luciferase assay can be used to study other cellular pathways or complex diseases across different research fields," Venken said. "For instance, the assay can be adapted to study the effect of drugs on insulin sensitivity in different cells types, the immune response to viral infections, or any other combinations of pathways."

[florida80]

News Release 13-Dec-2019

Neural network for elderly care could save millions

A deep neural network model helps predict healthcare visits by elderly people, with the potential to save millions

Aalto University


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If healthcare providers could accurately predict how their services would be used, they could save large sums of money by not having to allocate funds unnecessarily. Deep learning artificial intelligence models can be good at predicting the future given previous behaviour, and researchers based in Finland have developed one that can predict when and why elderly people will use healthcare services.

Researchers at the Finnish Centre for Artificial Intelligence (FCAI), Aalto University, the University of Helsinki, and the Finnish Institute for Health and Welfare (THL) developed a so-called risk adjustment model to predict how often elderly people seek treatment in a healthcare centre or hospital. The results suggest that the new model is more accurate than traditional regression models commonly used for this task, and can reliably predict how the situation changes over the years.

Risk-adjustment models make use of data from previous years, and are used to allocate healthcare funds in a fair and effective way. These models are already used in countries like Germany, the Netherlands, and the US. However, this is the first proof-of-concept that deep neural networks have the potential to significantly improve the accuracy of such models.

'Without a risk adjustment model, healthcare providers whose patients are ill more often than average people would be treated unfairly,' Pekka Marttinen, Assistant Professor at Aalto University and FCAI says. Elderly people are a good example of such a patient group. The goal of the model is to take these differences between patient groups into account when making funding decisions.

According to Yogesh Kumar, the main author of the research article and a doctoral candidate at Aalto University and FCAI, the results show that deep learning may help design more accurate and reliable risk adjustment models. 'Having an accurate model has the potential to save several millions of dollars,' Kumar points out.

The researchers trained the model by using data from the Register of Primary Health Care Visits of THL. The data consists of out-patient visit information for every Finnish citizen aged 65 or above. The data has been pseudonymized, which means that individual persons can not be identified. This was the first time researchers used this database for training a deep machine learning model.

The results show that training a deep model does not necessarily require an enormous dataset in order to produce reliable results. Instead, the new model worked better than simpler, count-based models even when it made use of only one tenth of all available data. In other words, it provides accurate predictions even with a relatively small dataset, which is a remarkable finding, as acquiring large amounts of medical data is always difficult.

'Our goal is not to put the model developed in this research into practice as such but to integrate features of deep learning models to existing models, combining the best sides of both. In the future, the goal is to make use of these models to support decision-making and allocate funds in a more reasonable way,' explains Marttinen.

The implications of this research are not limited to predicting how often elderly people visit a healthcare centre or hospital. Instead, according to Kumar, the researchers' work can easily be extended in many ways, for example, by focusing only on patient groups diagnosed with diseases that require highly expensive treatments or healthcare centers in specific locations across the country.

[florida80]

A self-cleaning surface that repels even the deadliest superbugs

Researchers create the ultimate non-stick coating, with medical settings and food industry in mind

McMaster University


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HAMILTON, ON, Dec. 13, 2019 - A team of researchers at McMaster University has developed a self-cleaning surface that can repel all forms of bacteria, preventing the transfer of antibiotic-resistant superbugs and other dangerous bacteria in settings ranging from hospitals to kitchens.

The new plastic surface - a treated form of conventional transparent wrap - can be shrink-wrapped onto door handles, railings, IV stands and other surfaces that can be magnets for bacteria such as MRSA and C. difficile.

The treated material is also ideal for food packaging, where it could stop the accidental transfer of bacteria such as E. coli, Salmonella and listeria from raw chicken, meat and other foods, as described in a paper published today by the journal ACS Nano.

The research was led by engineers Leyla Soleymani and Tohid Didar, who collaborated with colleagues from McMaster's Institute for Infectious Disease Research and the McMaster-based Canadian Centre for Electron Microscopy.

Inspired by the water-repellent lotus leaf, the new surface works through a combination of nano-scale surface engineering and chemistry. The surface is textured with microscopic wrinkles that exclude all external molecules. A drop of water or blood, for example, simply bounces away when it lands on the surface. The same is true for bacteria.

"We're structurally tuning that plastic," says Soleymani, an engineering physicist. "This material gives us something that can be applied to all kinds of things."

The surface is also treated chemically to further enhance its repellent properties, resulting in a barrier that is flexible, durable and inexpensive to reproduce.

"We can see this technology being used in all kinds of institutional and domestic settings," Didar says. "As the world confronts the crisis of anti-microbial resistance, we hope it will become an important part of the anti-bacterial toolbox."

The researchers tested the material using two of the most troubling forms of antibiotic-resistant bacteria: MRSA and Pseudomonas, with the collaboration of Eric Brown of McMaster's Institute for Infectious Disease Research.

Engineer Kathryn Grandfield helped the team verify the effectiveness of the surface by capturing electron microscope images showing that virtually no bacteria could transfer to the new surface.

The researchers are hoping to work with a commercial partner to develop commercial applications for the wrap.

[florida80]

Tracking lab-grown tissue with light

New proof-of-concept photonic pH sensor could advance studies of tissue regeneration

National Institute of Standards and Technology (NIST)


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Credit: J.L. Lee/NIST


Someday, doctors would like to grow limbs and other body tissue for soldiers who have lost arms in battle, children who need a new heart or liver, and many other people with critical needs. Today, medical professionals can graft cells from a patient, deposit them onto a tissue scaffold, and insert the scaffold into the body to encourage the growth of bone, cartilage and other specialized tissue. But researchers are still working toward building complex organs that can be implanted into patients.

Scientists at the National Institute of Standards and Technology (NIST) are supporting this field of research by developing a promising new kind of light-based sensor to study tissue growth in the lab.

The NIST team's proof-of-concept work, published today in Sensors and Actuators B, demonstrates a small sensor that uses a light-based signal to measure pH, the measurement unit for acidity, an important property in cell-growth studies. The same basic design could be used to measure other qualities such as the presence of calcium, cell growth factor and certain antibodies.

Unlike conventional sensors, this measurement method could be used to monitor the environment in a cell culture long-term -- for weeks at a time -- without having to disturb the cells regularly to calibrate the sensing instruments. Watching properties of the tissue in real time as they slowly change, over days or weeks, could greatly benefit tissue engineering studies to grow teeth, heart tissue, bone tissue and more, said NIST chemist Zeeshan Ahmed.

"We want to make sensors that can be put inside growing tissue to give researchers quantitative information," Ahmed said. "Is the tissue actually growing? Is it healthy? If you grow a bone, does it have the right mechanical properties or is it too weak to support a body?"

The work could have benefits beyond tissue engineering too, into studying the progression of diseases such as cancer.

"What these sensors could give people is real-time information about tissue growth and disease progression," said American University chemist and NIST guest researcher Matthew Hartings. Conventional sensors give researchers a series of snapshots without showing them the path between those points, Hartings said. But photonic sensors could provide scientists with continuous information, the equivalent of a GPS navigation app for disease.

"We want to provide researchers with a detailed map of the incremental changes that happen as tissue either grows in a healthy way or becomes diseased," Hartings said. "Once researchers know the 'streets' a disease is taking, then they can better prevent or support the changes that are happening" in a patient's body.

A Problem to Solve

Measurements of pH are a vital part of tissue engineering studies. As cells grow, their environment naturally becomes more acidic. If the environment becomes too acidic -- or too basic -- the cells will die. Scientists measure pH on a scale from 0 (very acidic) to 14 (very basic), with an ideal environment for most cells in a narrow range around a pH of 7.

Commercial pH instruments are highly accurate but unstable, meaning they require frequent calibrations to ensure accurate readings day to day. Without calibration, these conventional pH meters lose up to 0.1 pH units of accuracy daily. But tissue engineering studies take place on the order of weeks. A culture of stem cells might need to be grown for almost a month before they turn into bone.

"An increment of 0.1 pH is significant," Ahmed said. "If your pH value changes by 1, you kill the cells. If after a few days I can't trust anything about my pH measurement, then I'm not going to use that measurement method."

On the other hand, if researchers disturb the growing cells every time they have to measure the cell culture's pH, then the scientists are introducing another kind of uncertainty to their measurements, since they are altering the cells' environment.

What's needed for this kind of research, Ahmed said, is a measurement system that can stay inside an incubator with the cells in their culture medium and not need to be removed or calibrated for weeks at a time.

Brave New Sensors

For years, Ahmed and his team have been developing photonic sensors, small lightweight devices that use optical signals to measure a range of qualities including temperature, pressure and humidity.

Some of these novel devices use commercially available, flexible optical fibers etched with a Bragg grating, a kind of filter for light that reflects certain wavelengths and allows others to pass. Changes in temperature or pressure alter the wavelengths of light that can pass through the grating.

To adapt their photonic devices to a pH measurement, Ahmed and Hartings relied on a well-known concept in science: When an object absorbs light, the energy absorbed "has to go somewhere," Ahmed said, and in many cases that energy turns into heat.

"For every individual photon, the heat produced is a very small amount of energy," Ahmed said. "But if you have lots of photons coming in, and you have lots of molecules, it becomes an appreciable change in heat."

For their demonstration, the scientists used a substance that changes color in response to changes in pH, a material that many people may remember from biology classes: red cabbage juice powder. Cabbage juice changes its color from shades of dark purple to light pink depending on the acidity of a solution. That change in color can be picked up by Ahmed's photonic temperature sensors.

Researchers filled a petri dish with the cabbage juice solution. One optical fiber was positioned above the dish. It was connected to a laser pointer and shined light into the sample. A second optical fiber was physically embedded in the liquid. This second fiber contained the Bragg grating and acted as the temperature sensor. Ahmed's team controlled the solution's pH manually.

To make a measurement, the researchers shone one color of light -- such as red -- into the sample from above. The cabbage juice absorbed the red light to varying degrees based on its color, which depended on the pH of the solution at that time. The photonic thermometer fiber picked up these slight changes in the juice's heat. A change in temperature changes the wavelengths of light that can pass through the fiber's Bragg grating.

Next, the researchers shone a second color of light -- such as green -- into the liquid, and repeated the process.

By comparing how much heat was generated by each color of light, researchers could determine the exact color of the cabbage juice at that moment, and that told them the pH.

"Literally we said, 'Can we turn two laser pointers on and off for a few minutes and see if we can turn that into a pH meter?'," Ahmed said. "And we were able to show that it works over a wide range," from a pH of 4 to a pH of 9 or 10.

Ongoing work shows the photonic pH measurements are accurate to plus or minus 0.13 pH units and are stable for at least three weeks, much longer than conventional measurements.

Beyond Cabbage Juice

The researchers say that according to their tissue engineering collaborators, the new photonic sensors could provide useful information for a range of biological systems being studied, particularly the growth of heart and bone cells.

For their next round of experiments, already underway, the NIST researchers are using another pH-sensitive dye called phenol red. In addition, they are working to encapsulate the dye in a plastic coating around the fiber itself so that it does not interact with the cell medium. The team is also conducting its first test of the system in a real cell culture, with help from NIST colleagues who specialize in tissue engineering.

Future plans include measuring quantities beyond pH, which would simply require swapping out phenol red for a different dye sensitive to whatever property researchers want to measure.

NIST researchers will also be testing how cell cultures are affected by the slight, temporary temperature changes (about 1-2 kelvin) in localized areas of the sample that occur as a result of this measurement method. Ahmed says that so far, potential collaborators are not overly concerned about the issue of localized heating, and that his team will be working to reduce the temperature changes as much as possible.

And much further in the future, Ahmed hopes the measurement scheme could potentially be used to monitor the growth of tissue in a real person's body.

"The long-term goal is being able to put implantable devices into people where you're trying to grow bones and muscles, and then hopefully over time the sensors could be designed to dissolve away and you wouldn't even have to go back in and remove them," Ahmed said. "That's the ultimate dream. But baby steps first."

EDITOR'S NOTE: This story was updated on the afternoon of December 13, 2019 with an additional paragraph to indicate the temporary temperature changes that result from this technique as well as the researchers' plans to test their effects on cell cultures.

[florida80]

Tracking lab-grown tissue with light

New proof-of-concept photonic pH sensor could advance studies of tissue regeneration

National Institute of Standards and Technology (NIST)





IMAGE: An empty petri dish with two optical fibers, illustrating one version of the researchers' experiment. The left-hand fiber (usually shining infrared light, but depicted here as visible red light) is... view more 

Credit: J.L. Lee/NIST


Someday, doctors would like to grow limbs and other body tissue for soldiers who have lost arms in battle, children who need a new heart or liver, and many other people with critical needs. Today, medical professionals can graft cells from a patient, deposit them onto a tissue scaffold, and insert the scaffold into the body to encourage the growth of bone, cartilage and other specialized tissue. But researchers are still working toward building complex organs that can be implanted into patients.

Scientists at the National Institute of Standards and Technology (NIST) are supporting this field of research by developing a promising new kind of light-based sensor to study tissue growth in the lab.

The NIST team's proof-of-concept work, published today in Sensors and Actuators B, demonstrates a small sensor that uses a light-based signal to measure pH, the measurement unit for acidity, an important property in cell-growth studies. The same basic design could be used to measure other qualities such as the presence of calcium, cell growth factor and certain antibodies.

Unlike conventional sensors, this measurement method could be used to monitor the environment in a cell culture long-term -- for weeks at a time -- without having to disturb the cells regularly to calibrate the sensing instruments. Watching properties of the tissue in real time as they slowly change, over days or weeks, could greatly benefit tissue engineering studies to grow teeth, heart tissue, bone tissue and more, said NIST chemist Zeeshan Ahmed.

"We want to make sensors that can be put inside growing tissue to give researchers quantitative information," Ahmed said. "Is the tissue actually growing? Is it healthy? If you grow a bone, does it have the right mechanical properties or is it too weak to support a body?"

The work could have benefits beyond tissue engineering too, into studying the progression of diseases such as cancer.

"What these sensors could give people is real-time information about tissue growth and disease progression," said American University chemist and NIST guest researcher Matthew Hartings. Conventional sensors give researchers a series of snapshots without showing them the path between those points, Hartings said. But photonic sensors could provide scientists with continuous information, the equivalent of a GPS navigation app for disease.

"We want to provide researchers with a detailed map of the incremental changes that happen as tissue either grows in a healthy way or becomes diseased," Hartings said. "Once researchers know the 'streets' a disease is taking, then they can better prevent or support the changes that are happening" in a patient's body.

A Problem to Solve

Measurements of pH are a vital part of tissue engineering studies. As cells grow, their environment naturally becomes more acidic. If the environment becomes too acidic -- or too basic -- the cells will die. Scientists measure pH on a scale from 0 (very acidic) to 14 (very basic), with an ideal environment for most cells in a narrow range around a pH of 7.

Commercial pH instruments are highly accurate but unstable, meaning they require frequent calibrations to ensure accurate readings day to day. Without calibration, these conventional pH meters lose up to 0.1 pH units of accuracy daily. But tissue engineering studies take place on the order of weeks. A culture of stem cells might need to be grown for almost a month before they turn into bone.

"An increment of 0.1 pH is significant," Ahmed said. "If your pH value changes by 1, you kill the cells. If after a few days I can't trust anything about my pH measurement, then I'm not going to use that measurement method."

On the other hand, if researchers disturb the growing cells every time they have to measure the cell culture's pH, then the scientists are introducing another kind of uncertainty to their measurements, since they are altering the cells' environment.

What's needed for this kind of research, Ahmed said, is a measurement system that can stay inside an incubator with the cells in their culture medium and not need to be removed or calibrated for weeks at a time.

Brave New Sensors

For years, Ahmed and his team have been developing photonic sensors, small lightweight devices that use optical signals to measure a range of qualities including temperature, pressure and humidity.

Some of these novel devices use commercially available, flexible optical fibers etched with a Bragg grating, a kind of filter for light that reflects certain wavelengths and allows others to pass. Changes in temperature or pressure alter the wavelengths of light that can pass through the grating.

To adapt their photonic devices to a pH measurement, Ahmed and Hartings relied on a well-known concept in science: When an object absorbs light, the energy absorbed "has to go somewhere," Ahmed said, and in many cases that energy turns into heat.

"For every individual photon, the heat produced is a very small amount of energy," Ahmed said. "But if you have lots of photons coming in, and you have lots of molecules, it becomes an appreciable change in heat."

For their demonstration, the scientists used a substance that changes color in response to changes in pH, a material that many people may remember from biology classes: red cabbage juice powder. Cabbage juice changes its color from shades of dark purple to light pink depending on the acidity of a solution. That change in color can be picked up by Ahmed's photonic temperature sensors.

Researchers filled a petri dish with the cabbage juice solution. One optical fiber was positioned above the dish. It was connected to a laser pointer and shined light into the sample. A second optical fiber was physically embedded in the liquid. This second fiber contained the Bragg grating and acted as the temperature sensor. Ahmed's team controlled the solution's pH manually.

To make a measurement, the researchers shone one color of light -- such as red -- into the sample from above. The cabbage juice absorbed the red light to varying degrees based on its color, which depended on the pH of the solution at that time. The photonic thermometer fiber picked up these slight changes in the juice's heat. A change in temperature changes the wavelengths of light that can pass through the fiber's Bragg grating.

Next, the researchers shone a second color of light -- such as green -- into the liquid, and repeated the process.

By comparing how much heat was generated by each color of light, researchers could determine the exact color of the cabbage juice at that moment, and that told them the pH.

"Literally we said, 'Can we turn two laser pointers on and off for a few minutes and see if we can turn that into a pH meter?'," Ahmed said. "And we were able to show that it works over a wide range," from a pH of 4 to a pH of 9 or 10.

Ongoing work shows the photonic pH measurements are accurate to plus or minus 0.13 pH units and are stable for at least three weeks, much longer than conventional measurements.

Beyond Cabbage Juice

The researchers say that according to their tissue engineering collaborators, the new photonic sensors could provide useful information for a range of biological systems being studied, particularly the growth of heart and bone cells.

For their next round of experiments, already underway, the NIST researchers are using another pH-sensitive dye called phenol red. In addition, they are working to encapsulate the dye in a plastic coating around the fiber itself so that it does not interact with the cell medium. The team is also conducting its first test of the system in a real cell culture, with help from NIST colleagues who specialize in tissue engineering.

Future plans include measuring quantities beyond pH, which would simply require swapping out phenol red for a different dye sensitive to whatever property researchers want to measure.

NIST researchers will also be testing how cell cultures are affected by the slight, temporary temperature changes (about 1-2 kelvin) in localized areas of the sample that occur as a result of this measurement method. Ahmed says that so far, potential collaborators are not overly concerned about the issue of localized heating, and that his team will be working to reduce the temperature changes as much as possible.

And much further in the future, Ahmed hopes the measurement scheme could potentially be used to monitor the growth of tissue in a real person's body.

"The long-term goal is being able to put implantable devices into people where you're trying to grow bones and muscles, and then hopefully over time the sensors could be designed to dissolve away and you wouldn't even have to go back in and remove them," Ahmed said. "That's the ultimate dream. But baby steps first."

EDITOR'S NOTE: This story was updated on the afternoon of December 13, 2019 with an additional paragraph to indicate the temporary temperature changes that result from this technique as well as the researchers' plans to test their effects on cell cultures.

[florida80]

13-Dec-2019

Meaningful change in culture urged to save neurology, reduce gender gap


University of California - Davis Health


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(SACRAMENTO) -- Allison Brashear, Dean of the UC Davis School of Medicine, is working to save the future workforce of neurology and to reduce the gender gap in the medical specialty.

More trained neurologists are needed to meet the demand for care in the U.S. More trained neurologists are needed to meet the demand for care in the U.S.

In an editorial published Dec. 3 in the journal Neurology, Brashear and colleague Nina Schor call for meaningful changes in the culture of the field - ones that aren't portrayed as concessions to accommodate women's shortcomings or special needs. Schor is deputy director at the National Institute of Neurological Disorders and Stroke.

"Burnout among all physicians and the persistent predominance of men in the neurology workforce are widening the gender gap, at a critical time when the demand for neurologists is only expected to increase," Brashear said.

In the U.S. alone, the number of trained neurologists is expected to increase by only 7% by 2025, while the projected demand for services places the increased need at 16%.

"As women increasingly make up medical school classes, choose medical fields in which they can earn the same salaries as their male colleagues, seek positions that provide flexibility in workload and work hours, and retire before 65 years of age, the specialty needs to evolve to both meet these needs and prevent the burnout that may result in early retirement and part-time status," Schor said.

Reducing the gender gap in neurology means addressing a variety of factors, from burnout and women leaving the field, to the difference in pay between male and female neurologists - a gap which is one of the largest in any medical specialty.

