Post-communist pharmacist

This article is about the professional life of an average community pharmacist in post-communist Romania. It has been published on the blog of a fellow pharmacist, Johnathan Laird. You can check out his work here. And the link to the original article here. To all my fellow colleagues all around the world: be the change you want to project on the world!

To start my story, it’s important to understand the context of post-communist Romania and post-communist Romanians.

We are not a rich country ! This is one of the top descriptions that you will get from the majority of Romanians or anyone else for that matter. And it’s true! Painfully true for the majority of Romanians. But richness is not a virtue that you are born into, it’s something you work for. Being underappreciated and underestimated is a status quo for us even in our own country. But this article is not about why it is hard here or elsewhere for Romanians, what’s the cause of our poverty and how we can fix it. It’s about how, in these conditions, more and more of us manage to succeed and thrive in western countries and anywhere around the world. Especially Doctors, pharmacists and other professionals with high-level  skills. The word is ambition! But we will get to that later…

It is impossible to characterize the population of Romania (19 million people) with just a few word. But I will go on a ledge and try it. We are a genuinely calm and docile people, with altruistic traits that you rarely see these days. The fact that we have it hard (financial and otherwise) makes us connect to people, understand their hardships and relate to their sufferings. Romanians relate, it’s our thing!

My wife and I are pharmacists. We were born in the poorest region of Romania (the eastern part, called Moldova), where some families live on their children’s allowance from school (sometimes 100 euro/family for 3-4 people/month). It was not the case for us. We are not what you would consider poor. Our families gave us what we needed, education, values and possibilities. We represent the middle class of Romania, a class that did not exist during the Communist Period (1945-1989), a class that is trying to become relevant in our times. A society without a middle class is a society that is suffering. Romania has been suffering since decades, we have to close the wounds.

Communism!

A word that most people in the Western World have heard of, a kind of plague that haunted the Eastern part of the World. If you ask me, although I was 2 years old at the time of the Revolution that overcame the Communist rule in Romania (1989), communism was a bad thing for our country. Not only because it is an excess, not only because it creates holes in society but mostly because it created mentalities that, 26 years later, are still thriving in our lives. Mentalities that keep you from evolving. Mentalities about how to get ahead in life, about how to resolve things without really resolving them, about how to be “smart and clever” to get ahead and to make money. Closed-box thinking that keep people afraid , calm and docile. Too docile!

I chose Pharmacy as my profession. Why? Well, for the same reasons that a kid in Canada, France of China chooses pharmacy: it’s a clean, solid, no-nonsense profession. Taking this decision has the same characteristics wherever you are from. Pharmacy school was not easy, as I guess you all know already, or at least heard of. Lots of classes, 90% mandatory, 30-35 hours/week, no flexibility when it comes to seriousness (or the lack of). Solid stuff! 5 years flew by. After that, certified pharmacists. I have a few stories about the university life, but we can go on that trip down memory lane next time.

Didn’t really think past finishing my studies. I did not have a grand master plan about conquering the world and planting the Romanian flag on top of the European Parliament (at that time at least J). So, after finishing I started working in a nice, quiet community pharmacy in one of the “old people neighborhoods” of Cluj-Napoca , Transylvania (in the city where I finished my Pharmacy Studies). It was so nice!!!

To understand the culture in Romania means to understand our religion. Being the doctor or the pharmacist of the neighborhood is almost as important as being the priest of that neighborhood. People are very religious! Especially the nice, old people from the nice, old neighborhood. To understand how religious, I had a patient (an old lady) that came to the pharmacy once in a while (every 2-3 months) to get her treatment (cardiovascular problems, etc) and every day to give me holy bread from the church down the street. Although I always thanked her, and was glad to see her, I never told her if I believe in something, if I am baptized or not, if I need the bread or not. I always took the bread, always smiling. It was her way of saying “I trust you ! Please don’t let me down!”. When I stopped working in the pharmacy I told her I was leaving she asked for my telephone number, I gave it to her, she called me a few months later and I knew who it was. As a pharmacist and a human being I cannot let my patients down!

