A Relationship Beckons: Luca (#4)

To read this serialized blog of A Relationship Beckons from the beginning, click here: Crisis Averted #1 . Then navigate to the next post using the links in the upper corners.


My Ragazzo

“What are you doing here?”

Luca Clivio’s brows furrowed at Caroline’s apparently audacious question. He divided his threatening gaze between Caroline and her mother, Nora. Each time Luca’s eyes held hers, Caroline’s gut clenched. Today, it was like her intestines were being squeezed in a vise.

Luca let his eyes slip in Peter’s direction. Appearing to be asleep, the boy’s eyes were closed and he seemed to be breathing better. “The last time I checked, he’s my ragazzo, too.” The thickly accented Italian words were delivered with menacing elan underpinned by a calm yet intimidating intent. Luca relaxed his brows and hiked them in a silent challenge toward Caroline.

“I only meant…” She cleared her throat. “I mean I hadn’t had time to call you. How did you get here so quickly?”

Caroline shot her mother a quick look. Nora’s face had hardened to stone. Her defiant scrutiny of her ex-son-in-law was absolute and brimmed with loathing.

“Do I not have the right to see my son? Especially when he is in the hospital?”

Caroline swallowed hard. The saliva in her mouth was hot like scalding embers. “That’s not wh–”

“What…happened?” Luca demanded, drawing out both words.

Nora stood up and took one step toward Luca.

Luca responded in kind. “Where do you think you are going, old woman?”

“Luca!” Caroline spat barely above a whisper.

Nora wagged a crooked, dry and cracked finger at him. Then she challenged him. “Je sais ce que tu es et ce que tu fais, connard!”

Caroline rose from the chair creating a barrier between the two. “Mother, please do not do this. Not now!” Caroline spun toward Luca.

Luca chuckled to himself and divided an amused look between mother and daughter. He leaned in and in an ominous tone repeated his question. “What happened?”

Caroline moved a step sideways blocking Luca’s view of her irate mother. She cleared her throat again. “He had an asthma attack. I brought him here to get treatment.”

Luca simply stared.

“How did you know he was here?” Caroline asked, summoning a modicum of nerve.

Luca sniffled and wiped his nose with the back of his hand. Caroline noticed a rim of red around his eyes and a glassy sheen over the corneas. He was .

“Answer me, Luca! How did you know?!”

Surprising herself, Caroline reached out and grasped his elbow, turning him. Over her shoulder, she called to Nora. “Stay with Peter, we’ll be right back.”

The Hallway

Luca resisted at first. But Caroline squeezed her grip on him tighter. The last thing she wanted was Peter waking up. After a reluctant moment, he allowed her to guide him toward the hallway. When they were outside the room and out of Nora’s view, he wrenched his arm free and seemed to be struck by a thought. “Where is his inhaler?”

“Are you high? Have you been using?”

Luca’s visage turned degrees hotter. He raised his clenched hand and brought it to within inches of her face. Caroline instinctively moved back a step. Her heart lurched in her chest. “Are you going to hit me? Again!?” She demanded in a querulous gasp. Caroline looked beyond Luca and saw a nurse shoot a concerned glance in their direction. The healthcare worker quickly averted her gaze, but did not move off.

Then seconds later, she cast a sideways glance, keeping watch over the interaction. She picked up the handset of a phone at the nurses station and held aloft, waiting to see what happened.

Seeing Caroline’s distraction, he stealthily scanned the immediate area. “Why did you not give him his inhaler? You forgot it again, didn’t you?” Luca’s accusation stung, hitting her like a gut punch.

Caroline averted her eyes, admitting her perceived culpability. Once before several months ago, Caroline had left Peter’s inhaler at the house just before she dropped him at Luca’s for the weekend. After his tirade, she had driven home and returned to Luca’s with the medication.

The Accusation

“I told you this would happen!” Luca sucked in a deep, breath and clenched his fist again. The muscles in his jaw flexed with fury. “You stupid…”–he lowered his whispered voice several octaves–“bitch! You are a shitty mother.”

The hurt and frustration was all too familiar. Emotion swelled in her middle. She could feel tears welling. Caroline squeezed her eyes shut, The aspersions had been a weekly occurrence during their turbulent union. His jealousy, possessiveness and verbal abuse had been belittling and fear-inducing. After a while, she had become numb to the constant attacks. Leaving him had been a monumental, nerve-racking action on her part. Since their separation, Caroline had begun to climb out of the dark hole of depression and degradation Luca had dug and in which she had been living for the past few years.

This is why you left him, Caroline! This is why you left!

She swallowed hard, filled her lungs with air and launched an unplanned counter attack. The words were murmured but laced with contempt. The forefinger of her right hand jabbed at Luca. “You’re not going to do this! This is why we are no longer together.” She glanced toward the room where Peter lay sleeping and Nora stood, eyes wide, observing them melded to the floor as if she were cast in stone. “Peter is fine. He had an attack. I got him help!”

Luca inched closer to her, looming over her with his immense frame. But he stopped, slammed by her next utterance.