"In many fields and on six continents, women physicians, nurses, physician assistants and residents deal with larger clinical workloads, longer clinical hours, lower salaries and more personal caregiving and homemaking duties than their male counterparts," Brashear said. "There are also fewer women in leadership positions to advocate for change. Only 14 of 113 neurology department chairs are women."

The authors believe identifying and mitigating these factors may help narrow the gender gap and increase the supply of neurologists to better meet future patient needs. They suggest structuring positions to give more time to complete administrative tasks, offering more flexible work hours, providing daycare at the workplace, setting salaries at a level that encourages hiring help for daily tasks and chores in the home, and making it routine for all early career neurologists (men and women) to have mentors for personal and career support.

[florida80]

Students do better in school when they can understand, manage emotions

Emotionally intelligent students get better grades and higher test scores, study says

American Psychological Association


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WASHINGTON -- Students who are better able to understand and manage their emotions effectively, a skill known as emotional intelligence, do better at school than their less skilled peers, as measured by grades and standardized test scores, according to research published by the American Psychological Association.

"Although we know that high intelligence and a conscientious personality are the most important psychological traits necessary for academic success, our research highlights a third factor, emotional intelligence, that may also help students succeed," said Carolyn MacCann, PhD, of the University of Sydney and lead author of the study. "It's not enough to be smart and hardworking. Students must also be able to understand and manage their emotions to succeed at school."

The research was published in the journal Psychological Bulletin.

The concept of emotional intelligence as an area of academic research is relatively new, dating to the 1990s, according to MacCann. Although there is evidence that social and emotional learning programs in schools are effective at improving academic performance, she believes this may be the first comprehensive meta-analysis on whether higher emotional intelligence relates to academic success.

MacCann and her colleagues analyzed data from more than 160 studies, representing more than 42,000 students from 27 countries, published between 1998 and 2019. More than 76% were from English-speaking countries. The students ranged in age from elementary school to college. The researchers found that students with higher emotional intelligence tended to get higher grades and better achievement test scores than those with lower emotional intelligence scores. This finding held true even when controlling for intelligence and personality factors.

What was most surprising to the researchers was the association held regardless of age.

As for why emotional intelligence can affect academic performance, MacCann believes a number of factors may come into play.

"Students with higher emotional intelligence may be better able to manage negative emotions, such as anxiety, boredom and disappointment, that can negatively affect academic performance," she said. "Also, these students may be better able to manage the social world around them, forming better relationships with teachers, peers and family, all of which are important to academic success."

Finally, the skills required for emotional intelligence, such as understanding human motivation and emotion, may overlap with the skills required to master certain subjects, such as history and language, giving students an advantage in those subject areas, according MacCann.

As an example, MacCann described the school day of a hypothetical student named Kelly, who is good at math and science but low in emotional intelligence.

"She has difficulty seeing when others are irritated, worried or sad. She does not know how people's emotions may cause future behavior. She does not know what to do to regulate her own feelings," said MacCann.

As a result, Kelly does not recognize when her best friend, Lucia, is having a bad day, making Lucia mad at her for her insensitivity. Lucia then does not help Kelly (as she usually does) later in English literature class, a class she often struggles in because it requires her to analyze and understand the motivations and emotions of characters in books and plays.

"Kelly feels ashamed that she can't do the work in English literature that other students seem to find easy. She is also upset that Lucia is mad at her. She can't seem to shake these feelings, and she is not able to concentrate on her math problems in the next class," said MacCann. "Because of her low emotion management ability, Kelly cannot bounce back from her negative emotions and finds herself struggling even in subjects she is good at."

MacCann cautions against widespread testing of students to identify and target those with low emotional intelligence as it may stigmatize those students. Instead, she recommends interventions that involve the whole school, including additional teacher training and a focus on teacher well-being and emotional skills.

"Programs that integrate emotional skill development into the existing curriculum would be beneficial, as research suggests that training works better when run

[florida80]

News Release 12-Dec-2019

Students do better in school when they can understand, manage emotions

Emotionally intelligent students get better grades and higher test scores, study says

American Psychological Association


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WASHINGTON -- Students who are better able to understand and manage their emotions effectively, a skill known as emotional intelligence, do better at school than their less skilled peers, as measured by grades and standardized test scores, according to research published by the American Psychological Association.

"Although we know that high intelligence and a conscientious personality are the most important psychological traits necessary for academic success, our research highlights a third factor, emotional intelligence, that may also help students succeed," said Carolyn MacCann, PhD, of the University of Sydney and lead author of the study. "It's not enough to be smart and hardworking. Students must also be able to understand and manage their emotions to succeed at school."

The research was published in the journal Psychological Bulletin.

The concept of emotional intelligence as an area of academic research is relatively new, dating to the 1990s, according to MacCann. Although there is evidence that social and emotional learning programs in schools are effective at improving academic performance, she believes this may be the first comprehensive meta-analysis on whether higher emotional intelligence relates to academic success.

MacCann and her colleagues analyzed data from more than 160 studies, representing more than 42,000 students from 27 countries, published between 1998 and 2019. More than 76% were from English-speaking countries. The students ranged in age from elementary school to college. The researchers found that students with higher emotional intelligence tended to get higher grades and better achievement test scores than those with lower emotional intelligence scores. This finding held true even when controlling for intelligence and personality factors.

What was most surprising to the researchers was the association held regardless of age.

As for why emotional intelligence can affect academic performance, MacCann believes a number of factors may come into play.

"Students with higher emotional intelligence may be better able to manage negative emotions, such as anxiety, boredom and disappointment, that can negatively affect academic performance," she said. "Also, these students may be better able to manage the social world around them, forming better relationships with teachers, peers and family, all of which are important to academic success."

Finally, the skills required for emotional intelligence, such as understanding human motivation and emotion, may overlap with the skills required to master certain subjects, such as history and language, giving students an advantage in those subject areas, according MacCann.

As an example, MacCann described the school day of a hypothetical student named Kelly, who is good at math and science but low in emotional intelligence.

"She has difficulty seeing when others are irritated, worried or sad. She does not know how people's emotions may cause future behavior. She does not know what to do to regulate her own feelings," said MacCann.

As a result, Kelly does not recognize when her best friend, Lucia, is having a bad day, making Lucia mad at her for her insensitivity. Lucia then does not help Kelly (as she usually does) later in English literature class, a class she often struggles in because it requires her to analyze and understand the motivations and emotions of characters in books and plays.

"Kelly feels ashamed that she can't do the work in English literature that other students seem to find easy. She is also upset that Lucia is mad at her. She can't seem to shake these feelings, and she is not able to concentrate on her math problems in the next class," said MacCann. "Because of her low emotion management ability, Kelly cannot bounce back from her negative emotions and finds herself struggling even in subjects she is good at."

MacCann cautions against widespread testing of students to identify and target those with low emotional intelligence as it may stigmatize those students. Instead, she recommends interventions that involve the whole school, including additional teacher training and a focus on teacher well-being and emotional skills.

"Programs that integrate emotional skill development into the existing curriculum would be beneficial, as research suggests that training works better when run by teachers rather than external specialists," she said. "Increasing skills for everyone - not just those with low emotional intelligence - would benefit everyone."

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How does political news affect moods? New study in young doctors shows real-time effects

Major American political events of the last three years altered interns' moods, but non-political events didn't, signaling a politically aware generation of physicians

Michigan Medicine - University of Michigan


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IMAGE: The study looks at the impact of political events on the moods of young doctors. view more 

Credit: University of Michigan

They work in a bubble of 80-hour work weeks, and 24-hour shifts. They're caring for patients for the first time, while still learning the ropes of the medical profession. The constant stress wears on their mental health.

But for first-year doctors who started their careers in the past few years, a new study shows that certain political events pierced that bubble of intense training.

In fact, some political events affected their mood just as much as the intense first weeks of their training had.

In a paper in the journal BMJ, a team from the University of Michigan reports the results of a real-time, long-term assessment of the moods of young doctors, called interns, in relation to major political and non-political events of the past few years.

The authors call for further exploration of the interactions between politics and medicine, and the implications for physicians and their patients.

Monitoring mood

The study used data from an ongoing study of intern health that has already yielded findings about the high risk of depression among interns, and the relationship between intense stress and mental health in general.

The new paper focuses on daily mood ratings from 2,345 interns who were in their first year of training at American hospitals anytime between mid-2016 and late 2018, and how they changed in the immediate aftermath of major national and world events.

Three events -- the 2016 U.S. election, the 2017 U.S. presidential inauguration, and the failure of a federal spending bill to fund a Mexican border wall - were followed by the largest collective changes in mood.

The first of these events was actually associated with a drop in mood larger than the drop that interns experienced in the first weeks of their intense training. The second led to a sizable mood drop, while the third led to a collective mood boost.

The authors note in an accompanying commentary, the decline in mood immediately after the election was four times greater than any other day they had tracked, and female interns' mood drop was twice as large as that seen among male interns. The study group was 55% female, a slightly higher percentage than the current generation of recent medical school graduates.

Two-thirds of the major political events in the study period prompted significant changes in interns' moods. No non-political event during the study period - not mass shootings, hurricanes, wildfires, a royal wedding or a solar eclipse - affected interns' moods.

"This suggests to us that interns were deeply engaged with and affected by the election, even while facing the incredible demands of their intern year," says Elena Frank, Ph.D., the director of the Intern Health Study. "It also suggests that the 2016 election was experienced as deeply personal and distressing for many young women in medicine."

Politics and physicians

Srijan Sen, M.D., Ph.D., the principal investigator of the Intern Health Study and a professor of psychiatry at U-M, said that given the intensity of the intern year's demands, he had been surprised that any external event managed to affect the moods of interns as much as the study shows.

He recalls that Hurricane Katrina decimated New Orleans and neighboring areas of the Gulf Coast during his own intern year, and he only became aware weeks later.

"The new generation of physicians seems to be more politically engaged than how doctors had traditionally been seen," he says. "This suggests that there is a real opportunity for physicians to lend their voice and join the discussion on issues relevant to clinicians and their patients."

Frank, Sen and their colleagues used mood ratings collected daily from interns via a smartphone app used in the study, which asks them to assess their mood each evening. They combined these data with national Google search data about the most searched-for events during the study period.

They note that the strong negative and positive reactions to certain news events may also have to do with the changing demographics of those going into the medical profession - not just more women, but more people of color, and more people from varied socioeconomic backgrounds.

But the question of whether the broader range of backgrounds - and political views - of doctors will translate into more political activism and public expression of views still remains to be seen. Physicians in the past may have refrained from engaging in politics in public ways, to avoid having their political views affect their interactions with patients.

"There has always been a vigorous debate in medicine on whether physicians should engage in politics and to what extent," says Brahmajee Nallamothu, M.D., M.P.H., a co-author of the study and professor of internal medicine at U-M. "These data suggest deep engagement is happening in young doctors during even their most intense clinical workload."

The new findings may also add to understanding of how the tumult of the current period may be affecting people who aren't in the midst of intense medical training.

"Political events may be affecting people's moods in ways they didn't before, and we hope our research in general can help illuminate the ways that stress and external events affect mental health," says Sen.

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Why are giant pandas born so tiny?

New clues from bones put an old theory to the test

Duke University


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IMAGE: This newborn panda skull casts doubt on an old idea about why bears are born so tiny. view more 

Credit: Courtesy of Peishu Li and Duke SMIF.

DURHAM, N.C. -- Born pink, blind, and helpless, giant pandas typically weigh about 100 grams at birth -- the equivalent of a stick of butter. Their mothers are 900 times more massive than that.

This unusual size difference has left researchers puzzled for years. With a few exceptions among animals such as echidnas and kangaroos, no other mammal newborns are so tiny relative to their mothers. No one knows why, but a Duke University study of bones across 10 species of bears and other animals finds that some of the current theories don't hold up.

Duke biology professor Kathleen Smith and her former student Peishu Li published their findings this month in the Journal of Anatomy.

Baby panda skeletons are hard to come by, but the researchers were able to study the preserved remains of baby pandas born at the Smithsonian's National Zoo in Washington, D.C.

The National Zoo's first panda couple, Ling-Ling and Hsing-Hsing, had five full-term cubs in the 1980s, but none of them survived long after birth.

The researchers took micro-CT scans of two of those cubs, along with newborn grizzlies, sloth bears, polar bears, dogs, a fox, and other closely related animals from the Smithsonian National Museum of Natural History and the North Carolina State College of Veterinary Medicine.

They used the scans to create 3-D digital models of each baby's bony interior at birth.

As a baby animal grows and develops inside the womb, its bones and teeth do, too. The researchers examined the degree of ossification, or how much the skeleton has formed by the time of birth. They looked at whether the teeth had started to calcify or erupt, and the degree of fusion between the bony plates that make up the skull.

The panda may be an extreme example, but all bears have disproportionately small babies, Li said. A newborn polar bear's birthweight as a fraction of mom's is less than 1:400, or less than one-half of one percent of her body mass. For the vast majority of baby mammals, including humans, the average is closer to 1:26.

One decades-old idea links low birthweights in bears to the fact that, for some species, pregnancy overlaps with winter hibernation. Pregnant females don't eat or drink during this time, relying mostly on their fat reserves to survive, but also breaking down muscle to supply protein to the fetus.

The thinking is that, energetically, females can only afford to nourish their babies this way for so long before this tissue breakdown threatens their health. By cutting pregnancy short and giving birth to small, immature babies, bears would shift more of their growth to outside the womb, where babies can live off their mother's fat-rich milk instead of depleting her muscles.

Proponents of the theory concede that not all bears -- including pandas -- hibernate during the winter. But the idea is that small birthweight is 'locked in' to the bear family tree, preventing non-hibernating relatives from evolving bigger babies too.

"It's certainly an appealing hypothesis," Smith said.

But the Duke team's research shows this scenario is unlikely. The researchers didn't find any significant differences in bone growth between hibernating bears and their counterparts that stay active year-round and don't fast during pregnancy.

In fact, despite being small, the researchers found that most bear skeletons are just as mature at birth as their close animal cousins.

The panda bear is the one exception to this rule, results show. Even in a full-term baby panda, the bones look a lot like those of a beagle puppy delivered several weeks premature.

"That would be like a 28-week human fetus" at the beginning of the third trimester, Smith said.

Other factors might have pushed panda babies toward smaller sizes over time -- some researchers blame their bamboo-only diet -- but data are scarce, Li said. The researchers say the panda bear's embryonic appearance likely has to do with a quirk of panda pregnancy.

All bears experience what's called "delayed implantation." After the egg is fertilized, the future fetus enters a state of suspended animation, floating in the womb for several months before implanting in the uterine wall to resume its development and get ready for birth.

But while other bears gestate for two months after implantation, giant pandas are done in a month.

"They're basically undercooked," said Li, now a Ph.D. student at the University of Chicago.

The researchers say they only looked at skeletons in this study, and it could be that other organs like the brain tell a different story. But the new study suggests that baby pandas follow the same trajectory as other mammal relatives -- their bones mature in the same sequence and at similar rates -- but on a truncated timetable.

"Development is just cut short," Smith said.

Scientists are still searching for a complete explanation of why the panda's peculiar size differential evolved over geological time, and how.

"We really need more information about their ecology and reproduction in the wild," Smith said, and we may not have much time given their risk of extinction. But this study brings them one step closer to an answer.

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The wild relatives of major vegetables, needed for climate resilience, are in danger

The wild relatives of chile peppers, pumpkins, carrots, and lettuce join a growing list of poorly conserved plant species; these ancient plants have genes that may help our food withstand the harsh climate of our future; if they don't go extinct first

International Center for Tropical Agriculture (CIAT)


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IMAGE: These maps show the distribution of wild chile pepper taxa across the Americas. Green dots on the left map shows where wild species have been collected and stored in gene... view more 

Credit: Khoury et al.


Growing up in the wild makes plants tough. Wild plants evolve to survive the whims of nature and thrive in difficult conditions, including extreme climate conditions, poor soils, and pests and disease. Their better-known descendants - the domesticated plants that are critical to a healthy diet - are often not nearly as hardy. The genes that make crop wild relatives robust have the potential to make their cultivated cousins - our food plants - better prepared for a harsh climate future. But a series of new research papers show these critical plants are imperiled.

"The wild relatives of crops are one of the key tools used to breed crops adapted to hotter, colder, drier, wetter, saltier and other difficult conditions," said Colin Khoury, a scientist at the International Center for Tropical Agriculture, or CIAT. "But they are impacted by habitat destruction, over-harvesting, climate change, pollution, invasive species, and more. Some of them are sure to disappear from their natural habitats without urgent action."

Khoury and colleagues' latest focus has been on the wild relatives of vegetables, including chile peppers, lettuce, and carrots. Their most recent publication was on the distribution, conservation status and stress tolerance of wild cucurbits, or the gourd family, which includes zucchini, pumpkins, and squash. The findings were published online Dec. 10 in Plants People Planet.

Even with protection in the wild, the researchers found that many crop wild relatives require urgent safeguarding in gene banks to assure long-term survival. They determined that more than 65 percent of wild pumpkins and more than 95 percent of wild chile peppers are not in any gene bank.

Gene banks are repositories for seeds and other plant material that assure continued propagation of new plants and allow scientists to study their often complex genetic traits.

The studies include the first highly detailed maps of the distributions of the wild relatives of these crops. Mapping their ranges, and especially areas with a great density, endemism, and diversity, can help policymakers and conservationists prioritize areas in need of protection. The findings will help crop breeders more efficiently find wild relatives with traits needed for crop development. The results will be used to guide rescue missions aimed at collecting vulnerable species before they disappear.

"If they disappear, they are gone," said Khoury. "Extinction is forever, which is a loss not only in terms of their evolution and persistence on the planet, but also a loss to the future of our food."

"Our main finding is that more conservation work needs to be done to ensure that these wild species are well represented in gene banks, and are also adequately protected in their natural habitats," said Khoury, who is also a researcher at the United States Department of Agriculture and Saint Louis University. "We were able to produce maps that can help indicate to plant collectors and to land managers where the most significant gaps are in terms of current conservation, including where you might go to find and protect many species in hotspots of diversity".

A global effort for a global concern

The work also highlights the extent to which the wild relatives of vegetables have not been a priority for conservation when compared to other crops.

"Since they aren't cereal commodities, vegetables get less attention, especially when it comes to their wild relatives. But for health and sustainability reasons, these are the kind of crops that researchers should be devoting more of their time to," said Khoury.

The collection of studies is a big step toward providing foundational information about the wild relatives of these four globally important vegetable crops.

Contributors included botanists, geographers, crop breeders, and conservationists from international and national agricultural research organizations and leading universities. They drew upon their expertise, combined with vast amounts of publicly available research data, for the studies. They also used global climate information to assess which species might have the most useful adaptations to heat, cold, drought, and other crop production challenges.

Finally, they assessed how well the species are represented in current international and national gene banks, as well as how well safeguarded the species are within officially designated protected areas.

Chile peppers, pumpkins, carrots, and lettuce are among the most widely consumed vegetables in the world, with the first three crops providing essential nutrients such as vitamin A and C. Research on such crops has been minor compared to cereals and starchy tubers such as wheat, maize, rice, and potatoes, despite the widely acknowledged need to consume more vegetables across essentially all people worldwide. Because of the lack of research, these crops are often much less productive than grains and tubers. At the same time, these crops need more resources including water and land to produce them and are generally more sensitive to climate change and pests and diseases.

"Filling the gaps in information about the wild relatives of vegetable crops such as chile and bell peppers will help these crops fulfill the nutritional roles they will need to in the future," said Derek Barchenger, a plant breeder at the World Vegetable Center, located in Taiwan, who was involved in the chile research.

"The results reveal at high resolution the geography of the wild relatives of these important crops. This is of interest not only to conservation, but also to better understand the origins and diversification of these species over millions of years, and even possibly to shed further light on where the crops may have been domesticated," said Heather Rose Kates, a postdoctoral associate at Florida Museum of Natural History.

"Our research outlines some of the major breeding challenges that the crops face, in terms of climatic stresses, for example, heat and drought for carrots," said Najla Mezghani, the curator of vegetable crops in the National Genebank of Tunisia who was involved in the wild carrot research. "We determined which populations of wild relatives might have adaptations to these stresses that can make them particularly useful in plant breeding".

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Team finds bovine kobuvirus in US


University of Illinois at Urbana-Champaign, News Bureau


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IMAGE: University of Illinois veterinary clinical medicine professor Dr. Leyi Wang led the team that detected bovine kobuvirus in the U.S. view more 

Credit: Photo by L. Brian Stauffer


CHAMPAIGN, Ill. -- A virus that afflicts cattle that was first discovered in Japan in 2003 has made its way to the U.S., researchers report in the journal Emerging Infectious Diseases.

Bovine kobuvirus is fairly new to science, so its ill effects are not fully understood. It belongs to a family of viruses known as Picornaviridae, which includes Rhinovirus, a source of head colds and sinus infections in humans; and Poliovirus, which causes polio.

