Healthy Fear of Ebola in America

October 7, 2014
Jay Sochoka, RPh, BSPharm, CIP

We will soon have a wartime economy against an enemy that we can't even see.

My first professional pharmacy rotation was high-volume community pharmacy at the Thomas Jefferson University Hospital Apothecary. They were filling 500 scripts a day on a God-awful software program by today’s standards, getting patients out in 30 minutes or less, and not getting anybody killed. Moreover, they only filled scripts for Jefferson doctors, patients, students, and employees. If they had taken outside scripts, the workload would have been totally unmanageable.

The operation ran like a Rolex meeting for the Steelers’ dynasty teams, and quarterbacking the operation was Scott Kuhn, RPh. He showed me exactly what the little old bachelor of pharmacy degree could do in a boiler room setting, and he taught me the equation of efficiency + accuracy = quality—a mantra that is now 21 years old.

Although I only spent 4 weeks with Dr. Kuhn, I learned a lot. When I misfilled an alprazolam script with clonazepam, he let me know in no uncertain terms that I had just killed a patient. While it probably was not a fatal mistake for toxicity reasons, the patient could have gotten dizzy, mismanaged a flight of stairs, and suffered a fatal conclusion. From that moment on, I have had a healthy fear of my profession.

Thanks to Dr. Kuhn, I also developed a healthy fear of microscopic life and sub-life forms, namely bacteria and viruses. One morning, he ran by the profile of a patient who was one course fail of antibiotics away from going to the hospital for an IV. In his disgust, he said, “People who say that humans have no natural enemies are forgetting about bacteria and viruses. One day, they will be the only things left.”

To this day, I believe him. Bacteria and viruses evolve faster than we can keep up. Eventually, every antibiotic we have will be as powerful as oral penicillin 50 mg. In the big picture, our antiviral therapy is sketchy at best. In 25 years, nothing has even come close to resembling an HIV vaccine. If there was, I would be dispensing it already, and now—get this—Ebola has made it onto American soil. Why someone has not blamed President Obama for this yet is beyond me.

It actually is not his fault this time. Instead, I would say the hospital that let Patient Zero go home with a course of antibiotics after he said he had been in Liberia might have a glove in it. I’m surprised that, at the words “in Liberia,” plastic sheeting did not automatically canvas the examination room, sirens did not wail and buzz, and red lights did not start spinning as 2 men in black and a team in hazmat suits showed up.

If you have children, consider guiding them into a career in immunology or biotech, because they will always have a job. The United States’ involvement in Ebola’s eradication has escalated exponentially. We will soon have a wartime economy against an enemy that we can’t even see. I expect to be administering your Ebola vaccine as soon as it clears the FDA.

Jay Sochoka, RPh, just coughed.