“How many lines have you done? I can smell whiskey on your breath, too. You stink of it!”

A movement of gold and blue appeared from behind Luca’s left shoulder. It was the nurse, Gretchen, who’d taken Peter’s vital signs. “Excuse me,” she asked in a cheery voice. But she quickly divided a concerned look between them. “Is everything okay here?”

Luca shrunk back. Caroline hesitated. Mortified she rubbed her forehead with two fingers and sighed. “Yes, we’re fine.”

Gretchen paused, then held Caroline’s gaze. Her non-verbal question appeared to ask if she needed help. “We’re fine,” Caroline repeated.

After several moments, Gretchen gave a slight nod and moved off.

Caroline turned her attention back to Luca who was dragging a hand down his face. She resumed her interrogation. “How did you know Peter was here?”

The Woman

He had turned to regard the comely nurse. At Caroline’s question, he pivoted back toward her. The rotation of his shoulders revealed the figure of a woman thirty feet behind him. The lithe female leaned defiantly against the hospital wall on one shoulder facing Caroline and Luca. She was dressed in a form-fitting sweater, tight jeans and ankle-high black boots. Her straight blonde hair hung down to her breasts. The topography of her form curved and undulated in all the right places. One ankle was crossed over the other and her eyes were riveted firmly on them both. There was no sense of mortification on her features at being discovered studying them. In fact, her lips were curved into a smirk of satisfaction at the confrontation she was witnessing.

Something about her niggled Caroline’s brain. Her forehead squeezed into tight lines at the sight of this femme-fatale. “Is that your current screw?” She demanded, reverting her gaze back to her red-faced ex-husband.

“Watch yourself, puttana!” Luca swiveled his head to regard the figure to whom Caroline referred.

“Or is she your supplier?” Caroline persisted.

When he turned back to back to her, Caroline could see the muscles in his jaw and neck flexing with virulent tension. His face had taken on a deeper shade of crimson. She swallowed, unsure where her defiance was generated. Perhaps, it was because they were in public. Or perhaps, it was because she had reached the limit of her patience. She had yet to inform Luca, but she was going to file for sole physical custody with the courts. She refused to allow Peter to continue being exposed to his drinking, womanizing and drug use. However, telling him scared the hell out of her.

Apparently the realization that she was goading him cut through his drug and alcohol-addled fog. He relaxed just as an armed security guard appeared in Caroline’s field of view.

“That’s Deb. Debra Perry, she works for me,” Luca declared.

It was at that moment it hit her. She’d seen this woman before. But before the memory could take full form, the guard stepped forward so that Luca could see him also. He stood a few feet from the pair with feet spread and his hands resting on his thick utility belt. His muscles were taut, ready to react. “Folks,” he stated in a deep baritone. “You need to take this outside. You’re disturbing the staff.”

Luca scanned the officer and sneered. He split a condescending leer between the man and Caroline. After an unsteady moment, Luca snarled, “I was just leaving.” He leaned toward Caroline again. His gaze and his head wavered slightly. Caroline breathed in a healthy dose of his bourbon-soaked breath. “We are not done.”

The guard closed the distance, grabbing Luca by the upper arm. Luca wrenched it free. “Don’t touch me!” To Caroline, he whispered with a laser-focused intensity. “I’ll see you again, real soon!”

-To Be Continued-

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A Relationship Beckons: The Pharmacy (#3)

To read this serialized blog of A Relationship Beckons from the beginning, click here: Crisis Averted #1 . Then navigate to the next post using the links in the upper corners.

The Pharmacy

The Confrontation

“Why is the drive-thru closed?!”

It was more an accusation than a question. And it had been thrust at Jake Murphy by his supervisor and district manager, Stephan Willings. Willings was a small, wiry man of about twenty-eight dressed in black slacks and a white Oxford shirt with the Alliance name and logo embroidered over the left breast. Suspicious brown eyes bore into Jake over a thin, crocked nose that must have been broken at least once. Jake surmised he’d probably been punched. He wanted to crash his fist onto the man’s face right now. Today, Willings was not his supervisor, not a colleague or even an acquaintance.  He was the enemy personified.

Willings had taken over the DM position about eight months ago and gone through the corporate training in Charlotte for six weeks. To Jake’s mind this was akin to a re-education camp where new front line supervisors were forced to drink the Kool-Aid if they wanted to advance themselves into management. They quickly forgot what it was like to be a frontline pharmacist: the stresses, the frustrations and the constant worry about not making a drug error. Instead they spouted the company propaganda like mechanical automatons.

Today, Jake was mentally and physically exhausted. He was in great physical shape, lean and muscular. At least that’s what the mirror told him. He ran five miles a day while pushing Lizzie in her running stroller even on the days he worked twelve hour shifts at the pharmacy. This regimen was a holdover from his days in the Corps. It helped to offset his sometimes crappy diet, his mediocre and lackluster culinary skills and his profession’s twelve-hour work days.

