Doctor, Treat Thyself

For the majority of my career I have hosted veterinary students as part of a preceptorship program. I can’t tell you how many students have come through my doors since the beginning. Sadly, I also don’t remember most of their names. I do remember the really good ones and I’ll also never forget those on the other end of the bell curve. One in particular, I’ll call her Dragon Girl, stands out.

There are many anecdotes that come to mind at the mention of Dragon Girl. One in particular, is worth sharing.

Dragon Girl had some medical issues that necessitated her making several visits to the doctor while she was with us. One day my partner came across Dragon Girl rummaging through our pharmacy. When asked what she was doing, she responded:

“My doctor prescribed me some prednisone. I’m just filling the Rx.”

My partner was incredulous. Her initial reaction was to admonish Dragon Girl for multiple indiscretions (using a veterinary drug for a human prescription, filling a human prescription, taking drugs without permission and, likely, taking drugs without paying for them, regardless of the reason). Then, thinking the best of the situation, she decided to explain WHY she should not do what she was doing, rather than just lambaste her. After all, she was a STUDENT, and there was a chance that she really did not know that she should not do what she was doing, and this was an excellent teaching situation.

After taking a breath, my partner calmly explained the state’s pharmacy rules and regulations and reviewed the pertinent passages of the veterinary practice act. Thinking that this would help resolve the situation without being accusatory, she paused and waited for a positive response. Instead, Dragon Girl just dug her hole even deeper.

“Like YOU never self-medicate!” Dragon Girl retorted. (Just another example of her persistent recalcitrant behavior)

This brings me to Baytril. I have a very long history with the drug. In fact, as a resident, one of my resident projects involved establishing the pharmacokinetic parameters of Baytril in primates. Back then, Baytril was not called Baytril, it was called BVP2674. In my research I learned many cool facts about the drug. One interesting fact was that it was originally intended to be used in humans. However, Baytril had one particular side effect that prevented its introduction on the human side: it causes hallucinations and severe headaches. In some cases, it causes really bad hallucinations.

So, why am I talking about Baytril? Because I was in recent conversation with a friend (yes, really – a FRIEND) about his brush with the common cold. He said that he was getting a scratchy throat so he took some Baytril – standard dose – 5 mg/kg, bid. I asked him if it helped. He said he wasn’t sure, but that he stopped taking it because he couldn’t sleep and was having really bad dreams.

Okay, back to self-medicating. So, you’re at work and your colleague, let’s call him Jim, gets a nasty scratch from an obstreperous cat. He knows that he is at risk for infection. He is extremely busy, and has appointments booked all day. Jim does not want to take time off to go to the doctor, so he takes some amoxicillin from the clinic’s pharmacy.

Do you think colleagues or practice owners would authorize staff to take something from the pharmacy rather than have a minor incident like a cat scratch go on their work-comp record? What is that line in the sand that should not be crossed?
 

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