[Buttocks] Out of You and Me

Dear cliche users,

If I ever hear someone say that stupid phrase, 'Don't assume: you make an ass out of you and me,' I'm going to advise them to put on their most expensive outfit, go to the bad side of town, and walk from liquor store to liquor store flashing $100 dollar bills. See how far that gets them. Or they just can assume that it would probably be a bad idea.

You have to assume, you have the right to assume, and you have to take things for granted. You don't wonder in the middle of the night whether the sun will come out tomorrow or if the sky will be blue; you naturally assume it to happen because it's always happened that way. For those philosophers out there, you're not going to question every damn little thing; you'd go absolutely insane! If you have to question whether each table exists in and of itself, you'd end up eating your lunch on your lap (or does that exist? or does your lunch? or do you?).

Okay, I'm reaching the point of hyperbole. Fine. But I do get tired of people saying I generalize too much or assume too many things. That, I would contend, is the essence of my efficient thought process, the source of my intelligence. I ignore things which I feel don't matter, and I assume things which I judge can be assumed to be true. Then I distill the facts, and make a decision which happens to be correct more often than not. If I ignore what shouldn't have been ignored or assume that which should not be assumed, then I factor it in the next go-around.

People go wrong when they assume things incorrectly, thus leading to false conclusions. Or they assume racist/prejudicial ideas and voice them and get in trouble, ie Michael Richards & Mel Gibson. Caution: link contains excessive use of the n-word.

Good assumption: If you must have racist ideas, it's generally not a good idea to say them in public where people are videotaping you to be put on Youtube.

The more things that can be assumed and the more things that can be ignored, the better and more efficient the decision will be (and the more decisions you can make). That does not necessarily mean that the decision will be more accurate, just more efficient. I don't strive to be perfect in my thought; my quest is to be right the vast majority of the time. I quit going for 100s on grades a while back because perfection hindered progress.

I don't bring this up because I'm irritated that someone attacked my mode of reasoning and logic (to be right a lot of the time rather than all of the time); I bring it up because my OCD has recently flared up rather unexpectedly, and it has been quite frustrating.

To explain, I don't touch light switches or wash my hands to an excessive amount. I do like my things to be clean, in right angles, undamaged, orderly, controlled, etc. But that makes sense to me because it's efficient; I don't have to search for things because I know where they are because they have a place. Moving my stuff or damaging it will certainly piss me off, but it won't be the end of my world.

The weirdest thing, until recently, was that if I was uncertain whether I had locked my car, I'd walk back to check even if it was an entire parking lot. This only happens once every few months. And it is really just paranoia from living in Houston rather than OCD.

The truly OCD thing that has come up deals with the verification of prescriptions. For non-pharmacy folks, pharmacists get paid primarily to verify that a prescription has been filled correctly and that there aren't any major/severe interactions. This is required by law, but the law does not dictate how you're supposed to do it. You can make some hand gestures or pray or chant or trust that your techs did everything correct, but ultimately if the prescription is wrong, you're liable.

Depending on the error, you can be fined, your license can be reprimanded, you can be put on probation, and in the most severe of cases, it can even be revoked, though I've only heard of revocations for unethical things like stealing narcotics or deliberate falsifications (insurance fraud), not for an error in good faith. It's not like in It's a Wonderful Life where the druggist* becomes a bum because he misfilled a prescription for the little kid; if you make an honest mistake, they're probably not going to take away your livelihood. Probably not (again with my assumptions).

But people are another thing. They will sue sue sue like there's no tomorrow. Lawyers find ways to sue for stupid stuff that is already on the drug information sheet. Reglan: 'May cause tardive dyskinesia'. Lawyers think, 'that sounds really bad, so I can probably sue for it!' Accutane: 'May cause death, among other things'. The ambulance chasers, after reviewing the 10 pages of side effects: 'Aha! You didn't say GI side effects! Gotcha!'

So don't misfill. Because it can be potentially bad for the patient as well as very bad for you.
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Over the past year of being a pharmacist, I've developed my own process for verification. And fortunately, I have not misfilled of my own accord as far as I know. For me, the last step of verification is to make sure that what is in the vial is what it is supposed to be. This means opening the vial and comparing it to the picture on the computer screen or with the stock bottle it came from.

This usually isn't a problem because I fill most of the prescriptions I verify since I work alone at night. And so that last step of comparing pills is generally trivial for me since I trust in my work.

Until now. Nothing has happened; there hasn't been a misfill or even a close misfill. I have found that when I have too much time on my hands, I start to doubt in the certainty of my efficient process. In my thoughts and decision-making, I aim to be most efficient, not most accurate. But as a pharmacist, I aim to be most accurate first, since they don't take your license away for being too slow. When there are several prescriptions waiting, I temper my obsession with being 100% accurate with the necessity to get them out quickly.

On the final step, I check about 3 tablets directly, and then make sure all the rest have the same relative shape and color. Then I close the vial and shake the bottle to see if it's about the right quantity (30 vs 90-day supplies). Easy peasy.

But in the dead of night, I've spent up to 2 minutes doing that last check which should only take 5 seconds max. Open, check, close, shake. Open, check, close, shake. Repeat until I get frustrated.

It's like turning a light switch on and off. It is safe to assume that when you flick the switch, it will work (even though it may potentially not work); you don't have to check 10 million times. I tell myself the same thing with the verification, and it's gotten better. It seems to be really bad when I'm tired, which will happen when you voluntarily work 23 12-hr shifts in a row.

All logic fades, and I'm left with my basest instinct to be right.
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*not to be confused with a date-rapist, this is the old-school term for pharmacist