Previous studies conducted elsewhere in the world have found bovine kobuvirus in fecal samples of cattle with diarrhea. The new study confirmed this association by sequencing the microbial DNA in samples from cattle in the U.S. and analyzing the intestines of two calves that died after infection.

"Only bovine kobuvirus was detected in both cases," said University of Illinois veterinary clinical medicine professor Dr. Leyi Wang, who led the new study. "This provides evidence that this virus is the causative agent for calf diarrhea."

So far, no other negative associations with bovine infection have been observed. However, since almost no one in North America is looking for the virus in cattle or other species, it remains to be seen how this emerging disease agent influences health, Wang said.

"Continued surveillance of bovine kobuvirus is urgently needed to determine how widespread it is," Wang said. "Scientists have access to only a few genetic sequences of this virus in public databases. We need to be sequencing these viruses to learn more about their genetic diversity and evolution."

Four of nine samples tested at the U. of I. Veterinary Diagnostic Laboratory were found to harbor bovine kobuvirus, the team reported. All of the infected cows were from the state of Illinois.

Elsewhere in the world, bovine kobuvirus has been detected in about 10 countries in Asia, Europe, South America and Africa.

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Salmonella the most common cause of foodborne outbreaks in the European Union

Nearly one in three foodborne outbreaks in the EU in 2018 were caused by Salmonella, say the European Centre for Disease Prevention and Control and the European Food Safety Authority (EFSA)

European Centre for Disease Prevention and Control (ECDC)


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Nearly one in three foodborne outbreaks in the EU in 2018 were caused by Salmonella. This is one of the main findings of the annual report on trends and sources of zoonoses published today by the European Food Safety Authority (EFSA) and the European Centre for Disease Prevention and Control (ECDC).

In 2018, EU Member States reported 5 146 foodborne outbreaks affecting 48 365 people. A foodborne disease outbreak is an incident during which at least two people contract the same illness from the same contaminated food or drink.

Slovakia, Spain and Poland accounted for 67% of the 1581 Salmonella outbreaks. These outbreaks were mainly linked to eggs.

"Findings from our latest Eurobarometer show that less than one third of European citizens rank food poisoning from bacteria among their top five concerns when it comes to food safety. The number of reported outbreaks suggests that there's room for raising awareness among consumers as many foodborne illnesses are preventable by improving hygiene measures when handling and preparing food" said EFSA's chief scientist Marta Hugas.

Salmonellosis was the second most commonly reported gastrointestinal infection in humans in the EU (91 857 cases reported), after campylobacteriosis (246,571).

West Nile virus and STEC infections at unusually high levels

By far the highest increase in the zoonoses covered by this report was in the number of West Nile virus infections. Cases of this zoonotic mosquito-borne disease were seven times higher than in 2017 (1605 versus 212) and exceeded all cases reported between 2011 and 2017.

"The reasons for the peak in 2018 are not fully understood yet. Factors like temperature, humidity or rainfall have been shown to influence seasonal activity of mosquitoes and may have played a role. While we cannot predict how intense the next transmission seasons will be, we know that the West Nile virus is actively circulating in many countries in the EU, affecting humans, horses and birds. ECDC is stepping up its support to countries in the areas of surveillance, preparedness, communication and vector control", said ECDC's chief scientist Mike Catchpole.

Most locally acquired West Nile virus infections were reported by Italy (610), Greece (315) and Romania (277). Czechia and Slovenia reported their first cases since 2013. Italy and Hungary have also registered an increasing number of West Nile virus outbreaks in horses and other equine species in recent years.

Shiga toxin-producing E. coli (STEC) has become the third most common cause of foodborne zoonotic disease with 8 161 reported cases - replacing yersiniosis with a 37% increase compared to 2017. This may be partly explained by the growing use of new laboratory technologies, making the detection of sporadic cases easier.

The number of people affected by listeriosis in 2018 is similar to 2017 (2 549 in 2018 against 2 480 the previous year). However, the trend has been upward over the past ten years. Of the zoonotic diseases covered by the report, listeriosis accounts for the highest proportion of hospitalised cases (97%) and highest number of deaths (229), making it one of the most serious foodborne diseases.

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Paving the way to healing complex trauma


La Trobe University


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A major study led by researchers at La Trobe University in Australia has identified key themes that will be used to inform strategies to support Australian Aboriginal and Torres Strait Islander parents in the first years of their children's lives.

The Healing the Past by Nurturing the Future project aims to break the cycle of intergenerational and complex trauma experienced by Aboriginal and Torres Strait islander people, by co-designing strategies for new parents.

The international research team, led by Associate Professor Catherine Chamberlain of La Trobe's Judith Lumley Centre and published today in the journal PLOS ONE, reviewed more than 20,000 scholarly articles to build a comprehensive understanding of pregnancy and birth for parents who have experienced trauma in their own childhood.

The study identified seven themes, derived from studying interviews with more than 350 parents who experienced trauma as children, relate to parents' experiences during pregnancy, birth and the first few weeks after birth.

Associate Professor Catherine Chamberlain said the research is critical for informing discussions with Aboriginal parents and communities to create a strong foundation for work to heal complex trauma.

"This gives us a thorough and deep understanding needed to help co-design support strategies with communities to improve the lives of Aboriginal and Torres Strait Islander people and their babies," Associate Professor Chamberlain said.

"We have shared these themes in discussions with Aboriginal and Torres Strait Islander parents and community members to see if any are relevant. Doing so also helps parents to understand these experiences are shared, even in other countries.

"The next stage of our Healing the Past by Nurturing the Future project will use these themes to examine what support strategies have been evaluated in research. We will look at whether this research reflects what support parents say they want and what they feel works."

The seven themes are:

• New beginnings: Becoming a parent is an opportunity for 'a fresh start', to put the past behind them and move forward with hope for the future to create a new life for themselves and their
child.


• Changing roles and identities: Becoming a parent is a major life transition, influenced by perceptions of the parenting role.

• Feeling connected: The quality of relationships with self, baby and others has major impacts on the experiences of becoming a parent.

• Compassionate care: Kindness, empathy and sensitivity enables parents to build trust and feel valued and cared for.

• Empowerment: Control, choice and 'having a voice' are critical to fostering safety.

• Creating safety: Parents perceive the 'world as unsafe' and use conscious strategies to build safe places and relationships to protect themselves and their baby.

• 'Reweaving' a future: Managing distress and healing while becoming a parent is a personal ongoing and complex process requiring strength, hope and support.

Associate Professor Chamberlain said the seven themes also resonated strongly with Aboriginal and Torres Strait Islander parents and she was grateful to the research team for all their hard work and expertise, and to Lowitja Institute and the NHMRC for funding this phase of her work.

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News Release 13-Dec-2019

Breast-conserving treatment without surgery not supported at this time

Results of NRG Oncology study BR005

NRG Oncology


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SAN ANTONIO, TX - Results from NRG Oncology's BR005 study show that breast-conserving treatment without surgery cannot be recommended, based on the study criteria of clinical complete response, radiological complete response (rCR)/near rCR, and negative tumor bed biopsies. These findings were presented at the 2019 San Antonio Breast Cancer Symposium, held December 10-14.

This phase II study, which opened in June 2017, was designed as a two-stage trial to assess the accuracy of tumor bed biopsies in predicting pathologic response in patients with clinical complete and radiological complete/near complete response after neoadjuvant chemotherapy to determine if they could avoid surgery. All patients had received chemotherapy for their breast cancer, but had not yet had surgery. All underwent an image-guided biopsy after receiving chemotherapy. A total of 105 patients were enrolled from August 2017 through June 2019, with 98 being evaluable for analysis. Accrual was temporarily closed for futility analysis on June 26, 2019, because 36 of the evaluable patients had residual disease at surgery, which actually met the numbers for the primary analysis. The negative predictive value of the biopsy was 77.5% (95%CI: 66.8% to 86.1%) which did not meet the pre-specified threshold of >90% required to support the feasibility of initiating a study in which surgery could be omitted.

"Further analysis including central review of tri-modality imaging and assessment of an imaging algorithm with and without the addition of biopsy are underway. Once these are combined with information on biologic subtypes, a new prediction model will be defined," according to Mark Basik, MD, from Jewish General Hospital, and lead investigator of the study.

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NRG Oncology BR005 was supported by grants U10CA180868 (NRG Oncology Operations), and U10CA180822 (NRG Oncology SDMC). Clinicaltrials.gov identifier: NCT03188393.

Citation

Basik M, Cecchini RS, De Los Santos JF, Umphrey HR, Julian TB, Mamounas EP, White J, Lucas PC, Balanoff C, Tan AR, Weber JJ, Edmonson DA, Brown-Glaberman UA, Diego EJ, Teshome M, Matsen CB, Seaward SA, Wapnir IL, Wagner JL, Tjoe JA, Thompson AM, Wolmark N. Primary analysis of NRG-BR005, a phase II trial assessing accuracy of tumor bed biopsies in predicting pathologic complete response in patients with clinical/radiological complete response after neoadjuvant chemotherapy to explore the feasibility of breast-conserving treatment without surgery. San Antonio Breast Cancer Symposium 2019. Prog #: GS5-05.

About NRG Oncology

NRG Oncology conducts practice-changing, multi-institutional clinical and translational research to improve the lives of patients with cancer. Founded in 2012, NRG Oncology is a Pennsylvania-based nonprofit corporation that integrates the research of the legacy National Surgical Adjuvant Breast and Bowel Project (NSABP), Radiation Therapy Oncology Group (RTOG), and Gynecologic Oncology Group (GOG) programs. The research network seeks to carry out clinical trials with emphases on gender-specific malignancies, including gynecologic, breast, and prostate cancers, and on localized or locally advanced cancers of all types. NRG Oncology's extensive research organization comprises multidisciplinary investigators, including medical oncologists, radiation oncologists, surgeons, physicists, pathologists, and statisticians, and encompasses more than 1,300 research sites located world-wide with predominance in the United States and Canada. NRG Oncology is supported primarily through grants from the National Cancer Institute (NCI) and is one of five research groups in the NCI's National Clinical Trials Network. http://www.​nrgoncology.​or g

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News Release 13-Dec-2019

Taking shape: Scientists propose new structure for shell of HIV-1 virus

A newly proposed model for the shape of the HIV-1 viral shell may change how we understand the disease

University of Alberta


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IMAGE: A new study proposes a new structure for the shell of the HIV-1 virus, pictured here. Image credit Marcelo Marcet. view more 

Credit: Marcelo Marcet

The matrix shell of the HIV-1 virus may have a different shape than previously thought, and a newly proposed model has significant implications for understanding how the virus functions, according to a new study by University of Alberta scientists.

The research suggests that the HIV-1 virus is housed within a spherical matrix shell. When it infects a healthy cell, the shell fuses to the outside of the target cell and then releases the viral capsid inside where it attacks the cell.

"Our new proposed structure for the HIV-1 virus has a very peculiar shape, almost like petals of a flower," said Sean Graves, instructor in the Department of Mathematical and Statistical Sciences and co-author on the study. "A better structural knowledge of the matrix shell may help us understand the fusing and infection process." Graves is also coordinator of the Decima Robinson Support Centre, providing support to more than 1000 undergraduate students each term.

The research shows that the previous model used to describe the structure of the HIV-1 matrix shell was mathematically impossible and provides a viable alternative. While it is too early to anticipate whether the model will translate into new treatment for HIV, the research will help scientists to better understand and make predictions about the behaviour of the HIV-1 virus. Around the world, nearly 38 million people suffer from HIV or AIDS.

"Our contribution uses mathematical principles to help guide the scientific community in the right direction," added Marcelo Marcet-Palacios, adjunct professor of medicine in the Faculty of Medicine & Dentistry and co-author. "If our model is correct, then we can begin investigating ways we could block or interrupt the mechanism of viral entry. For example, by using a medication that could cross-link the 'petals' of the structure together to prevent the opening of the particle and thus stopping entry of the viral genome into the host cell."

The model is available to anyone, anywhere in the world online.

This research is the result of the work of an interdisciplinary team from the fields of biology, mathematics and computing science. One such collaborator is Weijie Sun, Faculty of Science alumnus and a former student of Graves'.

"This collaboration made it possible to come up with a new model consistent with previously observed evidence and allowed us to develop a computer program freely accessible online that other scientists around the world can use to recreate our work and further develop this new model," said Sun. "It is incredible what can be achieved in science when experts from different disciplines get together and collaborate."

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[florida80]

News Release 12-Dec-2019

Ultrasound blasts potent glioblastoma drug into brain tumor

Treatment successfully delivers drug across the blood-brain barrier directly to brain tumor in mice

Northwestern University


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• Glioblastoma currently has no cure. New treatments urgently needed
• Powerful drug is 1,400 times more potent than current treatment against the brain tumor
• Scientists applying to FDA for approval to test this novel treatment in patients with recurrent glioblastoma


CHICAGO --- One of most potent drugs for treatment of glioblastoma, the most deadly type of brain tumor, can't be used in patients because of two problems. First, it can't reach its target because it's blocked by the blood-brain barrier, a microscopic structure that protects the brain from toxins in the blood. And the conventional formulation for this drug is toxic to the brain.

But now Northwestern Medicine scientists have used a novel technology for opening the blood-brain barrier with an implantable ultrasound, and have delivered the powerful drug to the tumor in mice. In a new paper, they report on their findings of extensive preclinical research.

The scientists also discovered brain toxicity for the conventional formulation for this drug - paclitaxel -to the brain was caused by the solution required to dissolve the drug (cremophor.) Scientists tested a new formulation of the drug that uses albumin as opposed to cremophor, and it was not harmful to the brain.

Opening of the blood-brain barrier with an ultrasound increased the concentrations of this paclitaxel in the brain by five-fold. The study also showed that the brain tumor-bearing mice live much longer when treated with the powerful cancer-fighting drug paclitaxel, and survival was even further extended when treated in combination with ultrasound to open the blood-brain barrier.

The study will be published Dec. 12 in Clinical Cancer Research, a journal of the American Association for Cancer Research.

In the laboratory, paclitaxel is much more potent than the currently used chemotherapy temozolomide. When paclitaxel was tested against the brain tumor in a dish outside an organism, a 1,400-fold lesser drug concentration was necessary to kill same number of tumor cells, compared to the conventional chemotherapy used for this cancer.

The scientists are now applying to the U.S. Food & Drug Administration to launch a clinical trial to test this concept of a new formulation of paclitaxel in combination with the novel ultrasound technology to open the blood-brain barrier in patients. The planned trial aims to determine if the treatment is safe, and if it prolongs survival of patients with brain cancer.

"Glioblastoma currently has no cure, and when the tumor recurs there are not many treatment options," said the principal investigator for this study, Dr. Adam Sonabend, an assistant professor of neurological surgery at Northwestern University Feinberg School of Medicine and a Northwestern Medicine physician. "We urgently need effective new treatments."

The ultrasound technology may have broader benefits. "This ultrasound technology now will enable us to use many agents established in other cancers for patients with brain tumors," said co-investigator Roger Stupp, chief of neuro-oncology and the Paul C. Bucy Professor of Neurological Surgery at Feinberg.

Other clinical trials are testing ultrasound-based opening of the blood brain barrier with various chemotherapy agents, but none are using such a potent drug as paclitaxel.

How does it work?

The tiny ultrasound would be implanted during surgery into a window in the skull that does not contain bone. It is used in combination with microscopic gas bubbles injected into the blood at the same time the ultrasound begins. When the bubbles hit the sound waves, these vibrate and mechanically disrupt the blood-brain barrier. The opening is immediate, allowing penetration of the drug molecules. The blood-brain barrier opening is reversible and lasts for several hours after the sonication. The ultrasound emitter remains in the skull for repeated delivery of the drug.

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News Release 12-Dec-2019

The mathematics of prey detection in spider orb-webs


Society for Industrial and Applied Mathematics


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Spider webs are one of nature's most fascinating manifestations. Many spiders extrude proteinaceous silk to weave sticky webs that ensnare unsuspecting prey who venture into their threads. Despite their elasticity, these webs possess incredible tensile strength. In recent years, scientists have expressed increased interest in the spider orb-web as a biological-mechanical system. The web's sensory mechanisms are especially fascinating, given that most web-weaving spiders--regardless of their vision level--use generated vibrations to effectively locate ensnared prey.

"The spider orb-web is a natural, lightweight, elegant structure with an extreme strength-to-weight ratio that is rarely observed among other structures, either natural or manmade," Antonino Morassi said. "Its primary functions are catching prey and gathering sensory information, and study of the mechanisms that guide these processes through web vibration has been one of the main research goals in the field."
To understand the mechanics of orb-webs, researchers have previously utilized simplified patterns of wave propagation or relied upon numerical models that reproduce a spider web's exact geometry via one-dimensional elements. While these numerical models adequately handle wind, prey movement, and other sources of vibration, they fall short of providing insight into the physical phenomena responsible for web dynamics. In an article publishing this week in the SIAM Journal on Applied Mathematics, Morassi and Alexandre Kawano present a theoretical mechanical model to study the inverse problem of source identification and localize a prey in a spider orb-web.
Due to structural interconnectivity between the circumferential and radial threads, vibrations in an orb-web spread laterally and move beyond the stimulated radius. This observation led Kawano and Morassi towards realistic mechanical models that measure a fibred web's two-dimensionality, rather than more limiting one-dimensional models. "There was no mechanical model--even a simplified one--that described the web as it really is: a two-dimensional vibrating system," Morassi said. "We decided to use a continuous membrane model since theoretical models often permit a deeper insight in the physical phenomena through analysis of the underlying mathematical structure of the governing equations." These equations are also useful in identifying the most relevant parameters that dictate a web's response.
The authors classify their model as a network of two intersecting groups of circumferential and radial threads that form an uninterrupted, continuous elastic membrane with a specific fibrous structure. To set up the inverse problem, they consider the spider's dynamic response to the prey's induced vibrations from the center of the web (where the spider usually waits). For the sake of simplicity, Kawano and Morassi limit the model's breadth to circular webs. The geometry of their model allows for a specific fibrous structure, the radial threads of which are denser towards the web's center.
The researchers note that the minimal data set to ensure uniqueness in the prey's localization seems to accurately reproduce real data that the spider collects right after the prey makes contact with the web. "By continuously testing the web, the spider acquires the dynamical response of the web approximately on a circle centered at the web's origin, and with radius significantly small with respect to the web dimensions," Kawano said. "Numerical simulations show that identification of the prey's position is rather good, even when the observation is taken on the discrete set of points corresponding to the eight legs of the spider."
Ultimately, the authors hope that their novel mechanical model will encourage future research pertaining to nearly periodic signals and more general sources of vibration. They are already thinking about ways to further expand their model. "We believe that it may be of interest to generalize the approach to more realistic geometries -- for example, for spider webs that deviate a little from the circular axisymmetric shape and maintain only a single axis of symmetry," Morassi said. "Furthermore, here we considered the transversal dynamic response caused by orthogonal impact of a prey on the web. In real-world situations, impact can be inclined and cause in-plane vibrations to propagate throughout the web. The analysis of these aspects, among others, may provide novel and important insights, not only for the prey's catching problem but also for bioinspired fibrous networks for sensing applications involving smart multifunctional materials."

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News Release 11-Dec-2019

Virtual reality and drones help to predict and protect koala habitat


Queensland University of Technology


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VIDEO: QUT researchers have used a combination of virtual reality (VR), aerial thermal-imaging and ground surveys to build a better statistical model for predicting the location of koalas and, ultimately, protecting... view more 

Credit: QUT


QUT researchers have used a combination of virtual reality (VR), aerial thermal-imaging and ground surveys to build a better statistical model for predicting the location of koalas and, ultimately, protecting their habitat.

In the study, published in the journal PLoS ONE, researchers from QUT and the ARC Centre of Excellence for Mathematical and Statistical Frontiers (ACEMS) used the mashup of high-tech 360-degree imagery and heat-seeking drone cameras along with traditional techniques of ground surveys to develop a model that could be used to identify areas most likely to be home to koalas, which are facing population decline.

Lead author Dr Catherine Leigh, who is also an Associate Investigator with ACEMS, said the advantage of the multi-pronged approach was that it greatly increased the accuracy of the statistical model.

"It's about building a model that tells us with confidence where koalas are and where they're not," Dr Leigh said.

"When you start building up a model with all of that data, you get a much better idea about where the koalas are likely to be.

"If you can predict where koalas are, and the types of habitats they are hanging around in, then you know not only where to go to keep monitoring them but also the areas you need to protect."

In the study, the researchers used ground survey information captured between 2102 and 2017 from Alexander Clarke Park in Loganholme, south-east Queensland, which is an area that has vegetation ranging from dense forest to grass fields and contains facilities including playgrounds and a dog park.

Dr Leigh said one of the challenges with ground survey observations was that they could show a statistical bias of higher koala populations close to paths and other areas easily accessible by observers.

"When you're out in the field as an experienced koala observer or a citizen scientist, you really are restricted where you can walk. And koalas are hard to see, even by trained observers," Dr Leigh said.

