A view of nationalized healthcare, the other "biscuit," some boys from Jersey, and some from UT too! (Days 13-17)

Day 13: Monday, March 26 

Monday marked my and Carmen’s first day in the community pharmacy.  Carmen was assigned to Grove Park pharmacy (in zone 4) out in the far reaches of Lewisham.  I had my community experience at Kalmak Chemists in central London.  After navigating several train stations and even making several line changes and a bus route, I still arrived much earlier than my start time.  I was a little nervous about rush hour by myself and making a bad impression by being late!  Luckily, the bus dropped me off a mere 50 feet away from the pharmacy’s entrance…score!!  Mr. Meir Kattan (to be known from now on as Mr. K, as that is what everyone calls him, and I needed to fit in!) is the owner and has been for over 30 years.  He has been a pharmacist for more than 40 years (if I had to guess…I felt a little awkward asking his age!), and he is still super sharp and on top of his skills.  Though I only had the chance to work with him for four days (he took a holiday on Friday), I could already tell then that he is a great role model for pharmacists to follow!

At Kalmak, there is another pharmacist, Radia, who is Algerian and will actually complete her Ph.D. in genetics in the spring, so she is working as a pharmacist in the mean time since she had the degree to get into her other program.  Along with Radia, there is a pre-reg pharmacist (remember: in the UK, they graduate then do another year of rotations before they can take their exams and practice by themselves) named Paul.  He is a little older than most pharmacists, as he has changed careers from a civil engineer to pharmacy.  And his wife is expecting a baby (their 4^th!) in just a few weeks’ time.  

They were all very interested, just like the pharmacy students last week, to hear all about pharmacy school, education, and practice in America.  I feel like I’m getting pretty good at explaining it now!  Once again, they were amazed at how long we go to school, but are amazed that it’s a doctorate program.  From what I’ve gathered and been told by many pharmacists over here, the profession, as a whole, does not gather nearly as much respect as it does in the States, so for that, I’m very grateful to have been given the opportunity to be a pharmacist (in just a few weeks now!) in the US! 

I quickly realized that the relationships of everyone at the pharmacy remind me so much of being back at the Medicine Shoppe, and it made me miss it quite a bit!  The humor and quick comebacks from everyone, as well as the witty, ongoing banter, made me feel right at home.  Mr. K reminds me so much of Chuck (one of my pharmacists back home), just a bit older, and of course, British! Ha ha.  By the end of the day, I was bubble packing and working the computer like a (semi) pro!  I was quite proud of myself for picking up everything so fast.  Once thing to get used to though: different brand names for drugs and many of them aren’t yet generic in the UK though they have been for awhile in the States and vice versa.  Overall, I enjoyed my day there.  I made it home through rush hour in great time and didn’t get lost once!

Day 14: Tuesday, March 27

Tuesday started with more discussions about US vs. UK pharmacy, and this time, it was in terms of various over-the-counter (OTC) items.  Carmen and I had already briefly discovered that some items available OTC here are only with an Rx in the States, but I did not realize how many of these medications are available like that until today!  I spent a great deal of time perusing Kalmak’s OTC items and was amazed at everything that I could buy here (and for just a slight fraction of the cost) which would require both a doctor’s visit and prescription in the States.  Just to name a few: Flonase (fluticasone), a steroid nasal spray; acyclovir ointment (used for cold sores and fever blisters; here for just £5, whereas it cost me over $120 WITH insurance back home!); Voltaren (diclofenac) tablets and gel, which is an NSAID used for pain; and Imitrex (sumatriptan), a migraine medicine.  I was shocked that all these were available without a prescription!  The conversation soon turned to the nationalized (UK) healthcare vs. privatized (US) healthcare system and some politics.  Within about 2 political questions, Mr. K had me all figured out completely where I stood without me mentioning any political names at all. Ha ha.  And then the specific answer to his inevitable question (“I take it you won’t be voting for Barack?!”) was a resounding “NO!” which garnered a laugh from all.   

After lunch, I made everyone practice their best American accent, which had us all laughing!  Mr. K would definitely hail from the South if he were in America, whereas Paul’s sounds more like someone from New York.  Then Mr. K helped me with my own British accent and gave me tips for “properly” speaking British!  I gave it a try, and they all said I sounded pretty good (not sure if I believe them or not)! 

Even the UK loves Abraham Lincoln.  His statue is absolutely HUGE! 

After work, Carmen and I met up (after a little bit of stressful rush hour hustling and bustling) at Leicester (pronounced Lester, by the way) Square for a show!  At the recommendation of several people (including my parents and Megan), we decided to see Jersey Boys.  After using the discount (but licensed) ticket booth right in the middle of Leicester Square, we got our tickets for over 50% off!  Regular £86, we only paid £40, which ends up costing much less than if we had seen the show at the Fox in Atlanta (which is where mom and dad saw it).  Oh, and did I mention that our sets were on the 4^th row?  Yes, you read that right.  Row 4…practically touching the stage.  And all I have to say about the show is that it was absolutely awesome!  I highly recommend it to anyone!  The singing was phenomenal and all the songs I heard when I was little, I got to re-live again :)  A funny thing we noticed was that by the end of the show (a couple of hours into the singing), when the performers would get into a fast-paced speech, their accents would go between a great Jersey accent and their normal British accent.  It was hilarious and added a special something to the show if you ask me.  But then again, I’m quite partial to the British accent!!