If he got to eat during his shift, it was usually bites of a sub sandwich in between prescriptions. He ate decently about half the time. Mostly on his days off because he had to care for his four year old Lizzie. As a growing child, she required healthy, nutritious meals. So Jake shopped once a week. He prepared three meals-a-day least twice a week. On the days he worked, Jake’s sister and mother helped him out by watching her. Lizzie ate like a princess at Mimmi’s and Aunt Claudia’s house. Once a week, he indulged her with a Happy Meal. So far she enjoyed being spoiled by her grandmother and spending nights playing with her cousins. She was a handful, but that little angel put the sparkle in his eye and a spring in his step. Since Olivia’s death, Jake’s life had been a maelstrom of depression and grief punctuated by short bursts of fatherly pride underpinned by a parent’s limitless love.

Shortly after the frantic woman had arrived at the counter requiring help for her asthmatic son and the crisis had been resolved, Jake had ordered Helen to pull down the curtain on the drive-thru so that she could help him in her limited, untrained status as a technician trainee. That thirty minute episode had put them even farther behind with patients lined up waiting for shots and even more waiting for prescriptions. Closing the drive-thru was a cardinal sin in the industry. Management became apoplectic when pharmacists did it. Jake had been caught off guard by Willings’s visit ten minutes ago. Swearing under his breath, he whispered to himself, “Could this day get any worse?”

A Bad Day Gets Worse

Willings repeated his question. “I said, ‘Why is the drive-thru closed?'”

Jake sucked in long breath, held it a moment then blurted. “Because I’m drowning here. I have very little help. Helen’s doing her best. But she’s still in training.”

Willings shrugged. “You can’t close the drive-thru! Open it now!”

Jake began shaking his head before the last three words were out of his boss’s mouth. “No! If you want it open, get your butt over there and start ringing the register. It’s my license and the safety of my patients on the line.”

He had prepared himself for this moment for several months. Jake pulled open the drawer just below him and removed a three page document. He extended it to Willings. Jake glowered at this man who evidently had forgotten what it was like in the trenches. The man’s face hardened at the rebuke.

“What’s this?” He croaked hoarsely.

A Legal Remedy

“That’s the Virginia Board of Pharmacy’s Working Conditions Document. They put it out earlier this year. You need to read it. It says the pharmacist shall have complete control over every aspect of the practice of pharmacy. If you try to override it, the company could be subject to disciplinary action!”

The enormous tension that had been building crested at the back of Jake Murphy’s neck, spreading like an avalanche over his shoulders. Now, it engulfed every fiber in his athletic thirty-four year old body. He struggled to maintain his composure and hide his barely controlled stress.

It was just past noon on this late June Monday at Alliance Pharmacy. His pharmacy served the upper reaches of Newport News just south of Williamsburg. Things had gone to shit thirteen minutes into his day and had gone steadily downhill from there. His cell phone had chirped just after arriving indicating he’d received a text message. He’d turned over the phone lying on the counter in front of his computer terminal and read it.

“Damn it,” he muttered. He wanted to use more potent language, but a patient had been standing before him, waiting for Jake to acknowledge him. The man had been wearing a path on the shiny floor tiles in front of the pharmacy for ten minutes before Jake had raised the gates at nine. Kyle, his morning shift technician, said he’d tested positive for the virus and wouldn’t be coming in. He checked the work schedule taped to one of the bay walls in the pharmacy, Helen, his mid-shift technician and a middle-aged, pleasant woman who was still learning her duties would not be until ten-thirty.

The Onslaught

“I’m here for my booster shot,” the edgy patient demanded. “I’ve got to be to work in fifteen minutes.”

Jake sighed. “What’s your name?” The man gave it to the pharmacist.

Jake had pulled up the appointment schedule as three more folks walked briskly down the center aisle, their eyes leveled at the pharmacy department searching like starved animals.

Jake shook his head slightly and said, “Sir, your appointment is not until eleven. It’s only nine-fifteen–”

“Well, I just thought you could give me my shot and I’d be on my way.”

What Jake wanted to say was, “We’re not a fast food restaurant. You wouldn’t walk into you doctor’s office two hours early, would you?” Instead, he swallowed and as calmly as possible said, “Sorry sir, you’ll have to come back at your appointment time.”

The patient huffed, spun and stormed off.

Now hours later as Jake squared off with his direct supervisor, a trio of new patients approached, he cursed Alliance Pharmacy, the retail pharmacy industry and the mess they had made of his beloved, dedicated profession. Alliance, a large national chain struggled to keep up with the massive firms like CVS, Walgreens and Walmart. In the lust for the almighty dollar and increased market share, the chain pharmacies had trimmed labor hours, pushed ungodly amounts of prescriptions on their staff, added immunizations to the menu and scared off good help with poor working conditions and even worse pay.

Now as the morning had turned to afternoon, Jake felt like he was being swallowed by the leviathan-sized of  pile electronic prescriptions queued in the computer and COVID boosters that had been scheduled. Helen was frantically scurrying from the pharmacy bench to the inside register, trying to keep up while Jake tried to answer the phone, answer questions and fill prescriptions. On top of everything else, the company told him and all his compatriots that they had to accept walk-ins as well. “How the hell did they expect us to get the prescriptions filled?”