"They are slow moving and often hidden high in the canopy."

To counteract that, the researchers surveyed the area from the air using thermal cameras near sunrise, when the body heat of the koalas is detectable against the surrounding foliage.

The third part of the study involved sending researchers out to some of the 82 specific locations in the area where koalas were known to either be or not be, to take 360-degree images. Those images were then shown to a panel of koala experts wearing VR headsets, with the experts asked to state how likely the environment they were viewing in was 'good koala habitat'.

Dr Leigh said the advantage of using VR for the survey was it enabled them to bring the environment to the experts rather than having to take the experts to the field.

"They're called immersive experiences," Dr Leigh said.

"A lot of the research done on immersive experiences suggests that it helps to bring back the memories associated with when that expert has been in the field in the past, so they can be more cognizant of making the decision about the likelihood that a koala would be there."

The researchers found that the three-pronged system of VR-prompted expert information, thermal imagery and ground surveys proved to be 75 per cent more accurate at predicting koala locations than ground surveys alone.

"You put all three together and you get a much better model," Dr Leigh said.

Dr Leigh said the methods could be used by councils and town planning authorities to obtain critical information needed for koala protection.

[florida80]

Volume 90%



















































































































VIDEO: QUT researchers have used a combination of virtual reality (VR), aerial thermal-imaging and ground surveys to build a better statistical model for predicting the location of koalas and, ultimately, protecting... view more 

Credit: QUT


QUT researchers have used a combination of virtual reality (VR), aerial thermal-imaging and ground surveys to build a better statistical model for predicting the location of koalas and, ultimately, protecting their habitat.

In the study, published in the journal PLoS ONE, researchers from QUT and the ARC Centre of Excellence for Mathematical and Statistical Frontiers (ACEMS) used the mashup of high-tech 360-degree imagery and heat-seeking drone cameras along with traditional techniques of ground surveys to develop a model that could be used to identify areas most likely to be home to koalas, which are facing population decline.

Lead author Dr Catherine Leigh, who is also an Associate Investigator with ACEMS, said the advantage of the multi-pronged approach was that it greatly increased the accuracy of the statistical model.

"It's about building a model that tells us with confidence where koalas are and where they're not," Dr Leigh said.

"When you start building up a model with all of that data, you get a much better idea about where the koalas are likely to be.

"If you can predict where koalas are, and the types of habitats they are hanging around in, then you know not only where to go to keep monitoring them but also the areas you need to protect."

In the study, the researchers used ground survey information captured between 2102 and 2017 from Alexander Clarke Park in Loganholme, south-east Queensland, which is an area that has vegetation ranging from dense forest to grass fields and contains facilities including playgrounds and a dog park.

Dr Leigh said one of the challenges with ground survey observations was that they could show a statistical bias of higher koala populations close to paths and other areas easily accessible by observers.

"When you're out in the field as an experienced koala observer or a citizen scientist, you really are restricted where you can walk. And koalas are hard to see, even by trained observers," Dr Leigh said.

"They are slow moving and often hidden high in the canopy."

To counteract that, the researchers surveyed the area from the air using thermal cameras near sunrise, when the body heat of the koalas is detectable against the surrounding foliage.

The third part of the study involved sending researchers out to some of the 82 specific locations in the area where koalas were known to either be or not be, to take 360-degree images. Those images were then shown to a panel of koala experts wearing VR headsets, with the experts asked to state how likely the environment they were viewing in was 'good koala habitat'.

Dr Leigh said the advantage of using VR for the survey was it enabled them to bring the environment to the experts rather than having to take the experts to the field.

"They're called immersive experiences," Dr Leigh said.

"A lot of the research done on immersive experiences suggests that it helps to bring back the memories associated with when that expert has been in the field in the past, so they can be more cognizant of making the decision about the likelihood that a koala would be there."

The researchers found that the three-pronged system of VR-prompted expert information, thermal imagery and ground surveys proved to be 75 per cent more accurate at predicting koala locations than ground surveys alone.

"You put all three together and you get a much better model," Dr Leigh said.

Dr Leigh said the methods could be used by councils and town planning authorities to obtain critical information needed for koala protection.

[florida80]

News Release 13-Dec-2019

How a protein in your brain could protect against Alzheimer's disease

New research sets the stage for new therapeutic strategies for Alzheimer's disease

University of Alberta


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Research shows that white blood cells in the human brain are regulated by a protein called CD33--a finding with important implications in the fight against Alzheimer's disease, according to a new study by University of Alberta chemists.

"Immune cells in the brain, called microglia, play a critical role in Alzheimer's disease," explained Matthew Macauley, assistant professor in theDepartment of Chemistry and co-author on the paper. "They can be harmful or protective. Swaying microglia from a harmful to protective state could be the key to treating the disease."

Scientists have identified the CD33 protein as a factor that may decrease a person's likelihood of Alzheimer's disease. Less than 10 percent of the population have a version of CD33 that makes them less likely to get Alzheimer's disease. "The fact that CD33 is found on microglia suggests that immune cells can protect the brain from Alzheimer's disease under the right circumstances," said Abhishek Bhattacherjee, first author and postdoctoral fellow in the Macauley lab.

Now, Macauley's research shows that the most common type of CD33 protein plays a crucial role in modulating the function of microglia.

"These findings set the stage for future testing of a causal relationship between CD33 and Alzheimer's Disease, as well as testing therapeutic strategies to sway microglia from harmful to protecting against the disease--by targeting CD33," said Macauley. "Microglia have the potential to 'clean up' the neurodegenerative plaques, through a process called phagocytosis--so a therapy to harness this ability to slow down or reverse Alzheimer's disease can be envisioned."

Macauley is an investigator with GlycoNet, a Canada-wide network of researchers based at the University of Alberta that is working to further our understanding of biological roles for sugars. GlycoNet provided key funding to get this project off the ground in the Macauley lab and continues to support the ongoing applications of the project.

According to the Alzheimer's Association, 747,000 Canadians are currently living with Alzheimer's or another form of dementia. The disease affects more than 44 million people around the world.

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News Release 13-Dec-2019

Growing carbon nanotubes with the right twist

Researchers synthetize nanotubes with a specific structure expanding previous theories on carbon nanotube growth

Institute for Basic Science


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IMAGE: (a) Carbon nanotubes (CNTs) could be viewed as single-atom layer thick graphene sheets rolled into a cylinder. Different directions of rolling determine CNTs' properties. (b) Schematic diagram showing a carbon... view more 

Credit: IBS


In a recently published paper in Science Advances, Feng Ding of the Center for Multidimensional Carbon Materials, within the Institute of Basic Science (IBS, South Korea) and colleagues, have achieved the creation of a specific type of carbon nanotubes (CNTs) with a selectivity of 90%, and expanded the current theory that explains the synthesis of these promising nano-cylinders.

CNTs are incredibly strong and light nanomaterials made of carbon with superior current carrying capacity and very high thermal conductivity, making them ideal for electronic applications. Although CNTs are considered as some of the most interesting materials for the future, scientists are still struggling for their controllable synthesis.

The CNTs' shape can be compared to paper tubes: in the same way as a cylinder can be created by rolling a sheet of paper, so CNTs can be imagined as a single layer of graphite rolled up on itself. Similarly, as different tubes can be produced by rolling a paper around its long side, its short side, or diagonally at different angles. Depending on the rolling direction, a graphite layer can produce different CNT structures, some are conducting and others are semiconducting, thus selectively creating a specific type of CNT will be key for their future use, such as building energy efficient computer chips. However, CNTs are not produced by rolling, but are grown nanometer after nanometer, adding carbon at the rim of nano-cylinders, one atom at a time. Despite various studies during the last three decades, the understanding on CNT growth remains very limited and rational experimental design for the growth of specific types of CNTs is challenging.

One of the most promising manufacturing methods for CNT is the chemical vapor deposition (CVD). In this process, metal nanoparticles combined with carbon-containing gases form CNTs inside a high-temperature furnace. On the tip of the tubes, the metal nanoparticles play a critical role as catalysts: they dissociate the carbon source from the gases, and assist the attachment of these carbon atoms to the CNT wall, making the tubes longer and longer. The growth of the CNT terminates once the catalyst particle is encapsulated by graphitic or amorphous carbon.

Carbon atoms are inserted onto the interface between a growing CNT and a catalyst nanoparticle, in active sites of the rim, and are available to incorporate new atoms. A previous model of CNT's growth rate showed that the latter is proportional to the density of these active sites at the interface between CNT and the catalyst, or the specific structure of the CNT.

In this study, the researchers monitored the steady growth of CNTs on a magnesium oxide (MgO) support with carbon monoxide (CO) as the carbon feedstock and cobalt nanoparticles as catalysts at 700oC. The direct experimental measurements of 16 CNTs showed how to expand the previous theory. "It was surprising that the growth rate of a carbon nanotubes only depends on the size of the catalyst particle. This implies that our previous understanding on carbon nanotubes growth was not complete," says Maoshuai He, the first author of the paper.

More specifically, carbon atoms that are deposited on the catalyst particle surface can be either incorporated on the active side of the CNT or removed by etching agents, such as H2, H2O, O2, or CO2. To explain the new experimental observations, the team included the effects of carbon insertion and removal during CNT growth and discovered that the growth rate depends on the catalyst's surface area and tube diameter ratio.

"Compared to the previous model, we added three more factors: the rate of precursor deposition, the rate of carbon removal by etching agents, and the rate of carbon insertion into a carbon nanotube wall. When feedstock dissociation cannot be balanced by carbon etching, the rate of carbon nanotube growth will no longer depend on the structure of the carbon nanotube. On the other hand, the previous theory is still valid if the etching is dominating," explains Ding, a group leader of the Center for Multidimensional Carbon Materials.

Interestingly, the new theory of CNT growth leads to a new mechanism to selectively grow a specific type of CNTs, denoted as (2n, n) CNTs, which is characterized by the maximum number of active sites at the interface between the CNT and the catalyst. This CNT structure would correspond to rolling a sheet of graphite diagonally at an angle of around 19 degrees.

"If there is no carbon etching and the carbon nanotubes growth is slow, carbon atoms on the catalyst surface will accumulate," says Jin Zhang, co-author of the study and professor of Peking University, China. "This may lead to the formation of graphitic or amorphous carbon, which are established mechanisms of carbon nanotube growth termination. In this case, only carbon nanotubes which are able to add carbon atoms on their walls, that is with the highest number of active sites, can survive."

Guided by the new theoretical understanding, the researchers were able to design experiments that produced (2n, n) CNTs with a selectivity of up to 90%: the highest selective growth of this type of CNT was achieved in the absence of any etching agent and with a high feedstock concentration.

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News Release 13-Dec-2019

Nanoscience breakthrough: Probing particles smaller than a billionth of a meter


Tokyo Institute of Technology


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IMAGE: Tin oxide SNCs finely prepared by a dendrimer template method are loaded on the thin silica shell layers of plasmonic amplifiers, such that the Raman signals of the SNCs are... view more 

Credit: Science Advances

Scientists at Tokyo Institute of Technology (Tokyo Tech) developed a new methodology that allows researchers to assess the chemical composition and structure of metallic particles with a diameter of only 0.5 to 2 nm. This breakthrough in analytical techniques will enable the development and application of minuscule materials in the fields of electronics, biomedicine, chemistry, and more.

The study and development of novel materials have enabled countless technological breakthroughs and are essential across most fields of science, from medicine and bioengineering to cutting-edge electronics. The rational design and analysis of innovative materials at nanoscopic scales allows us to push through the limits of previous devices and methodologies to reach unprecedented levels of efficiency and new capabilities. Such is the case for metal nanoparticles, which are currently in the spotlight of modern research because of their myriad potential applications. A recently developed synthesis method using dendrimer molecules as a template allows researchers to create metallic nanocrystals with diameters of 0.5 to 2 nm (billionths of a meter). These incredibly small particles, called "subnano clusters" (SNCs), have very distinctive properties, such as being excellent catalyzers for (electro)chemical reactions and exhibiting peculiar quantum phenomena that are very sensitive to changes in the number of constituent atoms of the clusters.

Unfortunately, the existing analytic methods for studying the structure of nanoscale materials and particles are not suitable for SNC detection. One such method, called Raman spectroscopy, consists of irradiating a sample with a laser and analyzing the resulting scattered spectra to obtain a molecular fingerprint or profile of the possible components of the material. Although traditional Raman spectroscopy and its variants have been invaluable tools for researchers, they still cannot be used for SNCs because of their low sensitivity. Therefore, a research team from Tokyo Tech, including Dr. Akiyoshi Kuzume, Prof. Kimihisa Yamamoto and colleagues, studied a way to enhance Raman spectroscopy measurements and make them competent for SNC analysis (Figure).

One particular type of Raman spectroscopy approach is called surface-enhanced Raman spectroscopy. In its more refined variant, gold and/or silver nanoparticles enclosed in an inert thin silica shell are added to the sample to amplify optical signals and thus increase the sensitivity of the technique. The research team first focused on theoretically determining their optimal size and composition, where 100-nm silver optical amplifiers (almost twice the size commonly used) can greatly amplify the signals of the SNCs adhered to the porous silica shell. "This spectroscopic technique selectively generates Raman signals of substances that are in close proximity to the surface of the optical amplifiers," explains Prof. Yamamoto. To put these findings to test, they measured the Raman spectra of tin oxide SNCs to see if they could find an explanation in their structural or chemical composition for their inexplicably high catalytic activity in certain chemical reactions. By comparing their Raman measurements with structural simulations and theoretical analyses, they found new insights on the structure of the tin oxide SNCs, explaining the origin of atomicity-dependent specific catalytic activity of tin oxide SNCs.

The methodology employed in this research could have great impact on the development of better analytic techniques and subnanoscale science. "Detailed understanding of the physical and chemical nature of substances facilitates the rational design of subnanomaterials for practical applications. Highly sensitive spectroscopic methods will accelerate material innovation and promote subnanoscience as an interdisciplinary research field," concludes Prof. Yamamoto. Breakthroughs such as the one presented by this research team will be essential for broadening the scope for the application of subnanomaterials in various fields including biosensors, electronics, and catalysts.

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News Release 13-Dec-2019

City College leads new photonics breakthrough


City College of New York


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IMAGE: Light localized in space inside the topological crystal, entangled by interaction and topology. view more 

Credit: ITMO University

A new approach to trapping light in artificial photonic materials by a City College of New York-led team could lead to a tremendous boost in the transfer speed of data online.

Research into topological photonic metamaterials headed by City College physicist Alexander B. Khanikaev reveals that long-range interactions in the metamaterial changes the common behavior of light waves forcing them to localize in space. Further, the study shows that by controlling the degree of such interactions one can switch between trapped and extended (propagating) character of optical waves.

"The new approach to trap light allows the design of new types of optical resonators, which may have a significant impact on devices used on a daily basis, said Khanikaev. "These range from antennas in smartphones and Wi-Fi routers, to optical chips in optoelectronics used for transferring data over the Internet with unprecedented speeds."

Entitled "Higher-order topological states in photonic kagome crystals with long-range interactions," the research appears in the journal Nature Photonics published today.

It is a collaboration between CCNY, the Photonics Initiative at the Graduate Center, CUNY; and ITMO University in St. Petersburg, Russia. As the lead organization, CCNY initiated the research and designed the structures, which were then tested both at CCNY and at ITMO University.

Khanikaev's research partners included: Andrea Alù, Mengyao Li, Xiang Ni (CCNY/CUNY); Dmitry Zhirihin (CCNY/ ITMO); Maxim Gorlach, Alexey Slobozhanyuk (both ITMO), and Dmitry Filonov (Center for Photonics and 2D Materials, Moscow Institute of Physics and Technology.

Research continues to extend the new approach to trap visible and infra-red light. This would further expand the range of possible applications of the discovery.

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News Release 13-Dec-2019

Colliding molecules and antiparticles

A new theoretical study of the interaction between positrons and simple tetrahedral and octahedral molecules agrees with experimental work and could have useful implications for PET scanning techniques.

Springer


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Antiparticles - subatomic particles that have exactly opposite properties to those that make up everyday matter - may seem like a concept out of science fiction, but they are real, and the study of matter-antimatter interactions has important medical and technological applications. Marcos Barp and Felipe Arretche from the Universidade Federal de Santa Catarina, Brazil have modelled the interaction between simple molecules and antiparticles known as positrons and found that this model agreed well with experimental observations. This study has been published in EPJ D.

Positrons, the antimatter equivalent of electrons, are the simplest and most abundant antiparticles, and they have been known and studied since the 1930s. Particle accelerators generate huge quantities of high-energy positrons, and most lab experiments require this energy to be reduced to a specific value. Typically, this is achieved by passing the positrons through a gas in an apparatus called a buffer-gas positron trap, so they lose energy by colliding with the molecules of the gas. However, we do not yet fully understand the mechanisms of energy loss at the atomic level, so it is difficult to predict the resulting energy loss precisely.

Some of this energy is lost as rotational energy, when the positrons collide with gas molecules and cause them to spin. Barp and Arretche developed a model to predict this form of energy loss when positrons collide with molecules often used in buffer-gas positron traps: the tetrahedral carbon tetrafluoride (CF4) and methane (CH4), and the octahedral sulphur hexafluoride (SF6). They found that this model compared very well to experimental results.

This model can be applied to collisions between positrons and any tetrahedral or octahedral molecules. Barp and Arretche hope that this improved understanding of how positrons interact with molecules will be used to improve techniques for positron emission tomography (PET) scanning in medicine, for example.

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News Release 13-Dec-2019

Better studying superconductivity in single-layer graphene

An existing technique is better suited to describing superconductivity in pure, single-layer graphene than current methods

Springer


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Made up of 2D sheets of carbon atoms arranged in honeycomb lattices, graphene has been intensively studied in recent years. As well as the material's diverse structural properties, physicists have paid particular attention to the intriguing dynamics of the charge carriers its many variants can contain. The mathematical techniques used to study these physical processes have proved useful so far, but they have had limited success in explaining graphene's 'critical temperature' of superconductivity, below which its' electrical resistance drops to zero. In a new study published in EPJ B, Jacques Tempere and colleagues at the University of Antwerp in Belgium demonstrate that an existing technique is better suited for probing superconductivity in pure, single-layer graphene than previously thought.

The team's insights could allow physicists to understand more about the widely varied properties of graphene; potentially aiding the development of new technologies. Typically, the approach they used in the study is used to calculate critical temperatures in conventional superconductors. In this case, however, it was more accurate than current techniques in explaining how critical temperatures are suppressed with lower densities of charge carriers, as seen in pure, single-layer graphene. In addition, it proved more effective in modelling the conditions which give rise to interacting pairs of electrons named 'Cooper pairs', which strongly influence the electrical properties of the material.

Tempere's team made their calculations using the 'dielectric function method' (DFM), which accounts for the transfer of heat and mass within materials when calculating critical temperatures. Having demonstrated the advantages of the technique, they now suggest that it could prove useful for future studies aiming to boost and probe for superconductivity in single and bilayer graphene. As graphene research continues to be one of the most diverse, fast-paced fields in materials physics, the use of DFM could better equip researchers to utilise it for ever more advanced technological applications.

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News Release 13-Dec-2019

Research calls for new measures to treat mental illness and opioid use


University of Waterloo


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Opioid use among psychiatric hospital patients needs to be addressed through an integrated approach to managing mental illness, pain and substance use, a study by researchers at the University of Waterloo has found.

The study found that 7.5 per cent of 165,434 patients admitted to psychiatric hospitals in Ontario between 2006 and 2017 had used opioids in the year prior to admission, which compares to estimates that 2 per cent of the general population used opioids in 2015. Among patients who said they experience daily pain, the percentage who reported opiate use jumped to 22 per cent.

"The patterns of use we saw are problematic," said Christopher Perlman, a public health researcher. "Opiate use is strongly linked to pain, mental health conditions and use of other drugs. While we don't know how many patients were initially prescribed an opioid for pain, we do know that a large number of patients reporting pain in psychiatry also have an addiction concern."

The study highlights the challenging circumstances faced by those who use opioids. For instance, opiate use was almost twice as common among those whose employment or education was at risk (10.5 per cent) compared to those not at risk (5.8 per cent). Many patients who had used opiates did not have a partner or spouse, and individuals living in rural and northern communities were more likely to use opiates, as were young people, and males rather than females.

"If we are serious about supporting people with mental and physical health concerns, we need an integrated approach to service delivery, which includes assessing and addressing the risk of addiction," said Perlman, who is a professor in the School of Public Health and Health Systems at the University of Waterloo. "Right now, the way our health system is structured and funded, it's not easy to integrate physical, mental and substance use services."

"This study was able to shed some light on the needs of persons who use opioids, but this is really the tip of the iceberg. Because we lack integrated health information systems across various health providers, we really don't know the extent of the physical and health needs of individuals who use opioids across the population. That means they are either getting help elsewhere, which would be good - or more likely, that they are not getting care they need."