It was so nice working in Mercur. Giving advice to patients, listening to their health and family problemsJ, explaining complicated mechanisms of action in simple ways to simple people. I had the feeling that I was really helping people, I was connecting to them, to their worries, to them as a person. When I was treating a patient, I was also treating myself.

I had all kinds of patients. Patients that knew better, patients that did not know better, hypochondriacs, crazies, skeptics, believers, all the spectrum. It was a nice year, even though many of the patients that walk into a pharmacy in Romania think pharmacists are just shop clerks with a diploma. I remember once that I had a nice old man that told his grand-daughter “listen to the nice shop-assistant, he will sell us good medicines”. I smiled. I should have said “Sir, I am a pharmacist, I have years of University studies, I am a trained professional”. But, I looked at him and I knew he would not comprehend what I wanted to say, and I just told him “take this as I tell you and you will be better” and wished him a nice day. As a trained health professional you need to assess the situation you are in and modify your message to get through to the people you are addressing. Even If it means swallowing you pride once in a while. As a Romanian pharmacist, I am calm and docile because I treat calm and docile people.

Life was calm in CrisFarm Mercur, the name of the pharmacy I worked in. The name was inspired by the old communist fruit and vegetable market nearby (Mercur = Mercury in English, the Roman God of Commerce). We are symbolists, us Romanians. My boss was incredibly nice, an old school pharmacist that left us decide on everything when discussing with the patients and when it came to how to treat them (and what to sell them). He had full confidence in us as professionals. From a commercial point-of-view there was no pressure. This is not the case in 90 % of pharmacies in Romania!

Today, with the absolute reign of pharmacy chains, 80-90% of pharmacies in the country have to merchandise themselves, sell to the margin and work on targets. So, 80-90% of pharmacists in Romania have to sell their skin (a Romanian saying) and work on fulfilling their commercial targets instead of taking care of patients and their needs. Why? Because we let it come this far! Because, 10 years ago, when 80-90% of pharmacies in Romania were owned by pharmacists we did not hold our ground! Because we were “calm and docile”, because we let it come this far without saying enough is enough.

Now, the landscape is different. Pharmacists work for the corporate chain and not for the patients. Margins and targets and more important that treating and curing. We sold our souls to the Devil, as my religious patient would say, and we didn’t even have a choice. Can you imagine, in the world we live in today, as pharmacists and professionals of a liberal profession, with full and complete autonomy regarding our professional decisions, that it’s not always as clear-cut as you would think.

Are we happy with the situation? Not at all! If you ask the pharmacists working in these pharmacies, they would respond sincerely that they hate what they have to do. That they hate to have studied 5 years about treatments and illnesses and only work in marketing and commercial environments. They hate that they do not have a choice but to work there, in chain pharmacies. Where is our ambition? Where is our pride?  It gets lost along the way, when you realize that you do not own yourself anymore, that you are a product to be used by others because you and others before you did not put their foot in the door. As a pharmacist, in Romania today, in 80-90% of the case you are used as a selling device, a drug pushing machine. Do not get me wrong, not all the pharmacists do this. My colleagues, and thousands of other pharmacists despise this practice, they are strongly against this! But when your bread is on the table, you hesitate to say something to the boss. We live in a sweet “I let you live-you let me live” situation and this will change soon! Why? Because we had enough!

So how does it feel to work as a pharmacist in post-communist Romania?

It feels rewarding! Not because of the salary, not because of the benefits or the work environment. It feels rewarding because, by stripping away all the materialistic characteristics of a profession, even though you work in an environment which is stressful and you have to sell your skills for a few silvers, there are a lot of pharmacists in Romania working in pharmacies just because they can help people have a healthier life. It may sound utopist , but, at the end of the day doing something that you like and that makes you feel good is basic human needs!

As a post-communist Romanian Pharmacist, I want more and I will not stop until I will get it through the right way, by working hard! This is the path for me, for us, for all the young professionals in Romania and around the world: always wanting more and working for it no matter how many obstacles you find in your way. And, maybe, one day, I will plant the Romanian flag in the hearts and minds of French, German, British or Canadian people that I will work with! I would most definitely like that!

How about you? Would you like to work with a post-communist Romanian pharmacist?

The pharmacists,


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