Honorable Service

Jake remembered the frantic mother who’d brought her bluish-lipped son into the pharmacy. Tending to that emergency had put Jake and Helen even farther behind, but it was one of those moments a pharmacy staff would remember for a long time. They had assisted a boy in respiratory distress and calmed a fearful mother. Too often, they received the brunt of a patient’s frustration and impatience because they weren’t fast enough or their insurance co-pays were to high which of course the pharmacy had no control over. But today, they done something wonderful and heroic.

Jake knew that though he seldom saw the outcome of his work. It was good, honorable service. They eased patient’s suffering, improved their health and longevity. They prevented diseases by administering immunizations.  Today when he’d squeezed the albuterol into Peter’s lungs, he’d seen an almost immediate improvement in his cyanotic skin and labored breathing. A surge of relief and satisfaction had surged in him.

“My doctor just sent over a prescription five minutes ago.”

Jake held up a hand to the patient. “Sorry ma’am. We have at least a five hour wait.”

“Five hours?!”

Jake cast Willings a defiant look that said, “I dare you to say something!”

Willings muttered, “This is not the end of this!” He turned and spun, exiting the pharmacy. Jake watched him march through the front sliding doors. He turned back to the incredulous patient. “Yes, Ma’am. I do apologize. But we are short-staffed today. We want to make sure your prescriptions are correct.”

A sour moue slowly spread over her features. As she walked away, her frown deepened.

The next man in line was more understanding. ” He handed Jake his empty prescription bottle and said, “You guys are doing a great job. I’ll pick it up later in the week. Hang in there.” The older man shot a compassionate wink in Jake’s direction and smiled.


As the man walked away, Jake swallowed his bitter anger, allowing it to dissipate slightly. Needing to think of something pleasant in his life, Lizzie popped into his mind’s eye. He was doing this for her, he told himself. He put up with all this BS so she could have a decent life. Then little Peter appeared in his thoughts and he again surge of gratification brimmed in him. He remembered smiling at the intelligent and beautiful mother as her fear dissolved. Her knitted brows relaxed, her eyes brightened and a new level of attractiveness spilled forth. Watching the relief and admiration consume her temporarily melted Jake’s stress. He may have saved a life today. If nothing else, Jake could hang his hat on that fact. It was the only piece of good news his day held.

He would give Lizzie a big hug and a kiss tonight when he picked her up even tough she’d probably be asleep. And he would thank the Almightly for sending her to him.

In all the excitement, Jake hadn’t realized it until now. He hadn’t asked the mother her name. He hadn’t recalled seeing a ring on the woman’s left hand. A small niggle of desire and possibility sparked deep inside him. He smiled inwardly and hoped the boy was doing better.

-To Be Continued-

If you have a pharmacy story or a story (heroic or challenging) of everyday life in your healthcare world, send it to me by clicking the link below…

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A Relationship Beckons: The Emergency Room (#2)

To read this serialized blog of A Relationship Beckons from the beginning, click here: Crisis Averted #1 . Then navigate to the next post using the links in the upper corners.

The Emergency Room

The paramedics wheeled Peter who was resting on the collapsible gurney straight past the crowded waiting area into the emergency room proper. He was lying against the angled backrest trying to absorb the myriad of colors, sounds and activity surrounding him. His nose and mouth were covered by a clear, green face mask connected to tubing that snaked to an oxygen tank lying beside him. The boy had been talking incessantly since being placed inside the back of the large rig and seemingly had reveled at the special attention and the siren-screeching ride. “I can’t wait to tell Stephen that I got to ride in an amboo-lance,” he’d bragged to Caroline as she caught up to the stretcher as they off-loaded Peter from the ambulance.

Caroline had followed the medical transport in her Escalade to Tidewater Regional Medical Center in Newport News. Now, she walked just behind the pair of first responders keeping pace with her hand resting on the angled backrest. A young woman in green scrubs standing behind the counter at the circular nurse’s station saw the quartet approaching and pointed to an open, glass-walled room.

“Put him in room three,” she instructed.

The pretty nurse followed everyone into the treatment room and greeted her young patient. “And who do we have here?”

The reply was muffled and hollow through the oxygen mask. “I’m Peter. Peter Clivio.”

“Are you Mom?”

Caroline nodded, a relieved smile creeping over her face. She adjusted her large purse against her shoulder and pushed out a weak, “Yes.

The nurse turned her attention back to the boy. “My name is Gretchen. I’m one of the nurses who will be taking care of you today.”

The paramedics had lowered one side rail of the gurney and pushed it against the hospital bed. Gretchen asked Peter to scoot onto his new bed. She disconnected his oxygen tube from the O2 tank and reattached it to the hook-up in the wall. The paramedics recited a quick report of the boy’s vital signs and Gretchen wished them a good day. Caroline thanked the two young, athletic looking men as they gathered up their gear.

Gretchen rolled a tall, medical monitor on a wheeled pole to the bedside and proceeded to place a pulse oximeter on the middle finger of Peter’s right hand and a small blood pressure cuff over his bicep. She calmly explained what she was doing in a soothing, unhurried voice. Peter still breathed somewhat heavily. Each breath briefly fogged his mask.