The paper, "Factors Associated With Opiate Use Among Psychiatric Inpatients: A Population-Based Study of Hospital Admissions in Ontario, Canada" was co-authored by Oluwakemi Aderibigbe (Waterloo), Anthony Renda (independent), and Christopher Perlman (Waterloo), and published in Health Services Insights.

[florida80]

News Release 13-Dec-2019

Excessive antibiotic prescriptions for children in low-, middle-income countries

Many of the prescriptions given from birth through age 5 are unnecessary and might exacerbate resistance

Harvard T.H. Chan School of Public Health


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Boston, MA - Children in low- and middle-income countries (LMICs) are receiving an average of 25 antibiotic prescriptions during their first five years of life, an excessive amount that could harm the children's ability to fight pathogens as well as increase antibiotic resistance worldwide, according to a new study from the Swiss Tropical and Public Health Institute (Swiss TPH) and Harvard T.H. Chan School of Public Health.

"We knew children in LMICs are sick more often, and we knew antibiotic prescription rates are high in many countries. What we did not know was how these elements translate into actual antibiotic exposure--and the results are rather alarming," said Günther Fink, lead author of the study and head of the Household Economics and Health Systems Research unit at Swiss TPH.

The study--the first to look at total antibiotic prescribing in children under the age of five in LMICs--will be published on 13 December in The Lancet Infectious Diseases.

Global health threat

Antimicrobial resistance is one of today's biggest threats to global health and development, according to the World Health Organization. One factor contributing to this global health threat is the excessive use of antibiotics worldwide. Previous studies have shown that antibiotics are overprescribed to children in many countries. In Tanzania, for instance, several studies have shown that over 90% of children who visit a health facility receive an antibiotic, although only in about 20% of the cases treatment was actually required.

The research team from Swiss TPH and Harvard Chan School analyzed data from 2007-2017 from health facilities and household surveys from eight countries: Haiti, Kenya, Malawi, Namibia, Nepal, Senegal, Tanzania, and Uganda. The study found that, on average, children received 25 antibiotic prescriptions through age five--a "remarkable" estimate, the authors wrote, given that two antibiotic prescriptions per year is considered excessive in many high-income settings. Results showed that antibiotics were administered in 81% of cases for children with a respiratory illness, in 50% for children with diarrhea, and in 28% for children with malaria.

The researchers found that the number of antibiotic prescriptions in early childhood varied from country to country: While a child in Senegal received approximately one antibiotic prescription per year in the first five years of life, a child in Uganda was prescribed up to 12. In comparison, a prior study showed that children under five in Europe receive less than one antibiotic prescription per year on average. "This number is still high given that the vast majority of infections in this age group are of viral origin," said Valérie D'Acremont, a study co-author and head of the Management of Fevers group at Swiss TPH.

"What is unique about this study is that it provides a much more comprehensive picture of pediatric antibiotic exposure in LMICs than what has been reported previously. It combines both household data on where and when children are brought for care with data from direct observations of health care workers caring for sick children," said Jessica Cohen, the Bruce A. Beal, Robert L. Beal, and Alexander S. Beal Associate Professor of Global Health at Harvard Chan School and senior author of the study.

Impact on children

"The consequences of antibiotic overprescription not only pose a huge threat to global health, but can also result in a concrete health impact for these children," said Valérie D'Acremont. "Excess antibiotic use destroys the natural gut flora which is essential to fighting pathogens."

A Swiss TPH research project is underway to better comprehend the health impact of overusing antibiotics on children. "Understanding the concrete impact on individual children is crucial to achieve a policy change," said Fink. His research team is currently comparing policies at a country level to identify best practices that lead to lower antibiotic prescription rates.

[florida80]

13-Dec-2019

Mayo Clinic researchers present findings at the 2019 San Antonio Breast Cancer Symposium


Mayo Clinic


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SAN ANTONIO -- Mayo Clinic researchers will present findings at the San Antonio Breast Cancer Symposium Dec. 10-14 in San Antonio.

New Mayo Clinic studies to be presented include:

•"Women at Elevated Risk of Developing Breast Cancer May Benefit From Taking Anti-inflammatory Drugs"

•Embargoed until Friday, Dec. 13, at 6 p.m. EST

•Research from Mayo Clinic investigators suggest that some women with an elevated risk of developing breast cancer may benefit from taking anti-inflammatory medications.


"Several studies have evaluated whether the use of anti-inflammatory medications such as aspirin, ibuprofen and naproxen affect a woman's risk of developing breast cancer," says Amy Degnim, M.D., a breast surgical oncologist at Mayo Clinic in Minnesota, "but little is known about how use of these drugs might affect their risk after a benign breast biopsy." Dr. Degnim says about one million women receive a diagnosis of benign breast disease annually in the U.S. and having this history increases their risk of developing breast cancer.

Researchers surveyed women who had undergone a benign breast biopsy at Mayo Clinic between 1992 and 2001, and asked them to report which types of these medications they had used and for how long. Researchers also obtained information on which women had developed breast cancer at any point in the years after their initial benign biopsy.

"We found that women who reported using ibuprofen or naproxen had an approximately 40% reduction in breast cancer risk, while women who reported using aspirin had no reduction in breast cancer risk," says Dr. Degnim. "Women who used the drugs more frequently on a regular basis also had greater protection from breast cancer."

Dr. Degnim says the findings suggest that women who have had a benign breast biopsy may benefit from medications that reduce inflammation, except for aspirin, in terms of reducing later breast cancer risk. She cautions that this study was not a clinical trial and she does not recommend that all women should take these medications to reduce their breast cancer risk. "Our results support the need for a clinical trial to further investigate the risks and benefits of taking these medications to lower breast cancer risk."

"Young Women With Breast Cancer May Help Preserve Fertility by Avoiding Intensive Chemotherapy"

Embargoed until Thursday, Dec. 12, at 8 a.m. EST

Young women with HER 2-positive breast cancer may help preserve their fertility by choosing one type of chemotherapy over another according to the findings of a study led by Kathryn Ruddy, M.D., an oncologist at Mayo Clinic.

"Ovarian dysfunction is an important issue after cancer treatment because it can be associated with infertility and menopausal symptoms, such as hot flashes and impaired sexual function," says Dr. Ruddy.

Dr. Ruddy and her team surveyed study participants taking part in a randomized clinical trial testing the efficacy of T-DM1 versus a combination of paclitaxel and trastuzumab. Participants were asked questions about menstrual periods. "We found that young women with HER 2-positive breast cancer may be more likely to resume menstruation after receipt of two relatively new treatments, T-DM1 or a combination of paclitaxel and trastuzumab, than we have seen previously in young women who received older, more intensive chemotherapy regimens."

Dr. Ruddy says the findings should be good news for women who want to maintain fertility after treatment for breast cancer and that menopausal symptoms such as hot flashes may be less burdensome for patients treated with the newer regimens. Dr. Ruddy and her colleagues will perform additional analyses on the effect of tamoxifen on these results before publishing a paper on this study.

"Researchers Develop Tool to Identify Patients at Higher Risk of Heart Damage From Breast Cancer Therapy"

Embargoed until Friday, Dec. 13, at 6 p.m. EST

Researchers at Mayo Clinic in Florida have developed a tool to help identify patients who may be at higher risk of developing heart damage from anti HER 2 breast cancer therapy at an early stage.

"Cardiac toxicity is a known complication of anti-HER 2 therapy," says Pooja Advani, M.B.B.S., M.D., a Mayo Clinic oncologist. Dr. Advani says clinical studies have confirmed that the use of anti-HER 2 therapy in breast cancer patients can have a profound effect on patient survival.

"The most common manifestation of cardiac toxicity in breast cancer patients receiving anti-HER 2 therapy is a reduction in the ejection fraction without any symptoms," says Dr. Advani. Ejection fraction is a measurement of the percentage of blood leaving the heart each time it contracts.

Dr. Advani says risk factors, such as older age; a lower ejection fraction prior to the start of treatment; and the use of anthracycline chemotherapy, such as doxorubin or Adriamycin, have been consistently associated with a higher risk of cardiac toxicity from anti-HER 2 therapy.

Dr. Advani and her colleagues followed 604 breast cancer patients who were treated with anti-HER 2 agents at Mayo Clinic. They collected patient data, including, age, race, gender, body mass index, smoking history, medical comorbidities, use of heart medications, baseline heart function, thickness of the heart muscle and prior use of anthracycline chemotherapy.

Researchers identified patients who developed cardiac toxicity -- asymptomatic, symptomatic, or both. They performed a statistical analysis to identify risk factors that were associated with a high risk of developing cardiac dysfunction.

"We found that patients with certain risk factors including being over the age of 55, having a lower baseline heart function (ejection fraction less than 60 percent), having received anthracycline chemotherapy or patients having enlargement and thickening of the heart walls were most significantly associated with an increased risk of developing cardiac toxicity," says Dr. Advani. "This is consistent with previously reported studies."

Dr. Advani says patients receiving radiation therapy as a part of their breast cancer treatment were not found to be at a significantly higher risk of developing cardiac toxicity from anti-HER 2 therapy based on their findings.

Dr. Advani and her colleagues created a risk prediction model by assigning a score to each factor mentioned above and found that the cumulative risk score was a highly significant predictor of cardiac toxicity in patients.

"Using a risk prediction model at therapy initiation may help us identify patients who may benefit from an early referral to a cardiologist for close cardiac monitoring and treatment with medications to protect their heart function," says Dr. Advani.

[florida80]

News Release 13-Dec-2019

Research calls for new measures to treat mental illness and opioid use


University of Waterloo


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Opioid use among psychiatric hospital patients needs to be addressed through an integrated approach to managing mental illness, pain and substance use, a study by researchers at the University of Waterloo has found.

The study found that 7.5 per cent of 165,434 patients admitted to psychiatric hospitals in Ontario between 2006 and 2017 had used opioids in the year prior to admission, which compares to estimates that 2 per cent of the general population used opioids in 2015. Among patients who said they experience daily pain, the percentage who reported opiate use jumped to 22 per cent.

"The patterns of use we saw are problematic," said Christopher Perlman, a public health researcher. "Opiate use is strongly linked to pain, mental health conditions and use of other drugs. While we don't know how many patients were initially prescribed an opioid for pain, we do know that a large number of patients reporting pain in psychiatry also have an addiction concern."

The study highlights the challenging circumstances faced by those who use opioids. For instance, opiate use was almost twice as common among those whose employment or education was at risk (10.5 per cent) compared to those not at risk (5.8 per cent). Many patients who had used opiates did not have a partner or spouse, and individuals living in rural and northern communities were more likely to use opiates, as were young people, and males rather than females.

"If we are serious about supporting people with mental and physical health concerns, we need an integrated approach to service delivery, which includes assessing and addressing the risk of addiction," said Perlman, who is a professor in the School of Public Health and Health Systems at the University of Waterloo. "Right now, the way our health system is structured and funded, it's not easy to integrate physical, mental and substance use services."

"This study was able to shed some light on the needs of persons who use opioids, but this is really the tip of the iceberg. Because we lack integrated health information systems across various health providers, we really don't know the extent of the physical and health needs of individuals who use opioids across the population. That means they are either getting help elsewhere, which would be good - or more likely, that they are not getting care they need."

The paper, "Factors Associated With Opiate Use Among Psychiatric Inpatients: A Population-Based Study of Hospital Admissions in Ontario, Canada" was co-authored by Oluwakemi Aderibigbe (Waterloo), Anthony Renda (independent), and Christopher Perlman (Waterloo), and published in Health Services Insights

[florida80]

News Release 13-Dec-2019

New methods could help researchers watch neurons compute


Stanford University


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Since the 1950s at least, researchers have speculated that the brain is a kind of computer in which neurons make up complex circuits that perform untold numbers of calculations every second. Decades later, neuroscientists know that these brain circuits exist, yet technical limitations have kept most details of their computations out of reach.

Now, neuroscientists reported December 12 in Cell, they may finally be able to reveal what circuits deep in the brain are up to, thanks in large part to a molecule that lights up brighter than ever before in response to subtle electrical changes that neurons use to perform their compuations.

Currently, one of the best ways to track neurons' electrical activity is with molecules that light up in the presence of calcium ions, a proxy for a neuron spike, the moment when one neuron passes an electrical signal to another. But calcium flows too slowly to catch all the details of a neuron spike, and it doesn't respond at all to the subtle electrical changes that lead up to a spike. (One alternative is to implant electrodes, but those implants ultimately damage neurons, and it isn't practical to place electrodes in more than a handful of neurons at once in living animals.)

To solve those problems, researchers led by Michael Lin, an associate professor of neurobiology and of bioengineering and a member of the Wu Tsai Neurosciences Institute, and Stéphane Dieudonné, an INSERM research director at the École Normale Supérieure in Paris, focused on fluorescent molecules whose brightness responds directly to voltage changes in neurons, an idea Lin and his team had been working on for years.

Still, those molecules had a problem of their own: Their brightness hasn't always been that responsive to voltage, so Lin and his team at Stanford turned to a well-known method in biology called electroporation. In that technique, researchers use electrical probes to zap holes in cell membranes, with the side effect that their voltage drops rapidly to zero like a punctured battery. By zapping a library of candidate molecules, Lin and colleagues could then select those whose brightness was most responsive to the voltage shift. The resulting molecule, called ASAP3, is the most responsive voltage indicator to date, Lin said.

Dieudonné and his lab focused on another problem: how to scan neurons deep in the brain more efficiently. To make fluorescent molecules such as ASAP3 light up deep in the brain, researchers often use a technique called two-photon imaging, which employs infrared laser beams that can penetrate through tissue. Then, in order to scan multiple neurons fast enough to see a spike, which itself lasts only about a thousandth of a second, researchers must move the laser spot quickly from neuron to neuron -- something hard to do reliably in moving animals. The solution, Dieudonné and colleagues found, was a new algorithm called ultrafast local volume excitation, or ULoVE, in which a laser rapidly scans several points in the volume around a neuron, all at once.

"Such strategies, where each laser pulse is shaped and sent to the right volume within the tissue, constitute the optimal use of light power and will hopefully allow us to record and stimulate millions of locations in the brain each second," Dieudonné said.

that illuminates multiple points at once.

Putting those techniques together, the researchers showed in mice that they could track fine details of brain activity in much of the mouse cortex, the top layers of the brain that control movement, decision making and other higher cognitive functions.

"You can now look at neurons in living mouse brains with very high accuracy, and you can track that for long periods of time," Lin said. Among other things, that opens the door to studying not only how neurons process signals from other neurons and how they decide, so to speak, when to spike, but also how neurons' calculations change over time.

In the meantime, Lin and colleagues are focused on further improving on their methods. "ASAP3 is very usable now, but we're confident there will be an ASAP4 and ASAP5," he said.

[florida80]

News Release 13-Dec-2019

Standard pathology tests outperform molecular subtyping in bladder cancer


Medical College of Georgia at Augusta University


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IMAGE: Dr. Vinata B. Lokeshwar and graduate students Sarrah S. Lahorewala and Daley S. Morera. view more 

Credit: Phil Jones, Senior Photographer, Augusta University

While trying to develop a comparatively easy, inexpensive way to give physicians and their patients with bladder cancer a better idea of likely outcome and best treatment options, scientists found that sophisticated new subtyping techniques designed to do this provide no better information than long-standing pathology tests.

They looked at several sets of data on cancer specimens from patients with muscle invasive bladder cancer, a high-grade cancer associated with high mortality rates. The datasets included the one used to determine emerging molecular subtypes, and had outcome information on patients.

They consistently found that molecular subtyping of bladder tumors, which is currently being offered to patients, was outperformed by standard tests long-used by pathologists to characterize cancer as low- or high-grade and to determine the extent of its invasion into the bladder wall, surrounding fat, lymph nodes, blood vessels and beyond, they report in a study featured on the cover of the Journal of Urology.

"Muscle invasive bladder cancer is aggressive, it often has a very bad prognosis," says Dr. Vinata B. Lokeshwar, chair of the Department of Biochemistry and Molecular Biology at the Medical College of Georgia at Augusta University. "Everyone is trying to find out how to improve diagnosis, treatment and survival."

"Genetic profiling of a patient's tumor definitely has value in enabling you to discover the drivers of growth and metastasis that help direct that individual's treatment, even as it helps to identify new treatment targets," says Lokeshwar, the study's corresponding author and a member of the Georgia Cancer Center. "But using this information to subtype tumors does not appear to add diagnostic or prognostic value for patients."

Rather the investigators suggest that more study is needed before molecular subtypes are used to help guide patient care.

Evolving diagnostic approaches include compiling databanks on gene expression and mutations present in a cancer type to find patterns of gene expression that are then used to subtype tumors that "pathologically look similar" but are molecularly different. The idea is that molecular subtypes are better equipped to indicate which cancer is more or less aggressive and to help steer treatment options like whether chemotherapy before surgery to remove a diseased bladder is better.

It was RNA sequencing, or RNA-Seq, and a federal databank of genetic material from a wide range of cancers that enabled investigators from around the globe to examine gene expression in a particular tumor type, looking for common expression of some genes that correlate with a particular clinical outcome. Two subtypes, luminal, which predicts better survival, and basal, which predicts poor prognosis, were first identified for muscle invasive bladder cancer, and a total of six subtypes have now emerged. The first paper on subtypes in muscle invasive bladder cancer was published in the journal Nature in 2014.

But in their search to find a simpler, cheaper, widely available test to provide similar insight, investigators found that these emerging subtypes were outperformed by the usual clinical parameters like the tumor's grade and its spread to lymph nodes or blood vessels, Lokeshwar says.

Their work began in earnest with an exhaustive review by graduate students Daley S. Morera and Sarrah S. Lahorewala of the datasets on patients and differing classification methods used to identify the molecular subtypes.

They found 11 genes that were common in all subtype classification methods. They thought, if they were going to develop a widely available test, subtyping based on these common genes might suffice. They decided to call their new subtyping panel, MCG-1.

Instead of doing RNA-Seq, which costs several thousand dollars, they used the readily available reverse transcription quantitative PCR method costing less than $10, which also looks at gene expression and is actually used to verify RNA-Seq data, Lokeshwar says.

They first looked at their own cohort of 52 patients with bladder cancer, 39 of whom had muscle invasive disease. They found MCG-1 was only 31-36% accurate at predicting important indicators like likelihood of metastasis; disease specific survival, meaning surviving bladder cancer; or overall survival, meaning survival from all causes of death from the time of cancer diagnosis or beginning of treatment until the study's end.

Recognizing that the dataset they used was comparatively small and that they did not use RNA-Seq for analysis, they then used three patient datasets from the cancer database ONCOMINE which had more patients -- 151 with muscle invasive bladder cancer -- and also used RNA-Seq to look at gene expression.

"We found the same thing: MCG-1 could not predict disease-specific mortality," Lokeshwar says. On some patients in this dataset, information on response to chemotherapy, like commonly used cisplatin-based chemotherapy following surgical removal of the bladder, was available but subtypes could not predict chemotherapy response either, she says.

Next they looked at the dataset that has been used by a large network of investigators to identify the subtypes, The Cancer Genome Atlas, or TCGA. TCGA is a project of the National Cancer Institute and National Human Genome Research Institute that started in 2006, and has collected genetic material for 33 different cancers. The dataset includes routine pathology information on 402 specimens from patients with muscle invasive bladder cancer. It also includes these patients' overall survival and recurrence-free survival - that is when or if their cancer returned or progressed.

"Up until this point, we had been looking at patients that other groups had not looked at," Lahorewala says.

In this dataset MCG-1 predicted overall survival similar to findings reported from subtypes in several high profile publications.

"We were intrigued why MCG-1 could not predict anything in our cohort or the ONCOMINE dataset but predicted overall survival in the TCGA dataset," says Morera.

So they looked again at the 402 patients whose specimens were in the dataset and found that 21 patients' tumors were actually low-grade. Patients with low-grade tumors have higher survivability and a better prognosis than patients with high-grade muscle invasive disease.

When they removed the low-grade cases from the TCGA dataset, MCG-1 accurately predicted essentially nothing, not even overall survival. Then they included some patients with low-grade tumors into their own dataset, which they had looked at originally, and MCG-1 was now able to predict metastasis and disease specific survival, the investigators say.

All the existing subtypes are categorized as bad or better based on the cancer prognosis, the investigators say. The presence of the low-grade tumors in the classification of subtypes skewed the data to make it look like subtypes were predicting overall survival when really it was the grade of the cancer itself that was predictive.

"As investigators the first thing we did was to question our findings, since the results were so different than those reported by others," says Lokeshwar.

With the help of MCG biostatistician and coauthor Dr. Santu Ghosh, they also went back and looked at the same patients in the TCGA datasets and the subtypes they had been assigned by three different classification methods established by a network of bladder cancer researchers.

"Even with these established classification methods, the subtypes were accurate only about 50% of the time in predicting patients' overall survival. And once again, routine pathology parameters like invasion into lymph nodes or blood vessels were more accurate than the established subtypes in predicting patients' prognosis," says Lahorewala.

