Sunday, December 2, 2018

The Discombobulated Cancer Patient, the Ibrance and the Snooty Pharmacy Lady

I am probably known as the eccentric American at my local pharmacy, because I often cannot find the receipt for the medication I've paid for when I come to pick it up. Lucky for me the clerks are all very German and organized: "Ordnung Muss Sein" is the slogan by which Germans live, and they keep their own records and they find my stuff amazingly quickly.
But my personal style is more along the lines of "Chaos Must Be!" I find this sentiment works for many of life's thorniest issues, certainly the composition of essays, an activity in which I engage more and more. Fashion too. I buy a garment because the color grabs me, and later I realize it goes with this and that favorite thing. So I am only accidentally color-coordinated. I'm the same way with food: I buy carrots if they look fresh and four or five other items that strike my fancy and find, when I get home, that they all complement each other in a dish, and rare are the moments in my family when complaints emerge about the food. Maybe you'd call my style "unconscious" rather than chaotic. It's not deliberate, however, and not orderly, so would probably go with "chaos."
 I'm glad my dentist and my oncologist proceed along what seems compulsively careful, rule-driven lines. Less glad when the German bus driver opens the door on which I've just tapped only to howl indignantly, "PAUSE!" (translation: "It's my break! My five minute break! And no, you can't step in from the freezing temperatures and sit in the back of the bus while I consume my Butterbrot. Because I'm going to show you I have every right to my five minutes.") To do otherwise would be to disturb order. "PAUSE!" has two syllables in German, and is pronounced "POW-ZZUH!" although the last syllable is more of a hiss. With the emphasis the bus driver gave the word, it conveys: "PUNCH YOU IN THE NOSE!"
I walked into the pharmacy late on a Tuesday afternoon, having taught two classes, held office hours, and bought groceries. I was rolling a large shopping cart, carrying another heavy bag over my shoulder, and attempting to open my wallet and snag the receipt before the big bag fell off my shoulder. I didn't succeed. The pharmacy clerk, a new one unfamiliar with my lack of organization, beckoned me and I hauled all my bags up to her window and began explaining to her, as I went through section after section of the incredibly thorough wallet I bought at the (German) Christmas market last year, that I couldn't find the receipt.
"Are you speaking to me or to your wallet?" asked the clerk, smiling. It didn't seem to me that her smile was friendly. I apologized, located, finally, the receipt, and handed it to her. She gave me my medicine and as I put it in my bag I was still apologizing and feeling embarrassed.
So it was that I lost I medicine, I hoped not on the way home. I was searching for it for days, to the point where I nearly called my oncologist to request another prescription. I'd begun to consider looking up what I'd have to pay but of course chaotically did not, preferring to hope I wouldn't be spending more than 200 euros.
Now that I've just found the box of Ibrance, safe and sound, and will be able to start taking it as usual, the whole 21-day cycle again for the rest of the time the cancer lies in wait, not developing, being frustrated, I looked up the price on, which says: $11,797 is what I'd pay for a 21-day supply. 
After taxes, I make about 29,000 euros.
Good thing I did not lose that Ibrance, which probably would not have cost more than 2,741.61 euros here in Germany. Thank you, German government, and thank you, KKH insurance company, for saving the lives of women with metastatic breast cancer. 
No thanks to the sales clerk whose snarky moment pushed my normal discombobulation into enough chaos to eliminate my memory of where I'd set down the box of capsules. Bye-bye the two hours it took to find them. So glad to have them right where they belong on my coffee table.


  1. Yikes! So glad you found it. Your great gift has always been to think more clearly when disorder surrounds you. I think it's why you're so good at multitasking, and why you write so many good essays (and books). You may actually need the chaos present before you can create (writing, cooking, whatever). Most people, me included, need to eliminate chaos, impose as much order as possible, before we can embark on a creative project. Your style is unusual, but it obviously works!

  2. Well, it's really that I just never have time to clean up . . .

  3. In the US, expensive meds such as Ibrance, are distributed only by specialty pharmacies, mostly via mail order, such as Accredo. The nice ladies there call me once a month, to see if I am still alive, I think, before they ship 3 weeks of meds that have a list price of 12 grand. They always want the package to be signed for, which the package room in the basement of our building accomplishes quite efficiently while receiving hundreds of Amazon packages every day.

  4. Oh, my God. When will the U.S. regulate drug prices the way most European countries do? Thank you for replying.