The phone kept ringing and ringing… then it went onto the PA system: “Pharmacy 101”, “Pharmacy 101”, the annoying voice of a digital lady to remind the pharmacy team to pick up the damn phone – only if she knew how busy it was with endless prescriptions piling up and many angry customers standing in front of you expecting their prescriptions ready 3 hours ago. There was no time to pick up the phone.

Then my pharmacy technician picked up the phone and did the triaging for me. After some mumbo jumbo, my technician said, “The lady on the phone has applied some hemorrhoid cream inside her eyes and  they are really burning, so she wants to know what else she can do.”

Hemorrhoid cream for the eyes? It turns out the astringent properties of the cream to shrink hemorrhoids are used to treat swollen or puffy eyes. Off label use, of course. But what am I supposed to do or say to the lady. Did you not read the label – the cream is for your bump, not your eyes? I was speechless.

I have since went on google to find my answers. In fact, there are many youtube videos describing the benefits of hemorrhoid cream for dark circles around the eyes, puffy eyes, and the swollen eyelids.  Of course, I still won’t recommend using hemorrhoid cream to treat your swollen eyes but that doesn’t stop the public from listening and trying out these “recommendations” from the cyberspace.  But when things go wrong, that’s when they come to the pharmacists, or the doctors looking for relief, expecting us to fix these problems often not well described in our Lexicomp or Up-to-Date online references.

In fact, it was at that moment when I had an epiphany – that I realized everything I learned in my pharmacy education did not prepare for me to deal with these situations.  It doesn’t matter we are kept abreast of the latest evidence in medicine, many of the questions we get from the public will  unlikely be related to the latest clinical trial on statins, or the new guidelines on Asthma or COPD. But the connection with the patient is paramount.  The ability to establish a trusting relationship is important.  Educating the public is important.  I should stop being speechless and start to talk more with my patients – to find out why, what, how, where, when of every single concern they have and help to understand and learn with the patients. Only when they realize you genuinely care, can you be connected and understand exactly how to help them? And yes, sometimes it involves teaching them not to put the hemorrhoid cream in their eyes.

 

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