Gretchen noticed Peter’s hands trembling.

The nurse asked Caroline what had happened. Caroline relayed the episode of Peter’s asthma attack in the car and her frantic rush to the only place she could think to go quickly, the pharmacy in the northern stretches of Newport News and the heroic pharmacist who’d administered the albuterol puffs into her son’s lungs.

When she turned her attention back to Peter, Caroline took measure of this twenty-something angel who now captivated her son. She was about five-six with sparkly, ocean blue eyes that were striking beneath the silken, blonde hair pulled into a ponytail.

Her ex-husband Luca had taken Caroline to Italy three years before their divorce to Nerano, a small town on the western coast about three hours south of Rome on the Sorrentine Peninsula, a stone’s throw from Sorrento and a short drive to the Amalfi Coast and Positano. From their villa, they enjoyed a spectacular view of the Isle of Capri and the three Faraglioni in the Tyrrhenian Sea. She remembered the boat trip over to the island for a romantic lunch with Luca. Of course, that had been during better times–much better times.

She recalled marveling at the rich cerulean water as they circled the island in a charted boat. It was the bluest water she’d ever seen. Gretchen’s eyes held that same hue now over the pleated surgical mask as they darted between the instruments she was manipulating and her son who seemed taken by her natural beauty.

“–need this, Mrs. Clivio,” Gretchen said, holding out an unused blue mask to Caroline.

Caroline took the mask and replied, “It’s Miss Clivio.” She had divorced Luca a year ago. Though she was no longer married to the man, she’d kept his name for Peter’s sake. However, the moniker of “Mrs.” was one she refused to wear.

Gretchen nodded, acknowledging the correction. “Peter’s doing fine. His vital signs all look good. His breathing is a little labored but I think he will be okay. He’s trembling a little, probably due to the albuterol. The doctor will be in to see him in just a few minutes.” Gretchen slipped out of the room.

Nora Martel

It was then that an older, portly woman about Caroline’s height hastily entered the room. “Mon dieu! Is he okay?”

Caroline stood, leaving her purse on the chair. “Hi, Mom.” The women hugged. When they separated, Caroline looked her mother in the eye. “He’s fine. He had an attack. The pharmacist at the store gave him some albuterol. We brought him here just to be cautious.”

Though, she carried her years well, the ravages of time and raising four children had begun to take their toll. Her jowly face and liver-spotted skin added years to Nora Martel’s appearance. The hazel eyes still bespoke a sharp mind and the ability of critical analysis that came with sixty-five years of life’s trials and tribulations.

Nora’s eyes shifted to Peter in the bed. His eyes were closed. The fatigue and energy he’d exerted this morning trying to breath had caught up with him. Caroline followed her mother’s gaze to her son. “He’s exhausted. But he enjoyed the ride in the ambulance. He’ll have lots to tell his friends.”

“I won’t wake him. “And his father,” Nora added. She hesitated a moment. Then in a very soft voice muttered in French, “Est-ce-que le connard sait?” Nora Martel always reverted to her native language when she was worried.

Caroline sucked in a heavy breath and closed her eyes trying to summon patience. The last thing she wanted to endure this morning was the one quality her mother had perfected, and one in which she was a virtuoso: pushing Caroline’s buttons and finding fault with just about everything she did. Caroline performed a silent five count, re-opened her eyes and expelled the air and her response. “No, mother, the asshole doesn’t know.”

“Am I going to have to see him today?”

“Mom, this is not the time…or the place,” Caroline chided.

“You know how he’ll react when he finds out,” Nora continued.

Caroline cast her gaze to the ceiling. “Not now, please,” she insisted, bringing her eyes back to Nora’s. A single tear traced its way down Caroline’s cheek. Her mother was also always the first one to confirm what Caroline was thinking…and fearing. She could read her daughter blindfolded .

In addition to being concerned about Peter, Caroline’s mind struggled with the fear of what Luca might say–or–do when he found out about this latest episode. She had pushed the worry about Luca’s reaction into a corner of her mind temporarily as she phoned her mother to tell her to meet her at the hospital. Caroline had been on her way to her mother’s when Peter took ill. The plan had been for Nora to sit with Peter while Caroline ran errands. After she had hung up and as she trailed the ambulance, Caroline had become consumed with the possibility of Luca finding out. As a result, she experimented with different reasons and rationales for why she hadn’t remembered to bring Peter’s inhaler with her. Her hands had trembled as she gripped the wheel with a white-knuckled strange hold.

Despite the fact that they were no longer married, Caroline would never be rid of Luca. They shared a son. A son Luca doted on. Luca’s Italian heritage made him quick to temper. His occupation and his affliction made him suspicious and unpredictable. He was a powder keg. The tiniest spark could set off the volcanic rage, sending him into explosive–sometimes violent–tirades.

And for a few moments, Caroline recalled the relief and gratitude she’d felt when the pharmacist had administered the breath-saving medication. She made a mental note to go back to the pharmacy sometime soon and thank the man.