A recent study by investigators at Sweden's Lund University published in the journal Urologic Oncology supports the MCG investigators' findings. Their study of 519 patients who had their bladders removed because of bladder cancer found subtypes were not associated with cancer-specific survival.

Part of the problem with subtyping may be the inherent heterogeneity of tumors, says Morera. There is tremendous heterogeneity in the gene expression of tumors, even among the same tumor type, like bladder cancer, and within different parts of the same tumor as well. Furthermore, this pattern of heterogeneity can change both during tumor growth and treatment.

"Just because it's bladder cancer does not mean it's the same in all patients. We know that tumors are very dynamic and so there is heterogeneity," Lokeshwar says.

"Because there is heterogeneity, there could be problems when you want to categorize a tumor into a single subtype," says Morera.

As the name indicates, muscle invasive bladder cancer has already spread from the lining of the sac-like organ to its muscular wall. High-grade tumors, if not detected early, will spread into bladder muscle, whereas, low-grade tumors are rarely invasive. Painless blood in the urine is the most common sign of bladder cancer although only a small percentage of the individuals with it have cancer. Smoking is the major risk factor for bladder cancer.

[florida80]

A test of a customized implant for hip replacement

Scientists developed a mathematical model of an 'endoprosthesis-skeleton' system; special attention was paid to the geometry and internal structure of hip bones

Peter the Great Saint-Petersburg Polytechnic University


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IMAGE: General distribution of stresses in the "endoprosthesis-skeleton " model of the biomechanical structure when a patient is standing on two legs. The voltage range is from 1 to 100 MPa. view more 

Credit: Peter the Great St.Petersburg Polytechnic University

A team of scientists from the Advanced Manufacturing Technologies Center of the National Technology Initiative (NTI) of Peter the Great St.Petersburg Polytechnic University (SPbPU) (head -- Prof. A.I. Borovkov, the Vice-rector for Advanced Projects of Peter the Great St. Petersburg Polytechnic University) developed a mathematical model of an "endoprosthesis-skeleton" system. Special attention was paid to the geometry and internal structure of hip bones. Using advanced computer modeling technologies, the team assessed the integrity of the biomechanical structure for a typical case (a patient standing on two legs). Currently the team is working on a methodology that would reduce the time of such analysis to several days. The results of the study were published in the Vibroengineering PROCEDIA journal and presented at the 12th All-Russia Congress on Fundamental Issues of Theoretical and Applied Mechanics.

Hip joint arthroplasty is a relatively common procedure today. During arthroplasty the upper part of a patient's hip bone is replaced with a metal stem with a spherical joint element, and a cup to allow the head of the joint to rotate inside the pelvis. Medical companies manufacture standard elements with different parameters for ordinary hip replacement operations. However, after some time a certain share of patients experiences issues with implants and requires their replacement. As a rule, this happens due to the insufficient (or excessive) load the endoprosthesis puts on the hip bone causing its tissue to change. Moreover, bone strength can be affected by osteoporosis and other diseases. By the time of the second surgery (the removal of the initial implant and the installation of a revision one) a part of the hip bone becomes unfit as it is unable to bear the load. Therefore, when a patient comes to a secondary operation with a damaged hip bone, standard implants are of no use for them, and a regular cup (even if it is of a bigger size) might not work.

The manufacturers produce special sets of elements that can be combined with each other in different ways to be used in revision operations as well as in patients with compound fractures or cancer. However, such surgeries have high risk rates: any issue with a revision structure or additional bone tissue loss may cause grave health issues. It is extremely important to understand if the prosthesis is able to bear the load, and if the damage to the patient's bone can be avoided. Virtual testing before installation could help eliminate numerous post-surgical complications. However, there is currently no universal assessment method to do so. It takes a long time to build a model on the basis of bone CT results, while the patient's health parameters keep constantly changing. Therefore, the window between diagnostics and the surgery should be as short as possible.

A team of engineers from the Advanced Manufacturing Technologies Center of the National Technology Initiative (NTI) of Peter the Great St. Petersburg Polytechnic University (SPbPU) analyzed the integrity of an "endoprosthesis-skeleton" system for a case of hip joint revision arthroplasty and assessed the durability of the implanted structure and pelvis bones, as well as the distribution of load when a patient stands on two feet. The work describes the peculiarities of simulation model preparation. Currently, this process takes a long time, but the team is working on a method to reduce the whole calculation to several days.

Other groups tend to entirely ignore pelvic bones in their studies or to consider only their simplified models. However, in this case the researchers paid special attention to detailed description of pelvic bones including their external and porous internal layers. This was done due to the fact that the pelvis is often at risk in its entirety.

"If we consider the work done by us as a virtual test, the article described the load we put on the patient's skeleton and the implant, as if they were tested in reality. Studies like this help reduce the risk of complications in patients with individually designed implants. Hopefully, they would help prioritize prevention over cure," commented Mikhail Zhmaylo, a lead engineer at the Advanced Manufacturing Technologies Center of the National Technology Initiative (NTI) of Peter the Great St. Petersburg Polytechnic University (SPbPU)

[florida80]

New assay assesses multiple cellular pathways at once


Baylor College of Medicine


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IMAGE: Synthetic assembly cloning for inserting multiple luciferase reporters into a single vector. Nature Communications/The Venken lab view more 

Credit: Nature Communications/The Venken lab

A novel technological approach developed by researchers at Baylor College of Medicine expands from two to six the number of molecular pathways that can be studied simultaneously in a cell sample with the dual luciferase assay, a type of testing method commonly used across biomedical fields.

Published in the journal Nature Communications, the report shows that multiplexed hextuple luciferase assaying, meaning a testing method that can effectively probe six different pathways. It can also be used to monitor the effects of experimental treatments on multiple molecular targets acting within these pathways. The new assay is sensitive, saves time and expense when compared to traditional approaches, reduces experimental error and can be adapted to any research field where the dual luciferase assay is already implemented, and beyond.

"One of the interests of our lab is to have a better understanding of the processes involved in cancer. Cancer usually originates through changes on many different genes and pathways, not just one, and currently most cell-based screening assays conduct single measurements," said corresponding author Dr. Koen Venken, assistant professor of biochemistry and molecular biology, and pharmacology and chemical biology at Baylor.

To get a more detailed picture of the cellular processes that differentiate normal versus cancer cells, researchers resort to conduct several independent screening assays at the expense of time and additional cost.

"Our goal in this study was to measure multiple cellular pathways at once in a single biological sample, which would also minimize experimental errors resulting from conducting multiple separate assays using different samples," said Venken, a McNair Scholar and member of the Dan L Duncan Comprehensive Cancer Center at Baylor.

Dr. Alejandro Sarrion-Perdigones, first author of the paper, focused on developing a multiplexed method - a method for simultaneously detecting many signals from complex systems, such as living cells. He developed a sensitive assay using luciferases, enzymes that produce bioluminescence. The assay includes six luciferases, each one emitting bioluminescence that can be distinguished from the others. Each luciferase was engineered to reveal the activity of a particular pathway by emitting bioluminescence.

"To engineer and deliver the luciferase system to cells, we used a 'molecular Lego' approach," said co-author Dr. Lyra Chang, post-doctoral researchers at the Center for Drug Discovery at Baylor. "This consists of connecting the DNA fragments encoding all the biological and technological information necessary to express each luciferase gene together sequentially forming a single DNA chain called vector. This single vector enters the cells where each luciferase enzyme is produced separately."

Treating the cells with a single multi-luciferase gene vector instead of using six individual vectors, decreased variability between biological replicates and provided an additional level of experimental control, Chang explained. This approach allowed for simultaneous readout of the activity of five different pathways, compared to just one using traditional approaches, providing a much deeper understanding of cellular pathways of interest.

"In addition to applications in cancer research, as we have shown in this work, our multiplex luciferase assay can be used to study other cellular pathways or complex diseases across different research fields," Venken said. "For instance, the assay can be adapted to study the effect of drugs on insulin sensitivity in different cells types, the immune response to viral infections, or any other combinations of pathways

[florida80]

A test of a customized implant for hip replacement

Scientists developed a mathematical model of an 'endoprosthesis-skeleton' system; special attention was paid to the geometry and internal structure of hip bones

Peter the Great Saint-Petersburg Polytechnic University


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IMAGE


IMAGE: General distribution of stresses in the "endoprosthesis-skeleton " model of the biomechanical structure when a patient is standing on two legs. The voltage range is from 1 to 100 MPa. view more 

Credit: Peter the Great St.Petersburg Polytechnic University

A team of scientists from the Advanced Manufacturing Technologies Center of the National Technology Initiative (NTI) of Peter the Great St.Petersburg Polytechnic University (SPbPU) (head -- Prof. A.I. Borovkov, the Vice-rector for Advanced Projects of Peter the Great St. Petersburg Polytechnic University) developed a mathematical model of an "endoprosthesis-skeleton" system. Special attention was paid to the geometry and internal structure of hip bones. Using advanced computer modeling technologies, the team assessed the integrity of the biomechanical structure for a typical case (a patient standing on two legs). Currently the team is working on a methodology that would reduce the time of such analysis to several days. The results of the study were published in the Vibroengineering PROCEDIA journal and presented at the 12th All-Russia Congress on Fundamental Issues of Theoretical and Applied Mechanics.

Hip joint arthroplasty is a relatively common procedure today. During arthroplasty the upper part of a patient's hip bone is replaced with a metal stem with a spherical joint element, and a cup to allow the head of the joint to rotate inside the pelvis. Medical companies manufacture standard elements with different parameters for ordinary hip replacement operations. However, after some time a certain share of patients experiences issues with implants and requires their replacement. As a rule, this happens due to the insufficient (or excessive) load the endoprosthesis puts on the hip bone causing its tissue to change. Moreover, bone strength can be affected by osteoporosis and other diseases. By the time of the second surgery (the removal of the initial implant and the installation of a revision one) a part of the hip bone becomes unfit as it is unable to bear the load. Therefore, when a patient comes to a secondary operation with a damaged hip bone, standard implants are of no use for them, and a regular cup (even if it is of a bigger size) might not work.

The manufacturers produce special sets of elements that can be combined with each other in different ways to be used in revision operations as well as in patients with compound fractures or cancer. However, such surgeries have high risk rates: any issue with a revision structure or additional bone tissue loss may cause grave health issues. It is extremely important to understand if the prosthesis is able to bear the load, and if the damage to the patient's bone can be avoided. Virtual testing before installation could help eliminate numerous post-surgical complications. However, there is currently no universal assessment method to do so. It takes a long time to build a model on the basis of bone CT results, while the patient's health parameters keep constantly changing. Therefore, the window between diagnostics and the surgery should be as short as possible.

A team of engineers from the Advanced Manufacturing Technologies Center of the National Technology Initiative (NTI) of Peter the Great St. Petersburg Polytechnic University (SPbPU) analyzed the integrity of an "endoprosthesis-skeleton" system for a case of hip joint revision arthroplasty and assessed the durability of the implanted structure and pelvis bones, as well as the distribution of load when a patient stands on two feet. The work describes the peculiarities of simulation model preparation. Currently, this process takes a long time, but the team is working on a method to reduce the whole calculation to several days.

Other groups tend to entirely ignore pelvic bones in their studies or to consider only their simplified models. However, in this case the researchers paid special attention to detailed description of pelvic bones including their external and porous internal layers. This was done due to the fact that the pelvis is often at risk in its entirety.

"If we consider the work done by us as a virtual test, the article described the load we put on the patient's skeleton and the implant, as if they were tested in reality. Studies like this help reduce the risk of complications in patients with individually designed implants. Hopefully, they would help prioritize prevention over cure," commented Mikhail Zhmaylo, a lead engineer at the Advanced Manufacturing Technologies Center of the National Technology Initiative (NTI) of Peter the Great St. Petersburg Polytechnic University (SPbPU

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News Release 13-Dec-2019

Researchers reconstruct spoken words as processed in nonhuman primate brains


Brown University


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VIDEO: Using a brain-computer interface, a team of researchers has reconstructed English words from the brain activity of rhesus macaques that listened as the words were spoken. view more 

Credit: Nurmikko Lab / Brown University


PROVIDENCE, R.I. [Brown University] -- A team of Brown University researchers has used a brain-computer interface to reconstruct English words from neural signals recorded in the brains of nonhuman primates. The research, published in the journal Nature Communications Biology, could be a step toward developing brain implants that may help people with hearing loss, the researchers say.

"What we've done is to record the complex patterns of neural excitation in the secondary auditory cortex associated with primates' hearing specific words," said Arto Nurmikko, a professor in Brown's School of Engineering, a research associate in Brown's Carney Institute for Brain Science and senior author of the study. "We then use that neural data to reconstruct the sound of those words with high fidelity.

"The overarching goal is to better understand how sound is processed in the primate brain," Nurmikko added, "which could ultimately lead to new types of neural prosthetics."

The brain systems involved in the initial processing of sound are similar in humans and non-human primates. The first level of processing, which happens in what's called the primary auditory cortex, sorts sounds according to attributes like pitch or tone. The signal then moves to the secondary auditory cortex, where it's processed further. When someone is listening to spoken words, for example, this is where the sounds are classified by phonemes -- the simplest features that enable us to distinguish one word from another. After that, the information is sent to other parts of the brain for the processing that enables human comprehension of speech.

But because that early-stage processing of sound is similar in humans and non-human primates, learning how primates process the words they hear is useful, even though they likely don't understand what those words mean.

For the study, two pea-sized implants with 96-channel microelectrode arrays recorded the activity of neurons while rhesus macaques listened to recordings of individual English words and macaque calls. In this case, the macaques heard fairly simple one- or two-syllable words -- "tree," "good," "north," "cricket" and "program."

The researchers processed the neural recordings using computer algorithms specifically developed to recognize neural patterns associated with particular words. From there, the neural data could be translated back into computer-generated speech. Finally, the team used several metrics to evaluate how closely the reconstructed speech matched the original spoken word that the macaque heard. The research showed the recorded neural data produced high-fidelity reconstructions that were clear to a human listener.

The use of multielectrode arrays to record such complex auditory information was a first, the researchers say.

"Previously, work had gathered data from the secondary auditory cortex with single electrodes, but as far as we know this is the first multielectrode recording from this part of the brain," Nurmikko said. "Essentially we have nearly 200 microscopic listening posts that can give us the richness and higher resolution of data which is required."

One of the goals of the study, for which doctoral student Jihun Lee led the experiments, was to test whether any particular decoding model algorithm performed better than others. The research, in collaboration with Wilson Truccolo, a computational neuroscience expert, showed that recurrent neural networks (RNNs) -- a type of machine learning algorithm often used in computerized language translation -- produced the highest-fidelity reconstructions. The RNNs substantially outperformed more traditional algorithms that have been shown to be effective in decoding neural data from other parts of the brain.

Christopher Heelan, a research associate at Brown and co-lead author of the study, thinks the success of the RNNs comes from their flexibility, which is important in decoding complex auditory information.

"More traditional algorithms used for neural decoding make strong assumptions about how the brain encodes information, and that limits the ability of those algorithms to model the neural data," said Heelan, who developed the computational toolkit for the study. "Neural networks make weaker assumptions and have more parameters allowing them to learn complicated relationships between the neural data and the experimental task."

Ultimately, the researchers hope, this kind of research could aid in developing neural implants the may aid in restoring peoples' hearing.

"The aspirational scenario is that we develop systems that bypass much of the auditory apparatus and go directly into the brain," Nurmikko said. "The same microelectrodes we used to record neural activity in this study may one day be used to deliver small amounts of electrical current in patterns that give people the perception of having heard specific sounds."

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News Release 13-Dec-2019

Entrectinib effective, well-tolerated against ROS1 and NTRK lung cancers, especially with brain metastases


University of Colorado Anschutz Medical Campus


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IMAGE: Robert C. Doebele, MD, PhD, and colleagues update the effectiveness of entrectinib against ROS1+ and NTRK+ cancers. view more 

Credit: University of Colorado Cancer Center

Pooled analysis of three phase 1 and 2 clinical trials published online ahead of print in the journal Lancet Oncology show that the drug entrectinib is effective and well-tolerated against advanced ROS1 and NTRK fusion-positive non-small cell lung cancers (NSCLC). Results of the trials STARTRK-1 (NCT02097810), STARTRK-2 (NCT02568267), and ALKA, show 77 percent response rate to entrectinib in 53 patients with ROS1+ NSCLC, with a median progression-free survival of 19 months and a median duration of response of 24.6 months. In 54 patients with NTRK+ NSCLC, 57 percent responded to entrectinib, with a median progression-free survival of 11.2 months and a median duration of response of 10.4 months. Based on the early promise of these trials, in August 2019 the U.S. Food and Drug Administration granted entrectinib accelerated approval for the treatment of metastatic ROS1+ NSCLC and for advanced tumors across cancer types defined by NTRK fusion. The current journal articles update these findings that led to approval.

"For a drug to get simultaneous approval for use against two different targets is somewhat unique. I don't know of this ever happening before," says Robert C. Doebele, MD, PhD, director of the University of Colorado Cancer Center Thoracic Oncology Research Initiative, senior author on the ROS1 study, and first author on the NTRK study.

About 2 percent of lung cancers are driven by the improper fusion of the gene ROS1 with one of a handful of possible genetic partners, resulting in a cancer-causing ROS1 fusion gene. About 1 percent of all solid tumors, including but not limited to lung cancers, are similarly caused by NTRK fusion genes. The FDA-approved drug crizotinib can silence the action of ROS1 fusion genes in some cases, but can't reach cancers that have metastasized to the brain. And, unfortunately, 36 percent of patients with ROS1+ NSCLC already have brain metastases at the time of advanced disease diagnosis, and many more will go on to develop brain metastases during the course of care.

"For ROS1+ lung cancer, entrectinib represents a new and better standard of care due to entrectinib's effectiveness against ROS1 in the body and especially due to its activity against ROS1+ brain metastases," Doebele says. "For NTRK cancers, the picture is a little more complex and I think it depends on an NTRK+ cancer's chance of developing brain metastases. Personally, if I were a patient and felt there was any chance of me getting brain mets, I would want this brain-penetrating drug."

Included in these phase 1 or 2 studies were adults with locally advanced or metastatic ROS1+ or NTRK+ NSCLC who had received previous treatment not including other ROS1 inhibitors. Patients received entrectinib at a dose of at least 600 mg orally once per day, with at least 12 months follow-up. Doebele describes the drug as "well tolerated with a manageable safety profile," with side effects including weight increase (8%) and neutropenia (4%). Eleven percent of patients had serious treatment-related adverse events, the most common of which were nervous system disorders (3%) and cardiac disorders (2%). No treatment-related deaths occurred.

"The genes ROS1 and NTRK are on a growing list of known genetic drivers of non-small cell lung cancer. In addition to showing the benefit of entrectinib against cancers caused by these fusion genes, these results highlight the importance of genetic testing in NSCLC, especially when patients are diagnosed with the condition in the absence of other risk factors," Doebele says. "Only by testing for genes like ROS1 and NTRK can we match these genetic drivers of cancer with drugs like entrectinib."

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News Release 13-Dec-2019

Rapid tissue donation program offers feasible approach to improve research

Well-preserved postmortem lung cancer specimens allow for genetic and molecular analyses

H. Lee Moffitt Cancer Center & Research Institute


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TAMPA, Fla. - Precision medicine with targeted therapies has led to improved treatment options and patient outcomes. These approaches were developed by studying tumors grown in laboratories and patient samples obtained before and during their treatment. However, there is often a limited supply of patient samples to adequately study, and the samples that exist do not always tell the complete genetic story of how the patient responded to specific drugs and the reasons why they failed treatment. Researchers need a better way to determine how tumors respond to therapies and evolve to resist drug treatment.

In an article published in Cancer Medicine, Moffitt Cancer Center scientists describe a community-based program called the Rapid Tissue Donation (RTD) protocol. It enables patients to consent to donating tumor tissue and blood samples for research purposes after their death. The samples provided by patients postmortem enable researchers to study the genetic and molecular makeup of primary and metastatic tumors after the patient failed treatment, and to compare those finding with what was known about the patient during earlier phases of their therapy.

There were several challenges that the Moffitt team had to overcome before embarking on this program, including ethical considerations and logistical challenges, communication with hospice care facilities, locating autopsy facilities in the community and identifying tumors in postmortem specimens.

During a two-year span from Nov. 2015 to Nov. 2017, Moffitt researchers were able to gain consent from 21 lung cancer patients from Hillsborough, Pinellas and Pasco counties to participate in the RTD study. They collected 180 tumor tissue and blood specimens from nine deceased patients, while the remaining 12 patients were still alive at the time of the article publication.

One of the logistical challenges the researchers faced was the need to preserve the specimens as quickly as possible after death to ensure that the tissue and molecular material remained intact. The average time to collect the specimens for all nine patients was 15.8 hours. Samples were collected within 20 hours of death for eight donors, and by 41 hours from death for one donor due to unavoidable logistic complexities.

