Saturday, December 20, 2003

Visiting Pharmacies

You can tell a lot about us Iranians by visiting one of our many Pharmacies. As you could well imagine, I have been visiting quite of few of them lately. I think the roots of our present predicament could be observed in one of them. Yes, you guessed it. This is about culture. Now, I know this is a thorny issue. I don’t know exactly what pattern of behaviors can be characterized as culturally determined? Societies evolve over time and people’s behaviors change constantly. What are the determining factors? In what senses can one claim that a given activity –recently fashionable-- is part of the cultural heritage? In what senses other more durable features can be said to be the permanent attributes of a particular collective landscape? In what sense a certain manner of performance i.e. discipline, competence, spirit, curiosity, etc. can be considered determined by the past? How does a given set of behaviors fall in or outside cultural norms? What are the prerequisites of change? What other conditions have to first be met before that change can be implemented? You might be curious about the relevance. So, let us explore.
Walk into any pharmacy and you’ll encounter 3 to four people meandering around. There are always one or more computers that just sit on the counter looking pretty. It is usually a late model, advanced, Pentium-powered beast, and well, quite dazzling I suppose. But no one touches it. The pharmacists rudely fill your order, giving you whatever they have without attempting to give you any information about the medicine or its side effects. They usually scribble the relevant info about the dosage and the timing on one of the boxes.
Lots of the medications are domestically produced, but imports are also stocked and since insurance normally doesn’t pay for the imports and since the domestic products are priced at a fraction of the imports, then if you are judged to be affluent, you normally get the latest conspiracy theory about all the outdated raw material that was sold to some unnamed relative of some unnamed official in the ruling regime, which was then used in the making of the domestic product…and so you are encouraged to buy the imports.
If on the other hand, the import is not available, or that the pharmacist doesn’t remember you as an old customer, you get the same story about the imports, with a new twist: “have you noticed all the Levothyroxine in the market is foreign? They are past expiration date and dumped in the market [a secret agreement, involving our own officials, certain unnamed foreign governments and the rotten pharmaceutical industry.] Domestic products have been banned. So, here I have the last batch of the domestic ones and it is a lot cheaper!”
Then they calculate the price in their head, on a piece of paper or on a hand-held calculator.
When I ask—and I do always ask—“why don’t you use the computer?” The answer,
inevitably is, “Ey Agha…(roughly my good man) Who has time?”
“But it makes your life easier…you can keep a record of your inventory there.”
“Ey Agha forgetting the taxes? And the inventory changes all the time. Some medications are pulled from the market and the new ones arrive, whenever the government decides!
“You can’t control that, can you? All countries do stuff like that, besides,
that’s the point of using a computer-- it helps you keep watch more effectively.”
”My margin isn’t high enough for all that work?”
“You spend the exact amount of time with all these employees here one way or another. How high does your margin have to be?
“But life is hard, corruption, lack of freedom, high inflation, rotten roads, pollution, lies, propaganda…”
“What do these have to do with giving the needed information about the medication, using your computers, to your customers, who incidentally are paying an arm and a leg? The least you can do is to put all that information –the dosage and timing in there and give your patient a print out. It is better for your patients and for you--you don’t have to sit and write them a hundred times a day.”
“But a lot of people are illiterate or have no interest and the Government has let the culture decline and the Government has ruined our lives because of its incompetence, lack of funding for public schools, deteriorating standard of living, support for the Arabs, etc. !”
And so it goes on and on—a typical conversation roughly as I described.
And I am left thinking:
Here you are. You spend exactly the same number of hours in your pharmacy with the same number of employees-- day in and day out. How much freedom of expression do you require to be competent? What does government’s foreign policy have to do with how you order your activities in the shop? What is the exact level of the high margin you require to be as excellent a pharmacist as you could possibly be? Have you tried to verify the latest rumors you spread? If it’s true, why peddle your drugs? If not, why lie? Are you a pharmacist or are you in the rumor mongering business to increase your margin? If the social condition bothers you so much, close your pharmacy, or rent it out and let’s go about seriously changing our collective life.
But…but, there is always that not so insignificant factor of fear. Fair enough. It is, after all, one’s life, limb and skin. They are dear and shouldn’t be lost lightly. So, regardless of the difficulties of our social life, and our hopes and expectations for the future, we spend a certain amount of time in our lives doing what we have to do to survive. Must we wait before everyone is literate and the country corruption free before we utilize the tools at our disposal? What does it take to do a thorough job while at work? How much money does it take to not be rude to one’s customers? How much security does one need to not be carelessly filling prescriptions, putting one’s customer at risk?
Does culture determine behavior? Does lack of democracy? Does religion? Does history? Mythology? Ritual fasting? The celebration of the New Year in a particular month? Public holidays? The prayer at certain hour? The belief in the Messiah? The Laws of the land?
Quite possibly yes to all! Or, one may suddenly decide to let the tradition be damned! All it might take is an act of the will. There are certain things one can control and others one can’t—not in the short run. All that might be required is the affirmation of that control initially within the immediate sphere of one’s influence.
An affirmation that I will be at least curious about the new things I encounter today…just for eight hours. I’ll be sober minded. I’ll put my education to use and analyze in a cool, collected dispassionate way. I’ll be nice to my patrons, just each time one walks in. I’ll experiment to see what I can accomplish if I alter my routine, just a few times a day. I’ll think differently about my daily chores, just once in a while! Just for the eight hours I spend here in this shop. Not because I like it, but because I am here anyhow—so why not do the best I can. At the very least, it might make me feel better.
And so it is that at every turn in our society we encounter a witches’ brew of myopia, incompetence, wishful thinking, conspiracy theories, illusions, delusions, self aggrandizements and false hopes.
You might have guessed the punch line: that a rather incompetent pharmacist, absent very unusual set of circumstances, indubitably also makes for a terribly lousy revolutionary!

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