Day 15: Wednesday, March 28

So today was day 3 at the pharmacy.  Halfway done with this site!  It was pretty much just business as usual.  I’ve gotten the hang of everything, so I just go in and they hand me all my baskets to fill and bubble pack.  I caught on to the computer system and workflow of the pharmacy pretty fast and even got complimented on the owner for doing so well!  The actual pharmacy work area is quite small, though, so it’s starting to feel a wee bit cramped with four people working in a space I would normally allot for one person!  This seems to be the case in every pharmacy, and for that matter, everywhere in London!  They have a lot more people and a lot less space (they have been around a lot longer if you think about it), so everything here is pretty compact, right down to their tiny cars.  My Explorer would look like a monster driving down the roads.  But again, I digress.

Today we spent a long time discussing exemption qualifications so people don’t have to pay for their medications, as well as methadone use.  There are about a billion ways to gain exemption from paying for medications.  Some seem like a good idea to me, like free medication for all children, but others I can’t quite agree with, such as some chronic disease states (I agree with helping to pay for a lot of them that could not be helped, but those completely preventable diseases caused by poor lifestyle and eating choices, such as diabetes type 2, I have more trouble accepting) and emergency contraception.  Yes, you can jump on my case for this one if you want, and I know a bunch of people probably will and judge me for it, but for moral and ethical reasons, I just cannot stand behind it.  And that’s that.  Regular birth control is another one paid for free of charge, and I’m fine with that one.  I’m not way off the deep end on this issue, people, I just definitely swing to the right :) Now on to the methadone.  Methadone is a Class II controlled narcotic for its highly addictive properties.  In the States, regular pharmacies can only dispense it if “FOR PAIN USE ONLY” is written on the prescription.  There are clinics in the US that are specially licensed to dispense methadone to addicts trying to come off other substances.  In the UK, however, all pharmacies dispense methadone to addicts right there at the counter!  It’s a bright green liquid, and the pharmacist must watch the patient take the medication.  These patients come in for their dose every day and just walk up to the counter, swallow the liquid, and head on their way!  The first time I saw this, I was quite surprised!  After talking with the pharmacists, I learned that most patients are never really weaned off their dose, so they just end up addicted to the methadone instead of whatever they were on before.  But patients are more open about their problems, so it helps them instead of doing even more dangerous drugs to get the same high.  So, in conclusion (wow, that sounds like a school essay), I’m not really sure what is the better system.  I personally think the US clinics are better, but I’ve never actually been in one, just heard about them from my friends who have volunteered there, so I don’t want to make an uneducated decision here.  But like most issues so far, I’m still siding with the good ole USA! :)

Today was also a big day in that the University of Tennessee pharmacy students arrived!  And wouldn’t you know I completely forgot about it due to a horrific trip home!  There was really bad traffic, and the bus route was taking forever, so I decided to walk home from the station (a different station than I go to in the mornings and had never done the walk before, but I ride it home every day, so how hard could it be, right? Ha!)  It appears that I missed a right-hand veer since I was on the left side of the street, so I’m walking and walking and thinking something’s not quite right, and then I end up right smack in the middle of the ghetto!  It was not cool.  Not cool at all.  I couldn’t just bust out my street map either because what screams “TOURIST!” more than some blonde girl in dress clothes walking with a map?  I found a rail station (and realized it was NO WHERE NEAR the guest house) then a slight panic ensued.  I high-tailed it back up the road until I found the ever-sneaky missed veer.  I flagged down a bus at a bus stop, and it completely passed me and kept driving!  I couldn’t believe it.  I was so mad, but had already walked forever, so I just kept going.  By the time I finally got back, it was about an hour and half since I left, and normally it’s just a 30 minute trip.  We figured out I walked about 2-3 miles, so at least I got my cardio in for the day, right?!  

I walked the door all panicked and crazy-looking, I’m sure, and gross from my long walk in dress clothes and realized the UT boys and Carmen were all sitting there waiting on me!  I felt so bad, and I’m pretty sure the first impression they got of me was not super fantastic.  I fully intend on making it up to them!  Luckily, Michael and Stephen were so cool and chill about everything, and even though they had flown in that day, they were up for going out to dinner with us.  What troopers!  I could tell right away that Carmen and I would get along famously with them both.  We took them to Blackfriars for dinner, where I had my favorite cider (it had been a long day after all), gave them a quick tour of Big Ben, the London eye, Parliament, Westminster, and probably confused them like crazy with all of our routes darting through the stations!  What a day!  

Big Ben at night looks pretty cool.

I recently learned the London Eye was lit up in the UK flag colors for William and Kate's wedding last year.  Pretty cool!

The London Eye all lit up.  Fancy!!