Analysis of the specimens found that most of the DNA samples taken from the primary and metastatic tumors of the same patient were similar and contained the same DNA mutations. The researchers also discovered an AGK-BRAF fusion in one patient with a known EML4-ALK fusion and resistance to ALK inhibitor therapy. Activated BRAF can promote tumor growth. "This is a compelling finding because, had the AGK-BRAF fusion been detected during treatment, physicians could have adapted therapy to include a BRAF-targeted agent," said Eric Haura, M.D., medical oncologist and director of Moffitt's Lung Cancer Center of Excellence.

Analysis of tumor tissue samples for protein biomarkers showed that expression of the protein PD-L1 varied up to 55% among samples taken from the primary tumor and metastatic tumors from the same patient. Levels of PD-L1 are used as a diagnostic assay for lung cancer patients to determine if they should receive certain drugs.

"Twenty to sixty percent of individuals in this study would have a different PD-L1 result if different tumor sites were tested," said Haura. "This illustrates the importance of interpreting PD-L1 results with caution because a large number of patients might not be eligible for immunotherapy based on testing of one tumor site but would be eligible based on testing of a tumor in a different location."

Haura is pleased with the progress the RTD program has made and is excited for what is to come. He hopes that it can be expanded into other tumor types and even developed in partnership with other institutions.

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News Release 13-Dec-2019

Multi-omics approach offers new insights into peanut allergy severity

Findings could improve diagnostics and lead to new treatments

The Mount Sinai Hospital / Mount Sinai School of Medicine


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New York, NY -- Dec 12, 2019 -- Researchers at the Icahn School of Medicine at Mount Sinai have identified novel genes associated with the severity of peanut allergy, as well as ways in which these genes interact with other genes during allergic reactions.

The findings, published December 12 in the Journal of Allergy and Clinical Immunology, could lead to better treatments for peanut allergy.

Peanut allergy varies widely in severity and is the leading cause of fatal food-related anaphylaxis. The tests used to determine the existence of a peanut allergy don't offer any clues as to whether an individual ingesting a peanut could experience a minor rash, major swelling, or life-threatening issues such as difficulty breathing or cardiovascular complications.

The study's senior author, Supinda Bunyavanich, MD, MPH, Associate Professor of Genetics and Genomic Sciences, and Pediatrics, and Associate Director of the Elliot and Roslyn Jaffe Food Allergy Institute at Mount Sinai, was especially curious about why the severity of reactions varies so much, both as a clinician-scientist and as a mother of a child with a peanut allergy.

To help address this question, Dr. Bunyavanich and her team used novel multi-omic approaches (the study of the role, relationships, and actions of a system-wide measure of a given molecular type) to identify genes and networks of activity that might be driving the severity of peanut allergy reactions. The approaches included transcriptomics, the study of gene expression across the genome, and epigenomics, the study of reversible modifications to DNA that affect gene expression.

The study involved 21 children ages 7-17 with peanut allergy, who were given gradually increasing doses of peanut until they displayed an allergic response. The scientists drew blood from the participants at three times: before they ate, as they reacted, and after their reaction. The team confirmed their findings from the initial cohort by repeating the study in another 19 children.

Taking blood samples at multiple times allowed the team to analyze both the transcriptome and epigenome (which can tell scientists which genes are turned on or off through a process called methylation) as the children reacted. Using this genome-wide approach, they identified more than 300 genes and 200 CpG sites (areas where DNA can be activated or inactivated by methylation) associated with reaction severity. Combining these data using integrative networks, the team also characterized key interactions between gene expression, CpG sites, and reaction severity.

Not only did they identify novel genes associated with the severity of peanut allergy, but they also managed to characterize ways in which these genes interact with other genes and CpG sites during allergic reactions to regulate biological processes. "It was very exciting to apply multi-omics to uncover how genes and methylation sites interact to affect reaction severity in these peanut allergic kids," says Anh Do, PhD, lead author of the study and postdoctoral fellow in the Bunyavanich Lab.

Among the insights is that while the findings support recognized roles for adaptive immunity in allergy, they also suggest that neutrophil (a type of white blood cell)-mediated immunity plays a prominent role in reaction severity. "We know neutrophil-mediated immunity is part of immune responses, and this study suggests it may play a central role in the severity of peanut allergic reactions," said Dr. Bunyavanich.

Additionally, one of the reaction severity drivers the team identified, the gene ARG1, can be inhibited by arginase inhibitors, a type of drug under study for many diseases. This study's finding suggests it may be a potential target for treating peanut allergy as well.

Dr. Bunyavanich hopes future studies will identify biomarkers that can predict who is likely to have severe responses without having to expose them to peanuts first. But in the meantime, she states that this study "hopefully challenges people to think about food allergy with a broader lens."

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News Release 13-Dec-2019

Bone bandage soaks up pro-healing biochemical to accelerate repair

Trapping adenosine at the site of a bone break speeds recovery in mice

Duke University


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IMAGE: This graphic shows the healing progress of a fracture in a mouse treated with a new type of bone bandage that traps native adenosine (top), is preloaded with external adenosine... view more 

Credit: Shyni Varghese, Duke University

DURHAM, N.C. -- Researchers at Duke University have engineered a bandage that captures and holds a pro-healing molecule at the site of a bone break to accelerate and improve the natural healing process.

In a proof-of-principle study with mice, the bandage helped to accelerate callus formation and vascularization to achieve better bone repair by three weeks.

The research points toward a general method for improving bone repair after damage that could be applied to medical products such as biodegradable bandages, implant coatings or bone grafts for critical defects.

The results appear online on December 12 in the journal Advanced Materials.

In 2014, Shyni Varghese, professor of biomedical engineering, mechanical engineering and materials science, and orthopedics at Duke, was studying how popular biomaterials made of calcium phosphate promote bone repair and regeneration. Her laboratory discovered that the biomolecule adenosine plays a particularly large role in spurring bone growth.

After further study, they found that the body naturally floods the area around a new bone injury with the pro-healing adenosine molecules, but those locally high levels are quickly metabolized and don't last long. Varghese wondered if maintaining those high levels for longer would help the healing process.

But there was a catch.

"Adenosine is ubiquitous throughout the body in low levels and performs many important functions that have nothing to do with bone healing," Varghese said. "To avoid unwanted side effects, we had to find a way to keep the adenosine localized to the damaged tissue and at appropriate levels."

Varghese's solution was to let the body dictate the levels of adenosine while helping the biochemical stick around the injury a little bit longer. She and Yuze Zeng, a graduate student in Varghese's laboratory, designed a biomaterial bandage applied directly to the broken bone that contains boronate molecules that grab onto the adenosine. However, the bonds between the molecules do not last forever, which allows a slow release of adenosine from the bandage without accumulating elsewhere in the body.

In the current study, Varghese and her colleagues first demonstrated that porous biomaterials incorporated with boronates were capable of capturing the local surge of adenosine following an injury. The researchers then applied bandages primed to capture the host's own adenosine or bandages preloaded with adenosine to tibia fractures in mice.

After more than a week, the mice treated with both types of bandages were healing faster than those with bandages not primed to capture adenosine. After three weeks, while all mice in the study showed healing, those treated with either kind of adenosine-laced bandage showed better bone formation, higher bone volume and better vascularization.

The results showed that not only do the adenosine-trapping bandages promote healing, they work whether they're trapping native adenosine or are artificially loaded with it, which has important implications in treating bone fractures associated with aging and osteoporosis.

"Our previous work has shown that patients with osteoporosis don't produce adenosine when their bones break," Yuze said. "These early results indicate that these bandages could help deliver the needed adenosine to repair their injuries while avoiding potential side effects."

Varghese and Yuze see several other paths forward for biomedical applications as well. For example, they imagine a biodegradable bandage that traps adenosine to help heal broken bones and then decomposes into the body. Or for osteoporotic patients, a permanent bandage that can be reloaded with adenosine at sites that suffer from repeated injuries. They also envision a lubricating gel armed with adenosine that can help prevent bone injuries caused by the wear and tear associated with reconstructive joint surgeries or other medical implants.

"We've demonstrated that this is a viable approach and filed a patent for future devices and treatments, but we still have a long way to go," said Varghese. "The bandages could be engineered to capture and hold on to adenosine more efficiently. And of course we also have to find out whether these results hold in humans or could cause any side effects."

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News Release 13-Dec-2019

Study probing visual memory, amblyopia unveils many-layered mystery


Picower Institute at MIT


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IMAGE: Researchers used a genetic technique to knock out NMDA receptors in layer 4 of the visual cortex of mice. view more 

Credit: Bear Lab/ Picower Institute for Learning and Memory

In decades of studying how neural circuits in the brain's visual cortex adapt to experience, MIT Professor Mark Bear's lab has followed the science wherever it has led, yielding the discovery of cellular mechanisms serving visual recognition memory, in which the brain learns what sights are familiar so it can focus on what's new, and of a potential therapy for amblyopia, a disorder where children born with disrupted vision in one eye can lose visual acuity there permanently without intervention. But this time his lab's latest investigation has yielded surprising new layers of mystery.

Heading into the experiments described in a new paper in Cerebral Cortex, Bear and his team expected to confirm that key proteins called NMDA receptors act specifically in neurons in layer 4 of the visual cortex to make the circuit connection changes, or "plasticity," necessary for both visual recognition memory and amblyopia. Instead, the study has produced unexpectedly divergent results.

"There are two stories here," said Bear, co-senior author and Picower Professor of Neuroscience in The Picower Institute for Learning and Memory. "One is that we have further pinpointed where to look for the root causes of amblyopia. The other is that we have now completely blown up what we thought was happening in stimulus-selective response potentiation, or SRP, the synaptic change believed to give rise to visual recognition memory."

The cortex is built like a stack of pancakes, with distinct layers of cells serving different functions. Layer 4 is considered to be the primary "input layer" that receives relatively unprocessed information that arises from each eye. Plasticity that is restricted to one eye has been assumed to occur at this early stage of cortical processing, before the information from the two eyes becomes mixed. However, while the evidence demonstrates that NMDA receptors in layer 4 neurons are indeed necessary for the degradation of vision in a deprived eye, they apparently play no role in how neural connections, or synapses, serving the uncompromised eye strengthen to compensate, and similarly don't matter for the development of SRP. That's even though NMDA receptors in visual cortex neurons have directly been shown to matter in these phenomena before, and layer 4 neurons are known to participate in these circuits via telltale changes in electrical activity.

"These findings reveal two key things," said Samuel Cooke, co-senior author and a former member of the Bear Lab who now has his own at King's College London. "First, that the neocortical circuits modified to enhance cortical responses to sensory inputs during deprivation or to stimuli that have become familiar reside elsewhere in neocortex, revealing a complexity that we had not previously appreciated. Second, the results show that effects can be clearly manifest in a region of the brain that are actually echoes of plasticity occurring elsewhere, thereby illustrating the importance of not only observing biological phenomena but also understanding their origins by locally disrupting known underlying mechanisms."

'We were stunned'

To perform the study, Bear Lab postdoc and lead author Ming-fai Fong and used a genetic technique to specifically knock out NMDA receptors in excitatory neurons in layer 4 of the visual cortex of mice. Armed with that tool, she could then investigate the consequences for visual recognition memory and "monocular deprivation," a lab model for amblyopia in which one eye is temporarily closed early in life. The hypothesis was that knocking out the NMDA receptor in these cells in layer 4 would prevent SRP from taking hold amid repeated presentations of the same stimulus, and would prevent the degradation of vision in a deprived eye as well as the commensurate strengthening of the unaffected eye.

"We were gratified to note that the amblyopia-like effect of losing cortical vision as a result of closing an eye for several days in early life was completely prevented," Cooke said. "However, we were stunned to find that the two enhancing forms of plasticity remained completely intact."

Fong said that with continued work, the lab hopes to pinpoint where in the circuit NMDA receptors are triggering SRP and the compensatory increase in strength in a non-deprived eye after monocular deprivation. Doing so, she said, could have clinical implications.

"Our study identified a crucial component in the visual cortical circuit that mediates the plasticity underlying amblyopia," she said. "This study also highlights the ongoing need to identify the distinct components in the visual cortical circuit that mediate visual enhancement, which could be important both in developing treatments for visual disability as well as developing biomarkers for neurodevelopmental disorders. These efforts are ongoing in the lab."

The search now moves to other layers, Bear said, including layer 6, which also receives unprocessed input from each eye.

"Clearly this is not the end of the story," Bear said.

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News Release 13-Dec-2019

Moongoose females compete over reproduction


University of Helsinki


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IMAGE: A group of banded mongooses (Mungos mungo) enjoying morning sunshine at the study site, the Mweya peninsula in Western Uganda. view more 

Credit: Emma Vitikainen

A new study on wild banded mongooses reveals that females may use spontaneous abortion to cope with reproductive competition, and to save their energy for future breeding attempts in better conditions.

Researchers at the University of Exeter, UK, followed a population of wild banded mongooses (Mungos mungo) in western Uganda for 15 years, using ultrasound imaging to track which females became pregnant and which carried to full term. They discovered that there were more abortions during the dry season when food was scarce, and also when more females were competing over reproduction in the same group. Individual females were less likely to carry to term if they were young, in poor condition, or carrying smaller fetuses.

"Reproduction takes a lot of energy, and for a female whose offspring may have slim chances at survival, it makes sense to delay that investment until times are better. Spontaneous abortion may be an adaptive strategy in this species because it enables females to save energy for the next breeding attempt," says researcher, and senior author of the study, Emma Vitikainen from the University of Helsinki.

Banded mongooses are cooperative breeders that live in family groups where several females give birth at the same time to a litter that is jointly cared for by all the group members. Underneath this seemingly harmonious surface, co-breeding females compete over whose offspring do best. Pups that are born bigger have more help from their group members, grow faster and outcompete their littermates.

This study revealed that females adjust their own investment in response to the competition, and that females whose offspring would be more likely to lose out are more likely to cut their losses by aborting their fetuses mid-pregnancy. Banded mongooses also curb competition by evicting younger females. To focus on spontaneous pregnancy loss the researchers only looked at breeding events where no violent eviction events occurred.

"Female competition over reproduction is easily overlooked," explains lead author Emma Inzani from the University of Exeter, UK. "Males fight with horns and antlers over access to females, whereas female competition can be much more subtle. Our study shows that even in the absence of overt aggression, females adjust their reproductive decisions in response to competition from other females. "

All research was done under ethical permits from University of Exeter and Uganda Wildlife Authority and study methods caused no harm to pregnant mongooses

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Tracking titin in real time


Max Delbrück Center for Molecular Medicine in the Helmholtz Association


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IMAGE: Collage made from single cells expressing titin-GFP and titin-DsRed. view more 

Credit: Gotthardt Lab, MDC

Using new high-resolution imaging techniques, MDC researchers and colleagues have tracked titin, the body's largest protein, in real time throughout its entire lifecycle. The method and results could provide new insight into muscle development as well as treating damaged muscles and heart disease.

As twinkling lights brighten the holiday season, Max Delbrueck Center for Molecular Medicine researchers are cheered by red and green lights for an entirely different reason. Using colorful probes, a team has tracked the full lifecycle of titin, the body's largest protein known to play a key role in muscle tissue. Observing titin from synthesis to degradation has provided novel insight into the formation of sarcomeres, the main contractile units of heart and skeletal muscle. The results were reported in the journal Proceedings of the National Academy of Sciences (PNAS).

Titin is such a large molecule that its analysis provides unique challenges. The team attached red and green fluorescent tags to opposite ends of the protein, enabling them to observe titin's precise movements in muscle cells derived from the mouse heart, called cardiomyocytes.

"Cardiomyocytes are highly specialized and cannot skip a beat," said Michael Gotthardt, who heads MDC's Neuromuscular and Cardiovascular Cell Biology Lab and spearheaded the research. "We can watch how titin is made and inserted into the myofilament while everything is still working. It's beautiful to see."

Not just a pretty picture

The insight gained from being able to watch titin in real time is significant. Titin has long been assumed to be the rigid backbone of sarcomeres, the basic functional segments of heart and skeletal muscles that expand and contract. It turns out that titin is much more dynamic than previously thought, Gotthardt said.

Heart muscle cells appear to have a pool of soluble titin spread throughout the sarcomere, ready to replace proteins damaged in the repetitive process of muscle expansion and contraction. Overextended proteins are moved out of the cells and then degraded. All of this happens over the course of a few hours, which sounds fast, but is actually much longer than for any other sarcomeric protein.

The large amount of titin located outside the sarcomere was as surprise, seen for the first time thanks to the new genetic mouse model and imaging technique, Gotthardt said. Another unexpected finding was the diversity of titin molecules, called isoforms, that were observed. Faster moving proteins are likely different isoforms than slower moving ones.

"This is a look at the real life of the sarcomere," Gotthardt said. "We can understand the formation and remodeling of the myofilament structure, which has relevance to human disease and development."

Potential applications

The fluorescent probes can help researchers study how muscles rebuild themselves after exercise, or how heart muscles remodel after a heart attack. They might also help to better understand heart diseases associated with mutations in other sarcomeric proteins, said Franziska Rudolph, first author of the paper.

"This is amazing, to follow endogenous titin variants in real time from start to finish," Rudolph said. "So many experiments are possible with these mouse models and different imaging techniques."

For example, the technique could potentially be used to track implanted cells to see how well they are integrating with the native muscle fiber, and if they properly connect with their new neighbors to work as a unit or not. Such insight could show if cell based therapies are effective.

Validating the novel tools and establishing methods for image analysis was a challenge and required the collaboration with colleagues from MDC's Berlin Institute for Medical Systems Biology, University Medical Center Goettingen, and the University of Arizona. The team worked hard to show how the fluorescent proteins, which are genetically generated, had no unexpected side effects on muscle or titin development and function.

MDC researchers are continuing to investigate titin with the new tools, including how skeletal muscles respond to exercise

[florida80]

The Max Delbrueck Center for Molecular Medicine (MDC)

The Max Delbrueck Center for Molecular Medicine in the Helmholtz Association (MDC) was founded in Berlin in 1992. It is named for the German-American physicist Max Delbrueck, who was awarded the 1969 Nobel Prize in Physiology and Medicine. The MDC's mission is to study molecular mechanisms in order to understand the origins of disease and thus be able to diagnose, prevent and fight it better and more effectively. In these efforts the MDC cooperates with the Charite - Universitaetsmedizin Berlin and the Berlin Institute of Health (BIH ) as well as with national partners such as the German Center for Cardiovascular Research and numerous international research institutions. More than 1,600 staff and guests from nearly 60 countries work at the MDC, just under 1,300 of them in scientific research. The MDC is funded by the German Federal Ministry of Education and Research (90 percent) and the State of Berlin (10 percent), and is a member of the Helmholtz Association of German Research Centers. http://www.​mdc-berlin

[florida80]

Deck The Halls With Bouts Of Nausea

Lazy/Unhelpful, Non-Dialogue, Pharmacy, Texas, USA |
Healthy | December 16, 2019

I have chronic nausea. I take a prescription nausea medication to keep it under control so I can eat and function. The nausea is related to stress, as well as my diagnosed depression and anxiety.

Six days ago at the time of writing, two days before Thanksgiving, my grandmother, who has to handle most phone calls for me due to my hearing issues, called the pharmacy to request a refill of my meds because I was almost out. Later, we got a call telling us that the refill request had been denied because my doctor’s office said I had to see the doctor before I could get a refill. I called the doctor the next day and was told that they had sent in an approval, but they would send another one to be sure.

Pharmacy still said they had no approvals, only a denial.

Thanksgiving came and the office was closed. I checked the pharmacy again, and they still said they only had a denial and couldn’t fill it.

Black Friday, same deal, but we got a call from someone at my doctor’s office informing us that they’d be closed until Monday. I only had enough of my meds to get me through Black Friday. I ended up skipping my second dose so I would have one for Saturday morning, and was unable to eat dinner on Friday.

Same deal with the pharmacy on both Saturday and Sunday. No approvals received, only one denial, and they still couldn’t fill it even though I was unable to eat or drink without it at this time. I even got on the phone myself and cry and beg the pharmacist to give me an emergency three-day supply that the law allows, and was told no because of the “denial.”

This morning, Cyber Monday, after going the entire weekend feeling like I was in Hell since eating was pretty much impossible, my grandmother called my doctor’s office to set up an appointment for the first time slot they could fit me into today.

She was informed that they absolutely did not send in a denial, I did not need to see my doctor before getting a refill, and that their system says I don’t have to see my doctor for a refill on my medication until sometime next year. My doctor knows that I need the medication every single day to be able to eat, and I’m about twenty pounds underweight right now due to stress-induced illness that lasted for three months solid, so I need to be able to get a refill at any time until I gain some weight back.

It turns out that someone at the pharmacy put it on my file that they were sent a denial and got no approvals whatsoever. A few hours ago, I got a text saying that I had a prescription ready for pickup, which would be done first thing in the morning because we couldn’t get to the store.