Nora dug into her daughter’s eyes with her own. Caroline surmised that her mother realized that she had pushed too hard. Nora patted her arm and relented. “We’ll deal with that later.” But, Caroline knew the issue was not dead. Her mother would pursue it relentlessly.

The Doctor Departs

Their conversation was interrupted when a short but authoritative-looking man dressed in khakis, a blue shirt and red tie and cloaked in a knee length white coat entered. His stethoscope was draped horizontally around his neck. “Good morning,” he said. “I’m Dr. Hobson. Are you,” he referred to clipboard he’d retrieved from the holder outside the door. “Mrs. Clivio?”

Caroline frowned your, but chose not to correct him. “Yes,” she replied with a single nod.

“Peter experienced a breathing episode today?”

“Yes. I forgot his inhaler at home.” Caroline shot a glance at her mother whose brow crinkled deeply. “A pharmacist at the Alliance Pharmacy helped me and gave him two puffs of albuterol. He called the paramedics who brought him here.”

“Let’s take a look,” the doctor said, rounding the bed. He placed a hand on Peter’s shoulder and said the boy’s name. Peter roused and blinked several times, looking up at the newest stranger. He asked Peter to lean forward and take deep breaths as he placed the stethoscope along various spots around Peter’s back. Then he listened to his heart. After several minutes, his preliminary exam complete, the doctor replaced the stethoscope laterally around his neck. “He’s breathing well. Still a little wheezy. He’ll be fine. We’re just going to watch him for an hour or so.” The doctor nodded and departed.

Caroline lowered her head, relieved. She saw the doctor’s comfortable shoes hesitate as he exited the treatment room. A shadow spilled from the hallway into her field of vision. She heard her mother’s whispered word of contempt in her ear. “Merde!” Caroline spun her head toward Nora. Nora’s eyes did not move in her daughter’s direction. Instead they were riveted on something in the doorway.

Caroline hesitated a moment, realizing Nora was staring beyond her. Caroline turned her head in the opposite direction. It was not something. It was someone. Backlight by the harsh emergency room light of the nurse’s station, Luca Clivio towered over the departing physician. The tension in his frame, the hard eyes and the repeated flexing, relaxation and re-flexing of his right hand into a fist sent a dagger of dread through Caroline.

To Be Continued

If you have a pharmacy story or a story (heroic or challenging) of everyday life in your healthcare world, send it to me by clicking the link below…

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A Relationship Beckons: Crisis Averted (#1)

(This is a fictionalized scene based on a real incident that happened years ago.) To read the next installment, click on the link in the upper right corner.

The Crisis

“Honey, are you okay?”

Caroline caught sight Peter of the corner of her eye in the rearview mirror as they say at the red light. She was concerned. Her six-year-old was strapped into his car seat behind the passenger side. He seemed quiet and more subdued than normal this Monday morning. He protested saying he was tired. Dark circles hung beneath his young eyes. A niggling cough rattled in his chest.

Every other morning, he woke bounding from under the covers a chatty ninja, racing downstairs to watch cartoons or play with his toy cars heedless of her commands. She had taken his temperature and found it normal. Something just did not seem right.

Turning her head to look at him, she repeated her question. Again, there was no response. That was when she noticed the rapid heaving of his chest. His lips displayed a bluish haze. His rapid, shallow inhalations sounded like angry hisses.

She pulled over, stopped the SUV on the shoulder and quickly rifled through her purse looking for the albuterol inhaler. She could not find it. Panic welled in her. Dumping out the contents of the purse onto the passenger seat, her hands moved through the items desperately touching each one in the hope she’d overlooked it.

Shit! It wasn’t there.

Then the realization struck her: it was sitting on the kitchen counter where she had left it last night as she cleaned out her bag.

She swore out loud again.

Glancing into the backseat again, Peter’s head had slumped forward. His chin rested against his small, heaving chest.

Panic morphed into full-fledged terror.

Near Miss

Ramming the gearshift into drive, she slammed the accelerator to the floorboard. The Cadillac Escalade lurched forward, fishtailing sideways in the soft grass until the tires found purchase on the asphalt. A car horn blared followed by the sound of screeching rubber. The passing vehicle swerved dramatically barely avoiding colliding with her Cadillac.

She ignored the near miss and continued pressing the gas. Her mind ping ponged wildly, assessing her options as her heart was in her throat, bounding rapidly. Should she turn around and head back to the house to retrieve the inhaler? Or she should head to the nearest emergency room? By her estimates, both options meant thirty minutes.

Was Peter breathing?

Oh my God! She should have leaned into the backseat and checked on her son.

Her momentum pulled her alongside the car that had nearly struck her. The still-irate female driver glared over at her mouthing unheard epithets while at the same time moving one hand in rapid, ill-willed gesticulations. Ignoring her, the Cadillac crept passed the other vehicle as they both raced along. Her mind still trying to recall a place where she could take him that was nearby then through the windshield, she spotted a beacon of hope.