Also, on a very exciting and completely unrelated side note, Bryce sailed through his Cardio II final/class with flying colors, so thanks to all who kept him in your prayers throughout this class and especially since I’ve been gone.  On to Cardio III we go! :)

Day 16: Thursday, March 29

Thursday morning, I woke up and was definitely dragging!  Both Carmen and I had been attacked by what everyone here calls hay fever.  They claim to have super high pollen counts, but I doubt they have ever been to Atlanta, so no comment on that one ;)  But yes, it hit me HARD today.   

The beautiful daffodil gardens at Hampton Court Palace.  I blame them for trying to kill me.

Once I finally got myself to the pharmacy, it was the usual, so we had lots of fun conversations about the States vs. the UK.  I did have to give one of the pharmacists a quick geography lesson, as she thought that Georgia was a city in Atlanta.  Luckily, the internet saved the day, and one giant map of the US later (and the explanation that the AL next to GA does not actually stand for Atlanta, but rather Alabama, and that no, Alaska may look the same size as Hawaii, but it’s definitely not), and I’d say they were good to go!  Also, all week long, the lovely ladies who work down front in the pharmacy had been offering me “biscuits.”  I kept trying to explain that “no, that is not a biscuit, because you have never been to Chick-fil-A.”  Well, that just led to the “what’s a Chick-fil-A?” (internal gasp!!) conversation, and once again, the internet saved the day after I pulled up the CFA website and showed all the Brits what a TRUE biscuit looks like! Ha ha.  Their “biscuits” are more like cookies (like the butter cookies everyone wore on their fingers as kids and ate off one by one).  We’ll just say I won the biscuit conversation because NO ONE can trump a CFA biscuit except for my grandma, and she’s in the States too! :)

Today was my last day with the owner pharmacist, as he is off tomorrow for a long weekend holiday (aka vacation), and he gave me a great compliment saying he is sure I will be a great pharmacist after seeing me work with the people all week, my drug knowledge, and quick ability to grasp new systems.  This was a big deal to me because he’s been a pharmacist for almost 40 years, so I’m sure he’s seen quite a few people come through his pharmacy over the years!

Carmen, the UT boys (Michael and Stephen), and I were invited to Peggy’s for their welcome dinner.  Carmen and I really just got lucky and had a second welcome dinner!  As always, a great time was had by all, as Peggy and Ted are wonderful hosts.  We get along so well with them, and I know I will miss her so much once we head back home.  We were all laughing the whole night and hated having to leave to go back and get ready for our last day in the community pharmacy. 

Day 17: Friday, March 30

My last day at the community pharmacy was today.  This means that 2 weeks of my 5 week rotation are already over!  It really is going by so fast!  An interesting fact for today is that some very unintelligent high-up government official made some off-hand remark about a possible petrol shortage (petrol=gasoline) and that perhaps people should purchase a little extra to have on hand.  I’m sure you can imagine the absolute panic that ensued after that!!  Petrol stations were completely out of fuel and there was seriously none in all of London.  Turns out, there was never any risk of a shortage or crisis after all.  But he certainly created one!  I was certainly happy for the rail and bus system today since we wouldn’t have had any petrol to get around anywhere.  Also on a side note: the petrol prices are so much higher here.  It’s crazy.  It normally has run about £1.40 per liter.  So some quick conversions, people.  There are 5 liters (or litres as they spell it) in a gallon.  And $1.65 dollars-ish for every £1.  So 1.4x5x1.5= 11.55.  Yup, that’s right.  They pay the equivalent of $11.55 for one gallon of gas.  Kinda makes me not want to complain about gas prices ever.  But again, I have to consider how many people utilize the much better public transportation that can be found here and not in the US (or at least, not in Atlanta.  Oh, MARTA, you fail us once again). 

The pharmacy was crazy busy today, but it felt like I was back at home working.  I really feel like I contributed, and the pharmacist in charge even said she wasn’t sure how they would have gotten through the day without me since the other pharmacist was off.  Again, another compliment that meant a lot to me.  The hay fever was about to do me in, but luckily, I had a whole slew of normally unavailable in the US over-the-counter meds to choose from.  Along with the readily available Zirtek (yes, that’s how they spell Zyrtec) and phenylephrine, I was able to purchase some Flonase (or Pirinase in the UK, which is fluticasone generically) for only £6!  I can’t imagine what it would cost in the US after the doctor’s visit and whatever my lovely insurance decided to charge me.  I can guess it would be a lot more than that though!  I’m determined to rid myself of this hay fever and get back to fully enjoying my days!

Beautiful flowers at the park by Buckingham Palace.  Not really relevant to this blog, but there's a lot of words and few pictures, so I'll make it work: this is what is causing my hay fever.  There.  Done.  Made it work :)

When I went to leave at the end of the day, the pharmacist had a wrapped present for me since he was off that day.  It was some lovely hand lotion written all in French on the bottle and looks pretty fancy.  The weather here has been killing my hands, and I’ve been using the sample bottles at work all week, so it was also a very thoughtful gift.  Mr. K, Radia, and Paul, along with the great ladies down front, were so kind to me all week and welcomed even though they didn’t have to, and I had a wonderful experience at Kalmak Chemists!  Now, 2 weeks down and 3 to go!