I was watching an episode of the long-running BBC quiz Mastermind last week, revelling in the iconic music – “bom, bom bom baaaaa, baa-dum” – and of course the infamous black chair.
I imagine sitting in the chair would be as intimidating as our pre-registration exams, but more challenging still for pharmacists would be deciding our specialist subject. Hard enough for most people, but an almost impossible task for pharmacists when you consider what we have to learn and apply in the average day.
“SARS-CoV-2 is an RNA virus which encodes four major structural proteins, spike, membrane, envelope and a helical nucleocapsid. The S glycoprotein is considered the main antigenic target and consists of an S1 and S2 subunit.” So ran an extract from Public Health England’s “green book” on COVID-19.
I was grimly trying to understand this in preparation to be a COVID-19 vaccination volunteer when I was called away to deal with the domestic crisis of a dispenser who was debating taking on guardianship of a grandchild. I walked back into the dispensary to be presented by my pharmacist with a prescription query, and shortly afterwards spent 10 minutes with a young lady working through the rules of missing a dose of her contraceptive pill.
How typical of our profession. Not only that it is difficult to complete one task, no matter how simple and mundane or how complex and challenging, but also that our breadth of work frequently extends from the sublime to the ridiculous.
At one moment we might be identifying a potentially fatal prescribing error, where concentrated morphine had been ordered for an opioid naive patient, and the next we’re pouring over wholesaler price lists to find the cheapest generic in order to remain commercially viable.
In many ways this variety of responsibilities was what attracted me to pharmacy all those years ago. I shunned the thought of studying pure maths or physics, having seen friends who had done so at university struggling to find employment unless they were at the zenith of their profession.
And in turn our role as Polymath on the High Street is part of what makes us approachable to so many patients, particularly when hospitals are overwhelmed and GP surgeries are perceived as inaccessible.
Patients come to us expecting authority and knowledge about their health. We oversee their consumption of methadone and advise them on strategies to lose weight. They show us their rashes, their conjunctivitis, and their hospital letters with the expectation that we will understand and interpret all three. Having become accustomed to our supplying their flu jab, they now wait impatiently for us to be supplying their COVID-19 vaccination.
Impossible as it seems to encapsulate all that and more as a single specialist subject, I’d have to sum it up as “patient care”. Not a bad thing to specialise in.
A long-running C+D contributor, the identity of Xrayser remains a mystery, but his irreverent views are known by all. Tweet him @Xrayser