Pain Management 101- P4 Rotation Day 1

Today was my first day of my 180 days of rotations, after which I will have my PharmD and eligibility to take the NABPLEX for my licensure.

So…. I am with Ernie Dole, PharmD, who prescribes the most narcotics in the state. It is not because he shoves drugs at people . Quite to the contrary. It’s the cases he gets…many of them others won’t take.

Day 1: I saw a wide array of patients, and while I can’t really say much, I saw ages anywhere from 30’s to 80’s, stable people, abused people, drug addicts, reformed addicts, but most people struggling in some profound fashion or another. One of the biggest lessons: Pain causes stress, and stress causes pain. Help one, and you help the other. Most of the people I saw needed a behavioral health professional (aka psychiatrist) in order to deal with the turmoil in their lives contributing to their pain. Many of them had a wonderful sense of humor, despite their conditions. They were all of varying socioeconomic backgrounds, race, gender, metabolic profiles….

One guy was turned away, since he claimed that he would find what he needed to take away the pain on the street if we couldn’t help him. That is a liability, and if he isn’t willing to work with the system, we can’t trust him to use medications correctly and avoid an overdose on whatever combination he decided to pop, snort, smoke, or inject that day.

I have a decent level of sensitivity for the issues these people are dealing with. The one I just mentioned was obviously strung out, despite challenging us to take a UA, because he ‘would pass it right now’. At certain points, he reminded me of my first husband, who was a drug addict and alcoholic. Some of the women I felt or knew had been abused. I could see the signs, because I too had been in an abusive relationship with my first husband. Addiction and abuse often go hand in hand, unfortunately.

So, while many people don’t understand why someone who studies drugs needs to do clinical rotations, it is absolutely necessary. I have learned much about drugs, and much I can look up, but to see the whole picture and take into account all aspects, use my intuition, and put the puzzle together, I need to meet the people, question them, doubt them and trust them.

It’s going to be an interesting 4 weeks, indeed. I can’t wait to see what characters I meet tomorrow. I hope it’s half as interesting as the ones from today.


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