When she reached the turn off, Caroline jerked the wheel hard, barely braking. The Cadillac listed severely as the tires wined in protest. She skidded to a halt in one of parking spots at an obscure angle. The other driver, apparently unsatisfied with her earlier demonstration of dissatisfaction followed the Cadillac into the parking area.

Caroline pushed open the door so violently, it bounced back onto her. Pushing it open one more time, she rounded the hood in a full run and yanked open Peter’s door. She could she his chest moving erratically in short, inadequate bursts.

She unbuckled him from the car seat, pulled him onto her chest, darting around the other car which had stopped right behind her. The driver was exiting the car and shouting, “What the hell do you—”

Caroline screamed back, “He’s in trouble!”

She bolted across the parking lot in front of another car causing it to brake hard. Five seconds later, she disappeared inside the pharmacy.

Help Me

Jake swore under his breath at the growing workload before him for at least the tenth time today. The tightness in his chest expanded, threatening to consume him. As the pharmacist on duty on this first Monday of the month, the number of prescriptions thrown at him today was non-stop. He’d already had two patients scream at him because he’d had to tell them that their orders for pain medications wouldn’t be ready with the speed of a McDonald’s restaurant. It was always the patients on narcotics that gave him the hardest time. Another patient’s insurance wasn’t paying for her medication because it was too soon to fill. The patient refused to leave and was demanding that someone from the pharmacy call the insurance company to get an override because she was heading out of town.

If he had a dollar for every time he heard that one!

The woman stood at the drop-off window, arms crossed angrily across her middle, silently shooting impatient darts with her eyes at Jake.

He had COVID shots scheduled every fifteen minutes. And finally, to make matters worse, one of his technicians had called out sick.

Jake put his hand on his forehead and dragged it over his face, taking with it the patina of perspiration that had formed on his skin. As his palm passed below his nose, he opened his eyes and saw her. It was a thirtyish woman clutching a child to her chest running full speed down the center aisle straight toward the pharmacy department.

I don’t need to hear it from anyone else today, he thought.

The queue at the inside pharmacy register was four deep and—because of the callout—his lone technician had been camped out at the drive-thru for the last forty-five minutes. They had managed to fill very few prescriptions to this point. His best guess was that he had about eighty prescriptions to fill at the moment. And surely there would be more to follow.

Ignoring the work and the frustrated stares of the patients in line, Jake watched the mother frantically trying to get his attention. She jumped the line at the cash register and elbowed the elderly gentleman there out of the way.

“Help me please! Help me! It’s my son!”

She shouldered her son around to face the pharmacist. Jake’s held his breath and braced himself for some kind of tirade. His angst instantly turned to alarm when he saw the boy. His lips were blue and a gray cast painted his skin.

“Oh shit!” Jake exclaimed. “Is he breathing?”

The Rescue

“Yes…but barely. I left his albuterol at home.” The mother’s voice was husky with fear.

Jake turned his head and hollered to his technician at the drive-thru window. His throat immediately went to his throat. “Helen, get over here now and call 911!

The technician named Helen stopped and turned her head. “What?!”

“I said, ‘Call 911’! Now!”

Racing from his workstation, Jake ducked into one of the pharmacy bays. Finding what he needed, he moved out front without delay. He instructed Mom to move him to one of the chairs in the waiting area. They slipped through the line of waiters as Jake removed the albuterol inhaler from its box. He shook it hard for five seconds. He asked the boy’s name and mom told him. While propped up on mom’s lap, Jake held the inhaler to the boy’s face and placed the mouthpiece between his lips.

“Peter,” he instructed loudly, “when I count to three, I want you to take a deep breath. One…two…three…”

He’d depressed the canister. The boy did not respond. The pharmacist was certain the powder had not make it into Adam’s lungs. Jake could hear the panicked, rapid breaths of the mother coming faster followed by a weak declaration filled with terror, ” Oh my God!” Jake shook Peter’s shoulder hard, rousing him slightly. Behind him, he could hear Helen in the pharmacy shouting into the phone at the 911 operator.

Jake repeated the procedure and counting to three again. On three, the boy sucked in as deep a breath as he could muster while Jake simultaneously depressed the cannister on the device. Again, a short puff of powder hissed into the boy’s mouth. The pharmacist encouraged the child to take several deep breaths to drive the medicine deeper into his lungs. Jake shook the inhaler again and administered another puff a minute later. He checked the boy’s pulse and respirations as patients gathered and gawked.

Helen called from the pharmacy over the repeated dings of the drive-thru bell. The impatient driver outside–unaware of the crisis inside–was mashing the button. “An ambulance is on the way,” she shouted.

A few minutes later, the color began to return to the boy’s face and the cyanotic tint of his lips began to fade. His chest began to move with deeper, regular inspirations and the wheeze from his throat eased.

How to use an inhaler


“There it’s working,” Jake said.

Mom loudly exhaled relieved sigh. It was apparent, she had been holding her breath. “On my God!” Thank you…thank you so much!”

Mom hugged her son tight to her chest and caressed his hair with a thumb. A patina of sweat glistened on the child’s skin. Jake placed his fingers on the boy’s wrist and checked his pulse once more. He counted the boy’s respirations.