I have filed a complaint with corporate for the store the pharmacy is in, and my complaint has been forwarded to the store manager with the assurance that the incident will be investigated and that this absolutely should not have happened. The person I conversed with — via chat — was horrified about it.

I hope that pharmacist gets fired and feels proud of themselves for giving a disabled woman no less than five panic attacks over the course of three days and causing her a lot of unnecessary stress that has likely set back her recovery from illness. I won’t be able to fully enjoy Christmas with my family now because I’ll still be recovering and having trouble eating much food.

[florida80]

Just Another Kidney Stoner

Bad Behavior, Hospital, Lazy/Unhelpful, Nurses, USA | Healthy | December 15, 2019


(I have a massive kidney stone trying to pass. I’m in the hospital, waiting for surgery to reduce the size. I suddenly have massive pain, bad enough my vision goes fuzzy. I’m crying, unable to really form words. I press my call button. After a moment, a nurse comes in.)

Nurse: “Can I help you?”

Me: “Pain… bad…”

Nurse: “On a scale of one to ten?”

Me: “Ten!”

(Because of the pain, I practically shout the number.)

Nurse: “You don’t need to raise your voice! I’ll get you something!”

(She leaves and comes back a minute later with a pill.)

Nurse: “Here’s some Tylenol.”

(All I can do is look at her, since that won’t be anywhere near enough for how my pain is.)

Nurse: “Well?! Take it!”

Me: “Need more…”

Nurse: “Ugh, you’re probably just a drug seeker! I’m not giving you anything else!”

(At this point, I just break down sobbing. She storms out. A few minutes later, my doctor comes in.)

Doctor: “Are you okay?!”

Me: “Pain bad… help…”

Doctor: “Okay, sweetie, I just need to know if you can tell me what number you’re at.”

Me: “Ten…”

Doctor: “All right. Do you want me to wait here while I have someone bring you medication?”

Me: “Please!”

(She does stay with me. After she calls the pharmacy, she holds my hand and talks to me to calm me back down. Once the medication is brought up and put into my IV, she makes sure it starts working.)

Doctor: “Your nurse said you were asking for drugs?”

Me: “No, I pushed my call light and told her I was in pain. She yelled at me saying that’s all I wanted and then left.”

Doctor: “She apparently thought you were faking something to get pain meds for an addiction. There’s no way you could fake a kidney stone on the imaging results. I’ll make sure you don’t have to deal with her anymore.”

(True to her word, I didn’t see that nurse for the rest of my stay.)

[florida80]

That Flu Right Over Her Head

Health & Body, High School, Jerk, Louisiana, Parents/Guardians, USA | Healthy | December 13, 2019


(This event happens more than halfway through my junior year in high school. It’s important to note that prior to this, I have only missed about four or five days of school during my ENTIRE high school career, half of which were from when my grandmother died unexpectedly last year. This one particular morning, I wake up feeling like complete and utter crap. I also just so happen to have two major presentations today after lunch and my parents know about both of them. They basically have to fight to get me out of bed, accusing me of either lying or exaggerating to get out of my presentations. I manage to power through the first half of the day before breaking down at lunch and having my counselor essentially force my mother to come and get me. Naturally, she isn’t happy about it as she still thinks I’m purposefully trying to avoid my presentations.)

Mom: *in a very condescending tone* “I hope you’re prepared to go to the doctor. I’m bringing you back right after, too.”

(It’s very clear she’s trying to call my “bluff” and scare me into backing down, but I just quietly shrug. And just as she said, she brings me to a walk-in clinic near my school. After going through the standard procedure, the nurse seeing me takes a snot sample for a flu test.)

Mom: “I’m thinking it’s just a little cold at most.”

Nurse: “If that’s the case, we’ll probably just do a steroid shot, but let’s see the test results first.”

(She leaves and returns a few minutes later. To my mother’s surprise, the nurse is now wearing a procedure mask.)

Nurse: “So, he has the flu. We’re lucky y’all caught it within the first two days so we can write him a prescription for some Tamiflu that y’all can pick up at your preferred pharmacy. We’ll also give you a doctor’s note that says he can’t go to school until at least next Monday. Until then, make sure he gets plenty of rest and that he doesn’t have a fever for at least 48 hours prior to Monday.”

(My mother was horrified and ended up asking to have herself tested, too; she was negative. Although I feel bad for all my friends and classmates who sat by me that morning, I can’t help but gleefully remember my mom’s face when she realized that I wasn’t faking s***.)

[florida80]

When Laughter Is NOT The Best Medicine

Connecticut, Emergency Services, Punny, Silly, USA |
Healthy | December 11, 2019

(I am a paramedic.)

Me: *to a patient* “Let me borrow your arm for a blood pressure check, please.”

(The patient extends their arm.)

Partner: “Don’t worry; she’ll give it back.”

Me: “Yeah. I got in way too much trouble last time for not giving it back. The police even chased me!”

Patient: “The police chased you?”

Me: “Yeah! For armed robbery!”

Partner: *groans and slams back doors of the ambulance while walking away

[florida80]

It’s Not Just The Organs That Are Failing

Doctor/Physician, Hospital, Jerk, Lazy/Unhelpful, Uruguay | Healthy | December 9, 2019


(When my brother is around nine, he wakes up screaming in pain. As we have no vehicle of our own and no way of getting a taxi or a lift, my mother has to walk with a screaming child two kilometers to the hospital. She went to nursing school, but is not currently working as a nurse.)

Doctor: *after barely poking him* “Well, seems to be just some gas. He’s probably just using the pain to get attention.”

(My mother looks at her like she’s crazy, while my brother still cries and screams.)

Mom: “My son is not like that. Look, I am a nurse. I’m pretty sure he has appendicitis.”

Doctor: “Oh, nonsense. You don’t know what you are talking about.”

Mom: “But I do–”

Doctor: “Listen. I am a doctor. You are just a nurse. He is fine. Now leave.”

(My mother leaves the hospital furious. Not surprisingly, two days later, my brother’s appendix ruptures. My mom manages to get a passing car to take them to the hospital, and my brother has surgery. Because the hospital has no full anesthesia, they have to use local — the kind that only numbs the area — and my brother is operated on while awake and screaming. While he is still in surgery, my mother runs into the doctor in the hallway.)

Doctor: “Oh, you are here again. What, does your son have a headache now? It might be a tumor, don’t you think?”

(My mother almost attacked her, but her father entered the hospital on time and stopped her. My brother survived and made a full recovery, and my mother reported the doctor; unfortunately, nothing came out of it at the time, but a few years later she was forced into retirement for repeatedly misdiagnosing patients.)

[florida80]

Bring Them Back In For A Brain Check

Extra Stupid, Florida, Medical Office, USA | Healthy | December 8, 2019


(I am at the checkout desk of an urgent care medical office.)

Coworker: “How was your visit today?”

Patient: “Pretty good. I don’t like going to the doctor, but this was a great experience. Everyone was really nice.”

Coworker: “Thanks! Glad everything went well. Yeah, I work in a doctor’s office and I don’t really like going to the doctor, either.”

Patient: “Oh, really? What kind of doctor’s office do you work in?”

My Brain: “Seriously? Did she just ask that?”

[florida80]

Cheese Addiction Is Becoming A Problem

California, Health & Body, Los Angeles, Medical Office, USA | Healthy | December 5, 2019


(I work at a non-profit rehab for teens as a counselor. During their lunch, a new resident is having a heated argument with other staff over her dietary restrictions.)

Teen: “I can’t eat this; it has cheese. I’m vegan.”

Staff: “We’re trying to accommodate. The cooks have been made aware and are working on fixing you something else.”

Teen: “You shouldn’t be eating this stuff. Do you know how badly dairy and meat harms your body? You guys are all disgusting.”

Me: *screaming internally* “You shouldn’t lecture anyone when you smoke meth!”

[florida80]

She’s Not Being Very Hip

Aunts & Uncles, Health & Body, home, Non-Dialogue, Pennsylvania, USA | Healthy | December 2, 2019


My great aunt gets a call from a friend asking her if she wants to go grocery shopping at a popular bulk warehouse store and my aunt agrees. When her friend gets to the house, my aunt goes outside and slips on some ice in the driveway; she hits her hip hard and can no longer stand up. She refuses to call an ambulance, and two of her neighbors manage to get her into her friend’s car.

My aunt’s friend asks if she wants to go to the doctor right away but my aunt responds, “No, you came to go to the store so we might as well do that first.” So, her friend goes grocery shopping while my aunt stays in the car with a broken hip. Afterward, the friend insists my aunt go to a doctor. Instead of going to the emergency room, my aunt insists on going to a faster care doctor’s office.

They pull into the parking lot and my aunt’s friend explains the situation. A doctor comes out and tells my aunt they have no way to get her out of the car — she is somewhat of a larger lady — and that she really needs to go to the ER. My aunt complains. Finally, the doctor says, “Ma’am, you’ve broken your hip. This is something outside of our control. We can help you if you need something minor, but you are going to need surgery; you need to leave and go get the care you need.”

She finally agrees to go to the ER and she ends up having quite the lengthy recovery process because she is just as difficult in her physical therapy appointments.

[florida80]

When You Are Bugged To Go To The Doctor

Bizarre, California, Doctor/Physician, Medical Office, Non-Dialogue, Pets & Animals, USA | Healthy | November 27, 2019


When I’m in high school, I come down with a bad fever and my mother takes me to the doctor. I’m still seeing a pediatrician at this point. The building the office is in is undergoing construction.

Pretty soon I’m in the examination room, my mom sitting to the side. The doctor is a young woman, wearing a gauzy green sweater and some light gold jewelry. I notice a very shiny, pretty brooch shaped like a scarab pinned to her sweater.

She leans in with the tongue depressor, and as I watch in horror, the “brooch” sticks out a barbed leg and starts crawling up her shoulder! I scream and throw myself back.

“Are you okay?” asks the doctor. She thinks I’m scared of the tongue depressor.

“There’s a huge bug on you!” I yell.

This sets the doctor off. She shrieks, drops the tongue depressor, and starts frantically trying to brush the bug off her sweater. In the process, she breaks her necklace, sending bits of golden chain flying across the room. Part of it hits me and I think it’s the bug, so I scream again and the cycle begins anew.

Eventually, the doctor calms down a little, but we’re still trying to find the bug. She turns around and I spot it on her shoulder and yell, “It’s still there!” This time she holds still and my mom gets it off her with a tissue and squishes it in the garbage can.

Once everyone’s calmed down, Mom comments that she should have saved it, or at least not crushed it, since it was actually very pretty. She thought I was having a hallucination until she saw it herself! We figure it got in from all the construction downstairs. The rest of the appointment goes fine, though the doctor and I are a bit shaken up; my mom is pretty level-headed.

When we check out, the nurse at the desk asks what happened. We tell her and she laughs and says, “We get a lot of screaming in this office, but usually it’s not from the doctors!”

[florida80]

Right Bad Back At Ya

Bizarre, Canada, Funny Names, Hospital, New Brunswick, Nurses | Healthy | November 23, 2019


(I am in the waiting room of a hospital waiting for a scan to check out my back injury. For the purposes of this story, let’s just say that my name is John Smith. The nurse calls me in for my scan.)

Nurse: “All right, just jump up onto the table.”

Me: “Umm… sorry, I can’t do that.”

Nurse: “We can’t do the scan if you don’t get on the table.”

Me: “But… I can barely move. How do you expect me to jump onto a table?”

Nurse: “Sure, you can.”

Me: “I don’t think you understand. I am physically unable to get up onto the table due to a back injury.”

Nurse: “You don’t have a back injury.”

Me: “I’m sorry, but I’m pretty sure I would know why I’m at the hospital.”

Nurse: “Your name is John Smith, right?”

Me: “Yes.”

Nurse: “And your date of birth is [date]?”

Me: “Yes, it is.”

(A patient in the waiting room speaks up.)

Patient: “Sorry to interrupt, but I think you might have us confused.”

Nurse: “Your name is John Smith?”

Patient: “Yep.”

Nurse: “And I suppose your date of birth is also [date].”

Patient: “Yes.”

Nurse: “And you’re here for a scan?”

Patient: “Yes, I am.”

Nurse: “Well, this is an interesting coincidence.”

(She looks down at her computer.)

Nurse: “Ah, I see the problem. There are two different people named John Smith with the same birthday, who just happened to both have appointments for a scan within the same hour. I was looking for John M. Smith.”

Patient: “That’s me!”

(The nurse apologized and I got my scan not long after. It was a confusing few minutes, but at least I got a good story out of it!)

[florida80]

Operating Under Confusion

Children, Extra Stupid, Hospital, Nevada, Parents/Guardians, USA | Healthy | November 20, 2019


(I work for a pediatric dental practice. We are currently at our surgical center where kids get put to sleep so we can do all of the work necessary. There’s loads of paperwork, normal doctor check-ups, and numerous confirmations that patients’ parents need to go through before we see them. We have a two-year-old girl that needs work on every single tooth; she’s been on our waitlist for surgery for two months. We are about to bring her back to the OR.)

Nurse: “Okay, sweetheart, time to say bye to Mommy.”

Mom: *looking so confused* “Wait, why is she saying bye?”

Nurse: “I’m sorry, ma’am, but you aren’t allowed into the OR for sterilization purposes.”

Mom: “But how is she supposed to fall asleep without me reading her a story?”

Nurse: “The anesthesiologist–”

Mom: “The what?!”

[florida80]

Diagnosed With Not Quite Surgical Precision

Doctor/Physician, Ignoring & Inattentive, Medical Office, USA, Utah | Healthy | November 17, 2019


(In college, I start getting severe fatigue; I am sleeping ten hours a night, getting an hour or two nap each day, and still feeling exhausted all the time. I go to the student health center where they do some blood tests and diagnose me with hypothyroidism, where my thyroid doesn’t produce enough hormone. I am given a prescription for the generic of a synthetic thyroid hormone, and things improve drastically for several months. But after I have my prescription filled at a different pharmacy, I start having different symptoms: anxiety, feeling jittery all the time, being unreasonably cold, etc. I go back to the health center where they run more blood tests. This is what happens at the followup appointment when those blood test results come back.)

Doctor: “So, your thyroid hormone levels are much too high. You have hyperthyroidism.” *goes into treatment options, which basically boil down to either radiation to kill off part of my thyroid or surgery to remove part of it*

Me: “Okay. Well, before we start talking about surgery, don’t you think we should try reducing my [medication] dosage?”

Doctor: *stares at me for a second, then reads my chart more carefully* “Ah. Yes, yes, we should probably try that first.”

(A DIFFERENT doctor in the health center was able to explain that I’m in a small group of people that are sufficiently sensitive to thyroid hormone that the different levels in different generic brands can act like a completely different dosage, meaning that I need to be on the name brand to ensure my dosage stays constant. We put me on the name brand and I didn’t have any more problems, and I never saw the other doctor again.)

[florida80]

Conversational Heart Failure

Jerk, Medical Office, Pennsylvania, Reception, USA |
Healthy | November 15, 2019

(I have myriad medical issues which give me some bother. I have an appointment with my primary care doctor. This office knows about all of my conditions. I get to the building and ride the elevator to the fourth floor. I get into the office and go to the check-in desk. There are two office workers there. One I know; the other I don’t. The worker who I don’t know goes to check me in and sees I’m breathing quite heavily.)

Worker: “Walk the steps today?”

Me: “No. I have congestive heart failure.”

(The worker couldn’t get her foot out of her mouth, it was wedged in so deeply. The other worker, the one I knew, just burst out laughing so hard that she spit out part of her sandwich. I did let the first worker off the hook and said I didn’t care what she said. I was not offended at all. It was just too funny.)

[florida80]

Can’t Equate Numbers To Notes

Connecticut, High School, Jerk, Schoolmates, USA | Healthy | November 13, 2019


(My high school chemistry teacher is a very stern, organized lady. One of my friends is very bright but not organized at all, and he hates the very structured reports we have to make of our chemistry labs. He is constantly getting points off for one detail or another. One facet of these reports is that they are required to have two columns: one for equations and one for long-form notes. One lab, my friend and I are partnered and he actually is trying to do his report properly. The chemistry teacher comes to look over our work and taps his chemistry notebook disapprovingly.)

Teacher: “You haven’t labeled these columns; how am I supposed to know which is equations and which is notes?”

Friend: “See the one with numbers in it? That’s the equations column.”

(My friend immediately looked horrified with himself. He and the teacher just stared at each other for a long moment, and then she finally just huffed and moved on to the next group. I do realize that such labels are probably useful in a real laboratory, but to be fair to my friend, the teacher did sort of set herself up for that!)

[florida80]

One Ring To Rue Them All

Bad Behavior, Doctor/Physician, Pharmacy, USA | Healthy | November 13, 2019


My mom has an accident at work and spills boiling water directly on her hand, badly burning several of her fingers, one of which happens to be the finger she wears her wedding ring on. Her boss drives her to a nearby pharmacy clinic where she is seen by the on-call doctor.

At this point, her fingers have swelled a lot, locking her wedding ring on her finger and causing painful constriction. It’s clear that the ring needs to be removed. My mother is assuming they will cut the ring off of her finger, which she is sad about, but at this point, she’s much more concerned about relieving the intense pain she is in. The doctor comes into the room and quickly examines her hand, saying, “What a beautiful ring! It would be such a shame to damage it by cutting it off!”

He then proceeds to forcibly yank the ring off of her finger past the swelling, putting my mother in even more pain and tearing open the blisters that have started to form.

She has since healed and is relieved to be able to wear her ring again and not need to pay to have it fixed, but she isn’t sure it was worth all of the pain and the extra time it took to recover due to the blisters being torn.

[florida80]

A Shot Of Ignorance

Doctor/Physician, Hospital, Jerk, Patients, The Netherlands | Healthy | November 11, 2019


(One evening, I get the call every person with an elderly relative fears: my 90+ grandma has fallen down and can’t get up. Luckily, she ended up next to the phone; she actually tripped as she was walking over to it because it was ringing. Since everyone else in our small family is either on vacation, not on speaking terms with Grandma, or living in a nursing home on the other side of town and not in possession of a driving license — or their full mental faculties — I am the only one who can help her out. I race over, hoping it’s just a case of having to help her up because she is in an awkward position, but as soon as I walk in the door and see the unnatural angle of her leg, I know we have a fracture on our hands and have to go to the hospital. We end up in an examination room at the ER, waiting for either the x-ray nurse or the neurologist, whoever shows up first. The neurologist has been called because Grandma hit her head on the stone windowsill when she fell, which caused a small wound and a bit of blood. That wound is the cause of the following conversation with a very chipper ER doctor.)

Doctor: “Well, Mrs. [Grandma], I know you’re waiting for the x-ray nurse and the neurologist, but I’m neither; I’m just here to give you a little tetanus shot.”

(My grandma is neither stupid nor suffering from dementia, but she has never had more than an elementary-school education, and apparently, she never learned what a tetanus shot is, leading to this little gem:)

Grandma: “A tetanus shot? What is that for?”

Doctor: “Well, ma’am, that’s for what we call ‘street dirt’–“

Grandma: *interrupting indignantly* “Street dirt? I fell inside my own home!”

(She sounds like she thinks what the doctor said is the most ridiculous thing she’s ever heard, and he and I simply couldn’t contain our laughter. The doctor gives a brief explanation of what a tetanus shot is for, but too brief, apparently, because as soon as he is out the door…)

Grandma: “[My Name], what was all that about? I don’t get it. My house is clean!”

(I gave her a much more expansive explanation of germs, and why even her nice clean house wasn’t free of them. She was pretty horrified, but finding out her femur was broken soon took precedence. She could laugh about it later, though, when I mimicked her indignant tone. She almost sounded insulted at being associated with any kind of dirt.)

[florida80]

Mothers Are Fighters

Awesome Workers, Hospital, Inspirational, New York, Non-Dialogue, USA | Healthy | November 10, 2019


Two years ago, I was admitted into the hospital for seven weeks via the ER. In good weather, the hospital is roughly an hour away. My boys were three and eight at the time and I had been a stay-at-home mom for most of their lives. My parents stepped up and helped keep the kids on a regular pattern of school, therapy, and play dates along with FaceTiming me. My husband would drive two round-trips a day to stay with me, see our kids, take care of our pets, and work.

This pattern repeated itself over again for the next six months, and at one point, I was told to start preparing my boys for life without me. The staff at the hospital was amazing. They tried their best to give me a room that faced outwards so I could see the sunset. They made sure I could be unhooked from chemo and transfusions when my boys got to visit. Then, they completely surprised us on Christmas when they gave us a Christmas party in my hospital room.

There were presents, food, and joy even though it was extremely hard to be there. They helped me fight even when I was beyond exhausted.

They became my family and even now we all stay in touch. They were complete angels that helped our family get through an extremely scary time.

I’m now in remission and hopefully will get the “cured” status once I reach five years in remission.