Satisfied a crisis had been averted, he stood and said, “EMT’s are on the way.” He glanced around at the patients who had witnessed his intervention. A few had left. Those remaining peered at him with a newfound awe. One, an older man, said, “Great work, young man!”

The paramedics arrived and Jake relinquished care of the mother and child to the first responders.

Jake simply nodded and strode slowly back into the pharmacy and was greeted by three ringing phone lines, the incessant buzzing of the drive-thru and a stunned Helen. The tall stacks of prescription baskets listed precariously to one side like a dying plant.

“What do we do now?” Helen asked minutes later barely above a whisper.

The paramedics had loaded the youngster onto the collapsible stretcher accompanied by the relieved mother who made eye contact with Jake. She folded her hands in front of her in a prayer-like manner and mouther the words, “Thank you so much! I will be back.”

Jake moved his gaze to his technician and rolled his shoulders into a shrug and replied, “I guess we get back to work.”

To Be Continued…

If you have a pharmacy story or a story (heroic or challenging) of everyday life in your pharmacy, send it to me by clicking the link below…

Send David your pharmacy story…                                                                              Check out David’s Books

A Satisfying Shot

Pharmacy Access Saves

One observation all pharmacists understand is the nearly unlimited accessibility of pharmacists to the general public. For patients, this is a convenient and sometimes vital service. For pharmacists and their technicians, it is can be an extremely satisfying aspect of our jobs. At times, this ease of access can cause workflow problems for the very busy professionals behind the counter. In short, pharmacy access saves.

In this blog, I endeavor to highlight the great things we pharmacists do in improving the lives of our patients and to show how pharmacy access saves; and to educate the public and the industry about the obstacles and dangers inherent in a complex, overburdened retail pharmacy system.

I Need A Shot

Here’s an example of a wonderful service I was able to provide recently: An elderly woman called the pharmacy asking if she could receive a tetanus shot. She stated that she had cut her leg when the woman and her husband were spreading a manure over a garden. The woman was a regular patient with us. I was able to review her medication profile and run a report from Virginia’s Immunization Information System. She had not received a tetanus immunization in twelve years.

Pharmacy Access SavesWe were quite busy at the time (as usual). But I instructed her to come in right away. With the help of my competent technical staff, we moved around some workload to accommodate this patient. When she arrived, I inspected her wound. Luckily, it was not a deep laceration and did not appear to require sutures or an ER visit. And she said she didn’t want to go to the doctor. I administered her the tetanus shot and instructed her on how to care for the wound. Keep it clean. Apply triple antibiotic ointment. Watch for any signs of infection. The patient was extremely grateful for our speedy attention to her need.

We’re Not a Fast Food Restaurant

This situation is a perfect example of the benefit pharmacists and their technicians serve. She was able to come in without an appointment and receive her shot. This was a patient in true need of an immediate action from the pharmacist (unlike many of the overly demanding patients we sometimes encounter who think we are nothing more a pharmaceutical fast-food restaurant…this public image is one that our industry has cultivated over the last forty years and must fix! New York Times Article). And we averted the need for a visit to the doctor’s office, urgent care center or emergency room.

eMail Me Your Story

Pharmacists and pharmacy techs or patients: Please email me with your stories of how you really served your patients well.  I would love to highlight them in this blog. Tell me how Pharmacy Access Saves.

email me your pharmacy story

David Perry is a best-selling author and pharmacist. His medical suspense thrillers about pharmacy, medicine and healthcare are available in print, digital and audio formats are available where ever books are sold.


Perry to Present at 2019 CNU Writer’s Conference

Perry Presents at CNU Writer’s Conference

David Perry will present morning and afternoon breakout sessions entitled Writing Strong Three Dimensional Characters on Saturday, May 4th at the 38th Annual CNU Writer’s Conference.

Draw Your Readers In!

CNU Writer's Conference

CNU Writer’s Conference

Well-developed characters anchor entertaining and engaging plots and storylines. Because you want to draw your readers into your story and keep them engaged, you want to write exciting, flawed characters. Therefore, this workshop features strategies authors can use to flesh out complex protagonists, empathetic antagonists and interesting minor players. Subsequently, we will help authors address how to do this and more:

What traits make a character unique?

How do you avoid creating a caricature?

How do you make your antagonist more human?

What comes first; plot or character?

So, attend this workshop to learn more about great character development.

Proper Scene Formatting

Additionally, we will also provide suggestions for formatting your scenes and chapters to keep the reader turning pages.  Where do In start my scenes? And, how do you end a scene or chapter so your reader wants more? Finally,

About David

David Perry is the bestselling author of three novels. Currently at work on the third and fourth books in his Cyclops series, this will be David’s second time presenting at the CNU Writer’s Conference. His novel, The Cyclops Conspiracy, was nominated for the 2012 Library of Virginia Literary Award. He lives in Carrollton with his wife.

David Perry

David Perry

So, join David and many other writers and writing enthusiasts at the CNU Writer’s Conference May 3-4th on the CNU campus.

Attend The Conference

Finally, check out David’s website: www.davidperrybooks.com